Carolina GlobalBreastfeeding Institute

Department ofMaternal and Child Health

Gillings School ofGlobal Public Health

Carolina Global Breastfeeding InstituteGoals and Achievements

2006 - 2012

Breastfeeding has been shown to support health, development and survival among children and their mothers. In 2007, the Agency for Healthcare Research and Quality reviewed the literature and concluded that the use of infant formula is associated with increased risk of:

The University of North Carolinaat Chapel Hill

Chapel Hill, NC 27599-7445Tel: 919-966-3774Fax: 919-966-0458

www.sph.unc.edu/breastfeeding

CGBI Director:Miriam H Labbok, MD, MPH

FACPM, IBCLC, FABMTel: 919-966-0928labbok@unc.edu

acute otitis media (~100%) non-specific gastroenteritis severe lower respiratory tract infections (~250%) atopic dermatitis (~50%) type 1 and 2 diabetes sudden infant death syndrome (SIDS) (56%; ~100% vs. EBF) asthma (young children) (~50%) necrotizing enterocolitis (138%) childhood leukemia (~20%)

CGBI Associates:Dr Herbert Peterson, Chair,

Dept. of MCHEmily Taylor, MPH, Sr Projects

DirectorBrook Colgan, MPH,

IEC DirectorBarbara M Cameron, MA,

MSW, Dir., Childcare ProjectTamar Ringel-Kulka, MD,

MPH, co-PI, Childcare Project

And, for the mother, not breastfeeding or stopping early increases her risks of: types 1 and 2 diabetes breast cancer ovarian cancer maternal postpartum depression delayed rate of uterine involution postpartum blood loss maternal stress inefficiency in nutrient metabolism bone calcium loss

Dorothea Calhoun-Smith, Program Ass’t

Nathan Nickel, PhD Research Assistant

Advisory Group:Alice Ammerman, DrPH, RD

Barbara Crane, PhDJoe Holliday, MD, MPHBarbara Kennedy, MPH

Meg Molloy, DrPH, MPH, RDGinger Sall, BA

early fertility returnIn addition, breastfeeding increases her responsiveness to infant cues as measured in the brain regions implicated in maternal-infant bonding and empathy.

Today, research is confirming a meaningful link between formula feeding, and possibly bottle feeding, and obesity, now considered one of the major health challenges of this century. And the impact of not breastfeeding increases the risk of obesity for the mother as well as for the child.

Despite this clarity, the United States has a long way to go to achieve a

Anthony So, MD, MPAWilliam Sollecito, DrPH

CGBI is a Member of:The North Carolina

Breastfeeding CoalitionThe United States

Breastfeeding CommitteeThe Partnership for Maternal, Newborn and Child Health, at the World Health Organization

The World Alliance for

breastfeeding norm; some groups, such as young women, African American women, and the less wealthy, less educated are not benefitting from this knowledge and the support that they need to succeed in optimal feeding. As a result, they are not enabled to give their children the best start on life through optimal birth, breastfeeding, and birth spacing.

The Carolina Global Breastfeeding Institute was created specifically to address the need for breastfeeding support in North Carolina and beyond, and to serve as a center of innovation to further the evidence, to translate this research into action, and to train future leadership.

Breastfeeding Action

CGBI is part of the WHO Collaborating Centre on Sexual and Reproductive

Health at UNC

The following outlines our goals, how we work to address these goals, and our achievements over the last six-plus years.

Goals and Related Approaches:

The Carolina Global Breastfeeding Institute was established to work with local, state and international organizations so that together, we will “Nurture our Future”. CGBI continues on the same trajectory and, in 2012 in its seventh year of operation, has continued to grow, innovate, and expand activities in the areas of research, service and training, with the addition of new staff and grant-funded projects.

CGBI, along with its associates and affiliates, provides fundamental and meaningful contributions to the “Three Bs”: optimal birth practices, optimal breastfeeding support, and optimal birth spacing, as well as related reproductive health policies and programs.

Our goals are to:

1. Create and disseminate the evidence base for action: Breastfeeding-friendly operational and translational research and secondary data analyses

2. Educate and mobilize future leaders and influential groups, and developing new and innovative curricula and approaches

3. Communicate/Share: creating the go-to site for breastfeeding as a reproductive and health issue

4. Serve, Partner, Provide technical assistance: leveraging action at the State, National and International levels through partnering with individuals, communities and organizations; and technical assistance, including support for evaluation, meetings, policy enhancement, etc.

5. Become a Sustainable Contributor to the supporting innovation and progress in the Three Bs: Maintaining CGBI as a functioning administrative unit

We use one overriding approach and four additional more action-specific approaches in much work. E-TIER (Exploration, Translation, Innovative Intervention, Evaluation, and Replication) is our guide in all of our work. We find out what is available and collect

formative information, we translate this into the actin needed, we carry out the innovative intervention, whether it is community activity, the development of a new approach to training, or healthcare support, and we evaluate, document, and disseminate this activity to support replication and expansion. In addition, we use, as appropriate:

Quasi-experimental and Experimental design Formative Qualitative study Continuous Quality Improvement (CQI) Working Group Process Approach (WGPA) to gain expert input and consensus

Students are very involved in the majority of our research, service and training activities.

1. CREATION AND DISSEMINATION OF THE EVIDENCE BASE FOR ACTION:

Breastfeeding-friendly operational and translational research Breastfeeding-friendly Healthcare:

The major activity is our funded operational translational study of breastfeeding support in hospitals serving low wealth populations (CGBI/BFHC). Materials have been developed based on issues of need, and a toolkit, including these materials as well as training materials, is being prepared for posting on our website. Preliminary findings show that supported hospitals are more likely to reach their breastfeeding goals, and that all have made significant progress. Emily Taylor and Brook Colgan are providing key programmatic, technical and

training support to these efforts. In addition, Nickel is exploring existing datasets to further understand the relationship of breastfeeding support approaches and breastfeeding outcomes under AHRQ and USFDA funding. Findings this year will help hospitals select which of the practices are associated with the greatest impact on breastfeeding outcomes (submitted for publication) North Carolina Maternity Center Breastfeeding-Friendly Designation: CGBI is part of the advisory group convened by the NC Nutrition Branch of the Division of Public Health to design, implement and evaluation the program. The NC Maternity Center Breastfeeding Designation (NCMCBFD) includes consideration of a “5 Star” approach to encourage maternity facilities to practice the Ten Steps, with one star being awarded for every 2 steps in

place. Taylor is providing formative research and expert guidance based in the Breastfeeding-friendly Healthcare project. This year, many of the hospitals we work with gained stars, and UNC-H was designated Breastfeeding-friendly by the national initiative

Ready, Set, BABY – Prenatal Education: RSB is a 20-minute interactive session with five key focused areas of discussion. These focus areas inform pregnant woman about what to expect as part of normal maternity care at the hospital and the importance of breastfeeding. CGBI is conducting an evaluation of this program and will develop a toolkit of the materials for dissemination of the progam in other hospital settings.

Breastfeeding-friendly Community Care: Breastfeeding in Child Care: Translational and operational approaches were also used in this project to introduce breastfeeding support into child care facilities in Wake County, targeting those centers that serve low-wealth clients. Materials and curriculum were developed to train child care providers and directors, and >60 centers have participated in trainings. To date, follow up data are showing significant impact on providers’ knowledge, attitudes and practices. The NC Eat Smart Move More is working on the development of a Statewide designation based on our approach, and we have identified resources so that Barbara Cameron and Miriam Labbok are in discussion with county, state and federal agencies that have expressed interest in replication and expanding this effort.

