Enhancing Breastfeeding Support for At Risk Mothers Requires Systemic Support

Did you know that maternal and child health is one of the best indicators for a society’s health? Did you also know that the World Health Organization (WHO) considers breastfeeding the best source of nutrition for babies and that the American Academy of Pediatrics, considers breastfeeding one of the most beneficial health behaviors for mothers and their children?

Over the past few decades, multiple studies have confirmed that breastfeeding has positive effects for mother and child from a nutritional, physiological, and developmental perspective.

Simultaneously, overall breastfeeding rates in the United States have risen, most likely reflecting various legislative changes specifically addressing health, economics, employment, and welfare policies and practices with a unifying goal of providing systemic support for mothers to breastfeed. The Innocenti Declaration (1990) and U.S. legislations, including the Family Medical Leave Act (1993), Personal Responsibility Welfare and Work Opportunity Act (1996), the Affordable Care Act (2010), and the Healthy People Act (2010) have resulted in national policies such as the Surgeon General’s Call to Action to Support Breastfeeding (2011) and the Baby-Friendly Hospital Initiative (BFHI)
However, despite these many breastfeeding initiatives and the apparent overall success of enhancing U.S. breastfeeding rates over the past 25 years, African American mothers—have persistently lagged behind, showing, by far, the lowest breastfeeding rates. This puts African American mothers and their babies at higher risk for poor postnatal outcomes and may be a substantial contributor to the origins of health disparities among African Americans across the lifetime.

 Persistent disparities in breastfeeding rates among African American mothers raise concerns that socially disadvantaged mothers and babies may be at increased risk for poor postnatal outcomes. In a recent study (Johnson et al) published November 25, 2014 in the Journal Breastfeeding Medicine, a systemic review was conducted to identify effective breastfeeding interventions. The results of this study highlight that current breastfeeding interventions reflect approaches that are often not effective because they are disjointed and don’t address the complexity of social and health challenges many mothers and their children face.

Viable Solutions
Johnson et al (2014) found that effective breastfeeding support initiatives must function comprehensively, operate seamlessly from the societal level of national-, state-, and local-level policies, and be incorporated throughout major institutions such as hospitals, workplace, schools, and churches. In this way, researchers say, “mothers may benefit from authentic breastfeeding education and care from healthcare providers and community lactation groups necessary to attain heightened breastfeeding standards and outcomes among all mothers, but especially African American women”.

 More Action is Needed!
Effective breastfeeding Interventions should:

Recognize and address the conscious and unconscious racial bias that exist within breastfeeding inequities by creating more peer breastfeeding counselors, increasing the racial diversity of health and medical professionals, and by providing training for all medical personnel;
Provide workplace breastfeeding support in the form of pumping and storing stations, protected break-time for pumping, and flexible work schedules;
Support maternity leave as a mechanism for enhancing breastfeeding behavior;
Provide psychological and social support that target all mothers and especially those at risk for stress and depression;
Provide virtual support available through social media, internet, text-based programs combined with other services.
In sum, important community breastfeeding support systems will include personal networks, employers, healthcare institutions, faith-based organizations, and other stakeholders who daily engage with African American and other at risk mothers and children.

More research is needed that includes a cross-section of mothers from a diversity of socio-economic levels to help discern those barriers related to economic factors versus those factors related to racial and cultural experiences. Research should also help target the development of culturally appropriate interventions that mirror the psychological, social, cultural, and societal needs of African American mothers and other at risk mothers and their children.

This study was supported by a grant from the National Center for Advancing Translational Sciences through the Michigan Institute for Clinical Health Research and the Department of Psychiatry at the University of Michigan. Additional support was provided by the Program for Multicultural Health at the University of Michigan Health System.

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This entry was posted in Breastfeeding, Maternal Health, Pediatric Health and tagged Affordable Care Act, American Academy of Pediatrics, Baby-Friendly Hospital Initiative, breastfeeding, breastfeeding support, Family Medical Leave Act, health disparity, health equity, Health People Act, Innocenti Declaration, Michigan Institute for Clinical Health Research, multicultural health, National Center for Advanced Translational Sciences, Personal Responsibility Welfare and Work Opportunity Act, PMCH, Program for Multicultural Health, UM Department of Psychiatry, UMHS, University of Michigan Health System by angejohn. Bookmark the permalink.