By virtually any standard, African American mothers breast-feed their infants less than mothers in any other group. In a 2006 Centers for Disease Control graphic, Asian or Pacific Islanders were way out in front in breast-feeding their infants, followed by Hispanic or Latinos, Whites (not Hispanic), American Indians or Alaska Natives and, far behind, were African Americans (not Hispanic). In 2012, African American mothers still lag far behind.
Surgeon General Regina Benjamin, in her “Call to Action on Breast-feeding,” asked all sectors of society to help new mothers with breast-feeding. First lady Michelle Obama also came out in support of breast-feeding, tying her comments to preventing childhood obesity.
According to most reports, it is a proven fact that breast-fed children have fewer incidents of upper respiratory infections, diarrhea, sudden infant death syndrome, type 1 and type 2 diabetes, asthma, childhood leukemia and other diseases.
According Sahira Long, a Maryland pediatrician and board-certified lactation consultant, “only 60 percent of African American babies have even been given breast milk, compared to 77 percent for Caucasian women, 81 percent for Latinos and 83 percent for Asian Americans. This gap between African American mothers and other ethnic groups widens even more as babies get older. At six months, only 28 percent of African American were exclusively breast-feeding compared to 45 percent of Caucasians, 46 percent of Latinos and 56 percent of Asian Americans.”
A report co-authored by the California Women, Infants, and Children Association (CWA) and UC Davis Human Lactation Center found more than 90 percent of California mothers have made the decision to exclusively breast-feed their babies. However, in hospitals serving mostly low-income families, 40 percent of these mothers are not breast-feeding exclusively by the conclusion of their hospital stay.
“The Maternity Care Matters: Overcoming Barriers to Breast-feeding” report goes on to show how the support of hospital staff and the standard of care within a hospital directly affects the success of a breast-feeding mother, specifically during the first 24 to 72 hours. Breast-feeding rates could dramatically increase if hospitals did not undermine mothers’ intent to breast-feed by “failing to provide skilled support,” “delaying the first feeding,” and by “routinely providing formula supplementation,” the report said.
“Within the first hour of being alert, the mother should be reunited with her baby to start breast-feeding,” said Debbie Myers, the chief of Nutrition and Breast-feeding Services at South L.A. Health Projects. “We see babies receiving formula when the mother said she wants to breast-feed. It is up to the hospital to hold these employees accountable and step up their support for breast-feeding mothers. But, that is part of the problem. Many hospitals don’t have such policies, or it’s not enforced.”
Due to these lack of policies, the report asks all California hospitals to implement Baby-Friendly methods in order to provide mothers and babies with the best standard of care. Only 18 percent of hospitals in the state are Baby-Friendly. The initiative focuses on 10 steps designed to reduce barriers to exclusive breast-feeding. These steps include having a written breast-feeding policy, training all healthcare staff, and informing all pregnant women about the benefits of breast-feeding.
Additionally, the steps advise hospitals to help mothers initiate breast-feeding, show mothers how to breast-feed and how to practice exclusive breast-feeding. The hospital must allow mothers and infants to remain together 24 hours a day, encourage unrestricted breast-feeding, and establish breast-feeding support groups. Lastly, the hospital cannot undermine the mother’s choice by giving the child a pacifier or artificial nipples.
“Hospital practices are critical,” said Elizabeth Woods, the founder of Soul Food for Your Baby, an organization looking to revive breast-feeding among African American women. “If you see a nurse doing it, then you are more likely adopt it. It’s a detrimental message when the hospital says it’s OK to have formula.”
“It is often said breast-feeding may not be the choice for every mother, but it’s a good choice for every baby,” said Myers.
Los Angeles County is home to eleven hospitals among the 15 lowest-scoring in the state. This list includes Pacific Alliance Medical Center, Garfield Medical Center, Beverly Hospital, Centinela Hospital, Bellflower Medical Center, Monterey Park Hospital, Good Samaritan Hospital, San Gabriel Valley Medical Center, Valley Presbyterian Hospital, Methodist Hospital of Southern California and Hollywood Presbyterian Medical Center.
“Some of these hospitals are guarantees to become Baby-Friendly because they are now under contracts,” said Karen Peters, the director of the Breast-feeding Task Force of Greater L.A. “We are pleased many of them have accepted grant money, which means the changes will occur over a year- to three-year period. Those that have not yet made a commitment, we aren’t privy to their internal timeline.”
“I feel like hospital practices need to change, especially in the African American community,” said Woods. “It seems like hospitals in the African American community have the worst practices and are not Baby-Friendly. This further perpetuates the cycle in the community.”
Woods’ organization found the African American community has its own barriers to breast-feeding including negative cultural attitudes, complaints of pain, lack of support from a mother’s family, lack of education and sociological concerns.
“Society is friendlier if you pull out a bottle instead of exposing yourself and breast-feeding,” said Woods. “In terms of sociological concerns, African American women have many time constraints. They have so much on their plates it is easier to give the baby formula.”
Easier does not always mean healthier.
“Children are more at risk for obesity and diabetes if not breast-fed,” said Myers. “Mothers are also at a greater risk for breast cancer. Not breast-feeding really throws off our physiology and exposes us to chronic and devastating diseases.”
Ty Anderson, 24, began college in January 2012. The mother of two is currently breast-feeding her 6-month-old son Zamir, despite the demands of her collegiate schedule. During her hospital stay, Anderson did not receive a lot of support from the hospital staff. However, knowing the health benefits of breast-feeding, she decided to stick with it.
“I can see the difference between formula and breast-fed babies. It’s like a shield,” Anderson said. “My oldest son Zaire is 3 years old and has only had two colds.”