- Low Birthweight and Preterm Births
- Prenatal Care
- Teen Births
- Why This Topic Is Important
Breast milk is widely acknowledged as the most complete form of nutrition for infants, with a range of benefits for infant health, growth, and development (1). Infants who are breastfed receive protection from serious health conditions, including respiratory, ear, and gastrointestinal tract infections, allergies, diabetes, and obesity (1). Studies indicate that breastfeeding can reduce the incidence of Sudden Infant Death Syndrome (SIDS), when compared to formula feeding (1). Breastfeeding also offers multiple health advantages to mothers, such as reducing the risk of breast and ovarian cancer, diabetes, and cardiovascular disease (1). Increasing the proportion of children who are breastfed for at least the first year of life—as well as the percentage who are breastfed exclusively for the first six months—are important public health goals (1, 2). In fact, California has a statewide goal to make breastfeeding the normal method of infant feeding for at least the first year of life (3).
Not all women should breastfeed, however. For example, breastfeeding is not recommended for women who test positive for HIV, use certain drugs, or have active, untreated tuberculosis (1, 4). And not all women can consistently breastfeed due to occupational or other challenges (1, 5).For more information on breastfeeding, see kidsdata.org’s Research & Links section.
Sources for this narrative:
1. American Academy of Pediatrics Section on Breastfeeding. (2012). Breastfeeding and the use of human milk. Pediatrics, 129(3), e827-e841. Retrieved from: http://pediatrics.aappublications.org/content/129/3/e827
2. U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (2012). Healthy People 2020: Maternal, infant, and child health, MICH-21. Retrieved from: http://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child-health/objectives
3. California Department of Public Health. (2013). MCAH breastfeeding program fact sheet. Retrieved from: http://www.cdph.ca.gov/healthinfo/healthyliving/childfamily/Pages/BreastfeedingProgramFactSheet.aspx
4. Sachs, H. C., & American Academy of Pediatrics Committee on Drugs. (2013). The transfer of drugs and therapeutics into human breast milk: An update on selected topics. Pediatrics, 132(3), e796-e809. Retrieved from: http://pediatrics.aappublications.org/content/132/3/e796
5. CLASP, & Breastfeed LA. (2016). Public policies to support breastfeeding: Paid family leave and workplace lactation accommodations. Retrieved from: http://www.clasp.org/resources-and-publications/public-policies-to-support-breastfeeding-paid-family-leave-and-workplace-lactation-accommodations
- How Children Are Faring
In 2014, about 67% of California infants were exclusively breastfed in the hospital after birth, up from 57% in 2010. At the county level, figures ranged from 31% to 90% in 2014. Statewide, white infants continue to have the highest percentages of exclusive breastfeeding in the hospital (80% in 2014) compared to infants of other racial/ethnic groups.
- Policy Implications
Recognizing that breastfeeding has significant health benefits for children and mothers, all major health organizations recommend that infants be exclusively breastfed for the first six months, followed by continued breastfeeding with complementary foods until at least 12 months (1). While breastfeeding rates generally have been on the rise, and 90% of California infants start out breastfeeding, only 25% of babies are exclusively breastfed at the end of six months (1).
To increase breastfeeding rates, mothers need information about its benefits and support from the start to maintain breastfeeding through infancy (2). New mothers are more likely to breastfeed exclusively when hospitals develop breastfeeding policies, such as Baby-Friendly hospital practices, including routinely educating mothers and health care staff, facilitating breastfeeding within one hour after birth, keeping mothers and infants together, and limiting items that discourage breastfeeding (e.g., formula and pacifiers) (2). Mothers sometimes discontinue breastfeeding due to lack of insurance coverage for lactation consultants or breast pumps, or due to other barriers such as unsupportive workplaces (2). Continued breastfeeding is more likely when employers, health care providers and insurers, child care providers, families, and communities support that effort (2).
Policy options that could increase breastfeeding include:
For more information about breastfeeding, see kidsdata.org’s Research & Links section, or visit the U.S. Breastfeeding Committee and the Centers for Disease Control and Prevention.
- Continuing efforts to ensure that all California hospitals adopt and effectively implement infant-feeding policies aligned with the Baby-Friendly Hospital Initiative, as required by law; hospitals also need sufficient qualified professionals to support all new mothers with breastfeeding (2)
- Promoting collaboration among hospitals, health care providers, public health agencies, insurers, and other community partners to guarantee that new mothers continue to receive culturally competent, skilled support for lactation after they leave the hospital (2)
- Requiring health insurers to cover best practices for breastfeeding support, including in-person access to International Board Certified Lactation Consultants and quality breast pumps (2)
- Supporting and expanding paid family leave policies, as longer maternity leaves may increase breastfeeding duration (3)
- Facilitating pumping breast milk in the workplace by educating employers and improving enforcement of existing laws, which require employers (with some exceptions) to provide breastfeeding employees with a private space and time to pump breast milk (2, 4, 5)
- Promoting breastfeeding education for child care providers, so they can help support exclusive breastfeeding for children in their care, when needed (2)
- Enforcing state law permitting breastfeeding in public places (4)
Sources for this narrative:
1. Centers for Disease Control and Prevention. (2016). Breastfeeding report card: Progressing toward national breastfeeding goals. Retrieved from: http://www.cdc.gov/breastfeeding/data/reportcard.htm
2. California WIC Association, & U.C. Davis Human Lactation Center. (2014). Bringing breastfeeding home: Building communities of care. Retrieved from: http://www.calwic.org/storage/documents/FactSheets2014/full_report_2014_FINALxx.pdf
3. CLASP, & Breastfeed LA. (2016). Public policies to support breastfeeding: Paid family leave and workplace lactation accommodations. Retrieved from: http://www.clasp.org/resources-and-publications/public-policies-to-support-breastfeeding-paid-family-leave-and-workplace-lactation-accommodations
4. Cal. Civ. Code § 43.3 (1997). Retrieved from: http://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=CIV§ionNum=43.3.
