Tag: breastfeeding

Addressing breastfeeding disparities across the United States

By Valentina Giraldo Lozano, intern at 1,000 Days of FHI 360

Breastfeeding provides a fundamental contribution to early childhood nutrition and health. However, in the United States its benefits are not experienced by everyone equally, as breastfeeding rates vary significantly by race and ethnicity.

The national breastfeeding rate in the United States is relatively high: about 84% of infants are breastfed at birth. But when broken down by race and ethnicity, we see drastic disparities: the CDC reports that, at birth, 92.7% of Asian infants and 86.2% of white infants are breastfed, with rates dropping to 81.9% for Hispanic infants, 78.4% for Indigenous infants, and 77.3% for Black infants.  Black, Hispanic, and multiracial parents are also less likely to breastfeed for the recommended six months, compared to the U.S. national rate.

Multiple factors contribute to these disparities, including access to healthcare, socio-economic status, cultural norms, employment and childcare challenges and systemic racism.

The disparity in support often starts at the hospital, with maternity care facilities serving Black populations being much less likely to offer lactation support. A long history of medical racism and targeted marketing of formula to Black mothers also plays a role in Black mothers not being supported to breastfeed by medical professionals.

Low breastfeeding rates may also be a reflection of negative cultural perceptions of breastfeeding and a lack of support from breastfeeding role models in a mother’s family and community. Peer counseling and support groups can significantly increase breastfeeding rates and provide quality information in a culturally sensitive manner.

Socio-economic status and your job type can also play a role. Many lower-income jobs do not provide workplace supports that would support sustained breastfeeding, such as access to the Family and Medical Leave Act (FMLA) or employer provided- paid leave, flexible work schedules, or support for breastfeeding or expressing milk at work. This forces lower-income women to return to work sooner than other women, cutting short their opportunity to establish breastfeeding routines.

Racial and ethnic disparities in breastfeeding rates have significant implications for health and for future social and economic outcomes. Suboptimal breastfeeding rates are associated with a greater burden of disease among Hispanic and Black populations: the rates of the ear infection acute otitis media and necrotizing enterocolitis (the most common and serious intestinal disease among premature babies) are much higher in Black and Hispanic children than white children, as is the number of excess child deaths.

Policies have real impact

Breastfeeding doesn’t happen in a vacuum – to be successful, families need supportive policies. New hard-won policies, like the PUMP Act and the Pregnant Workers Fairness Act, are significant steps in the right direction. But stronger support is necessary, especially for Black, Hispanic, and Indigenous women who face significant barriers to breastfeeding.

Federal and state governments must take decisive action to ensure that all mothers have the support they need to breastfeed their children. This includes enforcing comprehensive policies like the PUMP Act, extending paid family leave, and ensuring workplace accommodations for breastfeeding mothers. Raising awareness about existing disparities and advocating for stronger, more inclusive breastfeeding support systems is essential for achieving equitable health outcomes among all parents and children. Employers, policymakers, and community leaders must collaborate to create environments that support breastfeeding mothers.

This year, the theme for National Breastfeeding Month is Nourish, Sustain, Thrive. Nourishing, sustaining, and thriving means ensuring that all mothers, regardless of race or socio-economic status, have the support they need to breastfeed during the critical first 1,000 days. By addressing disparities in breastfeeding rates and advocating for robust, inclusive policies, we can promote the health and well-being of infants and mothers across diverse communities. The journey toward equitable health outcomes begins with every drop of breast milk, and it’s a journey we must all support.

Nourishing, surviving, and thriving with breastfeeding

Breastfeeding gives babies the very best start to life—and benefits that reach far into the future. Breastmilk is nature’s perfect first food, tailor-made for babies providing all the nutrition including vitamins, proteins and fats that they need for the first six months of life. It also acts as a baby’s first vaccine, protecting them from common childhood illnesses.

Despite all the great benefits, both globally and across the United States, breastfeeding rates are low, risking malnutrition and disease for both mothers and babies.

As World Breastfeeding Week and National Breastfeeding Month begin, 1,000 Days celebrates the progress made to support families in breastfeeding their babies, while also recognizing the additional steps that need to be taken to truly support all those who chose to initiate and sustain breastfeeding.

