Baby Steps

The Milky Way is off to a galactic start this year thanks to Progress in Increasing Breastfeeding and Reducing Racial/Ethnic Differences, a study recently released by the Centers for Disease Control and Prevention (CDC).
The study highlights that more women are breastfeeding for longer periods and that the gap between black and white breastfeeding initiation rates narrowed in recent years.

This is all great news. Celebrate!

But the study also found that only 23.4 percent of women breastfed for 12 months, the recommended duration. Twenty three point four percent is a miserable number.

Contributing author Jessica Allen, MPH, MSW
Contributing author Jessica Allen, MPH, MSW

“It depends on which way you look at,” Contributing author Jessica Allen, MPH, MSW says. She reminds me that trends are on the rise.

Still, there’s that enormous number of women not meeting recommended breastfeeding durations. Additionally, she says many mothers aren’t satisfying their personal breastfeeding goals.

That’s where support comes in.

The authors of the study place a huge emphasis on support in order to boost breastfeeding rates and duration and to further close the gap between black and white breastfeeding rates.

“We have to make sure women who want to breastfeed are receiving the support they need,” Allen says. “We need to continue to look at things that we know work.”

For instance, the CDC has compiled a Guide to Breastfeeding Interventions. The guide features information for state and local community members to choose a breastfeeding intervention strategy that best meets their needs.

“Hopefully people become familiar with [women’s] goals and the impact they have,” Allen says. She says she hopes all community sectors do their part to help women in whatever feeding choices they make.

CDC Director Tom Frieden, M.D., M.P.H. comments on Progress in Increasing Breastfeeding and Reducing Racial/Ethnic Differences in a clip featured on the CDC’s website: “Hospitals can make a big difference by becoming Baby Friendly and insuring that every woman has the best possible chance of starting breastfeeding.”

The Baby-Friendly Hospital Initiative backed by a government official. Incredible news for moms and babies everywhere.

Even more, the report cites the Surgeon General’s Call to Action to Support Breastfeeding which outlines a number of actions aimed at increasing support for breastfeeding women.

Best Fed Beginnings, a project supported by the CDC, provides support to close to 90 hospitals to improve maternity care practices that support breastfeeding. The project aims increase the number of Baby-Friendly hospitals in the U.S.

In an effort to establish better support systems for mothers, the CDC “awarded funds to six state health departments to develop community breastfeeding support systems in minority populations.”

Because African American women struggle with breastfeeding more so than other populations, the authors of the report suggest increasing the number of lactation consultants in these communities.

However, just because lactation services are available does not mean that they are accessible. Services need to be covered by insurance. The Affordable Care Act helps to make lactation services affordable for families.

Services also need to be physically accessible to mothers. That is, bring the help into the home like the efforts at Maternity Care Coalition.

Limiting credentials and/or “claiming that one set of credentials is worthy of health insurance reimbursement and not others will severely limit mothers’ and babies’ access to quality care,” as stated in Healthy Children Project’s A RENEWED CALL FOR COLLABORATION AMONG LACTATION PROFESSIONALS.

Award-winning journalist Kimberly Seals Allers recently launched the Be First Food Friendly Movement which serves to transform communities, especially those with extremely low breastfeeding rates, into First Food Friendly environments. Be First Food Friendly is a great example of increased support in all facets of the community so that moms and babies can be successful at breastfeeding.

Multifaceted support is especially important for African American mothers: “…Even when accounting for factors such as socioeconomic status and maternal education, racial/ethnic differences in breastfeeding persist. This persistent gap in breastfeeding rates between black women and women of other races…might indicate that black women are more likely to encounter unsupportive cultural norms, perceptions that breastfeeding is inferior to formula feeding, lack of partner support, and an unsupportive work environment,” the CDC report states.

While some communities suffer from depressingly low breastfeeding rates, initiation rates in the Hispanic population did not increase significantly from 2000 to 2008.

“They started so high,” Allen says. “It’s like taking an A student to an A+.”

My hope for the moms who aren’t meeting breastfeeding recommendations or personal feeding goals is that with increased recognition for support, national breastfeeding rates will continue to creep upward.

Even while we make baby steps, I remain skeptical.

In the study’s full report we learn that “Breastfeeding initiation was assessed by asking, ‘Was [the child] ever breastfed or fed breast milk ?’ Breastfeeding duration was assessed by asking, ‘How long was [the child] breastfed or fed breast milk ?’ The wording of the breastfeeding duration question changed slightly in 2006 to ‘How old was [the child] when [the child] completely stopped breastfeeding or being fed breast milk ?’”

This Pediatrics’ study discusses characteristics of breastfeeding practices among U.S. mothers: http://pediatrics.aappublications.org/content/122/Supplement_2/S50.full.pdf+html.

Allen says that Progress in Increasing Breastfeeding and Reducing Racial/Ethnic Differences’ questioning didn’t allow researchers to decipher whether baby consumed breast milk straight from the source or from another vehicle. The study includes baby’s consumption of breastmilk in any form. One may assume then that breastfeeding and breastmilk feeding are created as equal in the scope of the study.

We must remember though that breastfeeding and breastmilk feeding are not the same. For instance, babies fed from a bottle are less likely to self-regulate milk intake.

Will increased awareness for breastfeeding support help more mothers breastfeed or breastmilk feed?

We know that any amount of breastmilk given to baby is beneficial but nothing compares to the biological norm of mother feeding baby at the breast.

“We are really encouraged to see some of these increases, but at the same time there is a long road ahead of us,” Allen says.

For more information on how support affects breastfeeding rates please visit: http://summaries.cochrane.org/CD001141/support-for-breastfeeding-mothers

To hear more from CDC Director Tom Frieden, M.D., M.P.H. please visit http://www.cdc.gov/breastfeeding/resources/breastfeeding-trends.htm and scroll down to “MMWR News Synopsis.”

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