Dear Kathleen:

The latest data on BF rates in P.R. is from 1980-82, (J. Becerra,
Breastfeeding Patterns in Puerto Rico, AJPH, June 1990, Vol80, No.6). The
study showed that the proportion of infants who had ever been breastfed was
38% ( in 1960 it was 59%,  in 1974 it was 25%), and the proportion of infants
who were exclusively breastfed for at least the first month was 4.1% (1960 -
27.45%). We don't have recent information but I think that although it is
probable that starting rates are improving, those of BF exclusively are still
low. Several factors have affected this situation, many of them are common in
your area. Among these are: Lack of knowledge of BF by health providers,
hospital  practices, ABM marketing, lack of State Policy and WIC.
I did  research on BF practices in several public & private hospital in P.R.
in 1994. It was found that none of the hospitals had a breastfeeding policy.
It was customary in all hospitals to feed supplementary glucose or formula to
newborns, as well as giving free formula packages to mothers on discharge.
Public hospitals do not allow breastfeeding until after discharge (62% of our
mothers give birth in public hosp.). By law, public hospitals can't receive
donations from ABM companies, but the government buys the ABM & discharge
packs!!!!
Things have improved since then. A Breastfeeding Task Force, started on 1993
(We were part of it), wrote a Breastfeeding Policy for Puerto Rico, which was
signed on Feb. 1995 by our Secretary of Health, Dr. Carmen Feliciano. Also,
one of our private hospitals, Ashford Presbyterian (where Janet Panchula
works as IBCLC) has the Certificate of Intent (Bravo! Janet). We are offering
BF Management Seminars, sponsored by the School of Public Health of the
University of Puerto Rico ,around the island and have plans to start a
Graduate Lactation Educator Certificate soon (sorry, but courses will be in
Spanish). I know that BF patterns are going to change and Breastfeeding will
be the cultural norm in our beautiful island. (Puerto Rico is a beautiful
sunny island, maybe we can have a Breastfeeding convention here!).
If anyone wants a copy of our BF State  Policy (Spanish copy),  please
contact me.

Ana M. Parrilla, M.D., MPH, IBCLC (very proud to be)
LLLI Medical Associate
Lactamar - Instituto de Lactancia Materna
PO Box 221144 Station
Rio Piedras, P.R. 00931
809-753-6467 / 809- 765-2889