Working Parents Support Coalition

Overview and call-to-action

Plan for today

1. Why maternity leave is important for health, breastfeeding and child development – Sandra

2. Working Parents Support Coalition - Luciana

3. Call to action for new members to join

Sandra G Hassink, MD, MS, FAAP

Past President American Academy of Pediatrics

Luciana Nuñez WPSC Founder

CEO Danone Early Life Nutrition US

Parental Leave: Building the Foundations of Health for Children and Families from the Start

Sandra G Hassink, MD, MS, FAAP

Foundations of Health: Goal for Every

Child

Sound, appropriate nutrition

Health-promoting food intake, eating habits

beginning with mother’s pre-conception nutritional

status

Stable, responsive environment of

relationships

Consistent, nurturing, protective interactions

with adults that enhance learning, help develop

adaptive capacities that promote well-regulated

stress response systems

Safe, supportive physical, chemical

and built environments

Provide places for children that are free from

toxins, allow active, safe exploration without fear,

offer families opportunities to exercise, make social

connections

developingchild.harvard.edu/files/5012/8706/2947/inbrief-

health.gif

Threats to the Foundations of

Child Health: National

Diet quality

– Children ages 2-17 who meet federal diet quality

standards: 50%

Obesity

– Children ages 6-17 who have obesity:18%

Food insecurity

– Children living in food insecure homes: 21%

Activity limitation

– Children 5-17 with activity limitation resulting from one or

more chronic health conditions: 9%

Threats to the Foundations of

Child Health: National

Emotional behavioral

Children 4-17 (parent report) who have serious problems with emotions, concentration, behavior, getting along with others 5%

Youth 12-17 with past-year major depressive episode 8%

Early education Children 3-4 not enrolled in preschool 52%

Poverty

Children 0-6 live in low-income households 48% (11% <50% poverty)

How can providing parental leave help?

Promotes healthy nutrition and healthy early feeding

and activity patterns from the start

Opportunity to extend breast feeding, engage in

interactive feeding – hunger and satiety cues

Opportunity to optimize motor development

Provides opportunity for increase parent infant

interaction

Opportunities to promote bonding, literacy, social

emotional health

Breastfeeding is the best feeding for infants

AAP Policy

Breastfeeding

Photo CDC

Breastfeeding at Work

U.S. Department of Health and Human Services. The Surgeon General’s Call to Action to Support Breastfeeding. Washington, DC: U.S.

Department of Health and Human Services, Office of the Surgeon General; 2011.

http://www.centrastate.com/maternity/breastfeeding-your-baby

Breastfeeding at Home Strengthens the relationship

between mother and infant in the critical first months of life Skin-to-skin promotes bonding

and attachment between mother and infant, increases the efficiency of breastfeeding, and enhances the neurological and psychosocial development of the infant

Smillie CM. Baby-led breastfeeding: a neurobehavioral model for understanding how infants learn to feed [presentation]. HealthConnectOne conference: Birth, Breastfeeding and Beyond, Chicago, IL, September 24, 2009.

Perez A, Petersen S. Meeting the needs of the youngest infants in child care. Zero to Three 2009;29:13–17

Infant Benefits: Respiratory Tract Infections and Otitis Media

Reduces risk of hospitalization for lower respiratory tract infections in the first year by 72% with exclusive breastfeeding for more than 4 months

Ip S, Chung M, Raman G,et al., Tufts-New England Medical Center Evidence-based Practice Center.Breastfeeding and maternal and infant health outcomes in developed countries. Evid Rep Technol Assess (FullRep). 2007;153(153):1–186pmid:17764214

Ip S,Chung M,Raman G, Trikalinos TA,Lau J. A summary of the Agency for Healthcare Research and Quality’s evidence report on breastfeeding in developed countries. Breastfeed Med. 2009;4(suppl 1):S17–S30pmid:19827919

Exclusive breastfeeding for more than 6 mos reduced the risk of pneumonia 4X compared to Infants who exclusively breastfed for 4 to 6 months

Chantry CJ, Howard CR, Auinger P. Full breastfeeding duration and associated decrease in respiratory tract infection in US children. Pediatrics. 2006;117(2):425–432pmid:16452362

Infants who breastfed exclusively for 4 months had 74% reduction in severity of Respiratory syncytial bronchiolitis compared with infants who never or only partially breastfed

Nishimura T, Suzue J, Kaji H. Breastfeeding reduces the severity of respiratory syncytial virus infection among young infants: a multi-center prospective study. Pediatr Int.2009;51(6):812–816pmid:19419530

Any breastfeeding compared with exclusive commercial infant formula feeding will reduce the incidence of otitis media (OM) by 23%.

