Achieving the right balance

California has a lot to be proud of.  The breastfeeding rates there are above the national averages across races.  85 percent of mothers in California initiate breastfeeding, compared to 74 percent nationally.  53 percent are still breastfeeding at the six-month mark, compared to 43 percent nationally, according to the CDC.  Like the rest of the country though, in California, breastfeeding rates among Hispanic and African Americans lag behind those of Caucasian women (though the rates are still higher than national ones).

The numbers in California are not just a matter of luck.  The state works hard to promote breastfeeding.  Health officials there have reached out to low-income communities and pamphlets are translated into Spanish.  They're hiring more lactation consultants to mirror the racial makeup of the state.  And importantly, they've increased the number of peer counseling sites form 15 to 53.  The peer counseling program trains women who are WIC recipients to teach others how to breastfeed.  Many of the peer counseling sites are headed by African American and Latina women.

California has implemented stronger laws that protect a woman's right to breastfeed in public, to pump at work and its hospitals are known for promoting breastfeeding.

This is all admirable.  But, achieving a good balance also means supporting those women who choose not to, or can't, breastfeed.

Health advocates in California now want to introduce a bill that would require all hospitals receiving state funding to attain Baby-Friendly designation.  It sounds good but one of the things it means is eliminating formula from being offered at hospitals on the theory that the formula samples influence a mother's decision to keep breastfeeding. 

And that's simply not true.  Most mothers I know made the decision on how to feed their child before reaching the maternity ward.  And for some mothers who have trouble breastfeeding initially, supplementing with formula is critical.  Even if formula is offered at hospitals, it doesn't mean the mother will then give up on breastfeeding.  I didn't and many people I know didn't.

Achieving a good balance and being "Baby-Friendly" should mean supporting women in their choice no matter what that choice is, and helping them be informed of what the choices are, and what the benefits to each choice are.  And let's be clear, while breastfeeding is best, it doesn't come without pitfalls!

No doubt California should be congratulated on its breastfeeding rates.  But it's inadvisable to mandate just one choice.  That will do nothing to help women feel informed and empowered and to make the right choice for them.