Breastfeeding-friendly Community Based Participatory work: Teen training commenced in 2010 based on the qualitative research. In addition, Community based Participatory Research funding was received from TraCS for women and children’s health support at the YWCA, focusing on building community for strategy and action. BEST for Babies in Durham County arose from the expressed need of the community and addressed breastfeeding among African American women.

Mothers’ understanding of breastfeeding and formula advertising: Focus groups have been completed elucidating information that confirms that women are misled and

misinformed by formula advertising. These findings reflecting the potential misperceptions of formula advertising have been shared at APHA, and accepted for publication. Exploring and disseminating information on inequity and disparities in North Carolina

Secondary Data Analyses: Recent analyses of the national IFPSII dataset has provided increased information on the impact of each of the Ten Steps on outcomes, informing future program priorities. Also, research on impact of Child Care on breastfeeding outcomes is showing that the major motivators are Mother’s Commitment and Mother’s Intended Breastfeeding Duration.

Lactation Consultants: CGBI past-student and current affiliate, Ellen Chetwynd, is actively involved in the study of LC reimbursement and the LC role in Healthcare, with a committee include CGBI personnel. Research for Program and Policy Improvements: Publications and Contracts and grants listings, appended

2. EDUCATION AND MOBILIZATION OF FUTURE LEADERS: Curricula development and training

International Curriculum on Lactation Sciences was developed at CGBI in 2009, and has been used as a basis for the Mary Rose Tully Training Initiative. • Mary Rose Tully Training Initiative: CGBI developed the first residential lactation

consultant training in the US and is based on the international curriculum, above. The Mary Rose Tully Training Initiative (MRT-TI) is a Pathway 2 training program to become an International Board-Certified Lactation Consultant (IBCLC).  The MRT-TI was initiated and developed in 2009 by the Carolina Global Breastfeeding Institute in collaboration with the UNC Women’s and Children’s Hospital and the UNC Gillings School of Global Public Health. This IBLCE Pathway 2 program is unique world-wide in that it: (1) was developed as a regular course of study within an academic Health Sciences

Center, (2) was formed originally as a collaboration between the school of public health and the hospital, and (3) is open to graduate students as part of their on-site academic training.  Multi-level and multi- UNC-unit commitment has been essential to the success of the MRT-TI, particularly on the part of the public health and clinical faculty. The MRT-TI is one academic year in length and includes 120 hours of didactic training, for which students earn a total of six academic credits from the Department of Maternal and Child Health in the Gillings School of Global Public Health.  Students also complete 300 hours of supervised clinical training at local medical training centers, for which students receive continuing education units.  The didactic and clinical components of the lactation program may be taken as part of a student’s regular course of study within a graduate program or

undergraduate nursing program. The course is entirely residential, supportive of the course philosophy of active and reflective learning.  Students journal their clinical experiences and, during each didactic session, two students share formal case study presentations. We have completed the third year of this 2-semester course, with 12 students. The 11 students last year performed admirably on the international LC Exam.

• In 2012, the MRT-TI is graduating 12 students, who will be eligible to sit for the international exam to become an IBCLC. This brings the total number of graduates from the MRT-TI up to 28 over the course of three years.  To date, the examination pass rate for the MRT-TI students is 100% and, historically, our students have performed above average on the test.  Upon successful completion of the course and exam, students may

work in a variety of capacities and settings. Examples of IBCLC positions that alumni of the MRT-TI currently hold include: (1) as a WIC breastfeeding coordinator, (2) as a lactation consultant in a hospital, clinic, or other maternity care service; (3) as a breastfeeding researcher/professor; (4) as a project manager of a breastfeeding-related project.

• In addition, Brook Colgan was invited to present our work on this at the International Lactation Consultant Conference 2011 and 2012, with Labbok, and Brook Colgan has now been invited to serve in a leadership role in the International Lactation Consultant Association education committee.

Infant Feeding Certificate: We developed and proposed a graduate certificate; however, the school has a moratorium on certificates at this time. Annual Scholarships: • The CGBI award is based on potential to contribute to the study of the mother-baby

dyad. Each year a student received support towards a paper on a breastfeeding issue.• The Tully Family Scholarship is provided to support the MRT-TI course. This year two

students received the award. Survey Course on Infant Feeding: Labbok offered this Masters-level Breastfeeding Survey course in the Spring Semester. It has been enthusiastically received, with a growing number of participants drawn from MCH, other departments and across other schools.

University Guest Lectures: Labbok and staff visited and presented at numerous university sites, including University of Berggen in Norway, in three universities in Australia, Bangladesh/Dhaka Medical Center, St Jude’s Children’s Research Hospital, University of Tennessee, University of Cincinnati, several sites in Australia, and many others. Labbok was an Invited Distinguished Speaker at the New Hampshire Institute of Politics, the site best known for the presidential primary debates. She spoke on Politics and Breastfeeding: Strange Bedfellows. In addition, she is frequently invited to offer lectures at educational sessions around the State, US and worldwide. State/National Conference Attendance and Lectures: CGBI supports and collaborates with the annual LCCU at Wake AHEC and the Annual Art of Breastfeeding Conference at the UNC

Friday Center, contributing to the programs annually. Colgan, Labbok, Nickel, Cameron and Taylor all presented at the APHA Annual Meeting. In addition, Taylor presented the closing keynote at the annual Art of Breastfeeding Conference, and has spoken at several perinatal meetings. In 2009, CGBI held a panel at the NCPHA meeting and all CGBI staff and two students presented at APHA. Labbok has started two new professional interest groups: ACPM Breastfeeding Interest Group, with the purpose of creating policy and sponsoring sessions; the ILCA/ABM Physician/LC interest group, to catalyze action by these double trained individuals. There are currently more than 120 worldwide signed up to participate. Peer review: CGBI served as peer reviewers for several publications, including the Maternal and Child Health Journal, the Canadian Medical Association Journal, Africa Nutrition Journal.

Labbok is on the Editorial Boards of Breastfeeding Medicine, Journal of Human Lactation, the International Breastfeeding Journal and the new Clinical Breastfeeding Journal. Carolina BEBES Student Organization:  The student organization Carolina BEBES (Birth and Breastfeeding:  Evidence Based Education & Support) hosted events and fundraisers, including lecture series, films, a monthly journal club, and student discussions. Co-led by 5 second-year graduate students, they have partnered with the North Carolina Breastfeeding Coalition on the Breastfeeding-friendly Business initiative and are involved in support for mothers’ rooms across campus, and activity that has resulted in their participation on a Chancellor’s Advisory Group. The BEBES lecture series is flourishing. BEBES was recognized

with the Bryant Award for Community Service in 2012. In 2013, the group plans to initiate an awareness campaign for resources available on campus. Breastfeeding and Feminism Symposia Series: The 7th Breastfeeding and Feminism: “Considering Women in the implementation of the Surgeon General’s Call to Action” was held for March 29/30, 2012, with about 100 participants. This is an ongoing collaborative effort with UNC-Greensboro. The 2011 event was co-hosted with CIMS and had more than 200 participants. Journal articles and an upcoming book have emerged from these symposia, with a Rutgers University Press edition coming out this year. Recent Highlights: Our first doctoral student, Dr Nathan Nickel graduated, and our third Mary Rose Tully Training Initiative, as well as our training under BFHC, resulted in 25 new

International Board Certified Lactation Consultants.