Ip S, Chung M, Raman G,et al., Tufts-New England Medical Center Evidence-based Practice Center.Breastfeeding and maternal and infant health outcomes in developed countries. Evid Rep Technol Assess (FullRep). 2007;153(153):1–186pmid:17764214

Exclusive breastfeeding for more than 3 months reduces the risk of otitis media by 50%. Serious colds and ear and throat infections were reduced by 63% in infants who exclusively breastfed for 6 months

Duijts L, Jaddoe VW, Hofman A, Moll HA. Prolonged and exclusive breastfeeding reduces the risk of infectious diseases in infancy. Pediatrics. 2010;126(1). Available at:www.pediatrics.org/cgi/content/full/126/1/e18pmid:20566605

Infant Benefits - Gastrointestinal Any breastfeeding is associated with a 64% reduction in the incidence of nonspecific

gastrointestinal tract infections, and this effect lasts for 2 months after cessation of breastfeeding Ip S, Chung M, Raman G,et al., Tufts-New England Medical Center Evidence-based Practice

Center.Breastfeeding and maternal and infant health outcomes in developed countries. Evid Rep Technol Assess (FullRep). 2007;153(153):1–186pmid:17764214

Ip S,Chung M,Raman G, Trikalinos TA,Lau J. A summary of the Agency for Healthcare Research and Quality’s evidence report on breastfeeding in developed countries. Breastfeed Med. 2009;4(suppl 1):S17–S30pmid:19827919

Duijts L, Jaddoe VW, Hofman A, Moll HA. Prolonged and exclusive breastfeeding reduces the risk of infectious diseases in infancy. Pediatrics. 2010;126(1). Available at:www.pediatrics.org/cgi/content/full/126/1/e18pmid:20566605

Quigley MA, Kelly YJ, Sacker A. Breastfeeding and hospitalization for diarrheal and respiratory infection in the United Kingdom Millennium Cohort Study. Pediatrics. 2007;119(4). Available at:www.pediatrics.org/cgi/content/full/119/4/e837pmid:1740382

Feeding preterm infants human milk is associated with a significant reduction (58%) in the incidence of necrotizing enterocolitis (NEC)

Ip S, Chung M, Raman G,et al., Tufts-New England Medical Center Evidence-based Practice Center.Breastfeeding and maternal and infant health outcomes in developed countries. Evid Rep Technol Assess (FullRep). 2007;153(153):1–186pmid:17764214

There is a reduction of 52% in the risk of developing celiac disease in infants who were breastfed at the time of gluten exposure

Akobeng AK, Ramanan AV,Buchan I, Heller RF. Effect of breast feeding on risk of coeliac disease: a systematic review and meta-analysis of observational studies. Arch Dis Child.2006;91(1):39–43pmid:16287899

Breastfeeding is associated with a 31% reduction in the risk of childhood inflammatory bowel disease.

Barclay AR, Russell RK, Wilson ML, Gilmour WH, Satsangi J, Wilson DC. Systematic review: the role of breastfeeding in the development of pediatric inflammatory bowel disease. J Pediatr.2009;155(3):421–426pmid:19464699

Reduction in Sudden Infant Death

Syndrome and Infant Mortality

Breastfeeding is associated with a 36% reduced risk of

SIDS Ip S, Chung M, Raman G,et al., Tufts-New England Medical Center Evidence-based

Practice Center.Breastfeeding and maternal and infant health outcomes in developed countries. Evid Rep Technol Assess (FullRep). 2007;153(153):1–186pmid:17764214

A proportion (21%) of the US infant mortality has been attributed, in part, to the increased rate of SIDS in infants who were never breastfed

Chen A, Rogan WJ. Breastfeeding and the risk of postneonatal death in the United States. Pediatrics.2004;113(5). Available at: www.pediatrics.org/cgi/content/full/113/5/e435pmid:15121986

It has been calculated that more than 900 infant lives per year may be saved in the United States if 90% of mothers exclusively breastfed for 6 months

