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How Does the United States Rank According to the World Breastfeeding Trends Initiative?

Cadwell, Karin, PhD, RN, FAAN, IBCLC, ANLC; Turner-Maffei, Cynthia, MA, ALC, IBCLC; Blair, Anna, PhD, CLC, IBCLC; Brimdyr, Kajsa, PhD, CLC; O'Connor, Barbara, BSN, RN, IBCLC, ANLC

The Journal of Perinatal & Neonatal Nursing: April/June 2018 - Volume 32 - Issue 2 - p 127–135
doi: 10.1097/JPN.0000000000000318
Feature Articles: Continuing Education

The World Breastfeeding Trends Initiative is an assessment process designed to facilitate an ongoing national appraisal of progress toward the goals of the United Nations Children's Fund (UNICEF)/World Health Organization (WHO) Global Strategy for Infant and Young Child Feeding. More than 80 countries have completed this national assessment, including the United States of America. This article describes the process undertaken by the US World Breastfeeding Trends Initiative team, the findings of the expert panel related to infant and young child feeding policies, programs, and practices and the ranking of the United States compared with the 83 other participating nations. Identified strengths of the United States include data collection and monitoring, especially by the Centers for Disease Control and Prevention, the US Baby-Friendly Hospital Initiative, and the United States Breastfeeding Committee. The absence of a national infant feeding policy, insufficient maternity protection, and lack of preparation for infant and young children feeding in emergencies are key targets identified by the assessment requiring concerted national effort.

Healthy Children Project, Inc, East Sandwich, Massachusetts.

Corresponding Author: Karin Cadwell, PhD, RN, FAAN, IBCLC, ANLC, Healthy Children Project, Inc, 327 Quaker Meeting House Rd, East Sandwich, MA 02537 (

Funding for the US WBTi national assessment was provided by the Healthy Children Project, Inc, a US nonprofit organization.

The editor for the United States' WBTi assessment was Holly Hansen.

The United States WBTi Expert Panel consisted of the following members: Karin Cadwell, PhD, RN, FAAN, ANLC, IBCLC; Lois Arnold, PhD, CLC (deceased); Anna Blair, PhD, CLC, IBCLC; Jeanne Blankenship, MS, RD; Kajsa Brimdyr, PhD, CLC; Kimarie Bugg, C-FNP, MSN, MPH, CLC, IBCLC; Ann Dozier, PhD, RN, FAAN; Geraldine Fitzgerald, RN, CPNP, IBCLC; Felisha Floyd, BS, CLC, IBCLC, RLC; Barbara O'Connor, RN, ANLC, IBCLC; Ana Parrilla-Rodriguez, MD, MPH, FABM, IBCLC; Brenda Reyes, RN, CLC; Linda J. Smith, MPH, IBCLC; Amy Barron Smolinski, MA, CLC, ALC; Robin Stanton, MA, RD; Cindy Turner-Maffei, MA, ALC, IBCLC.

Disclosure: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

Submitted for publication: September 15, 2017; accepted for publication: December 14, 2017.

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