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CDC gives state a 'C' for breastfeeding support

Within the last few years, I've heard many first- and secondhand stories of new mothers who were finding it difficult to breastfeed.

Some said their baby seemed utterly disinterested in nursing. Others worried about not producing enough milk. Still others developed sore, cracked nipples and despaired of ever being able to breastfeed free of pain.

Why so many young women were struggling with breastfeeding has puzzled me — until last week, when the Centers for Disease Control released a first-of-its-kind national report on breastfeeding practices at hospitals and birthing centers.

The report's findings were discouraging. When it comes to encouraging and supporting new moms who want to breastfeed, the average hospital scored only 63 out of 100.

Minnesota's hospitals had an unimpressive average score of 65 — at best, a C+ grade.

"I'm not surprised," said Evelyn Lindholm, RN, a board-certified lactation consultant at Fairview Ridges Hospital in Burnsville. "It takes a lot to educate staff and hospital administration to make [breastfeeding support] a priority in a hospital. The administration has to believe in it, and it's too easy for them to say, 'We can't afford it.' "


The benefits of breastfeeding

About 2,700 maternity hospitals and birthing centers participated in the CDC study, answering a 52-question survey about their breastfeeding practices. The institutions were scored on both breastfeeding-friendly practices (such as keeping mothers and infants together and providing mothers with helpful tips about nursing) as well as practices that undermine breastfeeding (giving infants formula or other supplements in the hospital).

Breastfeeding has been found to be beneficial to both mothers and babies. As noted by the U.S. Department of Health and Human Services, mothers who breastfeed tend to experience less bleeding after delivery and their uterus returns more quickly to its normal size. They're also at less risk of developing breast and ovarian cancers and, possibly, osteoporosis later in life.

For babies, breastfeeding offers a number of health benefits, including protection from respiratory, gastrointestinal, ear and other infections. Breastfed babies also tend to be leaner and perhaps less prone to obesity later in life.

Need for improvement

Although certain states had overall better scores than others (Vermont and New Hampshire led the list with scores of 81 each, while Arkansas was at rock bottom with a score of 48), nonsupportive breastfeeding practices were common throughout the country.

The report found, for example, that:

• 24 percent of hospitals routinely gave formula, sugar water or some other kind of supplement to healthy, full-term newborns, even when the mothers were willing and able to breastfeed

• 45 percent gave breastfeeding newborns pacifiers

• 70 percent sent new mothers home with gift packs containing infant formula

Giving newborns supplements and/or pacifiers undermines breastfeeding by creating "nipple confusion" for the baby and interfering with the mother's milk supply. Yet hospital nurses sometimes do it anyway to calm a crying baby separated from his or her mother or to test the baby's ability to feed — a test that is usually unnecessary.

About 80 percent of the hospitals surveyed claimed they provided breastfeeding assistance to new mothers, including tips on breastfeeding techniques. Yet 65 percent of the facilities advised women to limit how long they let their baby nurse — another practice that undermines breastfeeding.

Women bear some responsibility

Hospitals can do a much better job at encouraging breastfeeding, but women must take responsibility, too, said Lindholm. "The majority of the time formula is given because the mother is tired and doesn't want to hold the baby," she said.

Lindholm strongly recommends that mothers keep their babies with them right after birth, even if their newborns seem uninterested in nursing — and even if they themselves want to sleep.

"Be patient, and don't give up on the baby," Lindholm said. "Continue to offer the breast. It's that skin-to-skin contact that matters. A new baby may sleep two to three hours on the mama and then wake up and be ready to eat."

Don't have relatives and friends pass the baby around during those first few hours, she added. Newborns need to be kept close to their mother's skin so that when the baby is ready to nurse, he or she can easily "bob down and go to the breast," said Lindholm.

And as for sore, cracked nipples, Lindholm says repositioning the baby on the breast can usually help.  If not positioned correctly, the baby may need to suck harder to get milk —and that can cause the mother's nipples to become sore.

Fortunately, the soreness goes away once the mother learns how to best hold her baby during breastfeeding and how to encourage the baby to properly latch on.

Ask for help
If you encounter breastfeeding problems in the crucial hours and days right after the birth of your child, ask your physician or the hospital staff to refer you to a lactation consultant.

You can also contact the La Leche League of Minnesota and the Dakotas or call the U.S. Department of Health and Human Services Breastfeeding Helpline: 1-800-994-9662.

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