Bartick M, Reinhold A. The burden of suboptimal breastfeeding in the United States: a pediatric cost analysis. Pediatrics. 2010;125(5). Available at:www.pediatrics.org/cgi/content/full/125/5/e1048pmid:20368314

Reduction in Cancer, Obesity, Diabetes 15% to 30% reduction in adolescent and adult obesity rates if any breastfeeding

occurred in infancy compared with no breastfeeding Owen CG, Martin RM, Whincup PH, Smith GD, Cook DG. Effect of infant feeding on the risk of obesity across the

life course: a quantitative review of published evidence. Pediatrics.2005;115(5):1367–1377pmid:15867049

Each month of breastfeeding being associated with a 4% reduction in risk of obesity Ip S,Chung M,Raman G, Trikalinos TA,Lau J. A summary of the Agency for Healthcare Research and

Quality’s evidence report on breastfeeding in developed countries. Breastfeed Med. 2009;4(suppl 1):S17–S30pmid:19827919

Up to a 30% reduction in the incidence of type 1 diabetes mellitus is reported for infants who exclusively breastfed for at least 3 months

Rosenbauer J, Herzig P, Giani G. Early infant feeding and risk of type 1 diabetes mellitus—a nationwide population-based case-control study in pre-school children. Diabetes Metab Res Rev.2008;24(3):211–222pmid:17968982

A reduction of 40% in the incidence of type 2 diabetes mellitus is reported, possibly reflecting the long-term positive effect of breastfeeding on weight control and feeding self-regulation

Das UN. Breastfeeding prevents type 2 diabetes mellitus: but, how and why? Am J Clin Nutr.2007;85(5):1436–1437pmid:17490984

A reduction of 20% in the risk of childhood acute lymphocytic leukemia and 15% in the risk of acute myeloid leukemia for infants breastfed for 6 months or longer

Rudant J, Orsi L,Menegaux F, et al. Childhood acute leukemia, early common infections, and allergy: The ESCALE Study. Am J Epidemiol. 2010;172(9):1015–1027pmid:20807738

Kwan ML, Buffler PA, Abrams B, Kiley VA Breastfeeding and the risk of childhood leukemia: a meta-analysis. Public Health Rep. 2004;119(6):521–535pmid:15504444

Improvement in Neurodevelopmental

Outcomes Adjusted outcomes of intelligence scores and teacher’s ratings are

significantly greater in breastfed infants Kramer MS, Fombonne E, Igumnov S, et al., Promotion of Breastfeeding Intervention Trial (PROBIT)

Study Group Effects of prolonged and exclusive breastfeeding on child behavior and maternal adjustment: evidence from a large, randomized trial. Pediatrics. 2008;121(3). Available at:www.pediatrics.org/cgi/content/full/121/3/e435pmid:18310164

Kramer MS, Aboud F, Mironova E, et al., Promotion of Breastfeeding Intervention Trial (PROBIT) Study Group. Breastfeeding and child cognitive development: new evidence from a large randomized trial.Arch Gen Psychiatry. 2008;65(5):578–584pmid:18458209

Kramer MS, Chalmers B, Hodnett ED, et al., PROBIT Study Group (Promotion of Breastfeeding Intervention Trial). Promotion of Breastfeeding Intervention Trial (PROBIT): a randomized trial in the Republic of elarus. JAMA. 2001;285(4):413–420pmid:11242425

Significantly positive effects of human milk feeding on long-term neurodevelopment are observed in preterm infants, the population more at risk for these adverse neurodevelopmental outcomes.

Vohr BR, Poindexter BB, Dusick AM, et al., NICHD Neonatal Research Network. Beneficial effects of breast milk in the neonatal intensive care unit on the developmental outcome of extremely low birth weight infants at 18 months of age. Pediatrics. 2006;118(1). Available at:www.pediatrics.org/cgi/content/full/118/1/e115pmid:16818526

Vohr BR, Poindexter BB, Dusick AM, et al.National Institute of Child Health and Human Development National Research Network. Persistent beneficial effects of breast milk ingested in the neonatal intensive care unit on outcomes of extremely low birth weight infants at 30 months of age.Pediatrics. 2007;120(4). Available at: www.pediatrics.org/cgi/content/full/120/4/e953pmid:17908750

Lucas A, Morley R, Cole TJ. Randomised trial of early diet in preterm babies and later intelligence quotient. BMJ. 1998;317(7171):1481–1487pmid:9831573

Cognitive and Behavioral Effects

Maternal work in the first year of life is associated with decreases in reading and math test scores at ages 3–11

Baum CL. Does early maternal employment harm child development? an analysis of the potentialbenefits of leave taking. Journal of labor Economics. 2003; 21(2):409–448.

