West Virginia has some of the lowest breastfeeding rates in the country – especially for participants in the Special Supplemental Nutrition Program for Women, Infants and Children, more commonly known as WIC. But the Department of Health and Human Resources is working to change that, by providing WIC participants with an app that provides 24/7 breastfeeding support.
The app is called Pacify and it connects users to International Board Certified Lactation Consultants to answer questions and concerns about breastfeeding.
The American Academy of Pediatrics recommends that for the first six months of life, babies get all of their nutrition exclusively from breastmilk. When babies begin eating solid foods, normally at six months, mothers are recommended to keep breastfeeding, at least until their baby is a year old. But West Virginia’s breastfeeding rates are well below the national average.
Only about 69 percent of women ever breastfeed compared to a national average of 83 percent, according to the Centers for Disease Control and Prevention.
The DHHR said the hope is that if moms have more support, they will have an easier time with it and breastfeed for longer.
West Virginia WIC, which serves 75 percent of the babies born in the state, is the fifth WIC program in the nation to launch the app.
The app is free for all current, pregnant, and breastfeeding mothers in the WIC program. In a press release, the DHHR said Women can sign up by visiting their local WIC clinic. It is also available by subscription for moms not in WIC via the app store.
Appalachia Health News is a project of West Virginia Public Broadcasting, with support from Marshall Health and Charleston Area Medical Center.
For a variety of reasons, breastfeeding is just not possible for everyone. Formula was a lifesaving development when it was first created. Before formula, a lot of babies who did not have access to adequate breast milk starved to death.
Sometimes wet nurses provided babies with nourishment, if their mothers could not, or did not want, to breastfeed. These were usually women who earned an income by breastfeeding other women’s babies. In some cultures around the world, even today, milk sharing is a socially accepted practice among sisters and close friends who support each other by feeding a baby if the mother cannot produce enough milk.
In America, milk sharing is not a widely accepted practice. But increasing awareness of breastmilk’s advantages over formula is leading some to turn to milk sharing.
In 2017 the American Academy of Pediatrics issued a recommendation that at-risk, premature babies be fed donated, pasteurized breastmilk, if their mothers are not able to breastfeed. This milk comes from milk banks that are certified by the Human Milk Banking Association of North America, where donors are tested for contagious diseases.
Credit Elise Amendola/Associated Press
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A lab technician at the Mothers’ Milk Bank Northeast in Newton Upper Falls, Mass., prepares donated breast milk for pasteurization in August 2012. The process kills harmful bacteria.
But another, informal system of milk sharing could be putting some babies at risk.
Cooper’s Story
Kathryn Ellis had fostered several children, but bringing a 10-day-old baby home from the hospital was an entirely different experience.
“He was a safe haven baby, so he had been left at a hospital. He was tiny,” Ellis said.
At birth, baby Cooper weighed just six pounds. He had a pretty serious health condition, called hypoplastic heart syndrome, where the right side of his heart was not fully developed. Consequently, he needed multiple surgeries after he was born.
“The doctors even said to us before we took him home, “You don’t have to take him home. You can wait for a perfect baby.” And that wasn’t at all what i was thinking,” Ellis said. “I was thinking, “Of course I’m gonna take him and I’m gonna take care of him.””
So when he was 10 days old, Ellis took Cooper home, and started the process to adopt him. Like any baby, he needed around the clock feedings.
“I loved sitting just with him, and we’d sit up on the loft,” she said. “And the stove would be hot and in a fire and the heat would go up to that loft, and it would be quiet and dark. And I would look out the window and see snow and feel warm with him. I felt like that time was so special, to be just the two of us.”
Since Ellis was not his biological mother, she fed him formula. The doctors told her that, because of his condition, Cooper was vulnerable to viruses and infections.
Ellis had heard about scientific studies that show breast milk has immune boosting properties, and babies who drink breast milk have a better defense against viral infections, like the flu and common cold, so she wanted to feed him breastmilk. Most of these studies were done in the 1990s, and they led the American Academy of Pediatrics to recommend all babies be breastfed.
But since Ellis did not have her own breast milk, she decided to feed him donated milk. The milk usually arrived in a cooler packed with ice. The women who supplied the milk did not know each other, but they did have one person in common – a local midwife, named Angie Nixon, who had helped them deliver their babies. She reached out to each of them to ask if they would donate their extra milk. Nixon usually made the deliveries.