3. COMMUNICATIONS

Updated Website: Colgan has taken the lead in the revision of the CGBI website to facilitate outreach to potential collaborators, students, and other supporters (http://cgbi.sph.unc.edu/). Taylor has developed a webportal to support hospitals across the state in changing practices as part of a new Interstate Collaborative.

Development of Communications Strategy: CGBI is working towards recognition as the focal point for immediate, up-to-date information regarding breastfeeding and the mother-child dyad through development of “how-to” print and web-based materials and via participation in sensitization for policy change, meetings and mainstreaming. To this end, we identified funding support for toolkits providing information for others wishing to Take Action (http://cgbi.sph.unc.edu/take-action/toolkits). Two toolkits have been posted and 3 are in preparation. Breastfeeding Exclusive: The CGBI quarterly is entering its 4rd year of publication, and is achieving positive feedback. We have expanded the focus to highlight our affiliates and colleagues (http://cgbi.sph.unc.edu/news/bf-exclusive).

News Coverage: News releases on new breastfeeding data and other issues were disseminated. Most news coverage is available at http://cgbi.sph.unc.edu/news. Labbok is frequently contacted by ABC, Slate, N&O, and other news agencies for comment. Recent Highlights: Both Taylor and Cameron have been invited host speakers for CDC Webinars. Our newly designed, more user friendly website is up and running and our first 2 toolkits have been posted. The Breastfeeding Exclusive continues to be produced with positive feedback. At least 2 Sakai sites have been developed to aid communication amongst our partners.

4. SERVING, PARTNERING, PROVIDING TECHNICAL ASSISTANCE: leveraging action at the State, National and International levels, and technical assistance, including support for evaluation, meetings, policy enhancement, etc.

NC Statewide Activities: Technical support for program and policy impact continues to be a major and successful focus of CGBI. CGBI was a founding institution of the NC Breastfeeding Coalition; Taylor has been elected Chair in 2012, and all of CGBI and the BEBES organization are involved in this coalition. Labbok and Taylor are clinical co-leads for PQCNC this year focusing on a statewide effort to increase rates of exclusive breastfeeding during the hospital stay. CGBI remains active in the NC Child Fatality Task Force, and the associated Perinatal

Fatality committee. Taylor serves on the board of the North Carolina Perinatal Association, and Labbok is a member of the NC IOM Obesity interest group. Active participation and support by Labbok and Colgan in the SIDS and Safe Sleep Committees continues to be a priority to assist policy development in North Carolina. In addition, CGBI student, now an affiliate, Ellen Chetwynd has been in discussion with USLCA located in Raleigh to develop a Lactation Consultant registry for North Carolina, which will work to achieve two goals: assisting mothers/physicians looking for certified LC’s and assist certified LC’s to bill for reimbursement. “Ban the Bags” Golden Bow Awards and Toolkit: CGBI continues to support the NC Breastfeeding Coalition (NCBC) efforts in achieving “Ban the Bags Golden Bow Awards.”

Nearly a quarter of all hospitals in the State have been presented to hospitals that demonstrated freedom from formula advertising in the form of formula companies’ discharge bags. Business Case for Breastfeeding: CGBI continues to support the NCBC to work towards breastfeeding-friendly workplaces in NC through training in and active promotion of the Business Case for Breastfeeding toolkit developed by the US DHHS Office on Women’s Health, and hopes to feature UNC in this effort. Taylor prepared and won a grant application that resulted in additional funding for NCBC to work on materials for the US Surgeon General’s Call to Action to Support Breastfeeding. The stories and pictures are available at USBC. CGBI and BEBES are leading an effort within a Chancellors Committee to ensure that UNC-CH is fully on board.

National Agency and International Organization Assistance: Taylor was elected to the Board of US Breastfeeding Committee in 2010 and Labbok was appointed to the DHHS Secretary of Health’s Advisory Committee on Infant Mortality in 2011. Labbok also served on three expert panels in 2010: Contraceptive use in special situations (CDC), WIC research needs (IOM/USDA), and breastfeeding support in hospitals (CDC). In addition, considerable support is provided to UNICEF, as well as leadership positions in the APHA International Section, the World Alliance for Breastfeeding Action, and the Academy of Breastfeeding Medicine. CGBI hosted a meeting of the North American Region of WABA. Labbok is immediate past Chair of the APHA International Health Section and has co-authored the new Breastfeeding Policy and the first global MCHN Policy Statement for APHA. CGBI staff contributed technical inputs in

the development of the Surgeon General’s Call to Action to Support Breastfeeding and have played an important role in innovative implementation, and were recognized for these contributions by the Surgeon General in her graduation speech at UNC. Community Mobilization Efforts: Taylor and Ellen Chetwynd co-developed the NC Reproductive Continuum Coalition that is currently mobilizing to synergize efforts toward improved wellness across the reproductive continuum. Community Partnership: CGBI has been involved in two major community-based participatory research (CBPR) projects. One, funded by NIH, supported breastfeeding among African American families in Durham in partnership with the Christian Community Health Coalition. We also completed a grant from NC TraCS to collaborate with UNC-G and the

YWCA of Greensboro on CBPR to enhance the YW’s effectiveness. In addition, CGBI is building links with LLL/NC. Recent Highlights: CGBI has been recognized repeatedly in the December 2011 NC Health Department “Update on activities in support of the NC Blueprint Promoting, Protecting, and Supporting Breastfeeding”. In addition to our many local community, hospital, child care, and other mobilization and study efforts, Taylor’s election to chair the NCBC has been an important contribution.

5. DEVELOPMENT AND SUSTAINABILITY: Please contact CGBI@unc.edu or labbok@unc.edu with any suggestions or comments on development.

Donors: CGBI is grateful for the ongoing support of a very generous and anonymous North Carolina family that has enabled us to strive to support the creation of an enabling environment for families of our state, the nation and worldwide to choose and succeed with breastfeeding, the best start on life. In addition, there are now two more endowments: The CGBI Special Endowment Fund was created and funded by CGBI faculty and staff and The Mary Rose Tully Endowment was created by the Tully Family to support development and scholarship support for the Mary Rose Tully Training Initiative.

Grants and Contracts Awarded: Appended Outreach and Networking: CGBI continues to work on expansion of our network locally, statewide, nationally and internationally, for development activities and for action towards Nurturing our Future. Specifically, we are working towards training and research network development with a variety of partners. Recent Highlights: Three significant grants were received in 2011/12, (see grants section) and additional funds were received from CDC and MCH/B under existing grants for complementary activities.

Appendix 1: CGBI Publications and Presentations

Refereed Journal PublicationsIn final review Labbok M, Taylor E, Nickel N. Implementing the Ten Steps in Hospitals Serving Low-Wealth Patients.

I. Operational research design and baseline findings, Breastfeeding Medicine.Labbok M. UNICEF’s Monitoring of BFHI: Updates and analysis. Lancet.Parry K, Taylor E, Labbok M. Understanding Women’s Perceptions of Infant Formula Adverising.

Birth:Issues in Perinatal Care.