Berger LM, Hill J, Waldfogel J. Maternity leave, early maternal employment and child health anddevelopment in the us*. The Economic Journal. 2005; 115(501):F29–F47.

Maternal return to work within the first 12 weeks of her child's life is associated with reduced breastfeeding and immunizations and increased behavior problems in early childhood

Negative effects of maternal work are partially offset by

the positive effects of increases in income Berger LM, Hill J, Waldfogel J. Maternity leave, early maternal employment

and child health anddevelopment in the us*. The Economic Journal. 2005; 115(501):F29–F47.

Improved Maternal Outcomes

Decreased postpartum blood loss and more rapid involution of the uterus

Continued breastfeeding leads to increased child spacing secondary to lactational amenorrhea

Increase in postpartum depression in mothers who do not breastfeed or who wean early Henderson JJ, Evans SF, Straton JA, Priest SR, Hagan R. Impact of postnatal depression on breastfeeding

duration. Birth. 2003;30(3):175–180pmid:12911800.

Rate of child abuse/neglect perpetrated by mothers was significantly increased for mothers who did not breastfeed as opposed to those who did (OR: 2.6; 95% CI: 1.7–3.9).

Strathearn L, Mamun AA, Najman JM, O’Callaghan MJ.Does breastfeeding protect against substantiated child abuse and neglect? A 15-year cohort study. Pediatrics.2009;123(2):483–493pmid:191716136

In mothers without a history of gestational diabetes, breastfeeding duration was associated with a decreased risk of type 2 diabetes mellitus; for each year of breastfeeding, there was a decreased risk of 4% to 12%

Stuebe AM, Rich-Edwards JW, Willett WC, Manson JE, Michels KB. Duration of lactation and incidence of type 2 diabetes. JAMA. 2005;294(20):2601–2610pmid:16304074

Schwarz EB, Brown JS, Creasman JM, et al. Lactation and maternal risk of type 2 diabetes: a population-based study. Am J Med. 2010;123(9):863.e1–.e6

Women with a cumulative lactation history of 12 to 23 months had a significant reduction in hypertension (OR: 0.89; 95% CI: 0.84–0.93), hyperlipidemia (OR: 0.81; 95% CI: 0.76–0.87), cardiovascular disease (OR: 0.90; 95% CI: 0.85–0.96), and diabetes (OR: 0.74; 95% CI: 0.65–0.84).

Schwarz EB, Ray RM, Stuebe AM, et al. Duration of lactation and risk factors for maternal cardiovascular disease. Obstet Gynecol. 2009;113(5):974–982pmid:19384111

Cumulative duration of breastfeeding of longer than 12 months is associated with a 28% decrease in breast cancer (OR: 0.72; 95% CI: 0.65–0.8) and ovarian cancer (OR: 0.72; 95% CI: 0.54–0.97) Each year of breastfeeding has been calculated to result in a 4.3% reduction in breast cancer.

Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease. Lancet.2002;360(9328):187–195pmid:12133652

Economic Benefit

A detailed pediatric cost analysis based on the

AHRQ report concluded that if 90% of US mothers

breastfeed exclusively for 6 months, there would be

a savings of $13 billion per year

The savings do not include those related to a reduction in

parental absenteeism from work or adult deaths from

diseases acquired in childhood, such as asthma, type 1

diabetes mellitus, or obesity-related conditions. Bartick M, Reinhold A. The burden of suboptimal breastfeeding in the United

States: a pediatric cost analysis. Pediatrics. 2010;125(5). Available

at:www.pediatrics.org/cgi/content/full/125/5/e1048pmid:20368314

• U.S. Department of Health and Human Services. The Surgeon General’s Call to Action to Support Breastfeeding.

Washington, DC: U.S. Department of Health and Human Services, Office of the Surgeon General; 2011.

