This article is part of State of Health, a series about how Michigan communities are rising to address health challenges. It is made possible with funding from the Michigan Health Endowment Fund.
Support networks for breastfeeding parents are helping more little Michiganders get their best start in life. Amy Zaagman, executive director of the The Michigan Council on Maternal Child Health
(MCMCH), explains that the state’s breastfeeding networks serve as a structure of supports to ensure that lactation support professionals have the education, resources, and tools they need to engage with families and ultimately increase breastfeeding rates and the associated positive health and societal outcomes.
"Lactation support comes in various forms and should be centered on what each individual wants and needs to have breastfeeding 'success' – whatever that looks like for them," Zaagman says via email. "Having a network of lactation supporters driven by locally-grown community partners that share this commitment to honoring individuals' choices and goals is the best way to capitalize upon the uniqueness of Michigan’s communities to see overall statewide breastfeeding rates rise and give partners a platform to work together for policy and societal support."
The MCMCH highlights the mental and physical health benefits of breastfeeding in its Birth Equity Education Project, which published a report entitled "Breastfeeding: Removing Barriers and Supporting Equitable Outcomes
" in February 2022. The report also highlights the work of Michigan's breastfeeding support networks.
Specifically targeting disparities in successful breastfeeding among Black and Indigenous families, the Michigan Breastfeeding Network
(MIBFN) collaborates with organizations and individuals to bring about actionable, system-level changes through advocacy, education, and community building with a focus on making breastfeeding successful for working lactating parents on the job and at child care centers.
MIBFN partners with 17 community organizations across the state including Milk Like Mine
in Battle Creek, Birth Queens and Milk Queens
in Southwest Michigan, and You Overcoming Lactation Obstacles
(YOLO) in Flint. Providing breastfeeding support in accessible locations and staffed by skilled lactation professionals, these organizations help the families they serve to understand and overcome systemic and policy barriers to breastfeeding success, as well as personal or medical challenges that may arise.
Breastfeeding education materials at the Black Mothers' Breastfeeding Association in Detroit.
The MCMCH also notes that 13 certified Baby-Friendly
hospitals in Michigan are increasing breastfeeding success by helping new parents initiate breastfeeding within the first hour after birth. This facilitates skin-to-skin contact between parent and baby, and keeps the baby in the same room as their parents during the hospital stay.
Benefits and challenges
Current science confirms that breast milk offers many benefits for babies and parents. Antibodies in breast milk help babies develop a strong immune system. Breastfed babies have a lower risk for ear infections, stomach bugs, asthma, obesity, type 1 diabetes, and sudden infant death syndrome
. Studies have found
that breast milk supports healthy cognitive and language development. Breastfeeding also comforts babies as they come to terms with the new world they find themselves in.
Breastfeeding also has benefits for the lactating parent. Baby’s food is always available and ready to eat — and there's no need to run to the store for more expensive formula. During breastfeeding, the body releases oxytocin, a feel-good hormone that calms the parent and promotes emotional bonding with baby. Breastfeeding also reduces the risk
of breast and ovarian cancer, type 2 diabetes, and high blood pressure.
"We know the evidence is clear that human milk has many benefits," says Kaitlyn Bowen, MIBFN communications and data manager. "Especially in light of a pandemic, it is lifesaving medicine, full of nutrients, antibodies, and more."
In the early to mid-20th century, nature’s perfect plan for feeding small humans was scuttled by a perfect storm of "modern" developments. The perfection of feeding bottles and artificial nipples
made offering animal milk to infants more convenient. The medical profession began promoting formula feeding over breastfeeding. And formula companies seeking profits mounted huge advertising campaigns to discourage breastfeeding. While more than 70% of first-born infants breastfed in the '30s, less than 30%
breastfed by the mid-'60s. The rise of formula feeding impacted families of color even more.
"Breastfeeding is also a traditional practice that was stolen through genocide and slave trade," Bowen says. "The many systemic factors that prevent lactating families from reaching their goals are rooted in racism, capitalism, and the patriarchy."
Before abolition, enslaved African mothers were prevented from breastfeeding their own infants
so that they could act as wet nurses for the wives of plantation owners. In addition, greedy enslavers prevented new mothers from breastfeeding because they knew it naturally spaced pregnancies
, resulting in fewer babies being born into slavery.
"There is that relationship with wet nursing, the impact of mass marketing of infant formula to Black communities, and also the lack of support in hospitals. Often the assumption is that Black women are not going to breastfeed," says Kiddada Green, CEO, Black Mothers' Breastfeeding Association
. "Then there's the lack of paid maternity leave. Often Black women have to return to work much sooner than our counterparts."
