Breastfeeding: Putting the Stats into Practice

Breastfeeding may not be a panacea to maternal and infant health disparities but it is a proven way to improve health outcomes. But to make it real, we have to holistically support new mothers and their babies in breastfeeding.

Breastfeeding has been a hot topic over the past couple of weeks, most recently with the release of a study in Pediatrics that asserted that over 900 children’s lives can be saved each year if 90 percent of new mothers breastfed their babies for six months. It seems like a fairly simple goal; six months is a relatively short amount of time. However, the study explicitly says that mothers would have to exclusively breastfeed their children for six months, meaning exclusively feeding their babies breast milk; no water, formula or infant juice. This makes achieving this goal much more complicated.

Another study by the CDC highlights racial, ethnic and geographic disparities in breastfeeding. In 13 states (mostly southeastern), the difference between breastfeeding initiation rates between white women and black women was over 20 percentage points, and in six states black women’s breastfeeding initiation rates were under 45 percent. This means that the majority of these women didn’t even breastfeed at all.

So what’s the connection? Considering maternal and infant mortality rates in the black community are disproportionately higher than in white and “Hispanic” communities, it seems that increasing breastfeeding could make result in better outcomes for black women and their children. But will these monetary and infrastructural investments be made?

If we look to the workplace, employers are required to give only 12 weeks of (unpaid) maternity leave. It’s no wonder why breastfeeding rates take a sharp decline six months after birth. If a new mother is to exclusively breastfeed for six months but has to return to work, she will have to do a lot of pumping before and/or after work to ensure her baby is fully-fed throughout the day. At many places where people work for an hourly wage, there is no effort made to support new mothers and breastfeeding or pumping can instead be seen as a nuisance, resulting in reduced productivity. Because of economic, educational and geographic barriers to employment opportunities that offer full health benefits, women of color often cannot afford to take a long period of unpaid leave from work.  In this case, a woman is likely to be compelled to go back to work in order to provide for her family, especially if she is the sole breadwinner.

Some lactivists have taken issue with media assertions that workplace barriers are the primary culprit. Although they agree that many women have to struggle to find places and time to pump, health care reform will require employers to provider clean and safe spaces for breastfeeding or pumping. We will have to wait and see how this will be enforced. It seems that this is only one piece of the solution as some lactivists cite a myriad of issues including societal and cultural stigmas against breastfeeding moms, lack of education, lack of promotion of breastfeeding, and the abundance of free formula samples given at hospitals to new mothers and their babies. 

There’s also the issue of nutrition. If the point of breastfeeding is to provide nourishment and pass on immunities to the baby (along with mother-baby bonding and other health benefits), then women should be given quality food in the hospitals. Women of color are less likely to be insured, so you can pretty much guarantee that the hospitals serving these women will be serving processed, mass-produced foods with low nutritional value. I have seen not only nasty-looking meals given to new moms, but also foods that have no nutritional value, like Italian ice, which is full of sugar and artificial colors. These meals are not only unappetizing but unbalanced and do not provide proper nutrients to the mother or child.

Since most hospitals aren’t giving moms nutritional support from the start, it is likely that once women leave the hospital they still have to fight to maintain good eating habits as they manage a newborn. In many communities of color, there is little access to fresh and affordable fruits and vegetables, again making it difficult to eat healthy and thus pass on vitamins and nutrients that assist in development. If we are committed to more widespread breastfeeding, we should also be fighting to ensure that all communities have access to fresh and affordable fruits and vegetables.

Breastfeeding may not be a panacea to maternal and infant mortality disparities but it is a proven way to improve health outcomes. The Pediatric study points out that the U.S. could save $13 billion dollars by getting 90 percent compliance of mothers breastfeeding exclusively during the first six months. If we really want to save lives and of course, the almighty dollar, then the government should invest in creating a infrastructure that holistically supports new mothers and their babies.