Why Some Moms Are More Likely to Breastfeed

A new study says early breastfeeding differs by neighborhood, poverty, and race. Here's speculation as to why and what government organizations can do to help moms.

Why Some Moms Are More Likely to Breastfeed

Women who live in wealthier neighborhoods are more likely to breastfeed their babies longer than women in low-income areas, according to a new Department of Health report.

The recent survey came from the New York Department of Health and Mental Hygiene (DOHMH) and looked at disparities in New York City and how this important practice differed by poverty and race across the metropolis. While many women and communities know about the benefits of nursing, and most mothers initiate feeding after birth, there are several barriers to women, both nationally and in New York City, which leads to some being less likely to take it up.

Some stats from the survey include:

  • In 2013, babies born to mothers from low poverty neighborhoods were 1.6 times more likely to be exclusively breastfed within the first five days of birth compared with babies from high poverty neighborhoods (41% vs 25%).
  • Mothers receiving Medicaid had lower rates of some breastfeeding compared with mothers without Medicaid (65% vs. 73%).
  • Compared with older mothers, teen mothers had the lowest breastfeeding rates (17% exclusively breastfeeding and 47% some breastfeeding).

To get some clarity on why women in poorer neighborhoods were less likely to breastfeed, we talked to Lorraine C. Boyd, MD, MPH, New York City Department of Health and Mental Hygiene Bureau of Maternal, Infant and Reproductive Health at the DOHMH. "Even though most of the women know breastfeeding is good for mom and her baby, they're facing many barriers and different types of things getting in the way of breastfeeding, like hospital policies and practices, the marketing of infant formula, social norms, returning to work early after maternity leave and an unsupportive work environment."

A push for formula

One of the issues in lower-income neighborhoods around the country might be that the hospitals don't have a breastfeeding atmosphere or may have outdated methods, Boyd says. According to the report, healthy breastfed babies who are fed formula in the hospital are less likely to be breastfed beyond six weeks, and in NYC in 2013, 63% of healthy breastfeeding babies were introduced to formula while they were in the hospital.

There's also the social marketing of formula companies, Boyd adds. Pregnant women are being targeted by formula companies online and in print ads. A pregnant woman might see pamphlets in her obstetricians office and call a number or sign up online to get information about a brand's formula. Once signed up, she might get coupons for free formula and other offers that are tempting. "But using formula has been shown to decrease breastfeeding success rates," Boyd says. "While I'm not sure if the women in these communities know that, this is some of the breastfeeding knowledge we're trying to share." Women need support when it comes to breastfeeding and they're not getting enough of it, she says. "We think it's our responsibility as a health department to help them."

Pro-breastfeeding initiatives

New York City averages 120,000 deliveries a year and 89% of women attempt breastfeeding in the hospital, according to the survey. "But in many of the poor communities, that falls off quickly," Boyd says. "The health care providers needs to talk to women about breastfeeding in the prenatal period and discuss what happens after they go home."

Luckily, there are initiatives in place to help women in lower-income communities and moms everywhere get the support they need to breastfeed for longer periods of time. Some, like the The Newborn Home Visiting Program and Latch On NYC are New York City-based, but there are national programs to help low-income from all over America breastfeed. For example, Nurse Family Partnership works across the U.S. to pair up low-income new moms with a nurse for two and a half years to enhance breastfeeding. Meanwhile, Mobile Milk is a texting campaign that delivers encouraging messages and information about the benefits of breastfeeding, targeting women from 28 weeks into pregnancy until the baby is four months old. It's a NYC-based program, but women anywhere can text MILK to 877877 (also available in Spanish) for the prenatal and postnatal messages about breastfeeding.

"I think we feel very good that breastfeeding is going in the right direction in all neighborhoods, the word is out [nationally] that breastfeeding is a good thing," Boyd says. "We're trying to make a change with the support we're giving to providers, women, and the comunity at large—encouraging local businesses and faith-based groups to give women a place to breastfeed."