Healthy Choices

Most California mothers breast-feed newborns, but race gap persists


Almost all new mothers statewide are breast-feeding their infants in the first few days after giving birth in California hospitals, according to new data released by the state Department of Public Health.

The rate of in-hospital breast-feeding rose nearly 3 percentage points between 2010 and 2014, as a result of state and national efforts to encourage more new mothers to exclusively breast-feed their babies, at least through the first six months. Babies fed only breast milk during their first six months experience fewer ear infections, respiratory illnesses and bouts of diarrhea, among other health benefits.

“Since 2010, a constellation of support from many directions has moved California hospitals toward policies that support breast-feeding mothers,” said Dr. Connie Mitchell, deputy director of the state’s Center for Family Health, in a statement.

Despite the progress, the state still suffers from a racial gap in breast-feeding. Moms who are Asian, Hispanic or African American lag significantly behind white mothers, according to the state statistics.

In 2014, 93.5 percent of new California mothers tried breast-feeding of some duration during their newborn’s stay. But among those who exclusively breast-fed – no formula or other foods – the rate dropped to 66.6 percent and was sharply split along racial lines. More than 80 percent of Caucasian mothers were exclusively breast-feeding, compared with African American (56.3 percent), Asian (60 percent) and Hispanic (61.7 percent) mothers. Sacramento County saw similar percentages, except with a greater share of Hispanic women breast-feeding.

66.6 percent Rate of California mothers who exclusively breast-fed their newborns in the hospital in 2014

Nonwhite women face many barriers to breast-feeding, studies have shown, such as jobs or hospitals that do not fully support breast-feeding, marketing of infant formula and cultural norms that encourage formula feeding.

Among African American mothers, the disparity is often due to a lack of resources and role models, said Kenya Nealy-Fagbemi of Black Mothers United, which provides support and education for expectant mothers in Sacramento County. Some new moms, she noted, are going back to work but don’t have access to a quality breast pump. In other cases, they don’t have family role models to rely on for questions or support.

“There’s been a lot more awareness, and (African American) moms are starting to recognize the benefits, compared with 10 years ago,” she said. “We may be turning a corner. Although there are still challenges, the moms who are determined and in programs that educate them are the moms who are successful.”

Sites like also have encouraged more African American mothers to breast-feed, even posting photos of themselves nursing their babies to serve as role models.

California is pushing more maternity hospitals to become designated as “baby-friendly,” under the Baby-Friendly Hospital Initiative, a global effort by the World Health Organization and UNICEF to have new mothers exclusively feed breast milk – no water or formula – for at least a child’s first six months of life. The American Academy of Pediatrics makes a similar recommendation.

California has about 75 baby-friendly hospitals, which earn the national designation based on 10 criteria, including helping mothers initiate breast-feeding within one hour of birth; training staff on breast-feeding policy; and not giving infants a pacifier or artificial nipple.

Among local hospitals that have earned the rating are Kaiser Permanente South Sacramento Medical Center, Lodi Memorial Hospital, Marshall Medical Center in Placerville, Sutter Medical Center Sacramento, Sutter Davis Hospital and Woodland Memorial Hospital.

Under state law, all California maternity hospitals are required to meet the 10 baby-friendly breast-feeding requirements by 2025.

“We really need all hospitals to change. Our goal is that no matter where a mom delivers – in Fresno, Sacramento, San Diego or up in Shasta, we hope she’s going to get the support she needs” for breast-feeding, said Robbie Gonzalez-Dow, executive director of the California Breastfeeding Coalition, a nonprofit that works with hospitals and new mothers.

But getting the word out is difficult in some areas of the state. “We have no baby-friendly hospital in the (south) Central Valley, for instance,” Gonzalez-Dow said. “If you look south of San Joaquin Valley to all the way to Kern County, it’s a baby-friendly desert.”

Claudia Buck: 916-321-1968, @Claudia_Buck