By: Ashley Hollingshead, Project Associate
In the past few weeks, we have seen a rise in public conversations about breastfeeding. Last month Facebook lifted their ban on female nipples in breastfeeding photos after the #freethenipple campaign, a campaign fighting against Internet censorship, went viral. Breastfeeding came up again when 25-year-old Karlesha Thurman posted a picture breastfeeding her infant daughter at her graduation. When Karlesha received a wave of negative backlash on Twitter, Black Women Do Breastfeed, a Facebook page devoted to making Black mothers who breastfeed more visible, put the photo on their page.
These online actions are a step in the right direction to normalize breastfeeding. But normalizing breastfeeding in all communities is only the tip of the iceberg.
A web of policies and institutional practices, that work to reinforce each other, create barriers for all mothers to access the resources they need to successfully breastfeed.
We know breastfeeding is normal and beneficial for both mother and infant. Breastfeeding lowers the risk for sudden infant death syndrome (SIDS), diabetes, asthma and other respiratory diseases for infants. For mothers, breastfeeding helps maintain a healthy weight, while reducing the risk of postpartum depression, certain cancers and heart problems. However, breastfeeding initiation rates differ by race. According to the CDC in 2008, Black mothers had the lowest initiation rates at 58.9%, compared to 75.2% of white women, 63% of Asian women and 80% of Latinas.
So how does our system and policy create disparities in breastfeeding? A few ways are:
Hospitals
Baby-friendly hospitals, designed to protect, promote and support breastfeeding, are one proven method to increase breastfeeding initiation and duration rates. Furthermore, studies show that mothers who exclusively breastfeed while in the hospital are much more likely to carry on exclusive breastfeeding after discharge. However, a study from California WIC shows while baby-friendly hospitals have a positive correlation to breastfeeding, hospitals that do not have the resources to accommodate mothers who plan to breastfeed are located in low-income communities of color.
ACA Break Time Policy
The Affordable Care Act Break Time for Nursing Mothers policy requires employers to provide reasonable break time for a nursing employee to express milk, for one year after the child’s birth. Employers also must provide a place, other than the bathroom, that could be used by an employee to express breast milk. While a step in the right direction, this does not address all of a mother’s needs. For instance, employers do not have to provide refrigeration units for nursing mothers. If an employer does not provide refrigerators for their employees, breast milk is susceptible to spoil during the work day. Context matters.
First Food Deserts
In what Kimberly Seals Allers calls first food deserts, many communities, often low-income communities of color, provide very limited or non-existent support for breastfeeding mothers. A first food desert is defined as having no baby-friendly hospitals within a 35-mile radius and no easily accessible support groups. Additionally, more than 60% of employers do not have a breastfeeding policy in place, more than 40% of doctors do not offer lactation consultant referrals and more than 70% of childcare facilities are not trained to handle breast milk. Without the support and resources necessary for successful breastfeeding, low-income mothers of color and infants are left extremely vulnerable.
The latest conversations on breastfeeding are important in the movement to normalize breastfeeding. Exposing the nation to a community of breastfeeding mothers is an inspiration for countless mothers who plan to or currently breastfeed. In order, however, for breastfeeding to be truly normalized, we also need policies that address the root causes of the disparities that we see. This means transformational changes in hospitals, with employers and in our communities.