The Health Equity Blog’s mission is to contribute to the discussion of health policy using evidence and research, to explore the opportunities for health equity through policy change, to raise awareness about health disparities, and to increase public advocacy for health equality.

According to the CDC, “Health equity is achieved when every person has the opportunity to ‘attain his or her full health potential’ and no one is ‘disadvantaged from achieving this potential because of social position or other socially determined circumstances.’”

Achievement of full health potential is necessary in all aspects of life – from running errands to relationships with loved ones. Some people are born into environments that limit their ability to achieve their full health potential. We believe that because society created many health inequalities, society can also fix them.

Monday, September 2, 2013

What’s the Big Deal With Breastfeeding?

Two weeks ago, the Boston Globe published “A New Hampshire mother’s fight to breast-feed”.  The article is about Kate Abra Frederick, an employee of the New Hampshire Department of Health and Human Services, who requested that she get a 30 minutes lunch break (instead of a 15 break) so that she could drive to her son’s daycare and breastfeed him.  In exchange for a longer break, she offered to stay 15 minutes later at the end of the day.  The Department of Health and Human Services denied her request.   Kate chose not to return to work after her maternity leave and was thus terminated by her employer.  

My sister, who breastfeeds my niece, is in the Army.  When she went back to work after her maternity leave, she found out that unlike all the other armed services, the Army does not have a breastfeeding policy, only recommendations on how to handle the issue.  This means that although most women in the Army who chose to breastfeed will be supported in that decision (as my sister is), there may be some that will have a harder time.

These aren't the only examples of obstacles women face when breastfeeding.  We hear about Facebook taking down pictures of breastfeeding and women being asked to stop breastfeeding in restaurants and public places (even though breastfeeding is not included in indecent exposure laws and most women cover themselves while doing so).  You may react to all this by asking yourself one (or both) of these questions

1.) why do mothers fight so hard to breastfeed?
2.)  why aren't we as a society more supportive of breastfeeding?  

Why Do Some Mother’s Fight So Hard to Breastfeed?

Historically, researchers have found that breast feeding decreases the likelihood of infant deaths and, specifically, SIDS.  In more recent years, researchers have realized that many of those studies failed to control for other important factors like birth weight, maternal smoking, education and income.  Though the link between breastfeeding and infant death is no longer solid, researchers have still found that breastfeeding protects against varying health issues like otitis media (ear infections), diarrhea, gastroenteritis, respiratory tract infections, necrotizing enterocolitis, SIDS and dermatitis; it may also protect against asthma, obesity, type 1 and 2 diabetes, and childhood leukemia later in life (Golding, Emmett & Rogers, 1997; Viswanathan, 2007; Golding, Rogers, & Emmet, 1997).  The Agency for Healthcare Research and Quality (AHRQ) also found in a meta -analysis, that mothers who breastfed had a reduced risk for type 2 diabetes, breast and ovarian cancer and postpartum depression.  As you can see, breastfeeding offers clear benefits to both mother and baby.

According to the CDC, Mexican American and Non-Hispanic White children are more likely to be breastfed than Non-Hispanic Black children (See figure 2 for rates from 1993 to 2006).  

Breastfeeding rates and duration also increase as maternal income increases.  This trend is troubling for a few reasons:

1.) low income and black mothers are more likely to report that they stopped breastfeeding before the recommended duration because they needed to go back to work.
2.) breastfeeding is the least expensive option for parents which means that low income mothers would benefit more from it than higher income mothers
3.) lower income women often have more risk factors (smoking while pregnant, overweight/obesity, etc) than higher income mothers and so the protective aspect of breastfeeding would be even more important.

Why Aren't We As A Society More Supportive of Breastfeeding?

As I said this is the harder question to answer.  Right now, all I have is “I don’t know”. I do not think women who chose not to breastfeed their children should be made to feel bad about it - there are many reasons why a perfectly reasonable and loving mother would chose not to breastfeed which run from trouble physically doing it to increased stress from lack of sleep and unequal parental workload.  However, women should have a real choice when it comes to breastfeeding and should never have to decide between what they think is best for the health of their children and their jobs.

1 comment:

  1. This is an excellent article on the subject. I am a mother who had difficulties breastfeeding so after 6 weeks of starving my daughter because my milk would not let down, I put her on formula. She is healthy and happy, just like my other two bottle fed children. If you choose to breastfeed, your company should be supportive of your wishes. Aren't we all wanting healthy babies?