Letter from the AAP Section on Breastfeeding to Tommy Thompson

American Academy of Pediatrics
Section on Breastfeeding
Executive Committee                         Chair, Executive Committee
  Ruth A. Lawrence, MD                            Lawrence M. Gartner, MD
  Donna O'Hare, MD                            28398 Alamar Road
  Jane Morton, MD                             Valley Center, CA 92082
  Audrey J. Naylor, MD, DrPH                             Ph: 760-751-9479
  Richard J. Schanler, MD
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November 18, 2003

Honorable Tommy G. Thompson
Secretary
Department of Health and Human Services
200 Independence Avenue, SW
Washington, DC 20201

Dear Secretary Thompson:

    You recently received a letter from the Dr. Carden Johnston, President of
the American Academy of Pediatrics, indicating the Academy's support of the
National Breastfeeding Awareness Campaign to be launched shortly by the
Department of Health and Human Services.  We, the experts on breastfeeding and
lactation within the American Academy of Pediatrics must object to one portion of
Dr. Johnston's position, however.
Dr. Johnston expresses concern about the recommendation of The Advertising
Council to focus the advertisements on the risks incurred by not breastfeeding.
The Section on Breastfeeding, with 800 members, does not share that concern.
Dr. Johnston notes that he obtained his information on the planned
advertising campaign from the web page of The Advertising Council.  Neither he nor any
of us have seen the actual PSA's because they are still under development.
However, the web site of The Advertising Council provides some important insight
into their development of the advertising campaign:
"It's a conversion - not awareness - issue. CONFIDENCE AND CONSEQUENCE are
keys to conversion. Those who opt out/switch lack a key trait of committed and
continuing breastfeeding moms - CONFIDENCE. While aware of the 'breastfeeding
benefits', they currently perceive no real CONSEQUENCE to opting out. To
breastfeed is seen as analogous to "adding vitamins to the 'standard' (formula feed)
diet."
The Advertising Council and the Office on Women's Health, with assistance
from many other organizations and from members of our own Section on
Breastfeeding of the American Academy of Pediatrics have very carefully researched the
question of how the campaign should be oriented.  Through the use of many focus
groups which included participants from the target population and other data
collection points, they have come to the conclusion that for the advertising
campaign to be effective, it is essential that the message point out the risks of
not breastfeeding.  The focus group participants found this approach entirely
acceptable. We agree that this is a very appropriate and necessary technique.
 We believe The Advertising Council's extensive experience in public service
messages should honored and followed.  Many of their campaigns have had a
major impact on improvement of health and social conditions for our citizens.
Their PSA on Seat Belt Usage uses an approach similar to their plan for the
Breastfeeding Campaign; they provide examples of what can happen when not wearing a
seat belt.
Dr. Johnston's warning about "making any claims that cannot be scientifically
validated" is entirely valid.  We agree.  We know from those who have
participated in the preparation of the Breastfeeding PSA materials that every word
and claim made in these PSA's has been reviewed by multiple scientists and
validated by published research from respected medical journals.
We enthusiastically urge that the plans for release of the Breastfeeding
Awareness Campaign be kept on schedule and that the content and message not be
weakened.  The health and very life of our children is at stake here.  If we can
increase breastfeeding initiation and duration in this country, we can reduce
infant mortality, prevent an enormous number of major and minor childhood
illnesses and also save a great deal of money that would otherwise be spent in
caring for these illnesses and disabilities.
I and my colleagues would be very pleased to provide any additional data on
these issues and to assist your office in any way possible to assure a
successful Breastfeeding Awareness Campaign.
Sincerely, On behalf of the leadership and membership of the Section on
Breastfeeding of the American Academy of Pediatrics

                Lawrence M. Gartner, M.D.
                Professor Emeritus
                Departments of Pediatrics and Obstetrics/Gynecology
                The University of Chicago

                Chair, Executive Committee
                Section on Breastfeeding
                American Academy of Pediatrics

             ***********************************************

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