Originally published in the East Bay Times
August 22, 2019
By, Kevin Scott-Smith, MD

Opinion: Encourage more African-American moms to breastfeed

Reduce baby’s chances of obesity and diabetes; lower mom’s chances of breast cancer, ovarian cancer, heart disease

The health care industry moves with ardent enthusiasm to data and evidence-based care and applauds itself for delivering the right care at the right time. But, when it comes to low-income women of color and their babies, a great deal of health care providers shy away from doing the right thing.

Breastfeeding significantly reduces a baby’s chances of obesity and diabetes, and lowers mom’s chances of breast cancer, ovarian cancer and heart disease. Increasing breastfeeding to near-universal levels for infants and children could prevent more than 800,000 deaths in children worldwide and 20,000 maternal deaths from breast cancer, and save $300 billion globally in health care costs that are associated with not breastfeeding, according to a study by The Lancet.

Breast milk is nutritious, economical and accessible, yet only half of new moms in the United States breastfeed for the recommended 6 months of a new baby’s life. And women of color, particularly African American mothers living in poverty, are the least likely to breastfeed, turning instead to formula. At the start of a baby’s life, only approximately 64% of African American women initiate breastfeeding compared to 75% of white women and 80% of Hispanic women.

The World Health Organization (WHO) has developed the Ten Steps to Successful Breastfeeding to increase breastfeeding initiation and duration. Those hospitals that successfully implement the established criteria are certified by WHO as “Baby-Friendly” hospitals.

The 10 steps include training all health care staff to inform pregnant women about the benefits and management of breastfeeding; helping to initiate breastfeeding within one hour of birth; teaching new mothers how to maintain lactation even if they are separated from their infants; giving infants no food or drink other than breast milk unless medically indicated; and not offering pacifiers or artificial nipples to infants.

A Centers for Disease Control and Prevention report suggests that one reason African-American women have low rates of breastfeeding is that hospitals in cities with large populations of African-American women often do not take significant steps to encourage this healthy practice.

According to the Alameda County Public Health Department, of the total 1,408 births to African American women occurring in Alameda County Hospitals in 2017, 62% did not have access to Baby-Friendly policies and practices.

When you consider the disparities and inequities associated with the higher percentage of infants dying within the first year among low-income and African-American babies, it’s critical that everything possible is done to encourage breastfeeding as the healthiest option.

As one of only three hospitals in Alameda County currently certified as Baby-Friendly, Alameda Health System-Highland Hospital follows the Ten Steps to Successful Breastfeeding and has a rigorous protocol to protect, promote and support every new mother’s ability to breastfeed. (Kaiser San Leandro and Washington Hospital in Fremont are the other two certified Alameda County hospitals.)

Our job is to ensure mothers are informed about the benefits of breastfeeding, and to do our part to make breastfeeding the norm in our hospital, clinics and communities. We do this by addressing the social and individual challenges new mothers face while ensuring they can provide their baby an equitable chance for a healthy start to life.

To help mothers overcome these barriers, we are staffed with board-certified lactation consultants who are an integral part of the healthcare team and are on staff seven days a week. We integrate breastfeeding support into our culture of maternal care. The result is that Alameda Health System, in partnership with other organizations in Alameda County, is helping to increase the rate of African American women breastfeeding, bucking the national trend.

Research shows that breast is best. It is time for us to all be advocates and do what is right to provide our babies the best chance for a healthy life.

Dr. Kevin Scott Smith is chairman of the Department of Obstetrics and Gynecology at Alameda Health System-Highland Hospital.