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Well Fed: Moving Breastfeeding from Personal Choice to Public Health Issue

By Fia Curley

With her first pregnancy 11 years ago, Sakia'Lynn Johnson made some unusual choices. A student at a Historically Black University, Johnson had planned her pregnancy, and was determined to nurse her first child exclusively for six months and continue breastfeeding him until age 2 - a rare goal then and now.

Although Johnson was never given information about breastfeeding during her prenatal visits, she sought out breastfeeding resources on her own, determined to achieve her goal. Despite a Caesarean-section delivery and the subsequent struggle to feed, Johnson fought to follow her plan. She finally achieved her goal only after visiting a lactation consultant in a neighborhood Women, Infants, Children (WIC) office.

Now 33, Johnson continues to remain ahead of the curve.

According to the 2011 Breastfeeding Report Card [PDF | 935KB] from the Centers for Disease Control and Prevention, almost 75 percent of new moms have tried breastfeeding their children. Six months later about 44 percent of women are breastfeeding. However the number of moms who feed their children only breast milk for six months straight is a little less than 15 percent.

Documented health benefits of breast milk include decreased risk of ear infections, diarrhea, pneumonia, obesity, asthma and sudden infant death syndrome in babies. Studies also show that women who breastfeed have a decreased risk of breast cancer.

As numerous medical studies have supported the health benefits of breast milk, legislation, community programs and growing public awareness continue to move breastfeeding away from being just an optional way of feeding a newborn toward the spotlight as a major public health concern.

Based on the statistics, it's clear to many that the message is particularly needed in minority communities, which have drastically lower rates of breastfeeding, particularly in the category of only feeding babies breast milk for six consecutive months.

A little less than 60 percent of black babies are breastfed at least once. Twenty-eight percent of black babies receive some breast milk six months later, with only 8 percent being fed only breast milk at six months. Although breastfeeding rates within the United States have steadily increased during the past decade, disparities continue to exist, as many women face the challenge of questioning relatives who used formula to feed their own children, popular beliefs that the act of breastfeeding is inappropriate, a lack of social support and the historical after effects of family segmentation and regulations of government programming.

In 2011, the United States Breastfeeding Committee declared August to be National Breastfeeding Month Exit Disclaimer, with the first week coinciding with World Breastfeeding Week Exit Disclaimer. The 19th U.S. Surgeon General Regina M. Benjamin, MD, MBA also issued an official Call to Action to Support Breastfeeding, inviting employers, family members, health professionals and grandparents to not only ease the stress of breastfeeding mothers but to encourage breastfeeding in support of a healthy nation. The Affordable Care Act expanded access to breastfeeding counseling, support and supplies without any cost-sharing, which began Aug. 1.

"It is a struggle, no matter what," said Johnson, whose struggle to provide what she knew was right for her child led her to become an international board certified lactation consultant working in Florida.

"Breastfeeding decisions are usually made and most successfully reached when [women] have prenatal education," she said. "Moms who make it to six months make it because that was their goal from the beginning."

The American Academy of Pediatrics agrees. The February 2012 edition of Pediatrics concluded that "infant feeding should not be considered as a lifestyle choice but rather as a basic health issue. As such, the pediatrician's role in advocating and supporting proper breastfeeding practices is essential and vital for the achievement of this preferred public health goal."

Nurse-Midwife and Founder of the Developing Families Center Exit Disclaimer in the District of Columbia's Ward 5, Dr. Ruth Lubic said not to discount the additional benefits, particularly the bond between mother and child.

"The emotional benefits of breastfeeding are very important," Lubic said. "When I did midwifery in '61 and '62, nobody breastfed."

But Lubic has seen a slight shift over the past several decades.

"There's a real understanding that breastfeeding is important for the health of the mother and the health of the child," she said.

Although breastfeeding rates have increased steadily, Johnson still believes support is desperately needed for mothers, noting that most mothers she helps don't always breastfeed exclusively. She has personally seen the number of women who want to breastfeed increase, but finds rigid work schedules, inadequate pumping locations, advice from physicians to occasionally use formula and the availability of free formula, can all derail goals.

Despite the challenges, Johnson continues the mission of letting other mothers know that healthy breast milk is the best food for babies.

"Nobody ever asked me what my [breastfeeding] plans were," Johnson said. "So I do make it a point to ask-especially African-American and low-income women. I know it's hard, but… they need to know they aren't alone [because] sometimes when women breastfeed [they feel] alone in that quest."

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Content Last Modified: 8/14/2012 3:40:00 PM
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