This year, the theme for World Breastfeeding Week (August 1-7) is Closing the Gap: Breastfeeding Support for All. Globally, breastfeeding rates have increased by 10 percentage points over the past decade to 48%, nearly reaching the World Health Assembly target of 50% by 2025. However, despite the increase, wide discrepancies remain between individual countries; in some places, rates remain as low as 20%. The consequences of not breastfeeding can be deadly and lead to mass financial loss. Nearly 500,000 children and nearly 100,000 women die each year due to inadequate breastfeeding. These preventable deaths, combined with cognitive losses, and health system costs of inadequate breastfeeding leads to over US$570 billion in economic losses annually.

Here in the United States, most babies start out being breastfed, but the rates drop quickly and suddenly a few months into life when mothers return to work. Only 1 in 4 American babies is exclusively breastfed at six months of age, due in no small part to workplace barriers and a lack of paid maternity leave. We join with National Breastfeeding Month organizers the U.S. Breastfeeding Committee to honor the incredible work that organizations across the country are doing to make the world a little more friendly for new parents and families, and celebrate the following observances across the month:

We welcome you to join us this month to shine a light on why protecting, promoting, and supporting breastfeeding is so important. You can find our 2024 Inspiration Guide, featuring social media messaging and graphics, here.

Follow along on our Twitter/X, LinkedIn, Facebook and Instagram all month long!

Guest Post: Fighting for the Health of Women, Children and Community in Guatemala – Access to Health Care #Marchis4Nutrition

In honor of National Nutrition Month in March, 1,000 Days is amplifying the critical role the world’s mothers play in nourishing the next generation through our annual online #Marchis4Nutrition campaign. Throughout the month, we will also be highlighting stories from our partners. Follow along and get involved on Twitter and Facebook with the hashtag #Marchis4Nutrition.

The National Alliance of Indigenous Women for Reproductive Health (ALIANMISAR) consists of more than 90 organizations and actively participates in citizen monitoring, advocacy, and policy dialogue to promote better, more culturally-appropriate health services that are accessible to the indigenous populations, especially those living in rural areas and in poverty.

Vitalina de Leon Santos is a member of ALIANMISAR in Guatemala. This is her story.

My name is Vitalina de León Santos, I am 45 years old, married to Miguel Ajxup, a construction laborer, I live in the municipality of Momostenango, department of Totonicapán, Guatemala. I am the mother of two girls and a boy. The health of my children is my priority and although my family have scarce resources, I try to give them as much care as possible following the recommendations of the health services.

In 2012, municipality residents encouraged me to join the National Alliance of Indigenous Women for Reproductive Health (ALIANMISAR), which supports the HP+ project with USAID funds, to fight for our reproductive rights. In this organization, I have been involved in the training process that helped me to become aware, first of all, of the need to value myself as a woman and of the importance of my children’s health care. Since I became pregnant with my last daughter, Astrid Mireya Yulisa Ajxup de León 5 years ago, I took everything I learned into account and during my pregnancy I attended the health center to receive prenatal care where I was provided with iron and folic acid which I consumed with full knowledge of its importance. After the birth of Astrid, I gave her exclusive breastfeeding from the first hour of birth until she was 6 months old. I fed myself with cereals and stimulating herbs so that I had enough milk and my daughter was well nourished. After the six months, I have always tried to give her a healthy and nutritious diet.  I also attended the Health Center so that my daughter had her complete immunization schedule, vitamins and deworming medications.

My daughter is 4 years old now and I am very proud because I believe that these efforts have results in her good health, since she has not been malnourished and has not become ill, despite the fact that in my community many children are suffering malnutrition (The chronic malnutrition rate in children under 5 is 52% in Momostenango Municipality, one of the highest in the country).

Now, as ALIANMISAR municipal coordinator, I participate in the meetings of the Municipal Commission for Food and Nutritional Security of Children and Adolescents, as well as the Municipal Development Council, which allows us to advocate for the approval of projects that benefit the health of our people.   This is the case of the extension of the municipal capital health center for weight and height monitoring, which was requested to the municipality in 2017 and is currently being built.

I have also become a counselor about the upbringing and feeding of children in my community, visiting mothers to share the knowledge acquired in ALIANMISAR.

The ALIANMISAR is an organization of indigenous women that ensures compliance with reproductive rights and nutrition, with cultural relevance, through advocacy, monitoring and policy dialogue to promote the formulation and implementation of public policies that contribute to reducing maternal mortality and chronic malnutrition in Guatemala.

