Breastfeeding saves lives and resources
The journal Pediatrics recenly published an analysis estimating more than 900 babies and $13 billion dollars would be saved annually, if 90 percent of U.S. women exclusively breastfed for the first six months of a child’s life. The Register-Guard ran an Associated Press story on the findings.
Oregon Breastfeeding Rates
The CDC’s 2009 breastfeeding report card reports 74% of U.S. women initiate breastfeeding. Thirty-three percent and 14%, respectively, exclusively breastfeed at three- and six-months. The Healthy People 2010 goal for initiation is 75% and 25% for exclusive breastfeeding at six months.
At 90.4%, Oregon mothers lead the nation in breastfeeding initiation. Local lactation consultants suggest Lane County initiation rates are higher, perhaps as high as 95%.
Benefits of Breastfeeding
Breast milk is the most complete form of nutrition for infant health, growth, immunity and development. It is associated with lower rates of illness including ear infections, asthma, childhood obesity, juvenile diabetes and Sudden Infant Death Syndrome.
Breastfeeding benefits mothers, too. Long-term benefits include reduced risks for breast, ovarian and endometrial cancers as well as reduced risks of osteoporosis and bone fracture.
Communities benefit from breastfeeding because better health outcomes free up medical dollars, reduce sick time and increase long-term quality of life for women, children and families. From a purely economic perspective, the multiplier effects of breastfeeding are nearly limitless. Given nine in 10 Oregon women leave the hospital planning to breastfeed, it’s safe to say they are getting this message. So, what fuels the drop off?
Mother-blame has no place here
A pediatrician interviewed by The Associated Press cautions that “mothers who don’t breast-feed for six months shouldn’t be blamed or made to feel guilty, because their jobs and other demands often make it impossible to do so.”
The pediatrician is, of course, correct – mothers are not to blame. Most were not, themselves, breastfed meaning the extended family and community structure, including employers, offers no generational/cultural knowledge and is mostly at a loss to support her. Mixed messages and little to no support make for an inadequate foundation for learning, integrating and continuing exclusive breastfeeding.
The specter of mother blame too often dampens efforts to address the barriers to breastfeeding. Good, well-intentioned people shy away from discussions of reform, instead casting breastfeeding as a lifestyle choice rather than the public health imperative it is. An appropriate and honest alternative is to recognize that the failure is ours, the community within which women become mothers. From here, we can identify the major intersections a woman crosses as a new mother and make them safer.
New Mother Intersection #1: Hospitals
Because most women give birth in hospitals, it is the first major “new mother intersection.” Whatever happens here in the first hours and days has major, incalculable ramifications for breastfeeding duration. Most hospitals do not practice across-the-board, certifiable evidence-based breastfeeding care. Women’s experiences can be greatly influenced by who’s working that day.
Hospitals serious about breastfeeding rightly see high initiation rates as an insufficient measure of commitment. These facilities join the nation’s 88 world-class leaders in breastfeeding excellence by becoming a designated Baby-Friendly Hospital or Birth Center. Neither Sacred Heart Medical Center (SHMC) nor McKenzie-Willamette Medical Center, Lane County’s leading hospitals, is on this list. The PeaceHealth Nurse Midwifery Birth Center is Baby-Friendly.
Baby-Friendly facilities ensure all women receive care fully in line with evidence-based practice. They have codified policies requiring all staff, from nurses’ aides to doctors, who are in contact with mothers be trained to assist and assess initiation. Assessing can mean knowing when to call in a lactation consultant. Women and their support network learn about breastfeeding during pregnancy (not just once in a one-hour optional session), receive 24-hour lactation support and access to on-going, non-emergent expert and peer support throughout the first year postpartum.
Ensuring women go home with a good latch and access to a 24-hr hotline solves innumerable breastfeeding problems before they balloon into crises. Early, unaddressed breastfeeding challenges can dog a woman throughout breastfeeding.
Baby-Friendly signifies a shift in cultural milieu and norms. It does not mean saying “no” to a mother who prefers to formula feed. This rationale is often used to dodge serious discussion of improving facility practice. Baby-Friendly means, for example, that mothers are not encouraged to use formula or pacifiers, both of which wreak havoc with sound initiation, for non-medical reasons or without an understanding of the risk they pose to initiation.
Women shopping around for maternity care can be confident of quality breastfeeding support when they see the Baby-Friendly seal of approval on hospital literature. It would be a tremendous boon for the community, if SHMC and McKenzie-Willamette become Baby-Friendly designated facilities. Pursuing designation together would be an excellent service to the community.