Breastfeeding without borders: The APHA position

Effective 2008, APHA has a new position statement on breastfeeding, its first overarching position statement on the topic since 1982. While calling attention to past APHA statements related to breastfeeding, the new statement also puts breastfeeding into a global perspective in many ways. It reviews the evidence showing the risks of early weaning even in industrialized countries, as well as the excess deaths worldwide caused by lack of exclusive breastfeeding. Lack of breastfeeding is shown to be a significant global health problem, contributing to the global burden of disease. The new policy highlights the shortcomings of policies related to breastfeeding in the United States, compared to other industrialized countries. The policy endorses several international documents, including the WHO Code of Marketing of Breast-milk Substitutes, and the WHO/UNICEF Global Strategy on Infant and Young Child Feeding, as well as the Innocenti Declarations of 1990 and 2005, and the WHO/UNICEF Baby-friendly Hospital Initiative. Global policy issues include need for paid maternity leave, curbing the aggressive marketing of infant formula, the need for legislation to protect and support breastfeeding, exclusive breastfeeding to prevent the transmission of HIV, the need for consistent definitions of breastfeeding in the scientific literature, and the need to protect pregnant and lactating women from persistent organic pollutants. Conclusion: APHA's new breastfeeding policy statement puts breastfeeding into a global perspective, and highlights how much work needs to be done in the US to meet the standards of some other countries.