Published or In Press:

*Taylor E, Nickel N, Labbok M. Implementing the Ten Steps for Successful Breastfeeding in Hospitals Serving Low-Wealth Patients: II. Exploration of each Step in context, in press, December 2012, AJPH

Labbok M, Marinelli KA, Bartick M, Calnen G, Gartner LM, Lawrence RA, Meek JY, Gorrin-Peralta JJ, Parrilla-Rodriguez AM, Powers NG. Regulatory monitoring of feeding during the birth hospitalization. Pediatrics. 2011 Nov;128(5):1311-4.

*Cameron B, Javanparast S, Labbok M, Scheckter R, McIntyre E. Breastfeeding Support in Child Care: an international comparison of findings from Australia and the U.S. Breastfeeding Medicine, 2011 Dec.

Abrahams S, Labbok M. Breastfeeding and otitis media: a review of recent evidence. Curr Allergy Asthma Rep. 2011 Dec;11(6):508-12.

Bhutta, Labbok M. Scaling up breastfeeding in developing countries. Lancet. 2011 Jul 30;378(9789):378-80.

Labbok M, Taylor E. Call to action on breastfeeding in North Carolina: review and rationale. NC Med J. 2010 Sep-Oct;71(5):459-63.

Szucs K, Labbok M. The Academy of Breastfeeding Medicine, Journal of Human Lactation, 2011; 27(3) 299–300

*Ringel-Kulka T, Jensen E, McLaurin S, Woods E, Kotch J, Labbok M, Bowling JM, Dardess P, Baker S. Community-Based Participatory Research of Breastfeeding Disparities in African American Women, ICAN: Infant, Child, & Adolescent Nutrition published online 24 June 2011

*Evans K, Labbok M, Abrahams SW. WIC Programs and Breastfeeding: Do they differ by the racial and ethnic composition of WIC participants? Breastfeed Med Online Ahead of Print: March 31, 2011. doi:10.1089/bfm.2010

Labbok M. On “a call for clarity in infant breast and bottle-feeding definitions for research.” J Obstet Gynecol Neonatal Nurs. 2011 Mar;40(2):140; author reply 140-1. Epub 2011 Feb 11.

*Jensen E, Labbok M. Unintended consequences of the WIC formula rebate program on infant feeding outcomes: Will the new food packages be enough? Breastfeed Med 2011;6(3):145-9

2006-2010:Labbok M, Taylor E. Call to Action on Breastfeeding in North Carolina: Review and rationale. NC Med

J. 2010;71(5):459-63.463

Mason Meier B, Labbok M. From the Bottle to the Grave: Realizing a Human Right to Breastfeeding Through Global Health Policy. Case Western Reserve Law Review Summer 2010;60(4):1073-1142.

*McNiel ME, Labbok M, Abrahams SW. What are the risks associated with formula feeding? A re-analysis and review. Birth 2010;37(1):50-8.

Abrahams SW, Labbok M. Exploring the impact of the Baby-Friendly Hospital Initiative on trends in exclusive breastfeeding. Int Breastfeed J 2009 Oct 29;4:11.

Declercq E, Labbok MH, Sakala C, O’Hara M. Hospital practices and women’s likelihood of fulfilling their intention to exclusively breastfeed. Am J Pub Health 2009;99(5):929-35.

*Suyes K, Abrahams SW, Labbok MH. Breastfeeding in the workplace: Other employees' attitudes towards services for lactating mothers. Int Breastfeed J 2008 Oct 20;3:25.

Labbok MH. “The baby is breastfeeding”. Birth 2008;35(3):258; author reply 258.

Labbok M, Smith PH, Taylor E. Breastfeeding and feminism: a focus on reproductive health, rights and justice. Int Breastfeed J 2008 Aug 4;3:8.

Labbok M. Transdisciplinary breastfeeding support: Creating program and policy synergy across the reproductive continuum. Int Breastfeed J 2008 Aug 4;3:16.

Labbok M. Exploration of guilt among mothers who do not breastfeed: the physician’s role. J Hum Lact 2008;24(1):80-4.

*Straub B, Melvin C, Labbok M . A descriptive study of Cambodian refugee infant feeding practices in the United States. Int Breastfeed J 2008 Jan 24;3(1):2.

Millikan RC, Newman B, Tse CK, Moorman PG, Conway K, Dressler L et al. Epidemiology of basal-like breast cancer. Breast Cancer Res Treat 2008;109(1):123-39. Epub 2007 Jun 20.

*Labbok M, Echerd L, Nakaji E. Infant feeding area graphs: Insight for program planning inputs (abstract). J Hum Lact 2007;23(1):91.

Labbok M. Breastfeeding and Baby-Friendly Hospital Initiative: More important and with more evidence than ever. J Pediatr (Rio J) 2007;83(2):99-101.

Labbok M. Breastfeeding: A woman’s reproductive right. In: Keith L editor, FIGO (International Federation of Gyn/OB) Annual Report, 2006. Int J Gynaecol Obstet 2006;94(3):277-86.

Labbok M. ABM News: International update. Breastfeeding Medicine 2006;1(4):278-9.Labbok M, Wardlaw T, Blanc A, Clark D, Terreri N. Trends in exclusive breastfeeding: Findings from

the 1990s. J Hum Lact 2006;22(3):272-6. Labbok M, Nichols-Johnson V, Valdes-Anderson V. ABM Clinical Protocol #13: Contraception during

breastfeeding. Breastfeeding Medicine 2006;1(1):43-51.

Books and ChaptersIn final preparation:Labbok M, Colgan B. Safe Sleep – Wherever you sleep! Platypus Press, to be available Fall, 2012Labbok M, Taylor E, Parry K, Nwogi U. Achieving Exclusive Breastfeeding, Hale Press.

Paige Hall Smith, Bernice L. Hausman, and Miriam Labbok (eds). Beyond Health, Beyond Choice: Breastfeeding Constraints and Realities, New Brunswick: Rutgers University Press, 2012 (forthcoming).

Labbok M. Breastfeeding in Public Health: What Is Needed for Policy and Program Action? Chapter 3, In Paige Hall Smith, Bernice L. Hausman, and Miriam Labbok (eds). Beyond Health, Beyond

Choice: Breastfeeding Constraints and Realities, New Brunswick: Rutgers University Press, 2012 (forthcoming).

Paige Hall Smith, Bernice L. Hausman, and Miriam Labbok. Introduction: Breastfeeding Constraints and Realities. In Paige Hall Smith, Bernice L. Hausman, and Miriam Labbok (eds). Beyond Health, Beyond Choice: Breastfeeding Constraints and Realities, New Brunswick: Rutgers University Press, 2012 (forthcoming).

Paige Hall Smith, Bernice L. Hausman, and Miriam Labbok. Conclusion: Beyond Health, Beyond Choice: New Ways Forward in Public Health. In Paige Hall Smith, Bernice L. Hausman, and Miriam Labbok (eds). Beyond Health, Beyond Choice: Breastfeeding Constraints and Realities, New Brunswick: Rutgers University Press, 2012 (forthcoming).

Labbok M. Community interventions to promote optimal breastfeeding: Review of studies on early initiation, any breastfeeding, exclusive breastfeeding, and continued breastfeeding. USAID/ IYCN Washington DC. December, 2011.

2006-2010:Paige Hall Smith, Bernice L. Hausman, and Miriam Labbok (eds). Beyond Health, Beyond Choice:

Breastfeeding Constraints and Realities, New Brunswick: Rutgers University Press, 2012 (forthcoming).

