Colorado No. 1 for Breastfeeding in First 6 Months

A report by RMPBS Reports partner, Health Policy Solutions 

For other stories from Health Policy Solutions and additional news, visit RMPBS Reports.

By Katie Kerwin McCrimmon

Colorado leads the nation for mothers who exclusively breastfeed their babies for the first six months, according to the 2012 Breastfeeding Report Card released today from the U.S. Centers for Disease Control and Prevention.

Health experts view breastfeeding as one of the best strategies for reversing the obesity epidemic and cutting spiraling health costs. Businesses that help mothers continue breastfeeding and pump their milk cut sick time and boost employee loyalty, surveys have found.

Just this week, New York Mayor Michael Bloomberg, who is fighting super-sized sodas, announced Latch on NYC, a voluntary effort to make breastfeeding the default choice for new mothers by locking up and tracking infant formula at New York hospitals. 

Colorado and other western states have long been leaders in the resurgence of breastfeeding in the U.S., but health experts here say this year’s report card marks the first time that Colorado has clinched the No. 1 spot. Higher education levels in Colorado may cause more women to breastfeed their babies as long as possible in the Centennial state. Breastfeeding rates are also highest among Anglos and Latinas, and Colorado has a smaller population of African-American women, who have lower breastfeeding rates across the country.

Colorado is also fifth in the country for states where mothers initiate breastfeeding. The CDC found that 87.5 percent of new mothers in Colorado have breastfed their babies. That’s up from 80 percent last year, but last year’s low figure may have been an anomaly because the percentage of mothers who try to breastfeed in Colorado has long hovered close to 90 percent.

“Breastfeeding is one of our best protections against childhood obesity,” said Dr. Chris Urbina, chief medical officer and executive director of the Colorado Department of Public Health and Environment. “And yet, while we’ve made significant progress in Colorado, nearly three of every four Colorado mothers are not taking full advantage of the health benefits of mother’s milk.”

Colorado slips to 18^th in the nation among women who are still breastfeeding at 12 months.

Health officials say too many employers do not accommodate nursing mothers and too many hospitals do not yet comply with the Baby-Friendly Hospital Initiative, a global effort to encourage and recognize hospitals and birthing centers that offer an optimal level of care for infant feeding. Only 8 percent of Colorado births occur at baby-friendly hospitals.

“We want to be a society where all mothers are able to breastfeed easily at home, at work, at school, in the park or wherever they may be,” said Jennifer Dellaport, the Colorado Health Department’s breastfeeding specialist.

Fired for asking to pump breastmilk?

One mom who encountered lack of support in the workplace believes she was fired from a job at a day care facility in a suburb north of Denver in part because she asked for breaks to pump milk for her baby.

“I would get breaks sporadically. Then, there would be times when I’d be calling for a break and no one would come. I would call back and no one would come,” said the woman who was working as a $12-per-hour teacher. She asked not to be identified because she is considering legal action against her former employer.

The woman, a low-income single mom who was receiving breastfeeding support through Colorado WIC, said she told her employer during her interview that she would need breaks to pump and was told that supervisors would accommodate her.

Instead, she struggled.

“It gets very frustrating when you’re told one thing upon getting hired…and something different happens,” she said.

Her employer kept cutting her hours, she said,but she hung on to the job.

“I’m a single mom. I needed the money.”

Ultimately, she received a termination letter this summer. It did not mention the pumping breaks. Rather, the employer claimed that the woman had an attitude problem and was not treating the children well. She had never received any previous complaints about her teaching. She thinks the real reason was that she made clear she had the right under the law to pump her milk.

“I think I was high risk to them and they were looking for a reason to get rid of me,” she said.

The woman, who is in her 20s, said she wanted to breastfeed because “nature is best.”

“I weighed my options while I was pregnant: formula or breast milk. What I found is that there are so many more nutrients and breastfeeding bonds you with your child,” she said. “I at least wanted to do the first six months, or if I could, a year.”

The woman is now unemployed and looking for a new job. Stress and lack of pumping led to a decline in her milk supply and she’s no longer breastfeeding.

Most moms want to breastfeed

Dellaport said most mothers — including low-income moms who now give birth to one of every two Colorado babies — want to breastfeed.

“It’s not so much that mothers don’t want to breastfeed exclusively. It’s more about support,” Dellaport said.

She frequently gets calls from women whose employers are not helping them or women who are told they cannot breastfeed at public locations. Those calls spike in the summer when new moms breastfeed in public at places like swimming pools and restaurants. Under Colorado law, women have the right to breastfeed anywhere they have a right to be.

Breastfeeding support needs to start at birth, continue in the critical first weeks of life and flow seamlessly into the workplace, Dellaport said.

To that end, health officials have trained more than 100 people around the state on the “business case for breastfeeding.” They learn how to support mothers in the workplace, and provide breast pumps and peer support for low-income women who qualify for Colorado WIC, the supplemental nutrition program for women, infants and children. They also have pushed hospitals to better support breastfeeding mothers.

“Today, 35 out of 52 of our hospitals do not give discharge packs of formula. That’s a huge accomplishment. In 2003, about 98 percent of mothers received a discharge pack and now that number is greatly reduced,” Dellaport said.

Since mothers produce milk based on demand, early supplementation with formula can prevent mothers from building an abundant milk supply, Dellaport said.

“In the early weeks, we do not supplement with formula unless medically necessary. And when possible, we use donated milk,” she said.

Higher breastfeeding rates could save billions

The stakes are huge both for health and the economy.

“If 90 percent of the families in the U.S. complied with recommendations and exclusively breastfed for the first six months of life, the U.S. would save $13 billion a year,” Dellaport said.

The savings would come in reduced treatment costs for a handful of common childhood illnesses, including ear infections, asthma, childhood diabetes and respiratory illnesses, Dellaport said.

With respect to obesity, Colorado is the leanest state in the nation for adults, but child obesity is a growing epidemic here, with Colorado ranking 29^th in the nation.

Breastfeeding is widely seen as one of the most cost-effective strategies to reverse obesity and cut overall health costs, prompting Colorado health officials to use increased breastfeeding as a key component of reversing obesity, one of the state’s 10 Winnable Battles.

According to the U.S. Surgeon General, infants who are never breastfed are 32 percent more likely to become obese during childhood than those who are breastfed.

Extensive health department outreach and legal protections for breastfeeding mothers have helped increase the number of Colorado mothers who breastfeed. A 2004 state law established the right to breastfeed in public and a 2008 law mandated workplace accommodations for nursing mothers.

Among other efforts to help boost breastfeeding in Colorado:

• Business Case for Breastfeeding – a 2009 statewide training program for employers on how to accommodate employees who breastfeed, how to comply with the law and how to see a return on their investments.
• Colorado Can Do 5! – a statewide 2008-10 training program for all 53 birthing hospitals in Colorado on five maternity practices proven to support continued breastfeeding in new mothers. The Colorado Can Do 5! model is being implemented in more than half of Colorado hospitals and replicated in cities and states across the country.
• Colorado Special Supplemental Nutrition Program for Women, Infants and Children (WIC) – Since 2009, WIC further enhanced breastfeeding support through an improved food package, greater access to breastfeeding peer counselors, lactation support and breast pumps for low-income mothers.

8/1/2012 4:51:00 PM