Guest Post: Conquering Nutrition Myths in Myanmar – Breastfeeding #Marchis4Nutrition

In honor of National Nutrition Month in March, 1,000 Days is amplifying the critical role the world’s mothers play in nourishing the next generation through our annual online #Marchis4Nutrition campaign. Throughout the month, we will also be highlighting stories from our partners. Follow along and get involved on Twitter and Facebook with the hashtag #Marchis4Nutrition.

Save the Children believes every child deserves a future. They work in 120 countries around the world to give children a healthy start in life, the opportunity to learn and protection from harm. Save the Children does whatever it takes for children – every day and in times of crisis – transforming their lives and the future we share.

Save the Children works in many communities with mothers such as Ms. La Min to provide robust health and nutrition programs that save children’s lives and ensure they grow up healthy.

This is Ms. La Min’s story from Myanmar.

I thought that formula was better than my own breast milk because I had very limited knowledge about the benefits of breastfeeding – and also because of marketing by the formula companies.

They claim that formula is good for my child’s IQ and every mother wants to give the best to their child. Therefore, I thought it should not be a problem if I cannot breastfeed, because I can afford to buy formula instead. So I choose formula against my own breast milk.

Then, I realized that my child was getting sick at least two times a month and I needed to bring her to the hospital very frequently while I was giving formula to her. Her immunity was very low. I started thinking that something is going wrong. Later on, I became more aware about the benefits of breastfeeding and that “Breast milk is the best” by reading educational materials.

I thought formula was better for my baby’s IQ because of the marketing and because I didn’t have appropriate knowledge before. Moreover, every mother I saw at the antenatal clinic said that formula is better for children’s IQ. Then, I became to believe in formula.

Infant formula is heavily marketed at hospitals and at baby counters in shopping centers. When I went shopping to prepare for my delivery, I saw so many different formulas. Whenever I visited the hospital or shopping centers I saw promotional messages everywhere. They say that they have Dumex and Similac. They also say that Similac is more expensive but that is because it is the best. Sale attendants told to every mother like that. Every mother also say that Similac is good.

When I delivered my baby, I spent time with a nurse from the hospital because I didn’t have experience with child caring. The nurse said to me “You don’t need to breastfeed. Formula is better for your baby to be strong and have good IQ.” That was also one of the reasons I trusted in formula.

The nurses themselves are believing the wrong things because of those companies. Not only nurses but also many doctors. I was even shout at by a doctor for not giving formula to my baby. When they weighed my baby, the doctor said that my baby’s weight was below what it should be – and he said it was because I quitted the formula. I replied that I quitted because my lactation consultant told me that I don’t need to give formula, my breast milk is the best.

I want to know everything about breastfeeding. I have known most of the breastfeeding information for a mother-writer, so now I want to help other mothers. What I feel very sad about is that people from my native town believes my baby is smart because I gave her formula. Actually, it is not because of formula. It’s because of other measures such as how I’m taking care of her. I find it very difficult to explain my friends from home town.

Another story is in Yangon, in my neighborhood, there is a mother who operates a photo-copy shop. She can breastfeed well. One day, when her baby was about 3 or 4 months old, she told to me that she is very sad because she cannot afford buying formula. I asked her “Is it because you have no breast milk?” She said “No, I have enough breast milk. I want to give formula because every other mothers are giving formula.” I told them that breast milk is the best but they don’t believe me. The messages from the advertisements are nailed in their head.

I feel really sad because my husband still wants to give formula to our daughter because he wants her to be a big baby. In the battle of breastfeeding – the doctor and my husband are on the formula’s side and I’m the only one on the side of breast milk. We are always fighting. It’s very disappointing.

#Marchis4Nutrition: What if Moms had access to the support needed to reach their breastfeeding goals?

In honor of National Nutrition Month, 1,000 Days is kicking off its annual #Marchis4Nutrition campaign to amplify the critical role the world’s mothers play in nourishing the next generation. During the next 4 weeks, we will be imagining a world in which moms have the support they need to give their children a healthy start to life. This week we’re asking:

What if moms had access to the support needed to reach their breastfeeding goals?

