👋 Welcome to Starting Early. Every other week, we spotlight new reports, useful news, engaging interviews with people doing important work, and interesting takes on maternal health and early childhood development issues.
The benefits of breastfeeding are well documented and recommendations are consistent: Feeding babies breastmilk confers unique health protections and other benefits that last a lifetime.
Breastfeeding promotes Early Relational Health, an important buffer against childhood adversity. During breastfeeding, caregivers and babies make eye contact, engage in skin-to-skin contact, and strengthen their bond.
Unfortunately, though overall US breastfeeding rates are up over the past 10 years, wide, costly disparities in breastfeeding initiation and duration persist. That means too many families face poor health for infants and lactating parents, including increased incidence of infection, diabetes, obesity, and some cancers – particularly among families of color and low-income families.
Read on and click the links to go deeper.
1 big thing: Breastfeeding barriers threaten infant nutrition
Many barriers block babies from the nutrition needed for a healthy future. Today, 60% percent of mothers don’t breastfeed for as long as they intend to, due to such obstacles as:
- Inadequate education and lactation support
- Unsupportive work policies and lack of parental leave
- Unfavorable cultural norms and hospital policies/practices
- Lack of family support
Why it matters: The American Academy of Pediatrics affirms that breastfeeding helps protect against many acute and chronic pediatric disorders, including:
- Respiratory and gastrointestinal illness
- Sudden Infant Death Syndrome (SIDS)
- Childhood leukemia
- Obesity
- Asthma
Other lifelong benefits include more regular school attendance and higher earnings.
Not just for kids: Breastfeeding can help birthing people recover from childbirth and reduces the risk of breast and ovarian cancer, high blood pressure, and other disorders.
- Increasing worldwide breastfeeding rates could prevent about 20,000 maternal deaths and 823,000 infant deaths each year.
Racism and gaps in lactation support and care exacerbate low breastfeeding rates. The CDC reports that hospital maternity wards in predominantly Black communities are less likely to help initiate breastfeeding after giving birth or offer lactation support following delivery.
- By the numbers: Black women have the lowest breastfeeding initiation rate in 26 states and American Indian/Alaskan Native women have the lowest breastfeeding initiation rate in 13 states.
What’s needed: Policies that promote breastfeeding can improve the health of babies and mothers — especially in households that struggle to make ends meet. But stakeholder collaboration is needed. From The White House Maternal Health Blueprint to state breastfeeding in childcare toolkits, optimal infant feeding is everyone’s responsibility.
2. Promoting breastfeeding equity
The US Breastfeeding Committee identifies “4 P’s” for building a breastfeeding infrastructure:
- Parents
- Programs
- Policies
- Plan for emergencies
Investing in each pillar would enable families to benefit from a landscape that promotes secure infant feeding so all infants get what they need for the most promising beginnings. Highlights of each pillar include:
Parents — Support for Black breastfeeding moms: The Perinatal Health Equity Initiative promotes Black breastfeeding through its support group, Sistahs Who Breastfeed. Participants have access to a peer network of Black moms across New Jersey as well as one-on-one consults with a team of breastfeeding coaches. The program supports over 700 moms, virtually and in-person.
Program – Workforce development for skilled lactation support: The Vital Village Network’s Boston Breastfeeding Coalition provides group-based breastfeeding support services to caregivers. The Coalition is committed to improving access to breastfeeding support for every parent in Boston, strengthening connections between individuals and organizations that promote breastfeeding advocacy, and supporting skill-building for lactation counselors. Strategies include a service-learning model that supports community scholars to become peer counselors, ongoing professional development and training, and raising awareness through multimedia communications.
Policy – Federal protection for working moms: Congressional passage of the Providing Urgent Maternal Protections (PUMP) for Nursing Mothers in December 2022 marked significant progress toward closing coverage gaps left from a 2010 law that gave employees the right to reasonable break time and a private place to pump breast milk during the workday. The new law covers 9 million more women — one in 4 women of childbearing age — including teachers, software engineers, farmworkers, and many nurses.
Plan – Infant feeding in disasters and emergencies: The New Orleans Breastfeeding Center promotes disaster preparedness with Infant Ready, which offers emergency infant feeding kits, safe infant feeding and lactation training, educational materials, and other resources.
