Marin Voice: Community Clinics closing gap in support of breastfeeding for all 

The first week of August is recognized as “Breastfeeding Awareness Week,” and this year’s theme is “Closing the Gap: Breastfeeding Support for All.”

We acknowledge that there are some mothers unable to breastfeed their babies for medical or physical reasons, but the goal of the campaign is to increase breastfeeding support, reduce inequalities and ensure that all mothers who are able have the opportunity to breastfeed.

Mother’s milk is a superior form of infant nutrition, yet not all babies are breastfed and not all mothers are encouraged to feed their infants with the milk produced by their own bodies.

The American Academy of Pediatrics recommends infants are breastfed exclusively, without any formula, for the first six months of life, then continued along with solid foods through the first year or longer if desired. According to the AAP, about 84% of infants are breastfed at some point; but only 35% of babies are breastfed at all by their first birthday.

Obstacles to optimal breastfeeding may include:

• Education: Not all pregnant women are well-informed about the benefits of breastfeeding and may not prioritize it.

• Support: Not all families or communities encourage breastfeeding, and some may discourage it.

• Opportunity: Personal or family dynamics may make breastfeeding a challenge and vulnerable mothers may need additional support.

• Working: Returning to work may present an enormous challenge to breastfeeding, and not all women have the opportunity for expressing milk during work hours.

Benefits of breastfeeding include:

• Benefits for the baby: Breastfeeding reduces obesity, type 1 diabetes, sudden infant death syndrome, ear infections and stomach bugs; it also lowers the risk of asthma. Babies also get mother’s antibodies from breast milk, which help them develop a strong immune system and protect babies from illnesses.

• Benefits for the mother: Breastfeeding also has numerous medical benefits for the mother, including reduced risk of breast and ovarian cancer, type 2 diabetes and high blood pressure. In addition, breastfeeding fosters emotional bonds, mitigates postpartum depression and promotes cognitive and emotional development.

Marin Community Clinics provides medical support through bilingual caseworkers who provide culturally sensitive support prenatally and ensure that moms-to-be have an electric breast pump and other resources. Baby-friendly hospitals offer an optimal level of care to promote breastfeeding, and MarinHealth Medical Center holds this status. Marin Community Clinics pediatricians working in postpartum connect inpatient and outpatient services to bridge the connection to clinicians following discharge.

Some baby-friendly practices include:

• Training staff to promote their breastfeeding policy and educating all moms about the importance of breastfeeding

• Facilitating skin-to-skin bonding immediately after birth and working with moms to initiate breastfeeding in the first hour of life

• Practicing “rooming in” so mothers and babies remain together throughout their stay, allowing babies to feed on demand

• Teaching moms how to breastfeed and to maintain lactation when away from their babies.

Equity in breastfeeding includes having certified, bilingual lactation consultants and interpreters who help provide breastfeeding support, which may be critical to non-English-speaking moms. Marin Community Clinics has these available for moms after discharge from the hospital.

For low-income mothers, those with WIC (women, infants and children) benefits can get breastfeeding support from lactation consultants and hospital-grade breast pumps on loan. For those exclusively breastfeeding without formula supplemented by WIC, moms may receive more food to support their energy needs.

Once breastfeeding is established, care teams should help moms make return to work plans for milk expression and storage. We should also let mothers know their rights regarding pumping their milk at work. By law in California, every employer “must provide a reasonable amount of break time to accommodate an employee desiring to express breast milk for the employee’s infant child each time the employee has a need to express milk.”

As providers, we have an obligation to help mothers to overcome obstacles preventing breastfeeding. Pregnant women should be informed of all the benefits of breastfeeding and encouraged to make the healthiest choice for her baby and herself.

Dr. Jessica Hollman is a pediatrician with the Marin Community Clinics. She serves on the First 5 Marin Children and Families Commission.