In some communities in America there are breastfeeding cafes, weekly support groups, robust La Leche League meetings, a solid representation of international board certified lactation consultants in the area and mothers who nurse in public without nary a second glance.
In far too many other communities though, sadly mostly vulnerable ones, there is absolutely none of that. A breastfeeding support group is hard to find. The La Leche League is not active. Breastfeeding in public is never seen. Child care facilities have not been properly trained in handling human milk. In contrast to other communities, these places are virtual deserts of breastfeeding supports.
So when I show up in my usual roles of consultant on reducing the racial disparities in breastfeeding rates or as a breastfeeding advocate, asking these mostly black and brown women to please breastfeed their babies, how can I in good conscience encourage them to sign up for such an unfair proposition? Is it reasonable to expect a woman to breastfeed successfully with only her own sheer determination and will (and if lucky, one good lactation consultant at the hospital) to support her? How can a working mother continue to breastfeed if she struggles to find a child care facility that's been trained in handling human milk?
This is the reality for far too many mothers who are living in what I call "first food deserts." These are communities with minimal to nonexistent breastfeeding resources and support mechanisms for the first food--breast milk.
Just as the food movement has come to understand that access to fruit and vegetables is vital for health, women need access to the resources necessary to breastfeed successfully. Without this the breastfeeding experience is severely compromised or will never begin.
23 Miles Away
How can Angelique breastfeed? She was holding her 3-week-old baby when we met outside the Birmingham, Ala., office of the federal Women, Infants, Children nutrition program, called WIC. The closest breastfeeding support group is 23 miles away and she has no car. I made the drive to that (wonderful) support group myself and as the driving minutes passed, 31, 32, 33 to 34 minutes, my research assistant and I both had to ask: Is this what a woman in Birmingham must do to get support?
How can Angelique breastfeed when the WIC office where she goes for assistance doesn't offer a breastfeeding peer counselor program and the public health clinic just across the hall in the same building only refers breastfeeding moms back to the local hospital?
There has been a systemic failure in many neighborhoods and it's time to build micro-level support in the community.
The sobering reality is that women, across socioeconomic lines, are feeling burdened by breastfeeding messaging and the complexities of its reality. As a result they are rejecting the message, turning against each other and hovering behind the concept of "choice" like a soldier's protective shield in battle.
This cannot continue. For any of us.
It is time to extend the responsibility for breastfeeding success beyond a mother's shoulders, and into the community. Recent efforts have been rightfully aimed at hospitals to rid them of insidious infant formula marketing tactics. This is critical. But a hospital stay is only a two or three day experience for most women in this country, who will spend the majority of their breastfeeding journey in their community. If a woman leaves the hospital and enters a community that is a first food desert, she is still in a set-up for failure.
I met Angelique and so many women like her while exploring the concept of a first food desert and the role of community in spurring breastfeeding success in a pilot project I've led for the past nine months with the generous support of the W.K. Kellogg Foundation.
We went into key cities in three Southeastern states with some of the lowest breastfeeding rates in the country: Louisiana, Alabama and Mississippi. Our team of surveyors conducted a comprehensive assessment, gauging the actual community influences that a woman meets every day. We looked at everything from access to a support group and physician referrals to the levels of infant formula advertising in the community and the prevalence of nursing mothers rooms in public places.
Our sobering findings will open your eyes to the inequities of support and the absurdity of our expectations of mothers in these areas. One thing is clear: Our communities are the next frontier in ensuring healthier babies and healthier moms.
Please join me in petitioning the governors of Louisiana, Alabama and Mississippi to immediately meet with their state United States Breastfeeding Committee coalition leaders and commit to taking a First Food Friendly pledge. I am asking all mothers to take a stand for the mothers in New Orleans, Birmingham and Jackson as a starting point for transforming every first food desert in America into a first food friendly community. Please sign the petition today.