Free breastfeeding support for families in Flint
Flint-based YOLO is just one of the many community-based organizations supporting breastfeeding across Michigan. YOLO, led by board-certified lactation consultant Shonte' Terhune-Smith, offers doula services, which include prenatal check-ins, birthing support, post-natal consults, and lactation support. The organization also offers childbirth education and breastfeeding classes to parents and caregivers as well as courses for professionals who want to broaden their knowledge and skills in serving lactating families, especially families of color. Grant funding currently allows Terhune-Smith to provide free lactation services, including breastfeeding classes, home visits, and breastfeeding supplies, to families across the Genesee County area. Terhune-Smith also recently won funding to open a lactation clinic, which offers a nurse practitioner and an occupational therapist to help with breastfeeding questions.
Occupational therapy can help babies with a lip tie, tongue tie
, or other difficulties feeding. Babies with long-term medical issues are also referred for physical therapy to help maintain breastfeeding. As a trained health professional, Terhune-Smith also recognizes issues that lie outside the scope of her own practice. For example, when one mother brought in her baby for a routine postnatal check-in, Terhune-Smith recognized the baby was failing to thrive.
"As soon as I saw the baby, I knew something was wrong," Terhune-Smith says. "When she tried to put the baby to the breast, he looked really frail. His cry was alarming."
She called for an ambulance to bring mother and baby to the hospital, where he received life-saving treatment. He and mom are now back home and happy, supplementing breast milk with additional nutrition.
"The mom was relieved afterwards. She was very grateful," Terhune-Smith says. "When people think of lactation consultants, they sometimes think, ‘Oh, how difficult can breastfeeding be?’ Or, ‘Oh, you only help babies to latch on to the breast.’ We can be such a critical part of a medical intervention. We really are part of the health care team."
More support needed
Michigan's breastfeeding networks are advocating for a variety of additional social supports to make it easier to breastfeed children. The U.S. ranks worst out of 40 countries for paid maternity leave
, with zero weeks required. Even the second-worst, Switzerland, offers parents 14 weeks off, paid at 53.9% of full wage. Estonia, Bulgaria, Hungary, Japan, Lithuania, Austria, Slovakia, Latvia, Norway, and Slovenia all offer more than a year’s worth of paid leave. With the World Health Organization
and the American Academy of Pediatrics
agreeing that it’s best for infants to be exclusively breastfed for at least six months, six months’ paid leave would seem a logical starting point.
"Paid leave is the biggest policy we’re advocating for," Bowen says. "We had two really big federal policy wins in December: The Pregnant Workers Fairness Act
and the PUMP for Nursing Mothers Act passed
The Pregnant Workers Fairness Act gives workers the right to receive reasonable accommodations, like light duty, breaks, or a stool to sit on, for pregnancy, childbirth recovery, and related medical conditions, including lactation, unless it would be an undue hardship on the employer. The PUMP for Nursing Mothers Act provides the right to break time and space to pump breast milk at work to millions more workers, including teachers and nurses.
These are the kinds of systems changes that the Michigan Breastfeeding Network works for as it seeks to influence legislators and public health decision makers.
"We are emphasizing the importance of breastfeeding and how providing breastfeeding support benefits everyone," Bowen says. "Also, we want to see prioritized funding for community-rooted, skilled lactation professionals who work with Black, Indigenous, and people of color families."
Green says community organizations are critical to helping more lactating families have success with establishing and continuing breastfeeding. She emphasizes the value of home visiting programs and peer breastfeeding counselors. She would also like to see breastfeeding being viewed as a critical component of maternal-infant health within health care systems and health departments.
"It’s often assumed that when you're talking about maternal child health, breastfeeding is included. But it's not always explicitly mentioned. So those assumptions are not helpful," Green says. "Breastfeeding needs to be par for the course when we're talking about maternal child health, when we're talking about building vibrant, thriving communities for families. Unfortunately, I have attended many maternal child health conferences and professional development opportunities [where the topic] is either very limited or nonexistent. As a state and as professionals who lead this work, we have to be very, very clear that we're explicitly including breastfeeding in the work that we're doing."
Estelle Slootmaker is a working writer focusing on journalism, book editing, communications, poetry, and children's books. You can contact her at [email protected] or www.constellations.biz.
Kiddada Green photos by Nick Hagen. All other photos courtesy of the subjects.