“All babies should have breastmilk,” Nixon said. “So when we heard about this baby in need, that was my first thought, “Wouldn’t it be great if we could get that baby some breastmilk?””
Safety Concerns With Milk Sharing
In this case, Nixon had seen the women’s medical histories, and no infectious diseases were passed onto baby Cooper. But, this type of milk sharing is risky.
The American Academy of Pediatrics warns that feeding babies donated milk in this way is not safe. They recommend milk banks require blood tests from all donors and that they pasteurize human milk. There are health risks, like bacterial contamination, and life-threatening diseases, like HIV or Hepatitis C, which can be transferred through milk. Pasteurization kills these viruses and bacterial contamination.
A study published in the Journal of the American Academy of Pediatrics found that most human milk purchased over the internet was contaminated with some type of bacteria. The milk purchases over the internet had higher concentrations of contaminated milk than what is found in milk banks. Although some bacteria is safe, even beneficial, at least some of it is considered dangerous for infants.
The study, led by Dr. Sarah Keim, concluded that most of the bacteria found in the milk samples was likely caused by poor pumping, storage or shipping practices.
Kathryn Ellis said she knew there might be some risks with using donated milk, but she trusted that it would be alright. Also, the experience made her feel she had the support from her community, even from women she did not know.
“And for me to be giving him nourishment, which I knew was my job, but to know that there were other moms that had contributed to that,” she said. “I did feel a support of people that didn’t even know us.”
Feeling a part of a supportive community is something expressed by several other women contacted for this story, who donated or used donated milk through Facebook or other social media groups online. Several women said they feel like sharing milk connects them to their Appalachian culture — a culture that believes in the value of leaning on your neighbor or family for help.
But this culture of sharing does not protect against contagious diseases, especially in a region where HIV and Hepatitis C is now on the rise.
“We have no idea what’s in the milk,” said Dr. Stefan Maxwell, the medical director of the Newborn Intensive Care Unit, at CAMC Women’s and Children’s Hospital in Charleston, West Virginia. He warns against feeding babies donated milk from the internet.
“The nutrient value is probably high. But women are exposed to different viruses and bacteria,” he said. “And in this day and age where there’s a high prevalence of Hepatitis C or HIV, and some of these other transmissible viruses, it’s probably not a good idea to use somebody else’s breast milk, unless they’ve been tested.”
Why NICUs Use Donated Breastmilk
Dr. Maxwell does support the use of donated milk when it is tested and pasteurized. He encouraged his hospital to be among the first in the country to feed donated milk to the most at-risk, premature babies.
Dr. Naomi Bar-Yam is the former president of HMBANA. She also directs a milk bank in Newton Upper Falls, Massachusetts. She said HMBANA requires that all donors are screened, to ensure the breastmilk is safe and free of diseases.
“And we test moms for HIV, Hepatitis B and C, and Syphilis,” Bar-Yam said.
She said last year, they had to turn down more than 20 percent of the women who applied to donate because they did not pass the screening.
Still, thousands of women do successfully donate to HMBANA milk banks, and the numbers are increasing. Most are moms who have surplus breastmilk. Some are moms whose babies died.
“And they are saving lives, in helping others, and they talk about it in terms of this is something my baby and I can do to help others,” Bar-Yam said.
Credit Adobe Stock/ Yurii Zushchyk
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breast pump
She said research shows that when NICUs begin using donated milk, more moms actually make the choice to start breastfeeding their own babies.
That is what happened at Dr. Maxwell’s hospital, when they began using donated breastmilk three years ago.
“Well initially I thought we would have a negative response from the parents,” Maxwell said. “And in fact, we’ve had the unintended consequence where mothers who had not intended to breastfeed before, now decided that they wanted to use their own breastmilk.”
And Maxwell sees this as the ultimate goal, that more women, who are healthy, are encouraged to give breastfeeding a try. Because even though donated milk is better than formula, what gives babies the best chance of surviving, and thriving, is almost always their own mother’s milk.