5. Cal. Lab. Code §§ 1030-1033 (2001). Retrieved from: http://leginfo.legislature.ca.gov/faces/codes_displayText.xhtml?lawCode=LAB&division=2.&title=&part=3.&chapter=3.8.; Fair Labor Standards Act of 1938, 29 U.S.C. § 207(r) (1938 & 2010). Retrieved from: http://www.gpo.gov/fdsys/pkg/USCODE-2013-title29/html/USCODE-2013-title29-chap8-sec207.htm
- Websites with Related Information
- Academy of Breastfeeding Medicine
- American Academy of Pediatrics: Breastfeeding
- California Breastfeeding Coalition
- California Dept. of Public Health: Breastfeeding
- California WIC Association: Breastfeeding Advocacy Initiatives
- Centers for Disease Control and Prevention: Breastfeeding
- National Center for Education in Maternal and Child Health: Breastfeeding Evidence Brief
- United States Breastfeeding Committee
- Womenshealth.gov: Breastfeeding, U.S. Dept. of Health and Human Services, Office on Women’s Health
- Key Reports and Research
- 9 Steps to Breastfeeding Friendly: Guidelines for Community Health Centers and Outpatient Care Settings, 2015, California Dept. of Public Health
- Breastfeeding Among Minority Women: Moving from Risk Factors to Interventions, 2012, Advances in Nutrition, Chapman, D. J., & Pérez-Escamilla, R.
- Breastfeeding Report Card, 2018, Centers for Disease Control and Prevention
- Breastfeeding: An Overview of Oral and General Health Benefits, 2013, Journal of the American Dental Association, Salone, L. R., et al.
- Bringing Breastfeeding Home: Building Communities of Care, 2014, California WIC Association & UC Davis Human Lactation Center
- Long-Term Effects of Breastfeeding: A Systematic Review, 2013, World Health Organization, Horta, B. L., & Victora, C. G.
- Maternity Leave Duration and Full-Time/Part-Time Work Status Are Associated with U.S. Mothers’ Ability to Meet Breastfeeding Intentions, 2014, Journal of Human Lactation, Mirkovic, K. R., et al.
- Public Policies to Support Breastfeeding: Paid Family Leave and Workplace Lactation Accommodations, 2016, CLASP & Breastfeed LA
- Racial and Ethnic Disparities in Breastfeeding, 2015, Breastfeeding Medicine, Jones, K. M., et al.
- Racial Disparities in Access to Maternity Care Practices that Support Breastfeeding – United States, 2011, 2014, Morbidity and Mortality Weekly Report, Lind, J. N., et al.
- The CDC Guide to Strategies to Support Breastfeeding Mothers and Babies, 2013, Centers for Disease Control and Prevention
- The Impact in the United States of the Baby-Friendly Hospital Initiative on Early Infant Health and Breastfeeding Outcomes, 2016, Breastfeeding Medicine, Munn, A. C., et al.
- The Surgeon General’s Call to Action to Support Breastfeeding, 2011, U.S. Dept. of Health and Human Services, Office of the Surgeon General
- Vital Signs: Improvements in Maternity Care Policies and Practices that Support Breastfeeding – United States, 2007-2013, Morbidity and Mortality Weekly Report, Perrine, C. G., et al.
- County/Regional Reports
- 2016-17 California County Scorecard of Children's Well-Being, Children Now
- Breastfeed LA
- California WIC Association: Hospital Breastfeeding Rates & Reports
- Community Health Assessment and Community Health Improvement Plan, Los Angeles County Dept. of Public Health
- Fresno Community Scorecard
- Key Indicators of Health by Service Planning Area, 2017, Los Angeles County Dept. of Public Health
- Live Well San Diego Report Card on Children, Families, and Community, 2017, The Children's Initiative & Live Well San Diego
- The 23rd Annual Report on the Conditions of Children in Orange County, 2017, Orange County Children's Partnership
- More Data Sources For Breastfeeding
- California WIC Association: Hospital Breastfeeding Rates & Reports
- Child Trends Databank: Breastfeeding
- Maternal and Infant Health Assessment (MIHA), California Dept. of Public Health & University of California, San Francisco
- National Immunization Survey (NIS) Breastfeeding Data & Statistics, Centers for Disease Control and Prevention
- PeriStats, March of Dimes Perinatal Data Center
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