The Centers for Disease Control (CDC) has released new data on the state of breastfeeding in America. As several media outlets have reported, things look pretty good on first glance. But the report also highlights the shifting yet stubborn disparity between rich, white women’s breastfeeding rates and those of low-income and minority mothers — disparities that are enshrined through policies in this area that disproportionately hurt the poor.
There is fairly robust medical consensus on the merits of breastfeeding. Doctors, researchers, and government health agencies have all touted its health benefits for mother and child alike, including lowering babies’ risks for diabetes, obesity, asthma, and other chronic ailments and lowering mothers’ risks for ovarian and breast cancers. That also means lower health care spending on those illnesses that could save the country billions of dollars every year. “We know that more breastfeeding means healthier moms and healthier babies,” said CDC researcher Jessica Allen in an interview with Reuters.
Given those benefits, the latest CDC breastfeeding report card is encouraging. In 2010, as many as 77 percent of U.S. newborns were breastfed for at least some duration of time, and 49 percent of mothers were continuing to breastfeed at 6 months (a substantial increase from 2000, when only 35 percent of mothers breastfed at the same point in time). It’s important to note that those numbers represent partial, and not exclusive, breastfeeding. Doctors recommend that babies be exclusively breastfed for the first six months and partially breastfed for the first year.
But not all Americans are seeing equivalent gains. Slightly older CDC data shows that, while the gap between black and white breastfeeding rates immediately after birth improved between 2000 and 2008, there’s still a 16 point disparity for black mothers. The 6-month duration gap between black and white mothers’ breastfeeding rates stands at 17 percent. And low-income mothers of almost all races are less likely to breastfeed at any given time:
A series of policy shortcomings help explain these differences. A 2010 report by the California WIC Association and the UC Davis Human Lactation Center found that California women who receive care in better-funded hospitals are far more likely to exclusively breastfeed their newborns. By contrast, the lowest-performing hospitals for breastfeeding are those that primarily serve the poor.
Hospitals that care for low-income Americans have often been targeted for budget cuts that have forced them to shut down first-time mother training programs that include breastfeeding education. Many are overburdened and understaffed, making it easier for doctors and nurses to hand out formula milk rather than engage in the time-consuming process of preparing a first-time mom for the challenges of breastfeeding. And once these moms leave the hospital, continuing support programs are almost non-existent, leaving poor mothers to their own devices. Language barriers can also be a major hurdle in communicating good breastfeeding practices to patients.
For poor moms who have to work full or part-time jobs, the problems are even worse. Many of these women can’t afford child care facilities, and there’s no assurance that friends or relatives who take over day care duties approve of or are capable of breast feeding. That puts the burden on mom to pump breast milk at work, which doctors recommend they do two to three times per day.
Although Obamacare has added certain protections for nursing mothers — such as requiring employers to provide a clean, non-bathroom space with an electrical outlet and “reasonable” break time for workers to pump breast milk — those provisions don’t necessarily address all moms’ needs.
For instance, companies with less than 50 workers can claim a hardship exemption to bypass the law. Even at firms that do have to comply with the standards, moms struggling with financial hardship may be reticent to take advantage of them, since employers don’t have to pay nursing workers for the break time in question. And employers have no obligation to provide the tools that make breast pumping possible, including the breast pumps themselves or even refrigeration units to store the pumped milk.
Increasing funding for maternity care programs for hospitals that cater to the poor is one possible way to decrease the breastfeeding gap between the rich and the poor. Rep. Carolyn Maloney (D-NY) has also proposed the Breastfeeding Promotion Act, which would amend the Civil Rights Act to include lactation as protected conduct and thereby require employers to make better arrangements for working and nursing moms. But in the meantime, advocates who extol the virtues of breastfeeding should note that not all American mothers have the resources to do it.