Want to learn how you can donate breastmilk? Most milk banks accept milk through the mail, and will usually pay for shipping. The HMBANA website has a list of milk banks that follow safety guidelines through their organization. Here are some that are in, or close to, Appalachia:
Ohio Health Mothers’ Milk Bank
4850 E. Main St., Suite 140 Columbus, Ohio, 43213 Phone: 614-566-0630 Email: milkbank@ohiohealth.com
Only 17 percent of Americans have paid family leave from their jobs, according to the Bureau of Labor Statistics. In the early 1990s, the Family Leave Act was passed. It requires most employers to offer workers 3 months off after the birth of a baby — both men and women. But here’s the catch, employers don’t have to pay them for the time off.
Also, businesses with less than 50 employees are exempt from the Family Leave Act, so it’s legal for small businesses to fire workers if they take time off after a birth.
What all this means, is many parents — mothers in particular — who can’t afford to take unpaid time off, return to work soon after having a baby.
We don’t know when, on average, women in Appalachia return to work. There isn’t any research on that. But some breastfeeding advocates say they believe a need to return to work quickly may be one of the reasons women in Appalachia are less likely to breastfeed than women in the nation as a whole.
Nearly 900 women answered a West Virginia Public Broadcasting survey about being a working mom in Appalachia. From this, we were able to glean some insight into what working women in our region face, especially when it comes to the challenges of breastfeeding.
More than half of the women said they breastfed their babies.
More than half also said they received no paid time off work.
Returning to work after giving birth can be hard, regardless of how parents choose to feed their babies.
Kat Biller’s Story
On a Saturday morning in downtown Charleston, West Virginia, people are queuing up at the coffee shop inside a local bookstore.
Kat Biller has worked here for four years.
Like most hourly workers, Biller didn’t get any paid time off after giving birth to her daughter, Jackie. She said she would have loved more time off, but she couldn’t afford to miss another paycheck.
Credit courtesy Kat Biller
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Kat Biller with her daughter, Jackie
But she said there are benefits to working for a locally-owned business. Her bosses encouraged her to bring her infant to work. They provided space for her to feed the baby, change her diaper, and they made sure she didn’t work on her own, so that she could step away if she needed to. So four weeks after giving birth, Biller was back behind the register, with her baby sleeping in a sling across her chest.
After a month of working with her daughter at the bookstore, Biller asked if she could work evenings and weekends instead of during the day. Her employers agreed. So, while she was at work, her husband watched their daughter. He fed her the breast milk Biller pumped at work.
Biller said she knows family-friendly work environments like hers are rare. “Were the system as a whole to open up and allow for women everywhere to have even as much opportunity as I had, I think that would be much better,” she said.
Biller said she’s grateful for the flexibility that her job offers. Still, she said she wishes she would have had a few months paid time off to spend with Jackie.
No Paid Leave
Like Biller, many working mothers return just a few weeks after giving birth.
“I’ve had patients that they had the baby on a Friday night, and they had to go back to work on Monday morning,” said Stephanie Carroll, a lactation consultant in southeastern Ohio. Carroll is also the founder of the nonprofit Appalachian Breastfeeding Network, which seeks to increase breastfeeding in Appalachia. She said there’s a lot of pressure on women in our region — both cultural and economic — to go back to work early.
Why Some Women Dread Breast Pumps
Credit Adobe Stock
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breast pump
Pumping breastmilk which can be stored and fed to babies through a bottle — is an option that a lot of the moms we interviewed said they tried. Some had mixed success and all had conflicting emotions about pumping.
Breast pumps in the United States cost about $200 dollars. The Affordable Care Act of 2010 requires that most health insurance plans cover at least some of the cost. But while pumping enables working moms to feed their babies breast milk, there are drawbacks.
“It’s very mechanical,” said state employee Caitlin Ashley-Lizarraga. Lizarraga pumped at work until her son Cillian was 10 months old. “You start to feel like you’re a drone in a sci-fi movie or, you know, a post-apocalyptic world.”
Lizarraga just gave birth to her second baby in June. Before her baby was born, we met at a coffee shop one evening after work, and she told me she dreads pumping, even though she loves breastfeeding.
“For me at least, it was a connection to my mother, my grandmother, all the way back. But pumping strips it all away. And you literally feel like you’re just a dairy cow,” Lizarraga said.
She said she and some coworkers hang a sign of a cow over their cubicles when they pump breast milk at work. Often they pump right at their cubicle, so they can keep working, even though there is a designated pumping space at the office. Designated pumping spaces are another part of the Affordable Care Act, the Break Time for Nursing Mothers, that requires employers with 50 or more workers to offer a room and time for mothers to pump breast milk. And it can’t be a bathroom.
