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A Breastfeeding Tale of Four Cities Part 3: West

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Continuing our series on the landscape of breastfeeding in the US, we’re shifting our focus westward to Oakland, California. We’ll quickly assess the challenges that exist, then highlight a lactation support group that is working to close gaps and reach families in innovative ways.

While it’s true that no other area is consistently underperforming as significantly as the South when compared to the CDC’s Breastfeeding Score Card, there is room for improvement in every direction. This is true even on the West coast, where state breastfeeding rates are excellent at a glance. Per the scorecard, California is outpacing the national average in nearly every measure. California has already reached the Healthy People 2020 goals, and is on a trajectory to continue to outpace most states in the coming years. The data highlights some of the many things that are working well in California, such as the high percentage of Baby Friendly Hospitals (which directly correlates to the percentage of babies who receive solely breastmilk during their first two days of life), and childcare regulations that support breastfeeding success in the long run. California gets it right in many ways. However, as much as it is an anomaly, some pockets of California are also plagued by the same obstacles to success that we saw in the deep South and in Appalachia. As we’ve seen, some key factors have a detrimental impact on whether babies get mother’s milk as early, as often, and for as long a duration as is ideal. These factors include race, economic status, and access to quality care. The scorecard shows a significant gap in the number of births to the number of lactation supporters statewide. For example, in terms of free or low cost support, there are only around 2 certified lactation counselors and less than one La Leche League leader per 1,000 live births. Both of these figures are lagging compared to national averages.

So what support is there for parents who need help breastfeeding but may not be in a position to hire an IBCLC? One such solution has been working well in Alameda County, and specifically East Oakland. We caught up with the renowned TaNefer Camara, to discuss her community support group, The Lactation Café (TLC).

California scored well on the last BFing ScoreCard. How does East Oakland compare?

Overall California's breastfeeding rates are impressive and in some areas exceed national averages. In East Oakland, breastfeeding rates do not reflect state averages. East Oakland is an area that is still very much segregated by ethnic and socioeconomic lines. Some areas - particularly the community where The Lactation Cafe is held - are largely Black and Hispanic. While there has been an increase in breastfeeding initiation and duration rates over the past 5 years in Alameda county, there remains pockets of community that could benefit from additional support. Many of the families are receiving the message that breastfeeding is important but they fall short of breastfeeding goals due to work conditions, lack of familial support, medical reasons or misinformation.

Can you tell us a little about the group’s inception and how it has grown/evolved since it began?

The Lactation Cafe began as a pilot program sponsored by First 5 Alameda County. We started off with maybe 4 participants and grew to serve 10-15 moms each group. We collaborated with local health programs, hospitals and clinics to engage new families. The next phase will focus on sustainability and community capacity building. We hope to develop group participants into leaders who will lead and facilitate future groups.

How is the community better off due to your presence?

The Lactation Cafe has been a safe place for families to receive concrete support in times of need, gain knowledge of child development, build social connections and get the support they need to meet their breastfeeding goals. Moms who attend TLC and other groups in our community are able to share what they learn with other mothers, they become advocates for themselves, their children and their community members and they support one another.

Could something like the The Lactation Cafe be duplicated elsewhere?

Absolutely! TLC can be duplicated. We used the Strengthening Families framework as our guide and in alignment with our breastfeeding curriculum. The key to a successful group is outreach, engagement and community partnership. Oh, and good food. Whole some food and nutrition was a major part of our group.

Wherever there are breastfeeding disparities, local activists like TaNefer Camara, Tiana Pyles, Jada Wright-Nichols and Ngozi Walker-Tibbs are rising up to meet the need. Their work is changing the landscape of breastfeeding throughout the United States in real and impactful ways. As a student or professional lactation supporter, you too, have an opportunity to make an impact and to reach communities that have a greater need or unique barriers. We’ll highlight one more group in the North to round out our four cities tour next month and to bring this series to a close. The conversation will continue in various ways as LER works to prepare the next generation of lactation supporters to be informed and equipped resources to all breastfeeding families.

Nekisha Killings MPH IBCLC RLC.  This is part of a continuing series on diversity. Nikki is a lactation consultant in private practice in Lompoc, California and is LER's diversity consultant.

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Guest Tuesday, 28 March 2017