More infants are exclusively consuming breast milk immediately after being born in California hospitals than before, according to a new report from the California Women, Infants, Children Association and the UC Davis Human Lactation Center.

Exclusive breastfeeding numbers rose 8 percent since 2010, a significant step in the right direction, said Karen Farley, California’s program director for the federally funded WIC nutrition program.

Breastfeeding advocates say breast milk produces better health outcomes, including lower rates of childhood obesity, diabetes and other chronic health issues.

These protections are said to be strongest when babies receive nothing but breast milk for the first six months of life, and continue to receive breast milk, along with other foods, until they are at least 1 year old, the American Academy of Pediatrics said.

The new WIC report, available online today, indicates that as of 2013, across all racial groups and income levels, more mothers were giving their newborns only breast milk, at least in the first few days after birth.

“The numbers are very encouraging,” Farley said. “We’ve been working on closing the gap with low-income mothers.”

WIC attributes the increase in breastfeeding to a growing number of hospitals adopting “baby-friendly” policies such as training all nurses who work with mothers and newborns to be able to assist with and encourage breastfeeding.

“Twenty to 25 years ago, there was a real shift here,” said Nicole Casalenuovo, the interim unit director at Ronald Reagan UCLA Medical Center’s perinatal unit. “We started with rooming in (when the baby stays in its mother’s room instead of the hospital nursery), and then we cross-trained nurses so there was no more division between baby nurses and postpartum nurses. That’s when the breastfeeding rates started to go up.”

Statewide, of 426,773 births in hospitals, 92.9 percent of mothers gave their newborns at least some human milk, while 64.6 percent of the mothers gave their babies only human milk.

But hospitals that primarily serve low-income mothers have among the lowest breastfeeding rates, the report shows. Los Angeles County, which had the most births in the state during the reporting period at 118,005, ranked 43rd out of 50 counties with 92.8 percent of mothers giving babies any breast milk, and 53.3 percent giving only breast milk. Most of the lowest-scoring hospitals in the report are in Los Angeles County and Southern California.

Farley said there aren’t really any cultural differences to explain the disparity. Mostly it comes down to hospitals being able and/or willing to adopt “baby-friendly” policies.

According to the report – which includes detailed data by county, by demographics and by hospital – the number of baby-friendly hospitals in California went from 12 in 2006 to 62 in 2014.

But training large numbers of staff members is expensive and can be difficult for schedulers, and hospitals often get discounts on baby formula, bottles and other non-breastfeeding supplies. Casalenuovo said at her facility, the training is now simply incorporated into new-employee orientation.

Also, nurses at the UCLA medical center tend to keep up with the latest evidence, she said, and before the hospital made a concerted effort, they had already begun supporting nursing mothers by promoting immediate skin-to-skin contact, a factor many say plays a role in the success of breastfeeding.

Although it seems counter-intuitive, breastfeeding does not come naturally to every mother and infant.

“We really struggled,” said Beth Hernandez-Jason, a Merced mother of a 1-year-old son. “I cried a lot. I didn’t expect it to be so hard.”

At the hospital where she gave birth, she said, only one nurse was able to get the baby started breastfeeding – helping him latch on in a way that wasn’t painful for his mother. The hospital offers a lactation consultant, but only for women in the WIC program, so Hernandez-Jason had to find someone in the community who could help her.

“If you can’t do it, for whatever reason, it makes you feel like a bad mother,” she said. “You feel guilty.”

Once she and her son learned how to breastfeed correctly, she exclusively breastfeed until he was almost 8 months old and began showing interest in other foods as well as breast milk.

“I was honored to be able to do it, but after eight months, I was done,” Hernandez-Jason said.
There are many reasons mothers cite for not wanting to breastfeed. Some say it hasn’t been part of their family previously so they don’t see the need, they’ve heard formula is just as good as breast milk, they’ve heard it’s painful, or they plan to return to work and don’t think they will be able to breastfeed.

And there are mothers and infants who, for a variety of reasons cannot breastfeed. But WIC, groups like La Leche League and others offer support, advice, education and even breast pumps to make it easier for women who return to work after giving birth to provide their own milk to their babies.

Breastfeeding advocates say mothers need to come home from hospitals to communities of care, with prompt and effective referrals to culturally and linguistically competent support services after hospital discharge.

To make even larger gains in breastfeeding numbers, WIC advocates comprehensive policies and practices that support breastfeeding in community health centers and medical offices; projects to improve access to professional care through localized training programs, specialized medical clinics and mobile contacts; peer-counseling programs; and improved education among parents who might misinterpret infant behavior and think they need to start adding formula or sold foods to their babies’ diets.

“When you put qualified help in communities, breastfeeding rates go up,” Farley said.