Weekly Wednesday Wire: October 25, 2017

Please note: Inclusion of an item in this e-newsletter does NOT imply endorsement or support of such item by the United States Breastfeeding Committee, unless specifically noted.

Federal News

Leading Health Indicators Webinar, from HP2020

Join Healthy People 2020 on Monday, November 20, from 12-1 p.m. E.T. for a webinar entitled, "Who's Leading the Leading Health Indicators? Webinar: Nutrition, Physical Activity, and Obesity New!" Participants will learn the progress made toward achieving the Healthy People 2020 Nutrition, Physical Activity, and Obesity Leading Health Indicators. The Leading Health Indicators represent a smaller set of Healthy People 2020 objectives selected to communicate high-priority health issues and actions to help address them. Leading Health Indicators are used to assess the health of the Nation, facilitate collaboration across sectors, and motivate action to improve the health of the U.S. population.

Updated Clinical Guidance on Zika, from CDC

The Centers for Disease Control and Prevention have issued updated interim clinical guidance for health care providers caring for infants born to mothers with possible Zika virus infection during pregnancy. The updated recommendations emphasize that it is important for pediatric health care providers to assess risk of congenital Zika virus infection, to communicate closely with obstetrical providers, and to remain alert for any problems that may develop in infants without birth defects born to mothers with possible Zika virus exposure during pregnancy. The update includes information that has become available since the August 2016 release of the previous guidance. Read the press release.

Bipartisan Health Care Stabilization Act of 2017, from Congress

Last Tuesday, Senators Lamar Alexander (R-TN) and Patty Murray (D-WA), chair and ranking member respectively of the Health, Education Labor and Pensions Committee, announced they had come to agreement on a bipartisan deal to restore cost-sharing reduction payments, reinvest in outreach and enrollment, and streamline the state waiver process while maintaining the core patient protections enacted by the Affordable Care Act (ACA). Since that time, the proposal has been greeted by mixed signals by the Administration and Congress. The bill, titled "The Bipartisan Health Care Stabilization Act of 2017," has gathered support since last week, and it is now co-sponsored by 12 Democratic and 12 Republican Senators. The HELP Committee has also published a section-by-section summary of the bill.

USBC Update: The proposed bill would not directly impact the breastfeeding provisions of the ACA. Learn more about the health reform process and find links and future updates on our webpage: www.usbreastfeeding.org/health-reform

Member News

Highlights from the Summit on Breastfeeding, from ABM

The Academy of Breastfeeding Medicine has published highlights from the Ninth Annual Summit on Breastfeeding, First Food: The Essential Role of Breastfeeding. Summit accomplishments and presentations are documented in a special issue of Breastfeeding Medicine. Complimentary access is available through Tuesday, October 31. 

New Recommendations on Hepatitis C in Pregnancy, from SMFM/ACOG

The Society for Maternal-Fetal Medicine and American Congress of Obstetricians and Gynecologists have issued new recommendations regarding Hepatitis C (HCV) in pregnancy.  The guidance states that breastfeeding should not be discouraged for Hepatitis C positive women. Read the press release.

Prevention Fund Storify, from APHA

The American Public Health Association has published a "storify" outlining the critical role that the Prevention and Public Health Fund plays in helping improve health outcomes and reduce health costs. Established under Section 4002 of the Patient Protection and Affordable Care Act of 2010, the Prevention Fund is the nation's first mandatory funding stream dedicated to improving our nation's public health system. Cuts to this funding will specifically have negative impacts on programs devoted to young children, senior health, behavioral health, and mental health. 

Partner News

NAPPSS-IIN Webpage Launched, Pilot States Announced, from NICHQ

The National Institute for Children's Health Quality has published several announcements about the next iteration of the partnershipthe National Action Partnership to Promote Safe Sleep Improvement and Innovation Network (NAPPSS-IIN)—funded by HRSA/MCHB to continue to build upon practices to improve infant safe sleep and breastfeeding. NAPPSS-IIN will build off the previous work of the NAPPSS Coalition by partnering with national experts and organizations supporting safe infant sleep, breastfeeding and health equity to drive improvement and innovation. It will deeply engage communities in 14 states to test and implement improvement efforts. Activities to drive improvement include:

  1. Activate champions of safe infant sleep and breastfeeding behaviors within systems that intersect with infant caregivers and families at risk.
  2. Enable National Action Teams to drive measurable change in increasing the adoption of safe infant sleep behavior and breastfeeding on priority components of the National Action Plan to Increase Safe Infant Sleep.
  3. Translate evidence-based practices into "safety bundles"—a small set of three to five evidence-based practices performed collectively and reliably in hospital settings, as well as social services and child care settings—to improve the likelihood that infant caregivers and families receive consistent, evidence-based instruction about safe sleep and breastfeeding.

Florida, Massachusetts, Mississippi, New York and Oklahoma have been selected as pilot states for testing of the hospital bundle in one hospital site per state. For more information on NAPPSS-IIN check out the FAQ's on the webpage or email questions to nappss@nichq.org.

Tax Reform Webinar, from CHN

Join the Coalition on Human Needs on Tuesday, October 31, from 2-3 p.m. E.T. for a webinar entitled, "Tax 'Reform': What's Next & How State Advocates Can Engage." Center on Budget and Policy Priorities staff will discuss upcoming stages for the federal tax plan and how state advocates can take action.

