A recent study In the Journal of human lactation found that American women, by and large, were falling short of the goals of initiating and continuing breastfeeding set for them in the Healthy People 2010 project, a government initiative which attempts to define the methods through which good health can be enjoyed by Americans of all socioeconomic and ethnic groups, and spells out the means to achieve them. The idea was to have 75% of women initiate breastfeeding, have 50% of them still breastfeeding at 6 months (half of those exclusively), and 25% still nursing their infants at the age of one year.
Using data gathered by the CDC’s 2003 and 2004 National immunization surveys, they found that though nearly 71% of women started out breastfeeding their babies, this number dropped precipitously to 36.4% by 6 months (of which less than half – 15.5% – were breastfed exclusively), and only 17.7% were still nursing their babies at a year. In fact, the only demographic group which managed to meet all three of Healthy People 2010‘s breastfeeding goals were college-educated women. The young, unmarried, poor and less-schooled lagged behind. While it would be tempting to attribute the difference entirely to better knowledge of the benefits of breastfeeding in the educated group, the study notes that even lower-income women receiving help from the WIC program seem well-informed in that regard. The authors note in passing that
In addition, employment can be an obstacle to breastfeeding for low-income women, particularly if employed full-time
But it seems to me they consider this a minor factor, given the solutions they ultimately suggest to correct the low breastfeeding rates – as if a full-time working woman for minimal wage and rare bathroom breaks can, if only she had enough “support” (this being a term for being lectured to about the wonders of breastmilk by family, healthcare practitioners and social workers), breastfeed successfully for a year or more. In other word, the woman is expected to deal, pretty much alone, with the realities of combining long hours of physical work and feeding her baby. It’s not really surprising that many such women simply find the price too steep, and resort to using the almost-as-good Mommjuice replacement.
A well-educated woman (presumably married to an equally well-educated man) in a professional setting usually has the ability to take ample time for pumping breaks in a private office. She can also pony up the $200 or so it takes to buy an efficient breastpump. If she finds it all too much (and take from one who’s been there – she may very well do so!), she may be able to negotiate with her boss to get flextime, telecommute, or go whole hog (with the blessing of LLL) and quit, living on hubby’s salary. All of these are options not available to a young, single mom making minimum wage at the local burger joint.
“Support” in the form of providing moral encouragement and help regarding the mechanics of breastfeeding will only take you so far, US government. If you really want the US’s breastfeeding rates to approach Norway’s, you need to provide the social policy to match, meaning:
* Extended, universal, paid maternity leave (inclusive of health insurance benefits)
* A worker’s rights package that includes mandatory pumping breaks and provision of places to pump (perhaps even a hospital-grade pump that women can use when necessary)
* Security that no woman will stand to lose her job because she takes advantage of the above two.
You might also want to consider whether the Healthy People 2010 breastfeeding goals are really going to reap the expected health dividends as opposed to more modest goals and perhaps set your sights a wee bit lower, but that’s secondary, IMO.