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A Statewide Initiative to Address Childhood ObesityGood morning and thank you to the Georgia Hospital Association for inviting me to speak about this very important topic of Baby Friendly Hospitals. I want to take a few minutes to first talk to you about Georgia SHAPE, because I think it provides a framework for why Baby Friendly Hospitals and Breastfeeding are so important. 1Georgia SHAPEGeorgia SHAPE is a statewide multi-agency, multi-dimensional initiative of Governor Nathan Deal that brings together the governmental, philanthropic, academic and business communities to address childhood obesity in Georgia.2Georgia SHAPEPartners Department of Public HealthAtlanta FalconsYouth Foundation

Department of AgricultureGeorgia GrownThe Atlanta Braves Foundation

Department of Natural ResourcesTons of FunCoca Cola Department of Education

Arthur M. Blank Family FoundationChildrens Healthcare of AtlantaDepartment of Early Care and Learning (DECAL)Department of TransportationUniversity of Georgia3Georgia SHAPEIncludes strategies for addressing obesity from birth through the high school years

Efforts focus on schools, communities, child care centers, government and policy agencies, businesses, and medical practices

GeorgiaSHAPE.org

Georgia Department of Public Health developed the SHAPE website as a communications and resource hub for families, day cares and schools, businesses, community based organizations, foundations and the medical community.

5Georgia SHAPE InitiativesRecognize and support birthing hospitals that support breastfeeding

Increase the number of work sites that adopt policies that support breastfeeding mothers

Promote physical activity and nutrition programs in child care facilities and school settings

6Our New Reality

The graph illustrates the increase in obesity-related hospitalizations among children 2 19 years of age in Georgia from 1999 through 2010.Poor diet and lack of physical activity contribute to the rise in childhood obesity. Only 52% of middle school students and 43% of high school students in Georgia currently meet the CDC recommendations for physical activity. More than 44% of Georgias middle school students and 39% of high school students watch television for three or more hours on a school day and only 17% of high school students in Georgia consume five or more servings of fruits and vegetables a day. In 2008, Georgians spent $2.4 billion on the direct medical costs of obesity and lost productivity from disease, disability and death. In Georgia, obesity- related hospitalizations of children aged 2 19 years increased 338% over the eleven year period from 1999 to 2010.

7Why is breastfeeding important?Breastfeeding is among the best ways to prevent a child from becoming overweight or obese. Research has demonstrated that breastfeeding employees miss work less often because breastfed infants are healthier and the reduced healthcare costs for breastfed infants translate to lower health insurance premiums for businesses.8Why is breastfeeding important?Breastfeeding mothers have lower risks of breast and ovarian cancers

Lower rates of breastfeeding add $2.2 billion a year to medical costs

Helps protect against childhood obesity and other illnesses (ear infections, respiratory infections, SIDS)

9Breastfeeding

Percentage of Children Who Breastfeed, Georgia, U.S. & HP 2020 GoalCDC NIS Provisional Data, 2009This graph shows us how Georgia breastfeeding rates compare to national statistics and to the goal of Healthy People 2020. The number of children who have ever breastfed start off quite strong, despite being below the Health People goal. But when you look beyond those initial numbers, we in Georgia have work to do. 10BreastfeedingBased on 2011 data*, only 66.4% of Georgia mothers start breastfeeding after delivery

Healthy People 2020 Goal: 81.9%

*2011 combined GA Birth Certificate & Newborn Screening data

Georgias 5-STAR Hospital InitiativeAwards participating birthing hospitals for implementing evidenced-base maternity care practices that promote and support breastfeeding

The Ten Steps to Successful Breastfeeding,as defined by Baby- Friendly USA, the official credentialing agency of the Baby-Friendly Hospital Initiative (BFHI)

12Ten Steps to Successful BreastfeedingWritten breastfeeding policyTrain staff to implement policyInform all pregnant women about the benefits and management of breastfeeding.Help mothers initiate breastfeeding within one half-hour of birth.Show mothers how to breastfeed