Labbok M. Breastfeeding in Public Health: What Is Needed for Policy and Program Action? Chapter 3, In Paige Hall Smith, Bernice L. Hausman, and Miriam Labbok (eds). Beyond Health, Beyond Choice: Breastfeeding Constraints and Realities, New Brunswick: Rutgers University Press, 2012 (forthcoming).

Paige Hall Smith, Bernice L. Hausman, and Miriam Labbok. Introduction: Breastfeeding Constraints and Realities. In Paige Hall Smith, Bernice L. Hausman, and Miriam Labbok (eds). Beyond Health, Beyond Choice: Breastfeeding Constraints and Realities, New Brunswick: Rutgers University Press, 2012 (forthcoming).

Paige Hall Smith, Bernice L. Hausman, and Miriam Labbok. Conclusion: Beyond Health, Beyond Choice: New Ways Forward in Public Health. In Paige Hall Smith, Bernice L. Hausman, and Miriam Labbok (eds). Beyond Health, Beyond Choice: Breastfeeding Constraints and Realities, New Brunswick: Rutgers University Press, 2012 (forthcoming).

Labbok M, Nakaji E. Breastfeeding: A biological, ecological, and human rights imperative for global health. In: Murthy P, Smith CL, editors. Women’s global health and human rights. Sudbury (MA): Jones and Bartlett; 2009. p. 421-36.

Labbok M. Breastfeeding, fertility and family planning. In: Sciarra J, editor. Fertility regulation, psychosomatic problems, and human sexuality. Glob libr women's med (ISSN: 1756-2228) 2008; DOI 10.3843/GLOWM.10397, November 2008.

Labbok M, Taylor E. Achieving exclusive breastfeeding in the United States: Findings and recommendations. Washington (DC): United States Breastfeeding Committee; 2008.

Labbok M. Breastfeeding, birth spacing and family planning. In: Hale T, Hartmann P, editors. Textbook of human lactation. Amarillo (TX): Hale Publishing; 2007. p. 305-18.

Refereed unpublished oral presentations and/or refereed abstracts

Labbok M. Global Meeting on Determinants of Sustainable Development: Road to Rio +20, Dhaka Bangladesh, May 16, 2012: Breastfeeding, Birth care and Birth Spacing: Essential components of Sustainable Development, via video

Labbok M. CWC Scholar Presentation, April 26, 2012: Protecting and Supporting Breastfeeding and the

Reproductive Health Continuum at UNCLabbok M. NC IOM, Obesity Task Force, April 20, 2012: Breastfeeding in communities and child careLabbok M. NAPNAP/NC Meeting, April 19, 2012: Infant Nutrition: The global perspectiveLabbok M. IMBCO Webinar, April 17, 2012: How BFHI and IMBCI Complement: An Inseparable

Continuum

Labbok M. Australian Breastfeeding Association, Australia, March 11-17, 2012, Two presentation in Sydney, Adelaide, Perth: Coping with the Many Faces of Guilt: The experience and actions of mothers and health workers,  and Birthspacing, Reproductive Health and Breastfeeding

Labbok M. ACPM Annual Meeting, Feb 24, 2012, Lake Buena Vista, FL: The Role of Preventive Medicine and Public Health Physicians in the Support of Breastfeeding: Rationale and Implementation, In panel New ideas, new laws, new responsibilities for public health physicians: Prevention starts at birth with breastfeeding 

Labbok M. Grand Rounds, Morehead Hospital, January 17, 2012: What every physician needs to know about BF/Ten Steps

Labbok M. Latest research on the status of the Baby-friendly Hospital Initiative (BFHI) worldwide: Are we still making progress? Abstract and Presentation, APHA Annual Meeting, Washington DC,

October 31, 2011*Cameron B, Labbok M, Scheckter R, Petersen A, Ringel-Kulka T, Kotch J. Ten Steps for

Breastfeeding-Friendly Child Care: A New Tool for Improving Breastfeeding Support in Child Care Centers. Abstract and Presentation, APHA Annual Meeting, Washington DC, November 1, 2011

*Labbok M, Taylor E, Nickel N. Breastfeeding-Friendly Healthcare Project supporting the Ten Steps to Successful Breastfeeding in multiple hospitals settings: Preliminary operational research findings. Abstract and Presentation, APHA Annual Meeting, Washington DC, November 1, 2011

*Nickel N, Taylor E, Labbok M. Breastfeeding Friendly Healthcare Project: Strategies to Support the Implementation of the Ten Steps. Abstract and Presentation, APHA Annual Meeting, Washington DC, November 2, 2011

*Cameron B, Labbok M, Scheckter R, Petersen A, Ringel-Kulka T, Kotch J. Breastfeeding-FriendlyChild Care in Wake County: Operational Research to Improve Breastfeeding Support in Child Care Centers. Abstract and Presentation, APHA Annual Meeting, Washington DC, November 2, 2011

*Nickel N, Labbok M. Exploring the relationship between childcare arrangements and breastfeeding duration, Abstract and Presentation, APHA Annual Meeting, Washington DC, November 2, 2011

2006-2010:* Nickel N, Taylor E, Labbok M, Tully MR. Poster Abstract, 226567, Similarities and Differences

Between Baby-Friendly Assessment Tools: Findings from an Operations Research Multi-Case Study Examining Hospitals' Adherence to the Ten Steps to Successful Breastfeeding, 5017.0, Breastfeeding Poster Session, APHA Annual Meeting, Denver, CO, November 10, 2010.

* Labbok M, Cameron B, Petersen A, Turay K, Ringel-Kulka T, Kotch J. Poster Abstract, 228421, Can Childcare Workers Impact Breastfeeding Rates? An Operational Research Study, 5019.0, Obesity Prevention: Breastfeeding and Beyond, APHA Annual Meeting, Denver, CO, November 10, 2010.

* Nickel N, Taylor E, Labbok M, Tully MR. Health Care Provider Identified Barriers and Facilitators that Impact Ten Steps to Successful Breastfeeding Implementation: A Multi-Case Study Guided by Organizational Readiness to Change, 5170.0, A Quiet Breastfeeding Revolution: Taking The Ten Steps Across the USA, APHA Annual Meeting, Denver, CO, November 10, 2010.

* Labbok M, Shanahan M. Abstract, 227902, Which of the Ten Steps to Successful Breastfeeding has the Greatest Impact in the US? 5170.0, A Quiet Breastfeeding Revolution: Taking the Ten Steps Across the USA, APHA Annual Meeting, Denver, CO, November 10, 2010.

Colgan B, Labbok M. Abstract, 229721, Analyzing Safe Sleep Messages to Parents on Sudden Infant Death Syndrome (SIDS) Prevention, Breastfeeding, and Bedsharing, 5172.0, Qualitative Methods in Maternal Child Health, APHA Annual Meeting, Denver, CO, November 10, 2010.

Labbok M. Abstract, 222739, Breastfeeding for Social Justice and Human Rights: Addressing Racial Disparities, 5192.0, Targeted Strategies to Address Women's Health Disparities, APHA Annual Meeting, Denver, CO, November 10, 2010.

Labbok M. Abstract, 222686, Extending the Barker Hypothesis to Enhance Reproductive Rights and Justice, 4198.0, Creating Social Justice and Addressing the Right to Health through Translational Research in Reproductive Health, APHA Annual Meeting, Denver, CO, November 9, 2010.

Jensen E, Woods E, Ringel-Kulka T, McLaurin S, Kotch J, Labbok M, Baker S, Dardess P. Community-Based Participatory Research (CBPR) Approach to Understanding and Addressing Breastfeeding

Support Among African American Women, APHA Annual Meeting, Denver, CO, November 8, 2010.