- The Center writes, “Infants and young children are vulnerable in emergencies and are at high risk for malnutrition, infection, and death. Pregnant and postpartum women have special health, nutrition, and psychological needs in emergencies.”
3 questions for breastfeeding champion Dr. Nastassia Harris
We sat down with Dr. Nastassia Harris, assistant professor of nursing at Montclair State University, nurse researcher, and founding executive director of the Perinatal Health Equity Initiative, an organization dedicated to changing the narrative of Black maternal and infant health by helping Black moms have safer and healthier births.
In partnership with the Burke Foundation, Dr. Harris is conducting a study to identify breastfeeding needs, preferences, barriers, and successes of Black birthing people in New Jersey and advocate for culturally-congruent breastfeeding strategies. Here are highlights from our conversation:
What does the Perinatal Health Equity Initiative do?
Our work is primarily centered on improving pregnancy and birth outcomes for Black women. I consider us to be a gap organization, meaning our work is defined by interactions that we have with the community and what they tell us they need from us. We allow the community to drive where we go as an organization. And so we’ve experienced some shifts over the course of doing this work, but it’s resources, it’s education, it’s community building. It’s a safe space to be, an ear to listen, someone to hold your baby. It’s whatever that mama needs.
Our work covers the spectrum of reproductive health, but what is unique is that we cater specifically to Black women. We serve anyone who needs it but our work was designed with Black birthing people in mind. We offer classes, advocacy, clinical care, breastfeeding support, maternal and infant supplies, and one-on-one support through our perinatal community health workers and lactation staff. We stand in the fire for our families. If something in their care is not going according to plan, we fight for them.
What has emerged from your New Jersey breastfeeding study?
How far we’ve come. In my first lactation position, in 2012, I felt like a salesperson needing to pitch breastfeeding. That’s no longer the space we live in. I deal with more mothers who are being sabotaged from reaching their goal than mothers who have no interest in breastfeeding. What I’m seeing more is people want support. They want more help. They want their doctors to talk to them about breastfeeding. They want their nurses to spend time with them in the hospital, getting them up and running.
What changes would you like to see in our maternal health system for Black women and families?
I love what Charles Johnson [founder of 4Kira4Moms, whose wife died after delivering their second child] has said about getting to a place where he is irrelevant, meaning the landscape has changed to the point where his voice is no longer needed. And I think we’re all looking for that space of not needing to fight. I think there will always be a need for Black-led organizations to serve Black women, but I hope our work changes from a focus on advocacy and fighting to just providing support that people want — and that birth is a safe place for people, that people are not going through their pregnancies fearful that they might die. And I would like to see that change as a country.
For Black women, it’s really bad, but for all birthing people in our country, it’s bad. It’s not a safe place to give birth for anyone. And I think when we drill down and look at changing that for Black women, we’re going to change it for everyone.
The roundup
Learn about upcoming events, new funding opportunities, and jobs in maternal and infant health and early childhood:
- From data to action: Advocates for Children of New Jersey is hosting community conversations to review Trenton Kids Count 2023 data and brainstorm ways to serve the needs of Trenton children. The next conversation, April 19, will focus on juvenile justice and crime. Plus, join ACNJ and Superintendent James Earle, March 30, to learn about Trenton Public Schools’ 5-year strategic plan. Click here to view the Trenton Kids Count report and register for the community conversations and strategic plan review.
- Health disparities for Black moms: A recent New York Times article highlights racial disparities in maternal mortality between Black and white Californians. Regardless of socioeconomic status, Black women are more likely to die the year after childbirth.
- Breastfeeding public school teachers in New Jersey: A member of the New Jersey Education Association and a breastfeeding parent spoke with 4 breastfeeding experts about New Jersey’s protections for breastfeeding teachers and how working parents can navigate pumping at work.
- Bolstering community doula programs: Join HealthConnect One March 29 for the launch of the Forecasting and Sustainability Tool for Community Doula Organizations (Doula FAST) — a new resource supported by the Burke Foundation that helps organizations plan for and track anticipated costs of doula programs. Register here.
- Advancing birth equity: HealthConnect One seeks sponsors to support its Birth & Beyond Summit in College Park, MD June 20-22. Review the sponsorship package to learn more. Register here to attend the Summit.
- Promote group-based care: Burke partner, Centering Healthcare Institute, seeks its next CEO. Click here for the job description and information on how to apply.