Johnelle Shaw is a 27-year-old first-time mother with a two-month old son, Logan. She is visiting a lactation consultant at The Pulaski County Health Unit in Southwest Little Rock. Logan has a cold and is back for a breastfeeding check-in. The consultant weighs him in at 7.6 ounces, a full pound bigger than he was at his last visit a month before.
Shaw is breastfeeding without issues now, but says if she hadn’t been coached at the clinic, she would have stopped because it was hurting. Logan has a lip tie, a piece of skin connecting his upper lip and his gums, and he wasn’t able to latch on naturally. “I probably would have gave up…probably within that first week,” she says. When a mother stops breastfeeding early on, she will stop producing milk, and it’s hard to restart.
The Centers for Disease Control and Prevention says about 10 percent of Arkansas babies are still breastfeeding exclusively at six months. The state is ranked close to last for numbers of babies breastfed at any point after birth. Yet a coalition of healthcare providers around the state are trying to help them, and resolve any worries or confusion standing in their way.
Shaw is just a few months into the process, but healthcare providers recommend a full year of breastfeeding, including six months of breast milk to the exclusion of other foods. Lactation consultant Sarita Hendrix says she sets an example by breastfeeding her own children, even sometimes her four-year old son. She tells women it’s OK to ask questions, and she hears a lot of reasons why they stop.
“I didn’t have enough milk, that’s why. Or my mom couldn’t breastfeed me because we don’t make milk. That’s nasty. My breasts are too small. My breasts are too big. In the African American community, white people breastfeed, black people don’t breast feed.”
White women in Arkansas are more likely to breastfeed, agrees Jessica Donahue, a registered nurse at the Baptist Hospital in Little Rock, and Hendrix believes that gets to black women’s historical role as nannies for other women’s kids. Breastfeeding is also tied to socioeconomic factors and educational levels.
Pain or embarrassment about feeding in public are reasons women stop. Another is uncertainty about how much milk their baby is getting.
“With breastfeeding we don’t have lines on our breast. We have skin and flesh and it always is turning colors, and it’s hard one minute and it’s soft another minute and we don’t know how much our baby is getting, but the doctor is asking us how much the baby is eating,” says Hendrix.
Donahue says formula is not a sufficient substitute. “There are substances in breast milk that protect the gut. All of mom’s antibodies everything she’s been exposed to in her life, the baby is given immunity to that by early breastfeeding and then also by continued breastfeeding.”
A recent study from the University of Carolina, Chapel Hill, shows mothers and babies who breastfeed are less likely to suffer from cancer, heart attacks, and diabetes. It also helps with weight loss after birth.
But Donahue says breastfeeding is not a part of the United States’ culture the way it was before new mothers entered the workforce decades ago, and it’s seen as an inconvenience.
She says some women view breastfeeding struggles as a personal embarrassment — if they can’t figure it out on their own, they give up. We are out of the habit of breastfeeding as a country, and so it’s not always obvious what to do. Donahue says women are coached on breastfeeding by nursing staff at any modern hospital, but that they should be encouraged to ask questions for the weeks ahead. That’s why Baptist Health offers telehealth chats by video with doctors for women in rural areas. Baptist Health and the Arkansas Department of Health have launched a 24-hour help line as part of a statewide initiative to promote breastfeeding.
The Affordable Care Act has also recently expanded access to lactation consulting.
The final frontier for normalizing breastfeeding and making it feasible for mothers, is the workplace, Donahue says. Employers in particular are critical to the effort for women who feel they have to give up breastfeeding when they return to work.
“The barriers are at her work place. If her employer does not have a safe, clean, secure place for her to use a breast pump, then it’s going to be very difficult for her. But for employers, it’s actually a lot easier than they think.”
One time manager is a breast pump. Johnelle Shaw has been using a breast pump to bottle milk for Logan’s daycare, and that’s been useful during his recent growth spurt.
Her own mother, who only breastfed her for a few weeks before quitting, was the person who first encouraged her to get help. It took a little coaching and adjusting Logan’s grip, but now she says she’s gotten pretty relaxed breastfeeding at home and around town.
“We’re out in public, he starts crying and I just, ‘Hey! Mom, can you hold him right quick when I get ready?' and of course, you know, I go ahead and nurse him so, you know, I’m getting more comfortable as time goes by.”
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