By Molly M. Ginty
Sunday, May 11, 2008
The CDC just reported a sharp increase in U.S. women who have breastfed their infants. But the most-watched target--exclusive breastfeeding for six months--was disappointing. There all women fell short. Among African Americans it was only 20 percent.
(WOMENSENEWS)--Packed with protein, water, fat, sugar and nutrients, it's nothing short of the perfect food.
That's the dish on breast milk.
But last month's study by the Atlanta-based Centers for Disease Control and Prevention found good and bad news about how many U.S. infants are getting it.
The proportion of infants who were ever breastfed increased to 77 percent in 2006-2007 from 60 percent in 1993-1994. The new figure exceeds the 75 percent target set by the CDC's "Healthy People" initiative for the year 2010.
And within that finding, breastfeeding increased most significantly among the group least likely to practice it: black women, 65 percent of whom had ever breastfed, compared to 36 percent in 1993-1994. The comparative figures were 79 percent for white mothers and 80 percent for Mexican American mothers.
But for the CDC and other health agencies the gold standard in infant nutrition is six months of nothing but mother's milk.
And there the April 30 report found all infants getting less than they should, particularly if they're African American.
At six months, breastfeeding exclusivity rates were 40 percent among whites and 35 percent among Hispanics, but just 20 percent among African Americans.
"This report is good news because breastfeeding is the healthiest choice for mothers and children alike," says Dr. Ruth Lawrence, chair of the section on breastfeeding for the American Academy of Pediatrics, based in Elk Grove Village, Ill. "But researchers counted the number of women who had breastfed even once and not regularly. We have yet to reach the CDC target of having 50 percent of mothers breastfeeding exclusively at six months, and we have yet to have African Americans catch up to other groups."
Health officials say that unless mothers have HIV, tuberculosis or other health conditions that can affect the quality of their breast milk, they should breastfeed exclusively (offering infants no supplements, water, juice or formula) for the first six months of life. Studies show exclusive breastfeeding during this time lowers infants' risk of diarrhea, ear infections, respiratory illnesses and hospitalization.
In the developed world, U.S. mothers have some of the lowest rates of breastfeeding. Studies show 88 percent of mothers in Australia breastfeed, while 83 percent of Canadian mothers and 78 percent of British mothers do so.
Doctors recommend starting breastfeeding in the first hour of life, introducing solid foods at six months and continuing to breastfeed through the first year of life.
For infants, breast milk is easy to digest and contains antibodies that protect against bacterial and viral infections. Breastfed babies score better on IQ tests than formula-fed ones, and are at lower risk for asthma, diabetes, Hodgkin's disease, lymphoma, obesity and sudden infant death syndrome.
For mothers, breastfeeding reduces post-delivery blood loss, helps shrink the post-delivery uterus to its regular size and consumes up to 500 calories a day to promote weight loss after pregnancy. It protects against breast and ovarian cancers, and may also reduce the risk of hip fractures and osteoporosis.
In both mother and child, breastfeeding releases the bonding hormone oxytocin, forging emotional connection and helping both feel comforted and secure.
Breastfeeding is less time-consuming than formula feeding, which requires preparation and cleaning of bottles, produces no plastic waste and is free of cost while formula feeding runs about $300 per month.
In 1984, former U.S. Surgeon General C. Everett Koop began pushing for the formal inclusion of breastfeeding in medical training. Since then, the American Academy of Pediatrics has informed pediatricians, obstetricians and family doctors about breastfeeding to promote it.
From 2004 to 2006, the U.S. Department of Health and Human Services ran a National Breastfeeding Awareness Campaign, and the U.S. Department of Agriculture promoted nursing through its Women, Infants and Children program.
Today, La Leche League International of Schaumburg, Ill., is working to bring lactation consultants to more hospitals, while the Washington-based United States Breastfeeding Committee and the Raleigh, N.C.-based International Lactation Consultant Organization are promoting peer support programs, through which mothers who have successfully breastfed teach other women how to nurse.
Hospital administrators are turning to programs like those at Boston Medical Center, a government-designated "Baby Friendly Hospital," for examples of how to do it right.
But while medical authorities promote breastfeeding's health benefits, U.S. society is often ambivalent about it.
A 2005 study by the Families and Work Institute in New York found that while 60 percent of young mothers work, only a third of large companies provide a private, secure area where they can express breast milk.
The social networking site MySpace.com last year banned a Washington woman's Web page because it showed a photo of her breastfeeding her baby. MySpace deemed it violated its policies against nudity and sexually suggestive images.
Twelve states also restrict breastfeeding in public.
To boost breastfeeding, health advocates are supporting groups like Detroit's Black Mothers' Breastfeeding Association and lobbying for passage of the Breastfeeding Promotion Act, which would legalize public nursing in the12 states that limit it.
Co-sponsored by Rep. Carolyn B. Maloney, D-N.Y., and Rep. Christopher Shays, R-Conn., the bill would amend the 1964 Civil Rights Act to protect public breastfeeding; would provide tax credits to employers who create breastfeeding or pumping stations; would set performance standards for breast pumps; and would allow tax deductions for breastfeeding equipment. The bill is currently in committee in the House.
The U.S. Health Resources and Services Administration and the Office of Women's Health--both programs of the U.S. Department of Health and Human Services--are co-sponsoring a "Business Case for Breastfeeding" initiative to improve the nursing atmosphere for working mothers.
Researchers say U.S. views have changed radically from a century ago, when 70 percent of new mothers not only breastfed but initiated the practice without help from caregivers. African American women were more likely than other groups to nurse infants at the turn of the last century, notes Lawrence, of the American Academy of Pediatrics.
Explanations for the change include hospitals' increased practice since the 1970s of separating mothers from newborns at birth; the rise in Cesarean deliveries that require longer maternal recovery time and less opportunity to nurse within the first hour after birth; lack of lactation training among hospital staff; women's increased work force participation; and negative media images of breastfeeding.
African American mothers return to work earlier and are more likely to work while they have children under age 3 at home, says Susan Haynes, assistant director for science at the U.S. Office on Women's Health.
"Another key factor is the heavy marketing of formula feeding," says Lawrence. "Buy flowers for a woman who's just had a baby, and a bottle comes with the bouquet. Buy her infant a baby doll, and a bottle comes with the doll. Formula manufacturers have convinced immigrant women that bottle feeding is more American, convinced poor women it's more sophisticated and convinced women of all types that it's healthier."
Grassroots activists are also fighting to end the practice of offering free "discharge bags" of formula to new mothers. Provided to hospitals by formula companies, studies have shown these bags make mothers end breastfeeding earlier and start using formula sooner than they would otherwise.
Molly M. Ginty is a freelance writer based in New York City.
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African-American Breastfeeding Alliance
National Conference of State Legislatures
"50-State Summary of Breastfeeding Laws"
Centers for Disease Control and Prevention, "Breastfeeding in the United States: Findings from the National Health and Nutrition Examination Surveys, 1999-2006"
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