Despite breastfeeding being the biologically “normal” way to feed our babies, we do not live in a breastfeeding-friendly world. Although the majority of women breastfeed after delivery, less than half of babies in the U.S. are exclusively breastfed at 3 months, and only 1 in 4 are exclusively breastfed at 6 months.
Obstetricians and midwives can help to improve breastfeeding rates by discussing breastfeeding from the first prenatal visit through the end of pregnancy. In an ideal world, mothers would learn about the physiology of milk production, potential lactation-related problems, and a comprehensive overview of breast pumping during pregnancy. It’s important for partners to learn about how breastfeeding works, and what a huge commitment it is, so that they have the tools to help and support their breastfeeding partners.
Although breastfeeding is “natural,” it does not always come easily – it can take moms and babies weeks to months for things to go smoothly. We need to stop giving new and expecting parents the impression that breastfeeding is “easy,” because it is actually a lot of work (and a true labor of love!).
Postpartum lactation support in the U.S. needs to be improved.
We need universal coverage of lactation consultants and counselors by health insurers, an increase in the numbers of lactation consultants who are available for in-home visits, and to make sure that moms of newborns are informed that breast pumps are covered by health insurance. Aeroflow Breastpumps is a rapidly growing medical supply company whose main goal is to help mothers get breast pumps for free through their health insurance.
Despite record numbers of mothers of babies and young children entering the workforce over the last few decades, those who are breastfeeding continue to struggle to pump to provide breast milk. This is in large part because mothers are expected to fit breastfeeding and pumping into their existing workplace structures.
We need to overhaul the culture of our workplaces so that breastfeeding and pumping support is built in, and that there is an expectation that the majority of working mothers will need to breastfeed and pump at various points in time. Mothers should not have to choose between nourishing their babies and being productive employees!
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Supporting breastfeeding employees includes all of the following:
- Providing clean, safe, and private spaces to pump
- Access to electrical outlets
- Adequate break times (10-15 minutes is not enough time for many women)
- On-site childcare
- Flexible hours
- A refrigerator or freezer to store milk
Black mothers face unique breastfeeding challenges, both within and outside of the workplace.
At the present time, African-American mothers have low rates of breastfeeding initiation and breastfeeding 3, 6, and 12 months.
Possible ways to improve breastfeeding rates amongst African-Americans include identifying and investing in breastfeeding champions and other lactation resources in black communities, creating online support groups for black mothers, and educating women, their partners, and families about the importance of breastfeeding.
Other ideas for improving rates of breastfeeding include increasing the presence of black mothers in advertisements and marketing of breastfeeding and lactation supplies, investing in educating and training women of color to become lactation specialists, and connecting mothers with breastfeeding resources and websites for African-Americans. The U.S. Department of Health and Human Resource’s website, “It’s Only Natural,” has great information about the health benefits of breastfeeding for African-American mothers. Other excellent resources include Best Fed Beginnings and Soul Food for Your Baby.
In conclusion, providing breast milk needs to be viewed not as an inconvenience, but an investment in the future of our county. In order to decrease breastfeeding disparities we need to do all we can to support breastfeeding in all populations.
Jessica Madden, MD, is the Medical Director at Aeroflow Breastpumps, and she is a board-certified pediatrician and neonatologist who has been taking care of newborn babies for over 15 years. She is currently on staff in the neonatal intensive care unit (NICU) at Rainbow Babies and Children’s Hospital in Cleveland, Ohio, and has experience working in NICUs in the Boston Children’s Hospital and Cleveland Clinic Children’s Hospital networks. Dr. Madden provides in-home newborn medicine and lactation support through Primrose Newborn Care, a small business that she opened in 2018. In her free time, she enjoys traveling, yoga, reading, and spending time with her four school-aged children.
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