Hand-off Communication Webinar, from TJC

Join The Joint Commission on Monday, October 23, from 1-2 p.m. E.T. for a webinar entitled, "Do You Really Understand Your Hand-off Communication Processes?" Participants will learn proven practices for avoiding hand-off communication errors. This webinar is a complement to "Sentinel Event Alert, Issue 58: Inadequate hand-off communication," providing foundational insights into improving patient hand-offs. Participants can submit questions in advance of the webinar to DOCC@jointcommission.org.

Member/Partner/News Roundup on Proposed BFHI Guidelines

Public Comment Deadline Extended to 10/29 on Proposed BFHI Guidelines, from WHO/UNICEF

As reported in last week's issue, the World Health Organization and UNICEF have released proposed new guidelines for the Baby-Friendly Hospital Initiative. The proposal describes a revised set of the Ten Steps to Successful Breastfeeding and offers updated guidance for implementing the Baby-Friendly Hospital Initiative worldwide. The original comment period allowed less than two weeks for comments. In response to concerns on this count, the deadline has been extended to Sunday, October 29. Feedback will be taken into consideration in finalizing the guidelines before publication and dissemination. To access the document, please send an email to nutrition@who.int.

Response to Proposed BFHI Guidelines, from International BFHI Network

The International BFHI Network reports that it is in the process of reviewing the recently released document entitled, "Protecting, Promoting and Supporting Breastfeeding: The Revised Baby-friendly Hospital Initiative 2017" (comment deadline extended to midnight, Central European Time, Sunday October 29). This document was first made available on October 11 with only two weeks to fully digest its contents and consider its ramifications. It proposes wide sweeping changes to the BFHI and deserves thoughtful consideration. The Network does not believe it has sufficient time to provide the kind of feedback such changes warrant. As a result, it has called upon the WHO to withdraw the document until a more full and robust review of the proposal can be considered. 

The Network shares the following key concerns with the field, in the event that others wish to express a similar view point when submitting comments:

  1. The document completely re-envisions the 25-year-old BFHI which has successfully transformed maternity care practices and improved breastfeeding outcomes where it has been implemented.
  2. The restructuring, reordering and rewording of the Ten Steps to Successful Breastfeeding, which have been in place for 27 years, will cause massive confusion due to their widespread publication in journals and textbooks and the fact that they have served as the foundation for the work of large numbers of maternity care quality improvement efforts in addition to that of the BFHI.
  3. The revisions to the Ten Steps to Successful Breastfeeding are based on a review of the evidence that WHO refuses to release during the comment period, thus denying reviewers the benefit of critical information for which decisions have been made.
  4. The document will very likely derail current excellent and productive BFHI work as evidenced by the calls and emails to our current national offices from panicked heath care facilities.
  5. Global standards are the foundation to the BFHI and are essential to the global effort to improve breastfeeding rates. Assembling national advisory groups to develop individual standards for each country will not only be redundant, costly and time-consuming but the standards will be inconsistent throughout the world.
  6. The BFHI designation is one of the most effective strategies to achieve sustainable improvement in the quality of maternity care as evidenced by the success in many countries. Designation with continued monitoring is indeed an effective strategy to have an impact on continued breastfeeding.

Additional Update from Baby-Friendly USA, from BFUSA

"We have received many communications from designated facilities, as well as those currently in the 4D Pathway, expressing your concerns and asking for guidance on how to proceed in your Baby-Friendly activities and pursuits while these possible changes are under review. 

Let me be perfectly clear that, at this time, these changes are under consideration and are still a long way from being ratified and implemented. The document has generated extensive national and global discussion. It will take significant effort and time for the WHO to synthesize and consolidate this feedback into final, official language. It will then require some time on our end to develop an implementation strategy.

In the meantime, the current standards are in place and will remain in place for the foreseeable future. Our key message to you right now is that we encourage you to stay the course in implementing the current standards. We will advise you if and when any official changes are made to the initiative."

News from the Field

Partnership to Improve Community Health Report, from AHA/APA/NWA/DHPE/SOPHE

The American Heart Association, American Planning Association, National WIC Association, Directors of Health Promotion and Education, and the Society for Public Health Education have published a white paper to promote the results of the CDC's Partnerships to Improve Community Health (PICH) program entitled, National Organizations Empowering Communities to Improve Population Health. National organizations and local communities used core approaches, assessing community needs, working collaboratively through coalitions, and focusing on the most vulnerable and underserved populations, to achieve more equitable health outcomes. One report pullout specifically highlights approaches used to promote and support breastfeeding. The partners have also launched a website featuring interactive tools and resources to support community health initiatives.

Paper on Mayors and City Leaders Working to Improve School and Health Outcomes, from NLC

The National League of Cities has published an executive summary from the Mayor's Institute on Advancing Education and Health through the Community Schools Strategy. The summary highlights ways in which mayors and city leaders are working at the intersection of education and health to improve outcomes for students. Mayors and other city leaders can help children and families overcome barriers to good health and educational achievement by fostering collaborations between school districts, health systems, school and community based health providers, public health departments, and other community partners.

Collective Impact Connection

Article on Collective Impact for Public Health, from Engage! (Tamarack Institute e-magazine)

The Tamarack Institute has published an article entitled, "Collective Impact & Public Health: Partnering for Systems Change." The article explores case studies of the collective impact approach being used in public health partnerships.

News & Views

NBC Local News: "More adopted parents choosing to breastfeed babies"

SELF: "Why It's Totally Normal to Gain Weight After Breastfeeding"

TIME: "Motherhood Is Hard to Get Wrong. So Why Do So Many Moms Feel So Bad About Themselves?"

Fatherly: "What You Can Do To Make Breastfeeding Better For Your Partner, According to Experienced Moms"

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