A world in which women receive support to breastfeed is a world in which women and children thrive. Enabling women to breastfeed for as long as they desire would result in less illness and disease, as breastfeeding plays a key protective role for infant health.  Fewer children would die from diarrhea and pneumonia – two of the leading causes of child mortality globally – as well as Sudden Infant Death Syndrome (SIDS)—a leading cause of infant mortality in the U.S. If babies were breastfed early and exclusively for the first 6 months, evidence shows that over 820,000 lives could be saved each year.

And it is not just babies who would benefit from breastfeeding. For every year a mother breastfeeds, she significantly reduces her risk of developing ovarian cancer, invasive breast cancer and heart disease.

“If moms had access to the support needed to reach their breastfeeding goals, they could reduce their risk for certain cancers while providing the optimal nutrition for their children.”
– Helen Keller International’s ARCH Project

So what will it take for moms to have the support they need? From the outset, women need access to quality healthcare, including skilled breastfeeding counseling. Women need access to job-protected paid time off from work to care for their newborns and to establish breastfeeding. And women need better policies and programs that enable them to start and continue breastfeeding as long as they choose, including breastfeeding education efforts and restrictions on the unethical promotion of infant and toddler formula.

For women and children living in conflict or emergency settings, even more support is needed. Ample privacy and space, psychological counseling and assistance with attachment and positioning are critical. For some mothers, breastfeeding can even help reduce stress. But it means strengthening systems of support to do so.

“Breastfeeding is the natural diet containing all the nutrients a child needs.”
– Nutrition International’s National Program Manager, Dr. Ahsanullah Khan Bhurgri

ALL moms need support to reach their breastfeeding goals. Join the #Marchis4Nutrition conversation on Facebook and Twitter this month and tell us what you think: What does the world look like if moms have the support they needed to reach their breastfeeding goals…?

To learn more about the worldwide support needed for breastfeeding, check out the Global Breastfeeding Collective, a partnership of 20 prominent international agencies and non-governmental organizations, including 1,000 Days and led by UNICEF and WHO.

We Need Action And Investment For Moms And Babies Everywhere

At 1,000 Days we know investing in a child’s first 1,000 days sets the foundation for all the days that follow – enabling children to grow, learn and thrive, and nations to prosper. Yet last night President Trump said very little about investing in young children and their families during his State of the Union address to a joint session of Congress and the American public.

Today, as Congressional leaders gather to plan their agenda for the year ahead, we urge them and the Administration to prioritize the health and well-being of women, infants and young children in the United States and around the world. This includes ensuring:

  • Women and children have access to comprehensive and quality health care;
  • Young children and their families have access to affordable and nutritious foods;
  • Parents and caregivers have the support they need to give their children the strongest start to life, including through breastfeeding support and paid family leave; and
  • U.S. foreign assistance is invested in proven programs that enable all children and their families to thrive.

At 1,000 Days we remain committed to the belief that all children—regardless of where they are born—deserve the opportunity to reach their full potential. Achieving this vision will require smart investments and joint action; we hope to work with Congress and the Administration to move these priorities forward in the year ahead.

Coming Soon: First-Ever Dietary Guidelines for Pregnant Women & Young Children

The U.S. Department of Agriculture (USDA) recently invited 1,000 Days and several other stakeholders to share comments related to the development of the 2020 Dietary Guidelines for Americans (DGAs) which will – for the first time ever – include recommendations for pregnant women and children under age two. The public comments, which will be made public on USDA’s website within a month, were an important step forward as USDA stated its intent to make the 2020 DGAs process transparent, data driven and science-based.

Why do the new DGAs matter and what is at stake?

1,000 Days’ analysis of the state of early nutrition in the U.S. shows that far too many young children and their families are not getting the nutrition they need to thrive. One in 5 babies in the U.S. is never breastfed and 1 in 4 children ages 1 to 2 do not receive the recommended dietary allowance for iron—one of the most important brain-building nutrients. Further, over half of toddlers and preschoolers have one or more sugar-sweetened beverages per day, contributing to our nation’s high rates of childhood obesity.

It is within this context that the Dietary Guidelines for Americans are more critical now than ever, as they will, for the first time, include recommendations for pregnant women and very young children. The 2020 DGAs and the recommendations for pregnant women and young children will inform federal nutrition programs that reach young children and their families, as well as serve as an important reference point for physicians, nutrition counselors, and early childcare providers among others. Moreover, the new guidance will also provide parents and caregivers with the evidence-based information they need to give their children the best chance to lead healthy, prosperous lives that are free of preventable chronic disease.

