How long a new mom breast-feeds can boil down to hassles at work, whether her doctor ever stressed how super-healthy it is, even whether Grandma approves.
The surgeon general is issuing a call Thursday to eliminate obstacles to breast-feeding — and working moms may see the first steps: The new health care law requires that many employers start offering "reasonable" break times to pump milk and a private place to do it. No, the company bathroom no longer counts.
Breast-feeding benefits both baby and mother but it isn't always easy. Three-quarters of U.S. mothers say they breast-feed during their baby's first days and weeks. But within six months, that drops to 43 percent who are breast-feeding at least sometimes and just 13 percent who follow recommendations that babies receive only breast milk during that first half-year of life.
"The hardest thing is to keep it up, because our society and our culture aren't there to support them," said Surgeon General Regina Benjamin. "They really shouldn't have to go it alone."
Research has long made clear the benefits of breast-feeding. Breast-fed babies suffer fewer illnesses such as diarrhea, earaches and pneumonia, because breast milk contains antibodies that help fend off infections. They're also less likely to develop asthma, or even to become fat later in childhood. Nursing mothers shed pregnancy pounds faster, and if they breast-feed long enough can decrease their risk of breast or ovarian cancer.
The American Academy of Pediatrics says breast milk alone provides optimal nutrition for babies for about the first six months, the time when most babies begin solid foods, and that breast-feeding should continue to age 1.
By 2020, the government hopes to have 82 percent of women start breast-feeding and raise to about a quarter those whose babies are exclusively breast-fed for about six months. Today, those rates are lowest for black babies, with 58 percent starting out breast-fed and 8 percent exclusively breast-fed for six months.
Mothers who cannot or choose not to breast-feed shouldn't be made to feel guilty, Benjamin said.
But for those who want to, her office took a closer look at the obstacles and found plenty.
Women whose own mothers and grandmothers didn't breast-feed lack support and even may face skepticism, said Benjamin. She urged education of family members, including dad, during prenatal visits — and noted that breast-feeding can save up to $1,500 in infant formula in the first year of life.
Doctors and hospitals should stress the benefits of breast-feeding, before and at delivery. Certified lactation consultants can help ensure women get help with such issues as how the baby latches on and how to ease breast discomfort, she said.
But a big focus is on employers, to make sure moms have the time and privacy to pump milk when they return to work.
"It makes economic sense for the company," Benjamin stressed. "Women miss less time at work when the babies are healthy, and there's retention of their good employees."
That's why AOL Inc. created what it calls "mothers' rooms" in its offices in 15 cities around the country. They're quiet nursing spots that come equipped with two different kinds of breast pumps so moms don't have to haul as much gear, and part of a broader program that also includes access to lactation consultants that serves about 100 families a year.
The investment paid off, said vice president Gillian Pon: Since 2003, the company has seen a jump in employee breast-feeding and a drop in health claims for sick newborns.