An effort to increase breast-feeding in Philly

Nationwide, 78 percent of new moms start breast-feeding their infants.

Which means that 22 percent do not, a figure that distresses breast-feeding advocates.

The scenario is even more worrisome in Philadelphia, where in 2011, the most recent data available, just 62 percent begin breast-feeding.

The Maternity Care Coalition, a nonprofit formed in 1980, aims to increase that number. Although its overall mission is to improve health and well-being for moms and their children, it is perhaps best-known for its MOMobile, sending lactation nurses and outreach workers into low-income neighborhoods to work with women and promote breast-feeding.

We recently spoke with Arnetta Stewart, longtime program manager of the Northeast MOMobile, and Katja Pigur, the coalition's director of breast-feeding.

Give us a brief refresher course on breast-feeding. What are the benefits?
A.S.: Babies that are breast-fed are healthier babies. They have fewer infections and colds because it boosts their immunity. Breast-fed babies are less likely to be obese. The reason is if you give a baby a bottle and turn it upside down, the milk just flows out. A baby that is nursing has to draw the milk out, so it is giving their body the time to send a message to their brain that they are no longer hungry. Breast-fed babies do not overeat. Babies that drink from a bottle are overfed, and their bodies begin to recognize being overfed as the norm.

Breast-fed babies usually speak earlier because the jaw muscles are strengthened by breast-feeding. The fatty acids in breast milk help with brain development. Breast-feeding also promotes bonding between the mom and the baby.

It's also cheaper. Because we work with a lot of women who are low-income, it's worth noting that breast-feeding puts their children physically, mentally, and emotionally on the same playing field as moms of a higher income.

We encourage moms to breast-feed for six months. But they can continue breast-feeding until the baby or mom or both no longer want to. I've had moms breast-feed up to two years.

What hurdles do women face?
A.S.: Sometimes they don't have the support system, or they're not educated. They may not know the benefits. Sometimes, you have another mother or the grandparents that say, "Why go through all that? You can just give the baby a bottle and they'll be fine."

Or the mom has to go back to work. A lot of times, moms want to continue to breast-feed, but their job may not give them time to go pump.

They may not have the self-confidence they need. Sometimes moms will breast-feed in the house, but not even on the front steps. You have people ride by or walk by and say something. "Cover yourself up."

It's important for people to look at breast-feeding differently. For some reason, we're all fascinated with breasts, but for the wrong reason. You can walk on the beach naked, but you can't nurse a baby. People need to embrace it and look at it as the norm, because this is the best way we have to feed our babies.

What do women feed their babies instead?
A.S.: Very seldom do we find moms giving their babies anything other than formula if they're not breast-feeding, although you may find moms not putting as many scoops in the bottle as called for. They receive it from WIC [the federal Special Supplemental Nutrition Program for Women, Infants, and Children]. We provide emergency formula for moms that may run short; most people know we have the MOMobile.

K.P.: WIC also is providing education on breast-feeding. For a couple of years now, they have really put in a lot of effort. They have counselors. If a mom says she wants to breast-feed, she gets a bigger food package [women who breast-feed need more calories]. They provide pumps for moms in case she doesn't get one through her health insurance. Although, with the Affordable Care Act, providing breast pumps is mandatory.

What else is helping your cause?
K.P.: Before, when you had a baby, everyone got a bag of formula to take home from the hospital. Now, hospitals no longer do that. All Philadelphia's maternity hospitals are part of a breast-feeding promotion task force that started in January 2012. The first thing that has to happen is women have to initiate breast-feeding. Obviously, that happens right after birth. Before, you gave birth and right away the baby was taken from you to weigh, evaluate, all those things. But the natural thing is that when the baby is born and you put the baby skin-to-skin with the mother, the baby naturally finds the breast. Hospitals are working on changing those processes. They also are allowing mom and baby to stay in the same room, instead of in the nursery most of the time, so they can get to know each other and mom and baby can learn to breast-feed.

So now we need to work so that when moms go home, there is support in place. The MOMobile goes out and checks with them. How is breast-feeding going? Are there any concerns?

Also, there is an ordinance in Philadelphia that requires employers to provide adequate space and time so working moms can pump their milk. What the mom needs is adequate time so she can express her milk, and for that she needs a private space. She can't do that in the bathroom. That is legally not allowed. I work with employers to identify an appropriate space and make sure there is a written breast-feeding policy.

Do you think you're moving the needle?
K.P.: I totally think there is a shift happening in Philadelphia. The goal for breast-feeding initiation is 89 percent. We still have a ways to go, but definitely, it's getting better. Breast-feeding needs to be the natural outcome of birth.

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