How can groups get involved?

At 1,000 Days we are closely following the development of the 2020 DGAs, and will continue to communicate opportunities to become engaged in the process as they emerge.

In the meantime, here are some ways to get involved:

  • Read the recent reports by the Health and Medicine Division of the National Academies of Science, Medicine and Engineering (HMD) here and here and familiarize yourself with recommendations for the 2010 DGAs process.
  • When the call for nominations for the Dietary Guidelines Advisory Committee opens, nominate qualified experts with backgrounds related to maternal and young child health and nutrition, epigenetics, child development and breastfeeding.
  • Be on the look-out for open comment periods and submit comments in support of strong, timely, and science-based recommendations for pregnant women and young children.
  • Reach out to Cara Brumfield at Cara@thousanddays.org to connect on more opportunities to be engaged.

Guest Post: Looking to Eradicate Racial Disparities in Breastfeeding? Time to Bet on Black

In recent years, many innovative interventions have been implemented seeking to reduce the four-decades long racial disparity in breastfeeding rates. In 2011, the Surgeon General made a critical Call to Action, the National Institutes of Health and others have supported research on the topic, and many philanthropic organizations have offered generous funding to help alleviate the problem. These efforts have been key contributions to making small, incremental increases in improving African American breastfeeding rates in initiation and duration. I applaud that. But when it comes to the 6-month and 12-month exclusivity milestones, with the latter being the gold standard for infant nutrition, the gap between black and white rates still lingers at an unacceptable rate of 50%.

It’s time to Bet on Black—which is the theme for this year’s National Black Breastfeeding Week, August 25-31, celebrating its 5th anniversary this year. As researchers and other so-called experts seek to grapple with this tenacious issue—it’s time to turn to the black community for answers. Yes, the efforts of scientific research and evidence-based practices are very important, but we can’t discount the fact that these methods have only moved the needle but so far. Furthermore, for far too long, the black community has been defined by deficiencies—words such as disadvantaged are often used to describe low-income communities. But these words completely ignore the resilience, strength and experiential knowledge of communities of color. This language prevents us from turning to those most impacted as a partner in problem solving. This reeks of paternalistic models where one group seeks to “save” another, without ever acknowledging that perhaps that group has solutions to save itself but just needs to be supported to do so.

As one of the co-founders of Black Breastfeeding Week, I have also had first handf experience with betting on the black community. For the past three years, I have been a witness to community power as director of The First Food Friendly Community Initiative (3FCI), a pilot project in Detroit and Philadelphia, funded by the W. K. Kellogg Foundation. While the work was complex, the mantra was simple, “Whatever the question, the answer is in the community.”

In our project, the community is the “expert” and the only source of so-called evidence-based research we seek to use. We believe that the local residents have the experiential knowledge, the historical context and lived experience to be the best change agents for creating breastfeeding supportive communities and we are there to simply leverage that innate potential. To be clear, we do not ask the residents to execute an idea created by a researcher, public health official or other so-called authority. During the three-day training of our proprietary curriculum, residents choose and design the interventions they think will work best and then execute it as part of a paid internship opportunity that also provides job skills training.

This unique model, combining community breastfeeding support with individual job skills training, allows us to also address one of the most stubborn barriers to breastfeeding continuation in marginalized communities —social stressors. Our unique community assessment in Detroit, revealed that mothers were stressed out about jobs and how they would provide for their families. Here’s something we have definitely learned from lactation science: chronically stressed out mothers cannot successfully breastfeed.

Empowered by our trust in their ability to lead the community change, our 3FCI interns in Detroit chose to target local businesses to make commitments, display ‘Breastfeeding is Welcome Here’ signage or sign a letter of support. Of the 57 establishments targeted for their work, including restaurants, churches and child care centers, 25 agreed to sign a letter of support for breastfeeding, 20 agreed to display the 3FCI decal (including one funeral home!) within their business, 5 agreed to designate space within their facilities to allow mothers to breastfeed, and 3 agreed to also display their 3FCI certificate. That’s a powerful community presence for all—while making breastfeeding more visible where moms eat, work, play and worship. Remember, these requests to businesses came from local residents who were consumers and customers of the establishments they visited. The request to support breastfeeding came from their neighbors not strangers.

