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Improving Lives, One Breast at a Time

 OAKLAND — A white child born in the Oakland Hills can expect to live 15 years longer than an African-American child born in West Oakland. That stark description of the health disparities in Alameda County came from one of its public health directors, Kiko Malin, at a meeting about breastfeeding Tuesday.
Malin and other public health advocates are seeking to use breast milk to improve the health of the African-American community. African-Americans in the county suffer from higher rates of obesity, diabetes, high blood pressure, infant mortality, asthma and low birth weight than other ethnic groups, she said. African-American mothers are also less likely than those from other ethnic groups to breastfeed. 
While encouraging breastfeeding is hardly a cure-all, Malin and other health advocates say that it’s one tool that can help give vulnerable babies a good start.
“Non-breastfed infants are 32 percent more likely to become obese than breastfed infants,” said Malin. A baby’s risk of becoming an overweight child goes down with each month of breastfeeding, according to the Centers for Disease Control and Prevention
Community health workers cited a myriad of reasons that African-American mothers may be especially reluctant to try breastfeeding, including the legacy of slavery.

“We know our mothers were the ones breastfeeding white babies,” said Lucia Cordell, a community outreach worker for Alameda County Public Health. 

Allana Samuel, breastfeeding peer counselor for Alameda County WIC, said that women she describes as "inner-city, urban moms" are often resistant to breastfeeding.

“A lot of times I hear: ‘Breastfeeding is for white people.’ Or, ‘We don’t do that. We don’t breastfeed,’” said Allana Samuel, breastfeeding peer counselor for Alameda County WIC. What the women have heard about breastfeeding is often negative: “'I heard that it hurts.' 'I heard that my breasts are going to sag.'”

“Some women have never seen women breastfeed,” said Kimberley Hoglund, nurse and lactation consultant for Kaiser Hayward. “If they have, they don’t have a positive image around breastfeeding and they don’t believe it’s part of their community or something that they can do.”

Hoglund said that her own mother was resistant to the idea when Hoglund had a child. “My mother expected me to formula feed because that’s what she did and my grandmother did and it was a foreign idea for me to be breastfeeding,” she said. “It was an adjustment for them. They were really eager to give my daughter a bottle.”

And hospitals in the United States are not doing enough to support new mothers in learning to nurse their infants. Only 14 percent of hospitals nationally have a model, written breastfeeding policy. In nearly 80 percent of hospitals, healthy, nursing infants are given formula when it is not medically necessary, according to a report from the Centers for Disease Control and Prevention, released on Tuesday, which may undermine a mother's early attempts to nurse.

There are only 114 hospitals and birth centers in the country that have achieved all “10 Steps to Successful Breastfeeding” as defined by the UNICEF/WHO Baby Friendly Hospital Initiative. Those steps include helping mothers initiate breastfeeding within one hour of birth and giving newborn infants no food or drink other than breast milk, unless medically indicated.

In Alameda County, only one hospital has achieved the “baby-friendly” designation – Kaiser Permanente Hayward Medical Center. San Francisco General Hospital and the Women's Health and Birth Center in Santa Rosa are the only other facilities in the Bay Area which have done the same. 

Breastfeeding rates at hospitals around Alameda county vary widely.

While more than 90 percent of mothers and babies at Kaiser Hayward were exclusively breastfeeding in 2009, fewer than 60 percent were at Eden Medical Center, according to the California Department of Public Health.

And it’s not just socio-economic or cultural differences among their patient populations that drives these differences among hospitals' breastfeeding rates. 

“Some baby-friendly hospitals with a majority of patients on Medicaid are among the highest in breastfeeding rates,” said Dr. Kimberly Horton, chief nursing executive for Alameda County Medical Center. Highland Hospital, which is part of Alameda County Medical Center, hopes to achieve the “baby-friendly” designation this December.

“It’s gotten to the point when there is a formula bottle sitting in the room, it’s like a code blue. Everyone is really upset about it,” she joked, saying it’s an indication the culture is changing at the hospital where in 2009 fewer than 68 percent of babies were exclusively breastfed.

“Our babies deserve the best start, and Good Start formula is not it,” said Horton.

Alameda County Breastfeeding Coalition and First 5 of Alameda County organized the session for some 80 lactation consultants and peer counselors who work with low-income women and their babies, many at local offices of the federally funded Women, Infants, Children program. The event at Oakland's Preservation Park was convened in response to the Surgeon General's 2011 "Call to Action to Support Breastfeeding" and World Breastfeeding Week.

Photo Courtesy of Essence


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