Milisha’s Story
But employers don’t have to pay women for the time they spend pumping, so working moms can lose money, or have to stay late to make up the work. That’s what happened to Milisha.
“I don’t think it’s right. I think we should get paid for it.” We agreed not to use Milisha’s last name because she’s worried her employer might fire her for talking to a reporter. She said she had to clock out whenever she took a break to pump.
“Financially I made probably $150 less on each paycheck, because I was pumping. And a lot of people can’t do it financially.”
Milisha works at a call center, And sometimes calls went on so long that she went without pumping. “So sometimes you’d just sit there and you’d be miserable. And that was terrible.”
Not only is waiting to pump uncomfortable, it can cause an inflammation of the breast, called mastitis.
Inconsistent Pumping Breaks Leads to Lower Milk Supply
Milk works on a supply and demand system, so if women skip a feeding or a pump break, they can lose or weaken their supply of milk, especially in the first few weeks after giving birth.
“Stress itself doesn’t decrease your milk supply, but what it does is it might make you forget or neglect to pump or skip a feed. That’s what causes you to lose your milk supply,” said Dr. Kailey Littleton, a pediatrician and a lactation consultant.
Littleton said the best way to maintain a supply of milk after returning to work, is to pump regularly, every few hours.
“Which, it’s easy for me to say cause I was in a job where it was respected and honored,” said Littleton. But for women who work in restaurants or gas stations or other jobs with hourly pay, it’s not as easy to take a break every few hours, she said. “They probably would just fire you.”
Littleton said she hears this all the time. “People say, ‘I don’t think my job will let me do it.’ I write letters for moms all the time saying that they are legally required to allow this. I don’t know how effective all of that is, but sometimes it works.”
Even salaried employees struggle to juggle regular pumping schedules, and still, nine years after the Break Time for Nursing Mothers became federal law, not all employers offer women a place to pump milk.
Credit Eric Douglas/ WVPB
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Reporter Roxy Todd with her 6-month-old daughter
Angela Burkhart’s Story
Former kindergarten teacher Angela Burkhart said during a work training, she couldn’t find anywhere to pump.
“So I had to leave during the morning to go pump, I would pump on my way there, at lunch I would pump, and then I would pump on my way back. And every time I pumped basically in those three days was in my car,” said Burkhart.
These trainings were held at the local high school. She said she felt reluctant to ask for a special room to pump, especially for a training that only lasted a few days. And she said her boss was usually accommodating, and she felt lucky. At school she was given both time and a room to pump. Although, the janitor has walked in on her.
“Like at least a dozen times he walked in, absentmindedly.”
Still, Burkhart said she considers her situation better than what a lot of women face at work. Although she now works a different job, part time for the school system, she said she knows there are other teachers who still struggle to maintain pumping while they work.
Legal Consequences
There have been some lawsuits across the country for breastfeeding discrimination.
In February, a woman in Delaware won a $1.5 million lawsuit against Kentucky Fried Chicken for not being given an adequate place to pump breast milk.
Of the women who answered our survey, nearly 4 out of 10 said they didn’t feel like they had the flexibility to pump milk after they returned to work. Others feel more fortunate.
“In terms of having paid maternity leave and having a very flexible job, and having an office with a door that closes, and a refrigerator in my office. I’m able to pump at work,” said Molly Clever, an assistant professor of Sociology at West Virginia Wesleyan college. “And I’m able to have that support in my in my work environment. And I still struggle to do it. So how do women who don’t have that kind of job flexibility, and don’t have that kind of paid maternity leave, how do they do it?”
This lack of support in the workplace may be one reason why so many women stop breastfeeding earlier than they intended. The Centers for Disease Control released a report last year that said “most mothers in the United States want to breastfeed and start out doing so,” but after 3 months, those numbers begin to decline, and only a third continue to breastfeed for a year, which is what the American Association of Pediatricians recommends for all infants.
“How do we reconcile what we tell women is the recommendations of what you’re supposed to do to keep your child healthy, without providing them with any of the support that they need to actually accomplish that?” Clever said.
In the United States, breastfeeding rates are lower among low-income women and higher among high-income women. This is despite research that shows breastfeeding can provide lifelong health benefits to a baby and potentially save new parents money.
