May 5, 2016


In June 2015, Alison Stuebe, MD, was named Distinguished Scholar of Infant and Young Child Feeding at the Gillings School of Global Public Health. Her work in the Gillings School’s Department of Maternal and Child Health and the Carolina Global Breastfeeding Institute is supported by a generous gift from an anonymous donor, with the aim to advance – locally and globally – the science and practice of breastfeeding.

“I am thrilled to have this opportunity to forge collaborations with colleagues across the University,” she says. “By supporting more women in achieving their breastfeeding goals, we can improve health across two generations and around the world.”

Stuebe, who also is associate professor of obstetrics and gynecology in the UNC School of Medicine, calls breastfeeding “the ultimate public health behavior.” Babies who are breastfed have lower risk of ear, respiratory and gastrointestinal infections, she says, and of sudden infant death syndrome and leukemia. Mothers who have breastfed have lower risks of diabetes, heart attacks, and cancers of the breast and ovaries.

“Given these benefits, why wouldn’t we want to help every mother to achieve her breastfeeding goals?” Stuebe asks. “What if all children had an optimal chance to grow, thrive and reach their full potential, and all mothers could experience pregnancy, birth and parenting as an empowering and health-giving experience? If you look at all the things that medicine and public health can do to improve people’s well-being, few are even in the ballpark with breastfeeding.”

In January 2016, Stuebe and colleagues were selected by the Patient-Centered Outcomes Research Institute to receive a Eugene Washington PCORI Engagement Award to define unmet patient-centered health-care needs during the three months after a mother gives birth.

“The Fourth Trimester Project” will do just that. The project brings together mothers, health-care providers and other stakeholders to determine what mothers and infants need during the trimester after birth.

Many women experience considerable challenges during this period, including fatigue, pain, breastfeeding difficulties, depression, lack of sexual desire and incontinence. Postpartum care may be fragmented among maternal and pediatric providers; between 20 percent and 40 percent of women do not attend a postpartum visit. Rising maternal mortality and morbidity in the U.S. have made this work an even greater priority.

“In standard maternity care, we see a mother weekly in the month before her due date – and then, once the baby is born, we go six weeks without seeing her,” Stuebe said. “Every mother deserves comprehensive support to recover from birth and develop confidence to care for her baby. With this project, we will partner with mothers to discover the support they need.”

“This project was selected for funding not only for its commitment to engaging patients and others, but also for its potential to increase the usefulness and trustworthiness of the information we produce and facilitate its dissemination and uptake,” says Jean Slutsky, PCORI’s chief engagement and dissemination officer. “We look forward to following the project’s progress and working with UNC to share the results.”

Stuebe says that UNC-Chapel Hill, as a premier university, has an obligation to serve the people of North Carolina.

“We want to see reductions in infant mortality in our state,” she says. “We want reductions in obesity and the chronic conditions, such as diabetes, associated with obesity. I feel fortunate to help extend the bridges from our world-class breastfeeding institute to communities in North Carolina and around the world.
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Joining Stuebe as lead investigators for The Fourth Trimester Project are Sarah Verbiest, DrPH, clinical associate professor at the School of Social Work and executive director of the Center for Maternal and Infant Health in the UNC School of Medicine, and Kristin Tully, PhD, research associate at the Carolina Global Breastfeeding Institute in the Gillings School’s Department of Maternal and Child Health.

Hear Stuebe discuss the bright future of the Carolina Global Breastfeeding Institute at tinyurl.com/stuebe-video-WOD.


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Carolina Public Health is a publication of the University of North Carolina at Chapel Hill Gillings School of Global Public Health. To view previous issues, please visit sph.unc.edu/cph.