Tag: health care

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!

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.

CHIP Must Be Funded – But Not At The Expense Of Other Public Health Programs

Last week the U.S. House of Representatives passed the Championing Healthy Kids Act (H.R. 3922). While 1,000 Days supports the legislation’s inclusion of funding for Children’s Health Insurance Program (CHIP), Community Health Centers, and other health programs, we are deeply concerned about some of the offsets included in the bill. Specifically, the House bill cuts billions from the Prevention and Public Health Fund and jeopardizes families’ access to critical health coverage.

It has been more than a month since funding for CHIP expired. Without immediate Congressional action, health care for 9 million children and 370,000 pregnant women will remain in jeopardy. Additionally, funding for community health centers and other public health programs expired at the end of September. Congress is long-overdue in extending funding for these programs. However, by cutting the Prevention and Public Health Fund to pay for these extensions, Congress is undermining the very health care system America’s families depend on. The Prevention and Public Health Fund provides funding for many critical initiatives, including breastfeeding support programs, strengthening the public health infrastructure, and reducing health disparities. Together, these programs ensure pregnant women, young children and their families have access to the health care and support they need to be healthy and thrive.

1,000 Days urges Congress to find a bipartisan path forward that ensures all children and their families will have access to quality health coverage, without threatening other important public health programs.

5 Reasons Why The Latest Effort To Repeal The Affordable Care Act Is Bad For Moms And Babies

While the future of the Senate Republican’s latest effort to repeal the Affordable Care Act (ACA) is uncertain, one thing is very clear – the Graham-Cassidy bill is bad for moms and babies.

Here’s why:

  1. Maternity, newborn and pediatric care are at risk.
    States would be able to waive the essential health benefits – like prenatal, maternity and pediatric care – currently covered under the ACA. That’s why even physician groups like the American Congress of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) are strongly opposing the bill.

    Essentially, this bill could mean a return to a pre-ACA health system when 75% of plans on the individual market did not include maternity coverage. Women would be left to decide between going without needed health services or paying out-of-pocket. That’s a decision no women should be forced to make.

  2. Women could pay more for less health coverage.
    Health plans could charge more for comprehensive coverage. This means more women would be forced to choose between buying cheap bare-bones insurance packages that don’t cover their needs – and paying out-of-pocket for other services (like maternity care) – or paying exorbitant prices for health plans that provide the coverage they need.

    We’d be stepping back in time, before the passage of the ACA, when women could be charged more for their health insurance just because they are women.

  3. Pregnancy could become a pre-existing condition (again).
    Insurers would be able to decide what is – and is not – a pre-existing condition, and then charge more accordingly. Just like before the passage of the ACA, women could be denied coverage (or charged a lot more) for health insurance just for having given birth or being of child-bearing age.

    In fact, according to the Center for American Progress, insurers could charge pregnant women over $17,000 more, putting health insurance out of reach for millions of women – right when they need it the most.

  4. The Medicaid program would be gutted.
    About one TRILLION dollars in federal funding for Medicaid would be cut. Medicaid is a critical source of health insurance for millions of low- and middle-income people. As the largest insurance program for women, it covers the cost of nearly half of all America’s births.

    Without Medicaid, women would become uninsured and lose access to the comprehensive health coverage that they desperately need. For those who could keep their Medicaid insurance, their coverage would likely shrink as states replace comprehensive health services with bare-bones coverage for maternity and infant health services.

  5. It hurts working families the most.
    The bill would end the financial assistance that makes purchasing health insurance possible for millions of America’s middle-income families. It repeals subsidies within ACA – subsidies that currently 85% of people purchasing insurance coverage on the marketplace receive.Coupled with the proposed cuts to Medicaid, the Graham-Cassidy bill would leave millions of Americans without their health insurance, according to analysis from the Congressional Budget Office (CBO).

Graham-Cassidy is not the health care plan that America’s moms and babies—and thus the country as a whole—need. It is time for all Members of Congress from both parties to work together to ensure women, infants and young children have access to comprehensive and affordable health care they need to thrive.

Bipartisanship Is Possible – And We Need It Now More Than Ever

For the past several months, 1,000 Days and its community has called on Congress to work together to ensure America’s women, infants and young children have access to the comprehensive and affordable health care they need to thrive. From sharing personal stories to engaging directly with Members of Congress, we’ve seen how the power of people can truly affect change. Together, we protected health insurance for America’s moms and babies.

But now, once again, we find ourselves at a crossroads for health care—and we need everyone to weigh in.

On one hand, the Republican and Democratic leaders of the Senate Finance Committee have put forward bipartisan legislation to support the Children’s Health Insurance Program (CHIP), a crucial source of health insurance for millions of children across the U.S. Action is needed by September 30th to protect this important program. The introduction of this bill shows that health care can—and does—transcend partisan bickering.

On the other hand, Senate Republicans are making one last-ditch attempt to repeal the Affordable Care Act through the Graham-Cassidy bill. If passed, this bill would prove disastrous for America’s moms and young children.

The Graham-Cassidy bill would strip away comprehensive coverage and result in millions of people—including women and children—losing their health insurance. This bill proposes to:

  • Clamp down on, and quickly eliminate, the federal funding that makes individual coverage affordable.
  • Reduce Medicaid coverage for millions of parents and children.
  • Put benefit decisions in the hands of states and insurance companies, including to allow them to charge more for people with pre-existing conditions.

In short, this bill is a major step backwards for children and their families.

1,000 Days calls on Congress to reject all proposals that repeal the Affordable Care Act and instead to support and quickly advance bipartisan action, like the CHIP legislation, that invests in women, children and America’s future.

