These guidelines have been developed to enable professionals to assist women who are pregnant, or have recently had a child, and who use alcohol or drugs or who have a substance use disorder, to achieve healthy outcomes for themselves and their fetus or infant. They have been developed in response to requests from organizations, institutions and individuals for technical guidance on the identification and management of alcohol, and other substance use and substance use disorders in pregnant women. They were developed in tandem with the WHO recommendations for the prevention and management of tobacco use and second-hand smoke exposure in pregnancy.

"For nearly all infants, breastfeeding is the best source of infant nutrition and immunologic protection, and it provides remarkable health benefits to mothers as well. Babies who are breastfed are less likely to become overweight and obese. Many mothers in the United States want to breastfeed, and most try. And yet within only three months after giving birth, more than two-thirds of breastfeeding mothers have already begun using formula. By six months postpartum, more than half of mothers have given up on breastfeeding, and mothers who breastfeed one-yearolds or toddlers are a rarity in our society. October 2010 marked the 10th anniversary of the release of the HHS Blueprint for Action on Breastfeeding, in which former Surgeon General David Satcher, M.D., Ph. D., reiterated the commitment of previous Surgeons General to support breastfeeding as a public health goal. This was the first comprehensive framework for national action on breastfeeding. It was created through collaboration among representatives from medical, business, women's health, and advocacy groups as well as academic communities. The Blueprint provided specific action steps for the health care system, researchers, employers, and communities to better protect, promote, and support breastfeeding. I have issued this Call to Action because the time has come to set forth the important roles and responsibilities of clinicians, employers, communities, researchers, and government leaders and to urge us all to take on a commitment to enable mothers to meet their personal goals for breastfeeding. Mothers are acutely aware of and devoted to their responsibilities when it comes to feeding their children, but the responsibilities of others must be identified so that all mothers can obtain the information, help, and support they deserve when they breastfeed their infants. Identifying the support systems that are needed to help mothers meet their personal breastfeeding goals will allow them to stop feeling guilty and alone when problems with breastfeeding arise. All too often, mothers who wish to breastfeed encounter daunting challenges in moving through the health care system. Furthermore, there is often an incompatibility between employment and breastfeeding, but with help this is not impossible to overcome. Even so, because the barriers can seem insurmountable at times, many mothers stop breastfeeding. In addition, families are often unable to find the support they need in their communities to make breastfeeding work for them. From a societal perspective, many research questions related to breastfeeding remain unanswered, and for too long, breastfeeding has received insufficient national attention as a public health issue. This Call to Action describes in detail how different people and organizations can contribute to the health of mothers and their children. Rarely are we given the chance to make such a profound and lasting difference in the lives of so many. I am confident that this Call to Action will spark countless imaginative, effective, and mutually supportive endeavors that improve support for breastfeeding mothers and children in our nation."--Page v.

On the basis of a comprehensive literature review and analysis, Nutrition During Lactation points out specific directions for needed research in understanding the relationship between the nutrition of healthy mothers and the outcomes of lactation. Of widest interest are the committee's clear-cut recommendations for mothers and health care providers. The volume presents data on who among U.S. mothers is breastfeeding, a critical evaluation of methods for assessing the nutritional status of lactating women, and an analysis of how to relate the mother's nutrition to the volume and composition of the milk. Available data on the links between a mother's nutrition and the nutrition and growth of her infant and current information on the risk of transmission through breastfeeding of allergic diseases, environmental toxins, and certain viruses (including the HIV virus) are included. Nutrition During Lactation also studies the effects of maternal cigarette smoking, drug use, and alcohol consumption.

A complete resource for any health-care professional to provide expectant and nursing mothers with the most current medical advice on breastfeeding and related topics. Contains additional information on supporting breastfeeding mothers and meeting their specific physical and emotional needs.

The Model Chapter on Infant and Young Child Feeding is intended for use in basic training of health professionals. It describes essential knowledge and basic skills that every health professional who works with mothers and young children should master. The Model Chapter can be used by teachers and students as a complement to textbooks or as a concise reference manual.