In some cultures, mothers breastfeed children until four, five, even six years of age. In America, it’s more like months, sometimes weeks. The reasons women give up are varied, but now breastfeeding advocates are searching for new strategies to get more women to breastfeed for longer.
Writer and broadcaster Ama Chris Nsiah-Buadi, who is a freelancer for KPCC, said nursing was a challenge for her in the weeks after her baby was born.
"There was a moment when I nearly gave up,” she said. “I remember standing over the kitchen sink in tears."
Nsiah-Buadi indured pain for days upon days, unsure of why.
"It was week three or week four of being in pain and finding out that I had mastitis, and I was at a complete loss for what to do,” she said. Ultimately, she persevered, but it wasn't easy.
Scientific evidence on the benefits of exclusive breastfeeding is uncontested. Dr Neal Kaufman, a pediatrician and one of the Commissioners of First Five LA, describes breastmilk as the “perfect” first food. Along with necessary fatty acids, vitamins and minerals, the antibodies babies get through breast milk build immunity. Breast milk is also easily digestible, which is critical for a developing digestive system.
“We have leadership from the World Health Organization, the Academy of Pediatric medicine here, most leading health organizations agree that ideally the mother should feed her baby, should offer the breast milk for six months. And that’s exclusive," said Gail Christopher who heads breastfeeding outreach for the W.K. Kellogg Foundation.
Exclusive breastfeeding means no supplementing with infant formula. This can be really hard for mothers who, just home from the hospital amidst hormonal changes, sleepless nights and new-baby adjustments, hit a breastfeeding stumbling block.
“Where are the resources for mothers dealing with mastitis?” Nsiah-Buadi asks.
New statistics from the Centers for Disease Control show that while almost three quarters of mothers initiate breastfeeding on the birth of their baby, only 44 percent are still nursing at the six month mark.
Among those trying to change those statistics are Providence Little Company of Mary hospital in San Pedro. The hospital used to give free formula to moms, said Debbie Cheeks, the hospital's director of special services. And would ask women their preference of breast or bottle.
Now, mothers who deliver at the hospital are helped by lactation consultants -- and can even count on their help after they've gone home. They are not offered formula. The hospital is seeking to be certified “Baby-Friendly” by the World Health Organization and UNICEF.
Baby-Friendly hospitals are one new strategy to increase breastfeeding rates.
The California Breastfeeding Coalition is also trying to encourage workplaces to be more breastfeeding friendly. Executive Director Robbie Gonzalez Dow spends her days helping companies create policies -- and find places -- for women who have returned to privately pump milk. From corporate law firms to the agriculture fields where low-income women pick fruit, Gonzalez-Dow said California businesses are getting creative as they encourage their employees to comfortably express milk.
“But we still have a long way to go,” she said.
Breastfeeding advocates said they want to “reframe” how people think about breastfeeding. Christopher, of the Kellogg foundation said the American Academy of Pediatrics earlier this year called for breastfeeding to not be seen as an individual, social choice but rather as a health decision.
She said that statement was "pivotal."
"So much of the public discourse and debate around this issue has been framed around the social choice that the mother makes, and its not based on the science or the health of both the mother and the baby,” she said.
Advocates said breastfeeding should be seen as a public health issue, like wearing a seatbelt or stopping smoking. It's a tough position to hold. Christopher is insistent that the movement to encourage exclusive breastfeeding should never “demonize” women who don’t.
But that's exactly what's happening already, said writer and mother of two Suzanne Barston of Glendale. Barston tried hard to breastfeed, but she hit problem after problem. The pressure she felt to breastfeed and guilt over how badly it was going made her miserable.
As she pumped milk and tried to breastfeed, she said she developed, “really severe postpartum depression.” On her blog, Fearless Formula Feeder, Barston defends moms who need to, or choose to, formula feed.
Barston believes that initiatives like New York City’s “Latch-On,” where participating hospitals need a medical reason to dispense bottles and formula, can make struggling mothers feel even worse than they already do.
She says any initiative to increase nursing needs to be done, “without villainizing formula, locking it up, making it seem like a controlled substance."
But the increasing evidence on the benefits make the balance a tough one.
Another recent CDC study showed that obesity rates in poor children aged zero-5 declined between 1998-2007. One likely reason was an increase in breastfeeding rates, said Laurence Grummer-Strawn, Chief of the Nutrition Branch at the CDC and the study's author.