It’s Time to Work Together on Health Care

We at 1,000 Days are encouraged that members of the U.S. Senate put the health and well-being of Americans ahead of politics. We thank all the senators who voted to stop the rushed effort to repeal the Affordable Care Act (ACA) – which would have stripped 16 million Americans of their health insurance according to the non-partisan Congressional Budget Office. In particular, we commend Senators Collins, Murkowski and McCain for their courageous votes and calls for bipartisan negotiations through regular and deliberative Senate procedure.

We now urge all Members of Congress from both parties to work together to support and stabilize the health insurance markets and to build on current law to ensure women, infants and young children have access to comprehensive and affordable health care.

The Senate Health Care Bill – A Misguided Plan for Health Care Reform

Yesterday – after weeks of negotiations obscured in secrecy – the Senate health care bill was finally unveiled. But this draft legislation puts the health of moms and babies at risk.

The Senate bill will force women, in particular, to pay more out-of-pocket costs to get the care that they need before, during and after pregnancy by giving states the ability to design health benefit packages—eliminating protections for essential health services such as maternity care, childbirth and newborn and pediatric care.

The Senate bill will eliminate health insurance for millions of America’s most vulnerable people, including children, by fundamentally changing how Medicaid is financed and rolling back Medicaid funding.

The Senate bill will force hard-working families to pay more for lower quality insurance, endangering the health and well-being of women, infants and young children across America.

While Senate leadership is trying to cut federal spending, they are doing so at the expense of Americans’ health.

This is misguided policy, at best.

1,000 Days urges senators to find real solutions for America’s health care needs and focus on building a healthcare system that ensures all mothers, babies and toddlers in America have the care they need to thrive.

The Senate is Closing in on a Health Repeal Bill, Albeit Secretly

Earlier this year, all anyone in Washington could talk about was health care and the Republican efforts to repeal the Affordable Care Act (ACA). As details of the House of Representative’s health care bill—the American Health Care Act (AHCA)—became clear, people all over the country were talking about it and speaking out in strong opposition.

Read our statement on the House-passed AHCA.

Over the last month, the process has moved over to the Senate, where Senate Leadership has been crafting their repeal bill behind closed doors. Aside from the 13 senators (all of whom are men) working on the bill, no one yet knows the details of the plan. All the other 87 senators—Republican and Democrat alike—have not been consulted. There have been no Committee hearings and no debate. What’s worse—the public has not been offered the opportunity to weigh-in on a bill that will impact every aspect of their health, and possibly their livelihoods.

Why all the secrecy? Likely because Senate Leaders know that the House passed a bill that was bad policy.

Let us be crystal clear: the AHCA is a bill that would leave moms, babies and all of us significantly worse off than we are today, putting our health and economic security at risk. The Congressional Budget office estimates that 23 million people will lose health coverage under the AHCA over the next 10 years, 14 million in just the first year alone. According to the Center on Budget and Policy, 3 million children will lose coverage, in large part due to the deep cuts to Medicaid, the primary source of health insurance for America’s most vulnerable families. It’s worth noting that Medicaid covers half of all births in the United States—about 2 million births a year.

What little we do know about the Senate proposal is that it will be just like the AHCA.

The Senate bill will likely still result in a dramatic increase in the number of people who are uninsured, sky-rocketing premiums and deep and fundamental cuts to Medicaid. Under any version of the bill, moms and babies across the country will be charged more for less coverage, putting life-saving services out of reach.

While Senate Leadership is crafting their repeal bill—perhaps hoping no one will notice or understand the impact before it goes to a vote—now is the time to stay engaged.

Our elected officials should be listening to America’s moms who understand the value of high quality and affordable health care for themselves and their babies.

What’s your experience with health care or health insurance? What are your concerns for the future? Share your thoughts and we’ll make sure to share them with policymakers here in Washington. They need to hear from all of us. Before it’s too late.

Protecting Health Care for Moms and Babies is Non-Negotiable

Over the last several months, we at 1,000 Days watched closely as policymakers sought to repeal and replace the Affordable Care Act (ACA). For young children and their families, high-quality health care coverage is a foundational investment in healthier and more prosperous futures.

Thanks to the ACA, all health insurance plans – including employer-based plans – must provide women and children with health services during pregnancy, childbirth, infancy and beyond. And no woman can be denied coverage or charged higher costs because of pre-existing conditions like breast cancer, pregnancy, C-sections, and diabetes.

But efforts to repeal the ACA puts this all at risk.

As the House Republicans put forth their proposal to repeal and replace the ACA in early March – the American Health Care Act – 1,000 Days and its community mobilized and took action. Thousands of people spoke out and told Congress to protect comprehensive health insurance for women and young children. Dozens of people shared with us their personal stories of why health care matters.

In the end, the leadership of the U.S. House of Representatives called off the vote on the American Health Care Act. This means that, for now, millions of hard-working families with young children will not have to pay more money for lower quality health insurance. A later version of the proposed bill even threatened to remove such basic services as maternity care and pediatric visits.

While the House bill stalled, this looks to be just the beginning.

Even now, on the eve of the congressional recess, rumors are circulating that the House will again try to pass a health care repeal bill. As such, 1,000 Days and its community will remain vigilant.

Earlier this week we delivered our community’s petition signatures and personal stories to Members of Congress to let them know that we are watching what they do next.

Ultimately, the health of moms and babies must be a national priority. This means ensuring that women have the health coverage they need to have healthy pregnancies and healthy babies. This is non-negotiable.