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Reducing Barriers to Breastfeeding

posted on Mon, Nov 28 2011 11:22 am by Jennifer Bernstein


In a previous post, we talked about workplace barriers for breastfeeding mothers and provisions within the Affordable Care Act to overcome these barriers. This post aims to further that discussion by first exploring barriers to successful long-term breastfeeding that occur within the first few days of a baby’s life and then looking at recently passed California legislation aimed at tackling those barriers.

The benefits of breastfeeding throughout the first six months of life are well documented. Breastfeeding has been shown to have a positive impact on lifelong obesity risks and numerous other positive health outcomes. Many health care experts and organizations, including the U.S. Surgeon General and the World Health Organization, recommend that mothers breastfeed their babies exclusively for the first six months of life. So how many women are actually meeting this recommendation? You might be surprised, but recent data shows that only 14.1 percent of infants were breastfed exclusively through 6 months of age. As a part of Healthy People 2020, the national goal is to increase this proportion to 25.5 percent by 2020.

Understanding some of the barriers to establishing successful long-term breastfeeding is important to reaching the 2020 goal. Research findings suggest that hospital policies and practices can greatly influence a woman’s ability to breastfeed. General hospital practices seem to promote formula use and indirectly shorten breastfeeding duration. This is particularly true of hospital practices that prevent women from breastfeeding within the first few hours after birth.

 Establishing good breastfeeding behaviors early after birth is especially important to both long-term success and unique health benefits. Early breast milk, called colostrum, is actually known as liquid gold. Colostrum is a thick yellow substance that is very rich in nutrients and antibodies. Colostrum is only present in breast milk during the first few days after a woman gives birth. By the third to fifth day after birth, a woman’s breast milk changes to mature breast milk, which contains an appropriate balance of fat, sugar, water and protein to help with a baby’s continued growth.

Research has shown that the key to long-term breastfeeding success is early initiation of breastfeeding,  within the first 2-6 hours after birth, with no formula supplementation unless medically necessary. Giving a baby formula within the first few days greatly reduces a woman’s long-term breastfeeding success. Also, the longer a woman waits to initiate the first breastfeeding, the less likely she is to breastfeed exclusively.  

California has decided to step up and address this problem through landmark legislation, the Hospital Infant Feeding Act. The new act specifically identifies the importance of breastfeeding as a public health issue. The act requires hospitals to institute evidence-based policies that support breastfeeding through education, consistency in information and appropriate interventions. Each hospital is required to post a written infant feeding policy to address the pros and cons of early formula supplementation. These new policies will address the importance of early initiation of breastfeeding and discourage supplementation with formula.

The Infant Hospital Feeding Act highlights the important role that individual states can play in promoting breastfeeding, helping to reach the Healthy People 2020 goal and ensuring healthier lives for their youngest citizens.

This information was developed by Jennifer Bernstein, staff attorney for the Network for Public Health Law – Mid-States Region at the University of Michigan School of Public Health.

The Network for Public Health Law provides information and technical assistance on issues related to public health. The legal information and assistance provided in this document does not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state

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