Prevention Institute's Juliet Sims and Sarah Mittermaier make the case that California's Baby Friendly Hospital legislation would help to close the equity gap in breastfeeding rates.
By Juliet Sims and Sarah MittermaierSeptember 17, 2013
It’s distressing but true that the ZIP code a person lives in is one of the most accurate predictors of long-term health—and chances of experiencing chronic diseases like asthma, diabetes, and heart disease. It can even help foretell life expectancy. Now it turns out that the hospital a child is born in can start shaping his or her health from the very beginning of life.
Last week, data released by UC Davis Center for Human Lactation and the California WIC Association show that there’s a glaring breastfeeding gap in California based on the socioeconomic status of new mothers. A mother who gives birth in a hospital that serves primarily low-income families is far less likely to leave the hospital exclusively breastfeeding her infant than if she delivered that child in a hospital serving wealthier families. A bill passed by the California legislature and now sitting on Governor Jerry Brown’s desk will help address this inequity.
The benefits of breastfeeding to maternal and child health are well-documented. And in California, over 90 percent of mothers plan to exclusively breastfeed their babies when they enter the hospital. Yet only 40 percent are exclusively breastfeeding when they go home just a few days later.
Why the precipitous drop? What happens in those few days that hinders new mothers’ decision to exclusively breastfeed?
Hospital policies and practices are one of the strongest influences on a woman’s ability to carry out her breastfeeding plan. Those first hours and days of a newborn’s life—while mother and baby are still in the hospital—are a critical window for initiating and practicing breastfeeding. Mothers and babies who live in a community equipped with an accredited Baby Friendly hospital – that has implemented the 10 proven practices designed to support breastfeeding -- enjoy access to a team of nurses and staff members committed to helping mothers carry out their intent to breastfeed. UC Davis researchers found that California mothers who experience these baby-friendly practices report exclusive breastfeeding rates at three months that are 30 percent higher than those who do not.
But hospital experiences vary widely across socioeconomic lines. The report found that the hospitals that did the poorest job of helping women to breastfeed are those that served the largest numbers of low-income women and infants. The 15 lowest performing hospitals are based in Kern, San Bernardino, and Orange Counties, and report high percentages of Medi-Cal births.
The legislation that could help change this situation is Senate Bill 402. Sponsored by Senators Kevin de León and Fran Pavley, SB 402 would require that all perinatal hospitals in California adopt the “ten steps to successful breastfeeding” required to become a certified Baby Friendly hospital.
SB 402 gained momentum as it moved through the Senate and Assembly this spring and summer, attracting a broad base of support among California organizations, from the American Academy of Pediatrics to the California Nurses Association and the California Hospital Association. No organizations are on file opposing the bill. The UC Davis report describes breastfeeding as a “low-cost, low-tech intervention [that] promises better outcomes for babies, families, medical organizations, health care plans, and policy makers."
Governor Brown has many difficult decisions to make over the coming weeks as the legislative session draws to a close, but SB 402 shouldn’t be one of them. It’s a clear win for all Californians that would set every child on a healthier course.
“I am asking the Governor to sign Senate Bill 402,” Senator de León said. “All mothers who go into the hospital wanting to breastfeed should be given the same opportunities for success no matter their ZIP code.”