Percent US Children Breastfed by 6 mo

Lack of parental leave can be a significant

barrier to breastfeeding

Women intending to return to work within a year after childbirth are less likely to initiate breastfeeding

Mothers who work full-time tend to breastfeed for shorter durations than do part-time or unemployed mothers

Johnston ML, Esposito N. Barriers and facilitators for breastfeeding among working women in the United States. J Obstet Gynecol Neonatal Nurs 2007;36:9–20.

Fein SB, Roe B. The effect of work status on initiation and duration of breast-feeding. Am J Public Health 1998;88: 1042–1046.

Women with longer maternity leaves are more likely to combine breastfeeding and employment.

Arthur CR, Saenz RB, Replogle WH. The employment-related breastfeeding decisions of physician mothers. J Miss State Med Assoc 2003;44:383–387.

In a survey of 712 mothers, each week of maternity leave increased the duration of breastfeeding by almost one-half week.

Roe B, Whittington LA, Fein SB, Teisl MF. Is there competition between breastfeeding and maternal employment? Demography 1999;36:157–171.

Jobs that have less flexibility and require long separations of mother and baby further complicate breastfeeding

Kimbro RT. On-the-job moms: work and breastfeeding initiation and duration for a sample of low-income women. Matern Child Health J 2006;10:19–26.

Hourly wage workers face different challenges than salaried workers They typically have less control over their schedules

Their pay may be reduced if they take breaks to express breast milk. Brown CA, Poag S, Kasprzycki C. Exploring large employers’ and small employers’ knowledge, attitudes, and practices on breastfeeding support in the workplace. J Hum Lact

2001;17:39–46.

U.S. Department of Health and Human Services. The Surgeon General’s Call to Action to Support Breastfeeding. Washington, DC: U.S. Department of Health and Human Services, Office of the Surgeon General; 2011.

Mothers returning to work

2 out of 3 women in their third trimester of pregnancy said they planned to breastfeed exclusively in the first few weeks

But mothers planning to return to work within 6 weeks were 40% less likely to say they expected to breastfeed exclusively than those planning to return to work after 12 weeks.

MirkovicKR et al. J Hum Lact. 2014;30[3]:292-297

30% of pregnant women who intended to breastfeed for at least 3 months did not

Women who returned to work full time before 6 weeks were least likely to breast feed for 2 months.

Mirkovic KR et al. J Hum Lact. 2014;30[4]:416-419).

Employed mothers

Lower initiation rates

Shorter duration of breastfeeding

Rates of breastfeeding initiation and duration are

higher in women who have longer maternity leave

work part-time rather than fulltime and have

breastfeeding support programs in the workplace. • U.S. Department of Health and Human Services. The Surgeon General’s Call to Action to Support

Breastfeeding. Washington, DC: U.S. Department of Health and Human Services, Office of the

Surgeon General; 2011.

Parental leave

Most women need 4 to 6 weeks to physically recover

from giving birth before returning to work (longer for

a C section) 7th edition of Guidelines for Perinatal Care, published by the American

Congressof Obstetricians and Gynecologists(ACOG) and the American

Academy ofPediatrics (AAP) (http://bit.ly/1TOAjN6p 208)

The lack of paid maternity leave has been linked to

lower rates of breastfeeding and childhood

immunizations and higher rates of infant and child

mortality and depression in mothers Hajizadeh M et al. Soc Sci Med.2015;140:104-117; Heymann J et al.

PublicHealth Rep. 2011;126[suppl 3]:127-134

Maternal stress

Among mothers of 6-month-old infants maternal work hours were

positively associated with depressive symptoms and parenting stress

and negatively associated with mothers’ assessment of their overall

health

No difference in the quality of their parenting compared with the

mothers who were not working. Chatterji P et al. J Popul Econ. 2013;26[1] 285-301

Increases in symptoms of depression in mothers with less than 12

weeks of maternity leave and mothers with less than 8 weeks of paid

maternity leave were both associated with increases in depressive

symptoms Chatterji and Markowitz.J Ment Health Policy Econ. 2012;15[2]:61-76).

The United States the ONLY

developed country in the

world that does not require paid maternity leave.

At least 178 countries have

enacted laws to provide paid leave to new mothers, with more than

100 of those offering 14 or

more weeks of paid leave.

