Breastfeeding and Low-Income Families

Last week I was in the supermarket waiting in line.  The lady in front of me, clearly pregnant, had her groceries on the belt.  The last group of items was infant formula, the kind with the orange ring.  They were Similac sensitive formula.  On top of the cans was a pink WIC (Women, Infants, Children) check.

I came very close to running up to this stranger and making some sort of joke about putting the cans back where they came.  I didn’t.  I didn’t because I didn’t know this woman well enough to know if she was given formula for a medical reason.  I didn’t have all the facts about why she was choosing not to breastfeed.  My guess, though, is that it has nothing to do with a medical reason, but more to do with a personal reason or a lack of support.

According the CDC, only 57 percent of all low income women breastfeed compared to 74 percent of higher income women.   Also only 65 of non-Hispanic black women breastfeed.  In comparison, 80 percent of Mexican American women breastfeed and 79 percent of non-Hispanic white women breastfeed. (http://www.cdc.gov/nchs/data/databriefs/db05.htm)

One survey conducted with low income women reveled that reasons varied among the different racial lines.  Non-Hispanic black women said that they preferred to bottle feed.  Hispanics said that they were concerned about the health of the baby or the mother, and non-Hispanic white women were concerned about breastfeeding while working. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2865685/)

Another survey states that many of the non-breastfeeding mothers said that they did not want to get up in the middle of the night, didn’t want to deal with any pain, or that their partner preferred that they not breastfeed.  (http://www.ncbi.nlm.nih.gov/pubmed/20043706)

As you can probably tell, many of the women were being unsupported by the community at large.  While the Obama administration has pushed for new laws to ensure adequate breaks for nursing mothers, these changes are slow in coming especially for low-income mothers.  Even if a mother working in a fast-food restaurant was to obtain a breast pump for free through the WIC program, where would she find a private place to use it?  Her boss’s office?

Similarly with Western societies fixation on breasts being sexual, it’s very hard for a low-income mom to combat stereotypes within her usually ill educated community.  I have had to deal with some of this.  There’s a prevalent belief in my area that a mother usually stops nursing and begins formula feeding at six months of age.  It’s very difficult to explain why this is unnecessary, and it’s even more difficult to continue the nursing relationship without heavy criticism.   I can’t imagine how many low income women hear ill-informed information from their community elders yet never hear anything from actual medical research.

The silver lining is that the number of breastfeeding women is increasing.  In the last ten years or so, the number of non-Hispanic black breastfeeding women has almost doubled.  Many of the women have decided to breastfeed because they have been encouraged by WIC and breast-feeding friendly hospitals with on-staff lactation consultants.   Having someone to help you overcome early breastfeeding trials seems to be key.

I hope that sometime in the future the number of low-income women choosing formula over breastfeeding will be insignificantly small or at the very least the same rough percentages as higher income women.  We are making it easier for low-income women, but we still need to inform and to continue to offer support.  We have a long way to go to combat old wives tales and other misinformation.