Andrea Reedy is one of nine children. Her mother breastfed Andrea and the rest of them. So when Reedy got pregnant, she wanted to breastfeed too.
“It was just kind of something that I knew was there, knew I was capable of, because I had that example,” she said.
Reedy said breastfeeding was also the cheapest way to feed her baby. When she got pregnant, she was working as a nursing assistant, but the long hours were tough to handle in the later stages of her pregnancy, so she quit. Her boyfriend is a teacher.
“We were just broke,” she said. “Like you couldn’t afford formula, but we weren’t broke enough to have the assistance like the WIC and that kind of stuff, and so I just knew it was something I kind of had to do.”
Reedy and her boyfriend didn’t qualify for WIC, the federally funded Supplemental Nutrition Program for Women, Infants, and Children. WIC subsidizes the cost of formula. But Reedy had a lot of support from her mom and a friend who is a lactation consultant, and she was able to successfully breastfeed her daughter.
But for many low-income women, it doesn’t turn out that way. According to the Centers for Disease Control and Prevention, the more money you earn, the more likely you are to breastfeed and to stick with breastfeeding.
“We do know that those that are lower income have less access to care, less access to support,” said Stephanie Carroll, president of the Appalachian Breastfeeding Network. “There could be some addictions, there could be abuse going on in the family, so it’s several things impacting a lower income.”
Carroll said another barrier for lower-income women is the lack of paid maternity leave. “We have a lot of people going back to work early.”
Also women who qualify for WIC are incentivized to feed their babies formula. To qualify for WIC, a family of three must make less than about $39,000 a year.
“When it was started, back in the 70s — when we actually had our lowest breastfeeding rates — they didn’t recognize human milk as food,” said Carole Peterson a lactation consultant based in Indiana who helps train new lactation consultants around the country. She’s also the former chair the National WIC Association Breastfeeding Committee. Instead they viewed formula as food, so it was viewed as giving people containers of baby food.
That thinking has changed in the last few decades at WIC.
“They started realizing, ‘Well, yes, we’re giving formula. Yes, we’re getting rebates on formula. But the optimal nutrition for infants is human milk.’ So they had to make a big change,” said Peterson.
But low-income families had become used to feeding their babies formula, and WIC had developed a reputation as the formula giveaway program.
Here in Appalachia, that’s a lot of infants. About half of all the babies born in West Virginia, Pennsylvania, Kentucky and Ohio are supported by WIC, according to federal data.
Peterson said WIC is implementing a program that will train staff how to support women with breastfeeding in every WIC office around the country.
“Let’s say you decided you were going to breastfeed and you don’t think it’s working, which is 90 percent of what happens,” she said. “And it means when you walk in the door, let me take you to somebody to help you resolve those concerns and help you meet whatever your goals are. And your goals may only be until you go back to work, or your goals may be six months or a year, but you need somebody there to give you the information to meet those goals and not to just offer you formula.”
Peterson said the program should help bridge some of the access-to-care issues that rural, low income women struggle with.
Appalachia Health News is a project of West Virginia Public Broadcasting, with support from Marshall Health and Charleston Area Medical Center.
Infants should be exclusively breastfed for the first six months after birth, says the American Academy of Pediatrics, citing research that says breastfeeding is healthy for infants. It protects against diseases, obesity and stomach issues, helps the mother lose weight, and decreases risk of some cancers. But although breastfeeding is “natural,” for many women, it’s not “easy.”
When Emma Pepper got pregnant, she was totally on board with breastfeeding — until her son was born.
“He could never quite latch properly,” she said. “And he was actually born on a weekend in the hospital and so the lactation consultants weren’t available to support me in the very beginning.”
Pepper lives in Charleston, West Virginia. West Virginia Public Radio reporters called 14 hospitals in the state and only two had breastfeeding consultants available around the clock, even though it’s common for women to struggle with breastfeeding after giving birth.
Unless doctors and nurses have undergone special training, they may not have the expertise to help new moms learn to breastfeed. Only four hospitals in West Virginia require formalized breastfeeding training for nurses and doctors on labor and delivery floors.These hospitals have a “baby friendly” designation from Baby Friendly USA, a World Health Organization and UNICEF program designed to improve the role of maternity services worldwide.
