Letter of Support - DNPAO

Attachment F12

September 27, 2017
Anjani Chandra, Ph.D.
Principal Investigator
National Survey of Family Growth
National Center for Health Statistics
3311 Toledo Road
Hyattsville, MD 20782
Dear Dr. Chandra,
We are pleased to write to express our support of the National Survey of Family Growth (NSFG)
and to describe some of the ways these data are used in the Division of Nutrition, Physical
Activity, and Obesity (DNPAO) at the Centers for Disease Control and Prevention (CDC).
DNPAO’s mission is to lead strategic public health efforts to prevent and control obesity, chronic
disease, and other health conditions through regular physical activity and good nutrition. NSFG
helps facilitate our work toward that goal in several ways.
NSFG provides data related to breastfeeding initiation rates among women in the United States,
duration that infants are breastfed, and the age at which infants are first introduced to solid
foods and other non-breast milk nutrition. Data related to breastfeeding initiation and duration
in the U.S. are of particular importance to DNPAO since we know that breastfeeding is one of
the most highly effective preventive measures available to improve short- and long-term health
outcomes for both the infant and mother. Increasing access to breastfeeding friendly
environments is one of the Division’s strategic priorities, and having data sources to assess
breastfeeding patterns in the U.S. over time is essential to inform interventions to address that
priority. The American Academy of Pediatrics recommends that infants are exclusively
breastfeed until about 6 months of age, at which time solid foods should be introduced (AAP
2012). NSFG data also enables us to understand how frequently these recommendations are
being followed for U.S. infants over time.
Along with these breastfeeding data, information in NSFG related to maternity leave available to
its female participants have been utilized by our team to examine the associations between
duration of paid leave and breastfeeding initiation and 6-month duration. Authors Mirkovic et
al. found that women who received 12 or more weeks of paid leave were more likely to initiate
breastfeeding and to continue breastfeeding until 6 months, compared to women with no paid
leave.

Beginning in the 2017 data collection cycle, NSFG will begin collecting information related to
counseling mothers receive from health care providers on timing of solid food introduction and
discussion of other nutrition-related topics for their young children, as well as trusted sources of
advice mothers turn to for information related to nutrition for their young children. These data
will be very valuable to help DNPAO understand mothers interactions with the health care
system related to early child nutrition and to identify key potential areas for intervention to
improve the health of young children in the U.S.
In proposing these additions to NSFG, our colleagues at NCHS have been extremely helpful in
providing assistance with the development of the question wording and suggestions for the best
way to integrate them into the survey. They have consistently provided timely updates on the
status of the new questionnaire. NSFG staff have also been readily available answer any
questions we may have related to the use of the NSFG data to explore research questions. We
very much value the relationship that has developed between DNPAO and the NSFG team.
Sincerely,

Rafael Flores-Ayala, DrPH
Chief, Nutrition Branch
Division of Nutrition, Physical Activity, and Obesity
National Center for Chronic Disease Prevention and Health Promotion
Centers for Disease Control and Prevention
4770 Buford Hwy NE, MS F-77
Atlanta, GA 30341-3717
Phone: 770-488-5226
Email: rnf2@cdc.gov