* Smith PH, Labbok M, Cupito S, Nwokah E, Coley S. Choosing Feeding: Enhancing Breastfeeding Education for Teen mothers APHA Annual Meeting, Denver, CO, November 8, 2010.

*Labbok M, Taylor E, Colgan B, Nickel N, Cameron B, Pollet H, Ringel-Kulka T, Jensen E, Addressing Disparities in Breastfeeding Through a Comprehensive Statewide Approach, 15th Annual International Meeting of the Academy of Breastfeeding Medicine, San Francisco, California, October 27-30, 2010.

Labbok M. Breastfeeding After Six Months: A Forgotten but Revitalized Global Issue. Abstract and Poster Presentation, 137th Annual Meeting and Exposition, APHA, Philadelphia, PA, November 11, 2009.

Labbok M. Development of the Lactational Amenorrhea Method (LAM) for Family Planning: Research Results and Lessons Learned in Implementation. Abstract and Oral Presentation, 137th Annual Meeting and Exposition, APHA, Philadelphia, PA, November 10, 2009.

Labbok M, Taylor E, Colgan B, Abrahams SA Tully MR. Enabling Optimal Infant Feeding Through Research, Teaching and Advocacy: The Carolina Breastfeeding Institute. Abstract and Oral Presentation, 137th Annual Meeting and Exposition, APHA, Philadelphia, PA, November 10, 2009.

Labbok M. Best Practices in Breastfeeding Support: Controversies and Recommendations. Abstract and Oral Presentation, 137th Annual Meeting and Exposition, APHA, Philadelphia, PA, November 9, 2009.

Labbok M. Achieving Exclusive Breastfeeding Globally. Abstract, 136th Annual Meeting and Exposition, APHA, San Diego, CA, October 28, 2008.

Labbok M. Breastfeeding Without Borders. Abstract, 136th Annual Meeting and Exposition. APHA, San Diego, CA, October 28, 2008.

Labbok M. Breastfeeding for Health: A Global Human Right. Abstract, 136th Annual Meeting and Exposition, APHA, San Diego, CA, October 28, 2008.

Echerd L, Labbok M. Using the Theory of Planned Behavior to Inform Breastfeeding Intervention Planning for Women from a Faith-Based Organization and a Community Group. Abstract, 136 th Annual Meeting and Exposition, APHA, San Diego, CA, October 26, 2008 (accepted and withdrawn).

Labbok M. Breastfeeding as a Women’s Right Issue. SEWSA’s Frontiers of Feminism at Home and Abroad: A Multidisciplinary Conference, April 4, 2008.

*Abrahams S, Labbok M, Echerd L, Nakaji E. Infant Feeding Area Graphs: Insight for Program

Planning Inputs (abstract), J Hum Lact 2007;23(1):91. BFHI, poster, 135th Annual Meeting and Exposition, APHA, Washington, DC, November 7, 2007.

Labbok M. Issues in Implementing the New Growth Standards. Abstract, 135th Annual Meeting and Exposition, APHA, Washington, DC, November 5, 2007.

Labbok M. Common Infant Foods and Lactation Devices: Marketing, Misuse & Mortality. Abstract, 135th Annual Meeting and Exposition, APHA, Washington, DC, November 5, 2007.

Labbok M. Breastfeeding in NC: Supporting the Blueprint Actions, Joint Conference and Seminar, LLLI of North Carolina, SEWSA, Charlotte, NC, November 2, 2007.

Labbok M. First hour – Save ONE Million Babies: Actions in Support of the Theme of World Breastfeeding Week. Lincoln Community Health Center, WIC Program, Durham, NC, August 2, 2007.

Labbok M. Rationale and Use of the New WHO Growth Charts. Hong Kong Hospital Authority WBW Celebration for Physicians, Midwives, Nurses, Dietitians and Mother Support Groups and Other Health Care Workers. July 28, 2007.

Labbok M. WBW 2007: The Importance of the First Hour/First Day for Breastfeeding Success, Health, Growth and Survival. Hong Kong Hospital Authority WBW Celebration for Physicians, Midwives, Nurses, Dietitians and Mother Support Groups and Other Health Care Workers. July 28, 2007.

Labbok M. Rationale, Development, and Implications of the New WHO Growth Charts. Hong Kong Hospital Authority WBW Celebration for Paediatrics, Obstetricians and Specialists from Family Medicine and Community Health. July 28, 2007, April 3-5, 2008.

Labbok M. Baby-Friendly Hospital Initiative: Status and Updates. Abstract, J Hum Lact 2007;23(1):91.*Abrahams S, Labbok M, Echerd L, Nakaji E. Infant Feeding Area Graphs: Insight for Program

Planning Inputs, Abstract, J Hum Lact 2007;23(1):91. BFHI, poster. 135th Annual Meeting and Exposition, APHA, Washington, DC, November 7, 2007.

Labbok M. ABM News: International update. Breastfeeding Medicine 2006;1(4):278-79. Issues in Implementing the New Growth Standards. Abstract, 135th Annual Meeting and Exposition, APHA, Washington, DC, November 5, 2007.

Labbok M. Common Infant Foods and Lactation Devices: Marketing, Misuse & Mortality. Abstract, 135th Annual Meeting and Exposition, APHA, Washington, DC, November 5, 2007.

Other Invited and/or Sponsored non-refereed works, including papers, book reviews, monographs, newsletters

Arcoverde D, Van Esterik P, Labbok M and P Morrison. Meet Ted Greiner, A Breastfeeding Man and a Visionary. Mother Support Task Force (MSTF) World Alliance for Breastfeeding Action April 2011, 9(1): 11-12.

2006-2010:*McNiel M, Labbok M, Abrahams S. What are the risks associated with formula feeding? A re-

analysis and review. With Permission Birth. Breastfeeding Review. July 2010, 18.2:25-32. Breastfeeding research needs. IOM/USDA Panel, IOM, Washington DC, DATE??Labbok M. Overview of programs. ABC, Friday Center, October 2010.Labbok M. Policy. LCCU, Andrews Center, June 2010.Labbok M. Breastfeeding and contraception. CDC maternity and breastfeeding, May 2010

Labbok M. Why Breastfeed? Risks of Not Breastfeeding. 15th Annual International Meeting Academy of Breastfeeding Medicine, San Francisco CA, October 2010.

Labbok M. The Lactational Amenorrhea Method. Natural Family Planning Meeting, Milwaukee WI, July 16-17, 2010.

Labbok M. IYCN. Global Health Goals and Metrics, GHC, Washington DC, June 14-18, 2010.Labbok M. Breastfeeding in the reproductive health continuum. Women’s Deliver 2010, Washington

DC, June 7-9, 2010.Labbok M. Breastfeeding and Program-Level Medical Eligibility Criteria for use of Hormonal

Contraception. CDC MEC Expert Meeting, 2009.Labbok M. BF and the MDGs. MDG conference, Midego, Inc. 2009.

Labbok M. What’s Happening with Breastfeeding in North Carolina? Southeastern AHEC Mother’s Day, 2009.

Labbok M. Public Health Policy and Advocacy for IBCLCs: Think Globally – Act Locally. LCCU, 2009.