The hospital where Pepper gave birth is not one of the four. Pepper said she was told by a nurse to keep her son for more than an hour on each of her breasts to try to get him to latch. By the time she was discharged from the hospital, she said her nipples were raw.
“It ended up making my breastfeeding experience just more challenging overall,” she said.
A 2013 study published in the journal Pediatrics found that 60 percent of women don’t breastfeed as long as they intend to. This is because of latching problems, concerns about infant nutrition and weight, the need to return to work, or because they don’t have enough support as they try to figure out breastfeeding.
Kailey Littleton, a pediatrician and board-certified lactation consultant in Weirton, West Virginia, said a lot of women she sees have problems breastfeeding.
“Because the information is not great and a lot of the ‘help’ that women get is not the best for them, things tend to go awry,” she said.
Littleton said she hears stories from women about how friends and family or even doctors and nurses have encouraged them to supplement with formula. But supplementing with formula can impact breast milk supply, making it harder to breastfeed. She says many women are also told some pain is normal — but she says it’s not — and that pain is the sign of a bad latch.
When Pepper was discharged, her son still wasn’t latching properly. The doctor recommended she supplement with formula. Pepper was okay with that, but she still wanted to breastfeed. She worried that if she didn’t, her son would be sick more often.
In the meantime, she was being urged on by a lot of people. Her friends, her therapist, even her hairdresser, asked her if she was breastfeeding.
“And so I felt an extreme amount of just societal pressure to be able to live up to that,” she said. “And as a result of that I made some pretty extreme demands on my body in order to be able to fulfill that wish that I had for him.”
Pepper said she spent hundreds of dollars on pumps to increase her milk supply. About a week after giving birth she also connected with a local lactation consultant who suggested a strict regimen: breastfeed, then supplement with formula, then pump to increase milk supply. But Pepper said she was either breastfeeding or pumping around the clock. It wasn’t sustainable.
“I felt such an enormous sadness that I was wearing this pump all of the time, and I couldn’t hold and bond with my baby while I was wearing it, and I only had a limited amount of time for maternity leave,” she said.
After about two months, Pepper would have to return to work. She struggled to breastfeed for six weeks, then the lactation consultant recommended she switch to formula.
“Receiving that advice from her was part of what gave me the confidence to go ahead and switch to formula feeding when I felt I had exhausted every single avenue available to me to make breastfeeding work,” said Pepper.
It’s a decision she said she wishes she had made earlier.
Appalachia Health News is a project of West Virginia Public Broadcasting, with support from Marshall Health and Charleston Area Medical Center.
Edwin Hall is dressed in a footed onsie covered in the pastel shades of monkeys and hippos. Although Edwin’s just seven weeks old he already tells his mom…
Edwin Hall is dressed in a footed onsie covered in the pastel shades of monkeys and hippos. Although Edwin’s just seven weeks old he already tells his mom when he’s hungry with a sharp and persistent yelp.
Soon after he gets her attention, Edwin is practicing his sucking technique. His mom, Sarah, with the dazed look of the sleep deprived, talks with a La Leche League volunteer at the Madison County, Kentucky, Health Department about some breast-feeding challenges.
Advocates like to say that breast-feeding is a completely natural act but it does take some practice. Support from volunteers at the La Leche League or other lactation specialists can help nursing mothers persist if they have problems.
That kind of support is especially important in Kentucky, Ohio, and West Virginia, where breast-feeding rates lag behind the national average. Health researchers say that is beginning to change as an increasing amount of research points to health benefits from breast-feeding that can extend into adulthood.
Credit Mary Meehan / Ohio Valley ReSource
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Ohio Valley ReSource
New mother Sarah Hall got breast-feeding advice from a La Leche League volunteer.
Starting Conversations
La Leche League volunteer Ashley Kester is herself a mom. She has two boys and another child on the way. When she had her first baby, she said, she was almost clueless about the health benefits of breast-feeding. She said she can see a difference in the health of her second child.
She’s a nurse by profession, but it was through her work as a volunteer that she learned that a lot of new moms don’t know who to ask for help.
“Our moms in this generation haven’t really been exposed to a lot of breast-feeding, they may not have been breast-fed,” she said. “They don’t really know what it looks like and it can seem like a kind of an odd thing to do because formula feeding seems to be the norm.”
Breast-feeding rates vary across the country, with the highest rates in the western states and the lowest in the south. The Ohio Valley states rank among the lowest despite steady increases in breast-feeding in recent years.
