SGCTA at Five Years: Robbie Gonzalez-Dow

Robbie Gonzalez-Dow is the Executive Director of the California Breastfeeding Coalition. Robbie discussed the Cross-Sector Action Areas of the Surgeon General's Call to Action to Support Breastfeeding during the August 23 virtual town hall meeting. Below is a transcript of her responses:

What accomplishments from the five years since the SGCTA are you most excited about? Did these efforts target or affect disproportionately impacted populations, i.e., those with the greatest disparities in breastfeeding rates? If so, how?

I’m most excited that we have a statewide coalition because when the Surgeon General’s Call to Action came out, we were an informal coalition, and we have our 501c3 status now, which is very exciting. There are other coalitions throughout the state who are on the same path. There has been a development of very strong statewide breastfeeding coalitions.

Through that we have developed relationships with other stakeholders in our state, and that’s enabled us to be involved in many policy issues here in our state. It was mentioned by [Employment panelist] Jessica that California passed a law that requires school districts to provide lactation accommodation for parenting teens. That came about through a relationship with another statewide coalition, the California Latinas for Reproductive Justice. They approached us, so we were very involved from the beginning with the development of that legislation, which they sponsored. If we weren’t organized as a statewide coalition, I don’t think that would have happened. Maybe the issue would have come up, who knows, but we have been involved in legislation prior to that, so we have developed some credibility in the state when it comes to policy work.

We have another strong relationship with California Work & Family Coalition, and right now we’re working more in-depth and closer with them on paid leave issues here in California. Lots of good things happening with state-wide coalitions and building capacity. [The other coalitions] address the other sectors of the Surgeon General’s Call to Action.

I also wanted to mention that we have a very strong relationship with our California Department of Public Health. We’re developing a strong one with Health Care Services, and, also, our Department of Labor. So, the departments that enforce our lactation accommodation laws and our discrimination laws. Those relationships are getting stronger, but we’re helping them to know what the issues are for moms in our state when it comes to lactation accommodation and discrimination in the workplace.

Considering the focus of the USBC and the field on advancing equity in breastfeeding support, what is missing from the SGCTA that you see as an important priority for the next five years?

The one that really comes to mind because I’m seeing this with the survey lens, is being able to collect data. So, when we talk about health care records, we can’t even get reports on how many women are breastfeeding. [Health Care panelist] Catherine mentioned, how are women being served when they go to see the doctor after leaving the hospital? We don’t have really good measures to even look at in terms of breastfeeding rates.

In an electronic medical record, it’s not built to collect breastfeeding data. It’s not built in automatically, so it’s another step, and it’s another barrier. It’s missing as part of that surveillance data so that we can take a deeper look into why women aren’t breastfeeding longer or are they [breastfeeding]. We need some of that.

Looking at the whole (both existing action areas and any new ones suggested), which three implementation strategies do you think would have the greatest impact if prioritized over the next five years? How could these strategies best apply an equity approach?

A stronger emphasis, looking at the cross-sector and Action 8 [Continuity of Care], more home visiting, stronger home visiting. For moms it’s so limited right now, so that’s an area that really needs to have more focus. With that continuity of care, there’s more pay for performance. Looking at measures, I think those are top priorities. I also want to say some kind of funding system for statewide coalitions, because many of us struggle, but we’re part of this movement, we’re dedicated and making change and an important piece to make this change.

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