Labbok M. USG Expert Meeting. Call to Action for Breastfeeding, 2009.Labbok M. Evolutionary, Biological and Economic Perspectives. 4th Breastfeeding and Feminism

Symposium, Greensboro, NC, March 26-27, 2009.Labbok M. Enabling Breastfeeding: Programs and Policies that Support the Mother/Baby Dyad Here and

Around the World. LLL/NC, 2009.Labbok M. Breastfeeding: Is it a Right or a Responsibility. UNC Global Student Invited Lecture, 2009.

Labbok M. Hot Topics in Global Breastfeeding. Presentation, 2nd European Conference and Course on Breastfeeding Medicine, ABM/EURO. Vienna, Austria, October 4, 2008.

Labbok M. Why Breastfeeding? Presentation, 2nd European Conference and Course on Breastfeeding Medicine, ABM/EURO. Vienna, Austria, October 3, 2008.

Labbok M. Breastfeeding and Women’s Health. Presentation, Conference of European Lactation Consultants Association. ILCA-VELB, Vienna, Austria, October 2, 2008.

Labbok M. Standing in her Shoes: Commonalities, Differences, and the “Guilt” Issue. State of Vermont WIC, September 16, 2008.

Labbok M. Hot Topics in Breastfeeding. State of Vermont WIC, September 16, 2008.Labbok M. Supporting Exclusive Breastfeeding in the US: How we can make a Difference. WIC, State

of Vermont, September 16, 2008.

Labbok M. Overview – Exclusive Breastfeeding: Rationale and What Works. CORE Core Group Spring Membership Meeting, Atlanta, GA, April 16, 2008.

Labbok M. Public Health Policy and Advocacy for IBCLC’s. LCCU, April 15, 2008.Labbok M. Smillie C. News and Views – quarterly column. Breastfeeding Medicine, 2007-2009.Labbok M. (Keynote Speaker), Taylor E.* United States Breastfeeding Committee. Achieving Exclusive

Breastfeeding in the United States: Findings and Recommendations. Rockville, MD: US Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau, 2008.

Labbok M. Breastfeeding as a Woman’s Right. SEWSA, Charlotte, NC, April 3-5, 2008.Labbok M. Top Ten “Hot” Items for 2008. USCLA Comprehensive Lactation Care II: Honoring Cultural, Social and Physical Diversity, Berkeley, March 14, 2008.

Labbok M. Who owns the Guilt when Breastfeeding does not Happen? USCLA Comprehensive Lactation Care II: Honoring Cultural, Social and Physical Diversity, Berkeley, March 15, 2008.

Labbok M. Update on Successful Programs and Research Findings. Albert Einstein College of Medicine; Project BINGO: Best Infant Nutrition for Good Outcomes – Breastfeeding Promotion & Research: A Workshop for Practitioners, January 30, 2008.

Labbok M. Guilt: Causes, Consequences and Who’s Responsible. Albert Einstein College of Medicine; Project BINGO: Best Infant Nutrition for Good Outcomes – Breastfeeding Promotion & Research: A Workshop for Practitioners, January 30, 2008.

Labbok M. Global Cultural Insights. Albert Einstein College of Medicine; Project BINGO: Best Infant Nutrition for Good Outcomes – Breastfeeding Promotion & Research: A Workshop for Practitioners, January 30, 2008.

Labbok M. Supporting Exclusive Breastfeeding in the US. Albert Einstein College of Medicine; Project BINGO: Best Infant Nutrition for Good Outcomes – Breastfeeding Promotion & Research: A Workshop for Practitioners, January 30, 2008.

Labbok M. Advocacy for Exclusive Breastfeeding: How We Can Make a Difference. Second National Conference of State/Territory Breastfeeding Coalitions (NCSBC), Strength through Diversity: Advancing Breastfeeding Advocacy, January 26, 2008.

Labbok M. Supporting Exclusive Breastfeeding in the US. Breastfeeding Promotion & Research: A Workshop for Practitioners, January 20, 2008.

Labbok M. Global Cultural Insights. Breastfeeding Promotion & Research: A Workshop for Practitioners, January 20, 2008.

Labbok M. Guilt: Causes, Consequences and Who’s Responsible. Breastfeeding Promotion & Research: A Workshop for Practitioners, January 20, 2008.

Labbok M. Hot Topics: Update on Successful Programs and Research Findings. Breastfeeding Promotion & Research: A Workshop for Practitioners. January 20, 2008.

Labbok M. Ethical Issues for Donor Milk Banks. Presentation, 2007 International Congress, Human Milk for Human Infants: Evidence & Application. Human Milk Banking Association of North America, 11:00 AM – 12:00 PM, Fort Worth, TX, November 8, 2007.

*Abrahams S, Labbok M. BFHI. Poster, 135th Annual Meeting and Exposition. APHA, Washington, DC, November 7, 2007.

Labbok M. Issues in Implementing the New Growth Standards. Abstract, 135th Annual Meeting and Exposition, APHA, Washington, DC, November 5, 2007.

Labbok M. Common Infant Foods and Lactation Devices: Marketing, Misuse & Mortality. Abstract, 135th Annual Meeting and Exposition, APHA, Washington, DC, November 5, 2007.

Labbok M. Hot Topics in the World of Breastfeeding: Top Ten List. Bellas, November 2, 2007.Labbok M. Breastfeeding Issues in North Carolina: Disparities, Trends, Outcomes and Next Steps.

Bellas, November 1, 2007.Labbok M. International Perspectives on Breastfeeding. ABM Annual Meeting, Ft Worth, Texas,

October 13, 2007Labbok M. Seeking and Finding Action Synergy. 3rd Annual Symposium on Breastfeeding and

Feminism: 2007 Focus on Reproductive Health, Rights and Justice, September 25, 2007.Labbok M. The Rationale, Development, and Implications of the New WHO Growth Charts.

Presentation, World Breastfeeding Week Celebration in Hong Kong, HABFPC, Hong Kong, July

27-28, 2007. Labbok M. The New WHO Growth Standards: What Clinicians Need to Know. Presentation, World

Breastfeeding Week Celebration in Hong Kong. HABFPC, Hong Kong, July 27-28, 2007.Labbok M. WBW Theme: The Importance of the First Hour and Day for Breastfeeding Success, Health,

Growth and Survival. Presentation, World Breastfeeding Week Celebration in Hong Kong, HABFPC, Hong Kong, July 27-28, 2007.

*Evans K, Labbok M. Breastfeeding, Race/Ethnicity and WIC programs at the County Level in NC. Women in Health, Hilton Head, SC, June 2007.

Labbok M. WIC Prevention Intervention for Better Health Outcomes: Considering the Baby, Mother and Dad in Feeding. Presentation, 24th Annual Conference, National WIC Association, Pittsburgh, PA, May 1, 2007.

Van Esterik P, Clark D, Labbok M et al: contributor/editor. 1990 – 2005 Celebrating the Innocenti Declaration on the Protection, Promotion and Support of Breastfeeding: Past Achievements, Present Challenges and the Way Forward for Infant and Young Child Feeding, UNICEF Innocenti Research Centre, Florence, Italy, 2006.

Labbok M. Breastfeeding in 2006: More Important than ever. Presentation, 134th Annual Meeting and Exposition, APHA, Boston, MA, November 4-8, 2006.

*Labbok M, Echerd L, Nakaji E. Infant Feeding Area Graphs: Insight for Program Inputs. Poster and Abstract, 13th International Conference, Breast Milk: Physiology, Biochemistry & Outcomes, ISRHML, Niagara-on-the-Lake, September 22-26, 2006.