Credit Alexandra Kanik / Ohio Valley ReSource
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Ohio Valley ReSource
Kester said educational and socioeconomic differences play a role. Women who have higher levels of education, and higher income levels, tend to also have higher levels of breast-feeding.
She said a lot of the moms she works with have challenges, such as hourly jobs with short breaks, that make breast-feeding difficult. And she said talking about breast-feeding can be difficult.
Popular culture uses breasts for everything from selling beer to hawking cars, she said, but there is little talk about their biological purpose, nourishing newborns. That can make for some awkward initial conversations with new moms. There is often no exposure to the process before the baby is born.
Credit Alexandra Kanik / Ohio Valley ReSource
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Ohio Valley ReSource
Edwin’s mom, Sarah Hall, who is a agriculture professor at Berea College, was determined to breast-feed. But she said it’s been hard.
Her son had trouble latching on which made her nipples raw and made breastfeeding extremely painful. She said since she hadn’t breast-fed before she didn’t know it wasn’t suppose to feel that bad.
She also said just finding the right person to talk to about breast-feeding can be difficult, especially as a new mom juggling a whole new set of responsibilities on top of healing from the birth. That’s why she’s made getting to the La Leche League monthly meeting a priority.
Health Benefits
Dr. Ilana Azulay Chertok is a professor and associate director of nursing research and scholarship at the Ohio University. She is currently focusing on breast-feeding and maternal and infant health in Appalachia. Chertok said there are lots of factors to consider when looking at who does and doesn’t breast-feed.
“It could be related to population, location, culture as well as messages from the local health care providers,” she said. Attitudes toward breast-feeding can vary from community to community but the basics of health improvements for breast-fed babies is becoming better understood among moms.
Credit Mary Meehan / Ohio Valley ReSource
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Ohio Valley ReSource
Big Latch On participant Katie Saltz with her daughter.
Breast-feeding has been shown to reduce ear infections, respiratory illness, and bouts of diarrhea in infants, she said. A small study recently showed a slight but significant decrease in the level of obesity in breast-fed children in Kentucky and a number of other states. That study focused on families receiving food assistance through the WIC, or Women, Infants and Children, program.
Chertok said a study of 14,000 people across eight European countries also supported the idea that breast-feeding helped curb childhood obesity.
Chertok said breast-fed babies seem to develop a better biological signal to make them feel full.
“Once a baby already learns their satiety cures, which is obviously they learn very early that can affect them for a lifetime,”she said.
She says researchers are finding health benefits can stretch to adulthood as well. She explains breast-feeding helps create a healthy microbiome, or the many different bacterial species that makeup our digestive system.
That, she said, “affords us protection against autoimmune diseases such as diabetes.”
“Human milk has these bio-active components that help guide infants’ immunologic and metabolic development,” she said. “It really positively influences metabolic health.”
One Latch At A Time
Chertok said there have been lots of efforts to try to promote breast-feeding and the numbers show progress. In Kentucky, for example there was a 15 percentage point increase in breast-feeding between 2009 and 2014.
Earlier this year, some 50,000 women at synchronized events around the world simultaneously began nursing during the annual “Big Latch On.” Lexington lactation expert Doraine Bailey led the countdown for dozens of women sitting in a grassy park, breasts and infants at the ready.
She stood, hand in the air, and gave the countdown.
“Ready, set, latch!”
What followed next was mostly the quiet of babies nursing.
Bailey works for the Lexington-Fayette County Health Department. She said the increased support for nursing mothers through lactation consultants, health departments and volunteers means breast-feeding rates throughout the region are only going to continue to improve.
High-quality information is more readily accessible to mothers, she said. Even “Dr. Google” can play a positive role and more connections are possible via social media groups.
“We’ve just spent the last generation really improving the quality and quantity of the research that was done to really understand the breast,” she said. “It is not as mysterious as we’ve been making it.”
At the “Latch On,” mom Katie Saltz helped her daughter, Gwen, crack the code. After a few seconds, Gwen, emits a loud “gulp” followed by praise from Mom.
“She’s a pretty good eater. I’ve been blessed to have three kids that are good latchers,” she said.
And Bailey said that’s how the health benefits from breast-feeding will continue to grow: One Mom and baby, one latch-on at a time.