Yes, we can Bet on Black—we can turn to black communities and those from the black community for solutions for closing the breastfeeding gap. We can trust black communities and their residents to save themselves—our role is to figure out how we can offer the resources they need and get out of the way! We can change our language of lacks to a language of strength and capacity. We can all bet on black. As my co-founder, Kiddada Green, of Black Mother’s Breastfeeding Association says, “When we bet on black, we are all winning.”

Black Breastfeeding Week is a week-long, national celebration to increase awareness of breastfeeding as a key element of improving infant and maternal health outcomes in the black community. The week will feature over 60 community events and daily social media events. Get all the updates on the BBW Facebook page and on BlackBreastfeedingWeek.org.

Kimberly Seals Allers is an award-winning journalist and nationally recognized advocate for infant and maternal health. A former writer at Fortune and senior editor at Essence, she is the author of The Big Letdown—How Medicine, Big Business and Feminism Undermine Breastfeeding(St. Martin’s Press). A former Food & Community Fellow with the Institute for Agriculture and Trade Policy, Kimberly is a divorced mother of two who lives in New York. Learn more at www.KimberlySealsAllers.com and follow her on Twitter at @iamKSealsAllers.

40+ Organizations Call For A Constructive Dialogue On Infant Feeding Recommendations

Today, over 40 organizations signed-on to a joint letter to request a meeting with the co-founders of the Fed Is Best Foundation. Our hope is to engage in a constructive dialogue to discuss the concerns they have raised with respect to our nation’s infant feeding recommendations and associated health care practices.

You can read the full letter and see the list of organizations signed-on below.

——

August 15, 2017

Dear Dr. Castillo-Hegyi and Ms. Segrave-Daly:

We write to you as fellow advocates for the health and well-being of infants and their families. We believe that we share a common goal—to ensure that every baby gets the strongest start to life. It is in that spirit that we extend an invitation to you to discuss the concerns that you and your organization, the Fed Is Best Foundation, have raised with respect to our nation’s infant feeding recommendations and associated health care practices.

We believe the ground we have in common is far greater than the areas where we may have disagreement. For the sake of all children, mothers and families, we therefore seek ways to unite in a shared vision rather than engaging in divisive messaging. For example, we all agree that the health of the baby is the ultimate goal, that infant feeding is a highly personal decision, that the mother should be fully informed of her options in making this decision, that nobody has the right to impose their beliefs or values on another, and that no infant, mother, or family should suffer as a result of ineffective support or care practices. We also agree that many physicians and other health care providers need improved training and education to ensure the competency to properly diagnose and address infant feeding issues, and that improved continuity of care is needed to enable new mothers to access timely, integrated, and continuous care throughout the prenatal and postpartum periods.

That’s a lot of common ground to build on.

Where we seem to disagree is on the root cause behind the tragic stories that Fed Is Best has recently highlighted. That is where we would hope to engage in some honest and constructive dialogue to find shared messaging focused on providing the accurate and unbiased information families need to make their personal infant feeding decisions, along with the appropriate care and support they need to implement those decisions.

We believe that we can be most effective in serving moms and babies when we attack the root causes of problems, rather than each other. For this reason, we invite you to meet with us to talk about your concerns and discuss ways we can work together to ensure that no family has to endure the pain and heartbreak of a baby who doesn’t get the nutrition they need to thrive. We hope that you will take us up on our offer and look forward to receiving your response.