Labbok M. Baby-Friendly Hospital Initiative: Status and Update. Abstract, 13th International Conference, Breast Milk: Physiology, Biochemistry & Outcomes, ISRHML, Niagara-on-the-Lake, September 22-

26, 2006.Labbok M. Exploration of the Issue of Breastfeeding and Guilt. Abstract, 11th International Meeting of

the Academy of Breastfeeding Medicine, Niagara Falls, NY, September 19-21, 2006.Labbok M. Breastfeeding in Emergency Situations. Presentation, 2006 Conference and Annual Meeting,

Interdisciplinary Breastfeeding Practice: Integration through Innovation, International Lactation Consultant Association, Philadelphia, PA, 2:30 – 3:30 PM, July 15, 2006.

Labbok M. An Interdisciplinary Approach to Building an Evidence base in an Academic Setting: Implementing the Concept of “Transdisciplinarity.”Presentation, 2006 Conference and Annual Meeting, Interdisciplinary Breastfeeding Practice: Integration through Innovation, International Lactation Consultant Association, Philadelphia, PA, 3:15 – 4:15 PM, July 14, 2006.

Labbok M. ABM News: International Update. Breastfeeding Medicine, Dec 2006, 1(4): 278 -79.

Labbok M. The Immunologic Secrets of Breastfeeding: A Contribution to Advocacy and Social Marketing? 5th European Conference Lactation & Breastfeeding, May 12 & 13, 2006, MECC Maastricht/NL, May 13, 2005, 3:15 pm – 4:15 pm.

Labbok M. Breastfeeding in the Context of the AIDS Pandemic: 10 Myths. Gender, Child Survival and HIV-AIDS: From Evidence to Policy. York University, Toronto, May 7, 2006.

Labbok M. Breastfeeding as a Feminist Issue. 2nd Annual Breastfeeding and Feminism Conference. UNC Greensboro, NC, March 24, 2006.

Labbok M. Exclusive Breastfeeding: Why Bother? Presentation, International Conference on the Theory and Practice of Human Lactation Research and Breastfeeding Management, Orlando, FL, January 15-16, 2006.

Labbok M. Global Strategy for Infant and Young Child Feeding. Presentation, International Conference on the Theory and Practice of Human Lactation Research and Breastfeeding Management, Orlando, FL, January 15-16, 2006.

Appendix 2: Grants and Contracts

W.K. Kellogg Foundation: 4/1/12 - 3/31/15 Breastfeeding Support Innovation, Evaluation & Replication: Reaching Underserved Populations through Translation. The major goal of this project is translation of research for innovation in intervention research, with the goal of scaling up new approaches in the community.

CDC Subgrant (Pending) for Enhancing the Interstate Collaboration formed under AHRQ funding (below)

NIH - Bonuck, PI Albert Einstein COM Collaboration/BINGO and PAIRINGS [Subcontract] The major goal of this project is to explore breastfeeding outcomes in a predominantly Hispanic population, using differing support approaches. 10/1/11 – 4/30/12

The Carolina Women’s Center Faculty Scholar: awarded for activity in 2011.AHRQ: Interstate Conference on supporting the Ten Steps 2011 The purpose of this project is to support

a conference that will bring together a comprehensive, yet targeted, group of health department and state breastfeeding coalition representatives who are currently working toward systematizing implementation of The Ten Steps in their states’ maternity facilities.

USDHHS/MCH/B Sub grant Complementary support for inter-state collaborative meeting on implementing the Ten Steps 10/1/11 – 4/1/12

CDC: travel support, 10/1/11 – 4/1/12USDHHS/MCH/B Sub grant 2010 Bringing together a field of findings on breastfeeding intervention

and creating a toolkit for further implementation

USFDA 5/1/09 – 4/30/12 Secondary analyses IFPSII analyses on breastfeeding and childcare. The major goal of this project is the analysis of data on breastfeeding outcomes related to childcare using a national dataset.

NC Translational and Clinical Sciences Institute A UNC-UNCG-YWCA-Community Partnership for Women's and Children’s Health: The major goal of this project is to develop an ongoing community site for translational research study, while serving the community in development of improved women and children’s health intervention.

John Rex Foundation 1/1/09 - 3/31/12 Breastfeeding support in Wake County with a Focus on Child Care: The John Rex Endowment awarded the Carolina Breastfeeding Institute resources to improve maternal and child health outcomes in Wake County through increased breastfeeding duration and exclusivity.  This will be achieved by training and providing technical assistance to

the staff of licensed child care centers with the belief that they are prime facilitators of exclusive breastfeeding for six months, and continued breastfeeding to at least one year. 

Kate B. Reynolds Charitable Trust: 1/2009 – 12/2012 Creating Breastfeeding-friendly Services for Improved and Equitable Health Outcomes in NC: implementing the Ten Steps in NC Hospitals serving low wealth populations. The major goal of this project to improve breastfeeding equity employing a phased operational research design using baseline and interval data collection, with addition of an organizational change and key informant interview components. This project will impact on health outcomes by initiating sustainable quality changes in health care practices, rather than introducing additional work for already burdened health care workers. In addition, we will enhance self-sustainability by involving community and health care stakeholders.

AHRQ 2010-11 Effect of Baby Friendly Health Care policies on breastfeeding duration: a survival analysis approach incorporating causal inference: The purpose of this project is to examine the individually attributable marginal effect of exposure to policies reflecting each one of The Ten Steps to Successful Breastfeeding on exclusive breastfeeding and hospital discharge, exclusive breastfeeding duration, and any breastfeeding duration.

The Duke Endowment 1/09 – 12/10 (no cost ext thru 6/30/11) Creating Breastfeeding-friendly Services for Improved and Equitable Health Outcomes in North Carolina: Action in Support of the Recommendations of the North Carolina Blueprint for Protecting, Promoting and Supporting Breastfeeding: The Duke Endowment awarded the Carolina Breastfeeding Institute a two-year grant to create improved health outcomes through breastfeeding support for low-wealth populations. The major goal of this project is to improve breastfeeding equity through hospital-

based improvements and physician trainings. Selected hospitals serve a high proportion of low-income and under-insured mothers and babies.  They will serve as Best Practice Sites from which other maternity facilities to learn more about the process. 

USDHHS/MCH/B Sub grant 1/1/11 - 6/1/11 Bringing together a field of findings on breastfeeding intervention and creating a toolkit for further implementation

UNC Translational and Clinical Sciences Institute 2/15/10 - 5/15/11 A UNC-UNCG-YWCA-Community Partnership for Women's and Children’s Health. The major goal of this project is to develop an ongoing community site for translational research study, while serving the community in development of improved women and children’s health intervention.

1R21HD057815-01 NIH Ringel-Kulka, PI, Labbok Investigator 4/1/09 - 3/31/10 Community Participation Research of Breastfeeding Disparities in African American Women The major goal

of this project is to carry out a Community-Based Participatory Research (CBPR) approach to engage representatives of academic and community-based partners in partnering and collaborating to assess, address and improve breast feeding among African American women in Durham County.

CDC UNC-G Subcontract 9/30/08 - 9/29/09 A public health approach to adolescent breastfeeding promotion

ILCA 8/2008 - 7/2009 Academic Curriculum Development GrantDHHS Office of Women’s Health, 2007 and 2009, Conference support for annual meeting on

Breastfeeding and Women’s Perspectives