Maternity leave: the global landscape

The Family & Medical Leave Act was enacted in 1993 providing 12 weeks of protected, unpaid time off to full-time employees at companies with 50 people or more.

40% of workers are not covered by FMLA.

Resulting in: Financial stress to mom and family

Delaying essential medical appointments for newborns

Mothers ceasing breastfeeding early Mothers exiting the work force

Employee turnover Increased costs to recruit replacements

The reality in the US

Why does maternity leave matter to us

Our mission: Bring health through food

to as many people as possible

Health goals

Business goals

Employer goals

Reduce rates of maternal

anemia by 50%

No increase in childhood

obesity

Increase rate of exclusive

breastfeeding at 6 months to at

least 50%

• “War on talent” accelerating • Next generation are Millenials, for whom social company values and work/life

balance are key decision criteria.

Companies are proactively stepping up Strong momentum, driven by technology companies and starting to expand to “mainstream” industries

But we can do more if we work together…

Mission

Drive a collective commitment to a range of parental support practices that ultimately improve health, development, and economic outcomes for both families and companies

Vision/Purpose

By working together and partnering with leading experts, the coalition is a resource of best practices and data which is shared amongst members and with other companies looking to better support their working parents.

Q1

Initial discussions

with CGI

Shaping commitment

areas with partners

Q2 July

Summer meeting CGI

Barclays & KKR on board

August

E&Y, Nestle and new

partners on board

September

Finalizing individual

commitments and public

launch

Q4

Commitments ongoing and new partners

on board

Q1

Inaugural meeting:

4 workstreams

Milestones so far

2015

Q2

New members

to be announced

2016

Commitment to Action Improving parental support practices for positive impact

Three focus areas

Company culture In-office support Longer / paid leave

• Flexible return to work policies

• Create a culture of support

• Train managers / leaders

• Dedicated, appropriate lactation facilities

• Scheduling • Train managers,

educate parents

• Longer unpaid leave • Paid leave • Create awareness of

business case behind

1 2 3

Examples of individual commitments

6 months paid leave for primary caregivers

Breastfeeding support: 100% of employees with access to

upgraded breastfeeding rooms and CLC support

Flexible return-to-work parental policies

Double number of fathers taking

paternity leave Measure impact of

new policy in HR KPI’s

Breastfeeding support: child care companion during business trips,

shipment of breast milk, access to CLC

Metrics:

1. Defining common KPI’s

2. How can we measure it?

3. Plan to measure

Best practices:

1. Develop best practice toolkit (including breastfeeding chapter) by Q4

2. Build as open source to continuously update

Education:

1. Nutrition, breastfeeding and child development (pilot together with AAP)

2. Coaching for transitions: pilot scalable strategies building on existing experience from EY

Expansion:

1. Members: goal to get to 10 high-impact companies by year end

2. PR: create a 1st year update campaign around next CGI / UN General Assembly

Areas of common work for 2016

• Higher breastfeeding rates => lower risk of obesity (moms and babies), less NCD’s, lower incidence of allergies. Lower risk of breast and ovarian cancer => Healthcare savings of >$60Bio to the system

• Better early life brain development => higher IQ, intellectual abilities, closing the word gap => prosperity and equality for the next generation.

• Leave of ~9 weeks can lower infant mortality by 10%

Social

Economic

Health

Women advancement

Families

Companies

• Increasing women participation in the workforce = $4.3T by 2020.

• 15% above average financial returns; +53% return on equity +42% return on sales , 48% higher EBIT

• Higher return to work rates correlate with professional, economic and personal progress.

• Retaining two stable incomes

• Essential source for single mothers

• Better maternity leave makes women 50% more likely to increase lifelong wages

• Economic benefits of improvement (inclusion,

productivity and retention)

outweigh cost

• Increase # of women in workforce = more competitive economy and employers more (US

declining & below other developed nations)

• Macroeconomic benefits of a larger tax base, lower government health costs (-39%)

Multiplying the impact by working together

Leveraging media to help inspire others

Our ambition

New members by December 2016

What we expect from members

Commitments to action to support parents in the workplace that are: 1. New 2. Specific 3. Measurable

What members get out from the Coalition

1. Network 2. Best practice building 3. Best practice sharing 4. PR impact 5. Collective impact

How to join the coalition

Please connect before August: Luciana.nunez@danone.com