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 Putting Together the Pieces of the Puzzle: Achieving Equity in the “Landscape of Breastfeeding Support”

By Megan Renner
Executive Director, United States Breastfeeding Committee

Breastfeeding has been referred to as a "tidal wave" in recent years, with new legislation and policies being implemented, new organizations forming, new partnerships blossoming, and new investments being announced. Initiation and duration rates continue to climb and racial disparities are narrowing. Changes that seemed out of reach just a few years ago are happening on the national, state and local levels. The breastfeeding community is rallying together like never before and more families are receiving the support they need and deserve.

Despite recent policy changes and unprecedented attention in the media, our nation remains a challenging place for a woman to breastfeed her child due to the many barriers she encounters. The Surgeon General’s Call to Action to Support Breastfeeding (SGCTA), released in 2011, identifies the most challenging barriers keeping today’s mothers from reaching their personal breastfeeding goals, highlighting the crucial role of families, communities, health care providers, employers, insurers, researchers, and policymakers in ensuring all mothers have the opportunity to breastfeed. In the words of the Surgeon General, "Everyone can help make breastfeeding easier."

Recognizing the imperative for cross-sector collaboration to solve this "puzzle" and ensure that equity is truly embedded into the "Landscape of Breastfeeding Support," the United States Breastfeeding Committee (USBC) is leading an initiative to apply the Collective Impact model with a specific focus on increasing access to and continuity of skilled support for breastfeeding between hospitals and community health settings.

A major component of this initiative includes building coalitions to generate collective action to implement policy, systems, and environmental changes needed to increase breastfeeding rates and eliminate disparities. Recognizing that it is at the state and local level that initiatives will be implemented and adapted most effectively to address specific populations, USBC has cultivated strong partnerships with breastfeeding coalitions in every state, as well as several territories and tribal nations. State MCH directors and program staff are encouraged to join their piece to the breastfeeding puzzle by connecting with their state or local breastfeeding coalition(s).

Despite recent progress, there remains significant geographic, socioeconomic, and racial/ethnic disparities in breastfeeding rates across our nation, especially in the southeast and among African Americans. Groups with the lowest rates tend to also have the poorest health outcomes. Recent investments in breastfeeding support by the W.K. Kellogg Foundation and the Centers for Disease Control and Prevention, among others, have placed a high priority on efforts to increase equity and eliminate disparities in breastfeeding support. The following represent just a few highlights of this work:

This past spring, Surgeon General Regina M. Benjamin announced the launch of It’s Only Natural, a new public education campaign that aims to raise awareness among African American women of the importance and benefits associated with breastfeeding and provide helpful tips. The campaign was developed to equip new mothers with practical information and emotional support from peers, as well as tips and education about the benefits of breastfeeding and how to make it work in their own lives. The materials were specifically designed to reflect the experience of African American moms.

Reaching Our Sisters Everywhere, Inc. (ROSE) was established in 2011 to address breastfeeding disparities within the African American community. ROSE seeks to provide intervention at two levels: direct support to mothers and families through lactation management support, and cultural sensitivity training for health care professionals and community partners. Their first breastfeeding summit, "Reclaiming an African American Tradition," was held in July 2012; their second summit, "Organizing for Action: An African American Breastfeeding Campaign," was held in August 2013. In addition to the summits, ROSE has established collaborative initiatives within the states of Alabama, Louisiana, Mississippi, and North Carolina and is pursuing a faith-based initiative focusing on churches in the African American community.

August is National Breastfeeding Month, and this year a group of nationally recognized breastfeeding advocates declared Aug. 25-31 to be Black Breastfeeding Week. A major aim of the week was to position the conversation on breastfeeding within the black community as part of other parenting topics, like education, healthy living and dealing with issues of race. Events included a community forum in Detroit, a live interactive webinar via YouTube and several social media campaigns.

In June 2013, an Inequity in Breastfeeding Support Summit was held in Seattle, collaboratively hosted by Within Reach’s Breastfeeding Coalition of Washington, Mahogony Moms Breastfeeding Coalition, Native American Breastfeeding Coalition of Washington, and community breastfeeding activists. The summit aimed to increase the cultural competence of breastfeeding supporters, increase the proportion of breastfeeding counselors who are women of color, and increase the organizations that provide culturally relevant breastfeeding support to women of color.

It will take everyone at the table to not just talk about breastfeeding but to take action to build lasting changes in all sectors of our society so that women and their children can do what they are meant to do – breastfeed! Thank you to the Association of Maternal & Child Health Programs and its members for all you are doing to support breastfeeding families.

The United States Breastfeeding Committee (USBC) is an independent nonprofit coalition of nearly 50 nationally influential professional, educational and governmental organizations. Representing more than one million concerned professionals and the families they serve, the USBC and its member organizations share a common mission to improve the Nation’s health by working collaboratively to protect, promote, and support breastfeeding. For more information about the USBC Collective Impact initiative and national policy priorities, contact Megan Renner, executive director. For more information about USBC support and programs for the network of state/territorial/tribal breastfeeding coalitions, contact Kinkini Banerjee, coalitions relations manager.