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Subject:
From:
"Valerie W, McClain" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 11 Aug 2004 04:59:04 EDT
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Katherine,
I believe my confusion over the numbers is because the CDC website states the
following:

"In 2001, at the request of a CDC expert advisory panel, the National
Immunization Survey piloted breastfeeding questions to about 13% of respondents.
Since January 2002, these breastfeeding questions have been asked of survey
respondents to assess the population's breastfeeding practices."

This paragraph does not specifically say that they no longer use 13% of the
respondents.  There is no statement on this website saying that the methodology
of the survey was changed from the original Pediatrics 2003 article.  In fact
prior to reading the tables the CDC website states "Preliminary breastfeeding
data was published in Pediatrics 2003; 111:  1198-1201. Breastfeeding data
from the 2003 NIS are now available by geographic area and by socio-demographic
characteristics."

This paragraph would have been the perfect time to explain that the
methodology had changed to encompass all respondents rather than 13% of some 35,000
interviews.  If a method of collecting data has changed from the preliminary
findings, it would seem important to state that clearly.

As for footnotes on the table, I have read the footnotes and the footnotes do
not explain how data for exclusive breastfeeding was obtained.  The only
explanation is, "Exclusive breastfeeding is defined in this study as only
breastmilk and water--no solids or other liquids.  Since the Pediatrics 2003 is the
only reference given at this CDC website, I assumed that what was done during
the preliminary survey was repeated.  Again, it would seem important to clarify
that the survey has been revamped.

From correspondence with the FDA over Martek oils, I have learned that
specific statements are important.  No where at this website is there a specific
statement in which the methodology of the Pediatrics 2003 article is rejected.

It is good to know that some 35,000 phone interviews were made and that all
these people were asked breastfeeding questions.  Yet, this data is quite
surprising because it doesn't seem to fit with the reality I see.  But I recognize
that what I see may not reflect general trends, etc.

There are some troubling aspects to this particular survey and the fact that
breastfeeding data is being obtained at the same time as immunization data.
Someone who homebirthed and has not immunized might not perceive this survey as
innocuously as other people.  Particularly, the fact that at the end of this
survey they are asked for permission to contact their medical provider in
order to obtain immunization records.  I guess I find it amazing that this survey
gathering uses verbal permission rather than signed permission.  I would never
give someone over the phone verbal permission to obtain my children's medical
and/or vaccination records.  Might breastfeeding data that is obtained at the
same time as immunization data and permissions to obtain medical data,  be
perceived by the general public as another "enforcement" issue.  I am rather
troubled by the mixing of the issue of vaccination with breastfeeding.

Thank you for taking the time to explain the CDC's breastfeeding estimates.
Valerie W. McClain, IBCLC

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