Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.

For pregnant woman and women with infants, how accurate is information on the subject of (benefits, ease of initiating, continuing) breastfeeding ? information than others?

Does your question include a comparison of different health care approaches? (If no, your topic will still be considered.)

yes

If yes, explain the specific technologies, devices, drugs, or interventions you would like to see compared:

I would like to see different breastfeeding promotional materials reviewed for accuracy. The AAP breastfeeding website --(for health professionals section) and womenshealth.gov, (which I feel stretch the science) could be compared with the NIH breastfeeding website (which is much better).

And possibly Michigan WIC's breastfeeding website compared with New Yorks.

What patients or group(s) of patients does your question apply to? (Please include specific details such as age range, gender, coexisting diagnoses, and indications for therapy.)

Pregnant and postpartum women and their families.

Are there subgroups of patients that your question might apply to? (For example, an ethnic group, stage or severity of a disease.)

African Americans are targeted unfaily in some promoional materials.

Ther is one handout targeting them --- I could email it to you if you were interested.

Describe the health-related benefits you are interested in. (For example, improvements in patient symptoms or problems from treatment or diagnosis.)

The benefits would be that women could make decisions using accurate information. This would be a prevenative measeure for problems I will write about below.

Describe any health-related risks, side effects, or harms that you are concerned about.

I feel that postpartum depression (as well as extra stress on mothers and families)is linked to breastfeeding promotion that uses guilt and scare tactics. And I believe that when breastfeedng does not go well, infants can suffer as well.

Most promotional material make it sound as though breastfeeding always works, everyone can do it , and there is always enough milk. I have found this to be not true, fom research I have read, and from my own experience at WIC as well.

Appropriateness for EHC Program

Does your question include a health care drug, intervention, device, or technology available (or likely to be available) in the U.S.?

no

Which priority area(s) and population(s) does this topic apply to? (check all that apply)

EHC Priority Conditions (updated in 2008)

AHRQ Priority Populations

• Low income groups
• Minority groups
• Women

Federal Health Care Program

None

Importance

Describe why this topic is important.

I feel that women deserve accurate information, and on this topic, most information is outated.

We overstate breastfeedings benefits and how easy it is for women to breastfeed.

Most women truly want to breastfeed and a good portion of them find it very difficult, and feel very guilty when they are unable to, or quit becaue of pain, hardship, or low milk supply (or any other reason).

What specifically motivated you to ask this question? (For example, you are developing a clinical guideline, working with a policy with large uncertainty about the appropriate approach, costly intervention, new research you have read, items in the media you may have seen, a clinical practice dilemma you know of, etc.)

I work at a WIC clinic.

We hand out literature that cliams that breastfeeding prevents obesity, cancer, diabetes,learning disabilities, eye problems, dental problems, asthma, allergies, eczema, and low IQ's among other things !! I feel as though we are lying to our clents.

Research I have done (not that I am an expert) shows that breastfeeding prevents colds, ear infections, GI problems and may be extra helful with a preemie. The rest is unclear, or points in the direciton of breastfeeding not being related. And I have said , breastfeeding can be VERY difficult for MANY women--- it is heartbreaking to see women struggle with it or go to extreme measures to make it work, often to the detriment to themselves and the rest of their family. I spoke with 17 year old girl with a week and a half old baby, who was planning to work, go to high school, and pump her breasts out full time (the baby was not latching). And a diabetic, obese woman with two other children planning on pumping and dumping for aboput a month, to keep her supply up, while she was on blood pressure meds. I have many other stories from my experience as a WIC nurse.

Does your question represent uncertainty for clinicians and/or policy-makers? (For example, variations in clinical care, controversy in what constitutes appropriate clinical care, or a policy decision.)

yes

If yes, please explain:

We as a country, spend a lot of time and money on breastfeeing promotion mostly with innacurate information. I do not know it the benefits are truly there for this kind of money and time.

And I feel that it is unethical to give women misleading if not false information.

Potential Impact

How will an answer to your research question be used or help inform decisions for you or your group?

I feel that if a new study came out, the AAP, womenshealth.gov might change thier websites to be or accurate and science based. WIC might change to have more accurate materials as well.

I have been trying to change things by writing letters and sending research abstracts to the AAP, WIC, etc. I'm not having much luck !!

Describe the timeframe in which an answer to your question is needed.

I have no time frame --- obviously, the sooner the better.

Describe any health disparities, inequities, or impact on vulnerable populations your question applies to.

Nominator Information

Other Information About You: (optional)

Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)

I feel that if a new study came out, the AAP, womenshealth.gov might change thier websites to be or accurate and science based. WIC might change to have more accurate materials as well.

I have been trying to change things by writing letters and sending research abstracts to the AAP, WIC, etc. I'm not having much luck !!

Are you making a suggestion as an individual or on behalf of an organization?

Individual

Please tell us how you heard about the Effective Health Care Program

Dr Stanley Ip