1. Spatz, Diane L. PhD, RN-BC, FAAN

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Every year in the United States, approximately 4 million women give birth and over 80% initiate breastfeeding (Centers for Disease Control and Prevention [CDC], 2017, National Center for Health Statistics, 2018). Despite these large numbers, there is little research specific to pregnant and lactating women in the United States. As part of the 21st Century Cures Act, which was signed into law by President Obama, a congressional task force was mandated to address this major gap in research.


The Task Force on Research Specific to Pregnant Women and Lactating Women (PRGLAC, 2018) was established to advise the Secretary of Health and Human Services (HHS) on current gaps in research for pregnant and lactating women. This task force will report findings back to the Secretary of HHS by the end of 2018. The task force includes federal government partners such as the National Institutes of Health, the National Institute of Child Heath and Development, the CDC, the HHS Office of Women's Health, and the HHS National Vaccine Program Office, and the Food and Drug Administration (PRGLAC). Nonfederal members include representatives from key healthcare professional societies, nonprofit organizations, and pharmaceutical industry.


As a member of this Task Force and the only PhD-prepared nurse member, I felt compelled to write about the critical need for nurses to be aware of the gaps in research as well as the importance of being attuned to current legislative, governmental, and policy initiatives. One significant issue that I have brought to the Task Force in the critical need for research specific to lactation particularly related to milk supply concerns of mothers. Over 50% of U.S. women report milk supply concerns as a reason for breastfeeding termination during the infant's first year (Li, Fein, Chen, & Grummer-Strawn, 2008). Using current U.S. births and breastfeeding women, this issue is important to 1.6 million women today. If a mother experiences true low milk supply, there are no pharmacologic interventions available to her in the United States. An increasing body of research has demonstrated the critical window of opportunity for women to effectively establish a normal milk supply (average of 700-800 mL per day, range 440-1,220 mL) and as nurses we have an obligation to provide evidence-based lactation education, care, intervention, and support to ensure that mothers can reach their personal breastfeeding goals (Spatz, 2018). Despite best efforts in promoting breastfeeding in the United States, only 22% of infants are exclusively breastfed for the first 6 months (National Center for Health Statistics, 2018) and although multiple factors can influence breastfeeding rates (familial and social support, return to work, etc.), milk supply is of upmost importance.


If a mother does not develop a copious milk supply early on, she is not going to be a long-term breastfeeding mother. It is my hope that PRGLAC will lead to an increase in awareness, funding, and research that is clearly indicated. Mothers should have pharmacologic treatment options for low milk supply beyond herbal preparations which are used by many mothers but have little published research on their effectiveness. Nurses are the largest healthcare professionals in the United States and need to be aware of these initiatives and opportunities. Nursing research on this important topic is very much needed.




Centers for Disease Control and Prevention. (2017) Breastfeeding report cards. Retrieved from [Context Link]


Li R., Fein S. B., Chen J., Grummer-Strawn L. M. (2008). Why mothers stop breastfeeding: Mothers' self-reported reasons for stopping during the first year. Pediatrics, 122(Suppl. 2), S69-S76. doi:10.1542/peds.2008-1315i [Context Link]


National Center for Health Statistics. (2018). Births; Final data for 2016. Retrieved from [Context Link]


Spatz D. L. (2018). Helping mothers reach their personal breastfeeding goals. Nursing Clinics of North America. 53(2), 253-261. doi:10.1016/j.cnur.2018.01.011 [Context Link]


Task Force on Research Specific to Pregnant Women and Lactating Women (PRGLAC). Retrieved from