Breastfeeding isn’t a choice.

It’s World Breastfeeding Week. A time when we are given the chance to celebrate our successes, and reflect on where we need to improve. As a breastfeeding mom, I feel proud of the time and effort I have put in to breastfeeding my children. This post is not about our personal successes, while valid, and worth celebrating. This post is going to be about support, systemic support, for parents and breastfeeding.

Let’s start with some stats:

First, 83.2 percent of babies born in 2018 started off breastfeeding. By the time they are 3 months old, only 47 percent are still breastfeeding, and only 35% are still breastfeeding by the time they are 12 months old, which is the minimum recommended by all major health organizations. The CDC Breastfeeding Report card elaborates HERE.

Why does this matter? Breastfeeding as it relates to public health is known to protect babies against diseases like diabetes and cancer, protect against infections like ear infections, protects against allergies and illnesses, and generally affects the overall health of babies, children, and adults for the rest of their lives.

Breastfeeding is a women’s health issue too. Did you know breastfeeding also protects women from diseases like diabetes and cancer? It’s true, the longer you breastfeed the more protection your body receives. This is a big deal. Click here for more info.

The public health protections that women and babies receive from breastfeeding are real, and significant. Why then, are we seeing the breastfeeding rates drastically decline soon after babies are born? The answer: Systemic failures to support women and families.

And that is what this post is going to be about, because breastfeeding is NOT A CHOICE for most Americans. When you are forced to return to work after a mere two weeks (like 1 in 4 women are in the United States) you are not being given the choice to breastfeed. Physiologically speaking, a breastmilk supply is not even established until around 12 weeks. Mothers and babies are meant to be together, as a unit, in those first three months, to learn the dance of their new diad. Separating these two in this vulnerable time is dangerous to the health of both (as we can see in the dismal and terrifying statistics around maternal and infant mortality in this country, especially among women and babies of color). Did you know it is illegal to separate puppies from their mothers before 8 weeks? And yet, in this country, women are routinely forced to go back to work and leave their babies in the care of someone else, well before then.

In capitalism, time is money. Breastfeeding is time. Therefore, breastfeeding isn’t free. While long touted as a “free” option for baby feeding, this discounted that women’s time is valuable, and often necessary to support herself and her family.

Breastfeeding is expensive. It is COST PROHIBITIVE for many. Especially for vulnerable populations that are already struggling, perhaps are food and housing insecure, and cannot therefore afford to breastfeed without sacrificing the rest of the family’s health and safety. Here’s a great article from the Washington Post about the real cost of breastfeeding Breast-feeding isn’t free.

If we want to prioritize the health of mothers and babies, and improve these dismal statistics for maternal and infant health, then we must address the real barriers to breastfeeding that exist.

First, if 12 months is the minimum amount of time that infants need to be breastfed, then we need a minimum amount of PAID LEAVE of 12 months. Some states are headed in the right direction, but anything less than 12 months will not get us where we need to be. If we fail to support families, then we are removing any choice to breastfeed. Many women cannot simply pump their breast milk, that isn’t how our bodies are meant to operate. Separating women and infants inherently disrupts the physiological relationship necessary for successful breastfeeding for many women.

Second, we must provide FREE and ACCESSIBLE culturally relevant supports for those who are trying to breastfeed. IBCLCs (internationally board certified lactation consultants) are few and far between, yet they are the only lactation professionals with the clinical experience necessary to provide the support many women need in the first days, weeks, and months of breastfeeding. Not only are their not enough of these professionals, they are often cost prohibitive (typical fees range between $75-$150 dollars for a single visit), and are often not covered by insurance. Countries with the highest rates of breastfeeding have these services fully covered and incorporated into routine postpartum health care. (We could add doulas to this list, the research shows having a doula significantly increases the likelihood of early breastfeeding, as seen in this study here.

Finally, some women cannot (whether because of a physiological condition such as IGT or because of a trauma they have suffered) breastfeed. Some infants are separated from their parents out of necessity (consider infants who are adopted). For the infants in our society whose parents cannot provide them with breastmilk, it is entirely feasible that these infants be provided with the breastmilk of another human as the World Health Organization recommends. Here is the current information on human milk sharing. It is possible for us to create a system which takes away the need for the profit driven infant formula industry, and allows for a non-profit, public health based system where ALL humans have access to HUMAN milk, which would improve overall health outcomes of infants and babies who do not have access to their parent’s milk.

So next time you discuss breastfeeding, let’s stop with the woman shaming, individualistic talk about choice. It’s classist, racist, and certainly not helpful if your goal is to increase breastfeeding rates and therefore improve health outcomes of women, birthing people, and their babies. Let’s instead focus that judgement on our shitty society, and what systems we can improve together, so we have healthier, safer humans in this country.

Want to get involved? Here are some places we think are focused on helping make things better:

New York Health Act

Black Mothers Breastfeeding Association

National Partnership for Women and Families