Ten Steps to Successful Breastfeeding6) Only allow babies breast milk, unless medically indicated7) Practice rooming-in8) Encourage breastfeeding on-demand9) No artificial teats or pacifiers10) Encourage community support groups

Baby-Friendly Facilities

SOURCE: CDC National Survey of Maternity Practices in Infant Nutrition and Care (mPINC), 20112011 Data from the CDC shows us there is some improvement in attributes associated with baby-friendly facilities. However there is much room for improvement. Right on now in Georgia, we have ZERO Baby-Friendly hospitals. 15Georgias 5-STAR Hospital InitiativeDoctors Hospital, ColumbusGwinnett Medical Center, LawrencevilleHamilton Medical Center, DaltonPhoebe Putney Memorial Hospital, AlbanySoutheast Georgia Health System, BrunswickSouthern Regional Medical Center, RiverdaleThe Medical Center, ColumbusTift Regional Medical Center, TiftonWellstar Kennestone Hospital, Marietta

Thats changing. Nine hospitals were chosen to participate in the Georgia 5-Star Hospital Initiative. Each hospital received up to $7000 through a grant from the Centers for Disease Control and Prevention to help defray implementation costs of becoming a Baby-Friendly hospital.

16National Initiative for Childrens Healthcare Quality (NICHQ) Hospitals in GeorgiaAtlanta Medical Center, AtlantaDeKalb Medical, DecaturDoctors Hospital, AugustaEmory University Hospital Midtown, AtlantaGrady Health System, AtlantaPiedmont Henry Hospital, StockbridgeWellStar Cobb Hospital, AustellSeven other Georgia Hospitals are working on becoming accredited Baby-Friendly Hospitals through a program announced in June, led by the National Initiative for Childrens Healthcare Quality.17Safe Sleep Campaign

Breastfeeding is just one practice we know helps keep babies healthy. Safe sleep is another. This poster highlights for parents and caregivers of infants the importance of always putting babies down to sleep alone, on their backs, in a crib. The posters will soon be found in government buildings throughout the state. 18Safe Sleep CampaignGeorgia First Lady Sandra Deal and the Georgia Childrens CabinetGeorgia Department of Public HealthGeorgia Department of Human ServicesGeorgia Department of Driver Services Georgia Department of Juvenile Justice The Safe Sleep campaign is a collaborative effort led by Georgia First Lady Sandra Deal and the Georgia Childrens Cabinet. Supporting agencies include the Georgia Department of Public Health, the Georgia Department of Human Services, the Georgia Department of Driver Services and the Georgia Department of Juvenile Justice.19Safe Sleep Campaign

We are also in the process of producing a video with stories from families who have lost a child to a sleep-related death. And some famous Georgia grandmothers who can help explain the importance of all infant caregivers knowing about Safe Sleep.20Role for HospitalsCreate Safe Sleep Policies for NICU and Well Baby NurseryTrain staffEndorse and model :Supine Sleep PositionEducate families on safe sleep guidelines before dischargeShare our Safe Sleep video in hospital

21Thank YouBrenda Fitzgerald, M.D.CommissionerGeorgia Department of Public Healthbrfitzgerald@dhr.state.ga.us22Chart170.976.9Ever Breastfed81.940.847.2Breastfeeding at 6 months60.617.625.5Breastfeeding at 12 months34.127.836Exclusive breastfeeding at 3 months46.212.916.3Exclusive breastfeeding at 6 months25.5

GAU.S.Column1HP 2020

Sheet1GAU.S.Column1HP 2020Ever Breastfed70.976.981.9Breastfeeding at 6 months40.847.260.6Breastfeeding at 12 months17.625.534.1Exclusive breastfeeding at 3 months27.83646.2Exclusive breastfeeding at 6 months12.916.325.5To resize chart data range, drag lower right corner of range.