Sincerely,

1,000 Days
Academy of Breastfeeding Medicine
Alabama Breastfeeding Committee
American Association of Birth Centers
American Breastfeeding Institute
American Samoa Breast Feeding Coalition
Arkansas Breastfeeding Coalition, Inc.
Baby Cafe USA
Baby-Friendly USA, Inc.
Best for Babes Foundation
Breastfeeding Task Force of Nevada
California Breastfeeding Coalition
California WIC Association
Childbirth and Postpartum Professional Association
Eastern Kentucky Breastfeeding Coalition
Georgia Breastfeeding Coalition
Healthy Children Project, Inc.
Indiana Breastfeeding Coalition
International Board of Lactation Consultant Examiners
International Childbirth Education Association
Kansas Breastfeeding Coalition, Inc.
La Leche League USA
Louisiana Breastfeeding Coalition
Macomb County Breastfeeding Coalition
Massachusetts Breastfeeding Coalition
Michigan Breastfeeding Network
The Milk Mob
Mom2Mom Global
MomsRising
Mothers’ Milk Bank
Mothers’ Milk Bank Northeast
National Alliance for Breastfeeding Advocacy
National WIC Association
Nebraska Breastfeeding Coalition
New Hampshire Breastfeeding Task Force
New Mexico Breastfeeding Task Force
New York Statewide Breastfeeding Coalition, Inc.
NYC Breastfeeding Leadership Council, Inc.
Ohio Breastfeeding Alliance
Reaching Our Sisters Everywhere, Inc.
Rhode Island Breastfeeding Coalition
Texas Breastfeeding Coalition
United States Lactation Consultant Association
Vermont Breastfeeding Network

Guest Post: Playing Football with Infant Health: U.S. Breastfeeding as a Game of Inches

This week the U.S. Centers for Disease Control and Prevention released new data on breastfeeding rates from 2004 to 2014. The encouraging news is that more babies start breastfeeding and breastfeed for longer. The percentage of babies who start out breastfeeding increased to more than 82% surpassing the U.S. Government’s Healthy People 2020 goal of 81.9% initiation rate.

Yet while greater numbers of babies start out breastfeeding, there is still a sharp drop-off in the numbers of babies being exclusively breastfed (i.e. no other food or drink other than breastmilk) at 3 months and 6 months. The analysis of the CDC’s National Immunization Survey (NIS) data found that in 2014, children who were being exclusively breastfed for three months now stands at 46.6%— a big increase from the 36% rate in 2009—but still almost half the number that start out breastfeeding.

In addition, when it comes to six months exclusive breastfeeding —the gold standard of infant nutrition and the recommendation from the American Academy of Pediatrics and other health organizations—the number of infants being fed at this standard drops to 20%.

In America only 1 in 5 babies is being fed in accordance with the health recommendations.

Breastfeeding does not occur in a vacuum-it is impacted by cultural views, structural barriers, supportive and non-supportive policies and the impact of commercial interests. In fact, the CDC release also showed that 1/3 of all babies were supplemented with formula before 6 months and 15% were supplemented with artificial milk before 2 days.

But perhaps the most sobering detail in the CDC release is the continuation of the racial disparities in breastfeeding rates. Among infants born during 2010–2013, 64.3% of non-Hispanic black infants started breastfeeding, compared to 81.5% of white infants, a gap of 17.2 percentage points.

In 14 states, primarily in the Midwest and South, the difference in breastfeeding initiation between white and black infants was greater than 15 percentage points and the disparity exceeded 25 percentage points in seven of these states. The percentage point differences between white and black infants in exclusive breastfeeding through 6 months ranged from −4.2 in Rhode Island to 17.8 in Wisconsin, and at 12 months duration, the difference ranged from −4.4 in Minnesota to 31.6 in DC, the report detailed.

These gaps show that even with increased support and awareness, black families are not receiving the multi-dimensional support needed to successfully breastfeed.

Given that the mortality rate for black infants is more than twice that of white infants, more needs to be done to ensure that all women can give their babies the powerful life-saving, brain-boosting and health-giving benefits of breastfeeding.

And what we are learning overall, is that women want and are willing to try breastfeeding but something gets in the way—no maternity leave? An unsupportive employer? Fear of being shamed while breastfeeding in public? Limited child care options that easily facilitate human milk feeding? The possibilities are varied. What we don’t have in place are structural solutions that don’t fully rest the weight and responsibility of breastfeeding squarely on the shoulders of mothers.

Until breastfeeding is properly supported systemically and structurally, breastfeeding will remain akin to football—a game of inches, with some women eking out small gains while pushing through and past monumental obstacles but rarely making it to end zone or scoring the collective touchdown.

We are pleased to see the inches, but mothers and babies deserve the whole nine yards.

Kimberly Seals Allers is an award-winning journalist and nationally recognized infant health advocate. Her fifth book, The Big Letdown—How Medicine, Big Business and Feminism Undermine Breastfeeding was released in January by St. Martin’s Press. Learn more at www.KimberlySealsAllers.com and follow her on Twitter @iamKSealsAllers.