In the United States, breastfeeding rates are lower among low-income women and higher among high-income women. This is despite research that shows breastfeeding can provide lifelong health benefits to a baby and potentially save new parents money.
Andrea Reedy is one of nine children. Her mother breastfed Andrea and the rest of them. So when Reedy got pregnant, she wanted to breastfeed too.
“It was just kind of something that I knew was there, knew I was capable of, because I had that example,” she said.
Reedy said breastfeeding was also the cheapest way to feed her baby. When she got pregnant, she was working as a nursing assistant, but the long hours were tough to handle in the later stages of her pregnancy, so she quit. Her boyfriend is a teacher.
“We were just broke,” she said. “Like you couldn’t afford formula, but we weren’t broke enough to have the assistance like the WIC and that kind of stuff, and so I just knew it was something I kind of had to do.”
Reedy and her boyfriend didn’t qualify for WIC, the federally funded Supplemental Nutrition Program for Women, Infants, and Children. WIC subsidizes the cost of formula. But Reedy had a lot of support from her mom and a friend who is a lactation consultant, and she was able to successfully breastfeed her daughter.
But for many low-income women, it doesn’t turn out that way. According to the Centers for Disease Control and Prevention, the more money you earn, the more likely you are to breastfeed and to stick with breastfeeding.
“We do know that those that are lower income have less access to care, less access to support,” said Stephanie Carroll, president of the Appalachian Breastfeeding Network. “There could be some addictions, there could be abuse going on in the family, so it’s several things impacting a lower income.”
Carroll said another barrier for lower-income women is the lack of paid maternity leave. “We have a lot of people going back to work early.”
Also women who qualify for WIC are incentivized to feed their babies formula. To qualify for WIC, a family of three must make less than about $39,000 a year.
“When it was started, back in the 70s — when we actually had our lowest breastfeeding rates — they didn’t recognize human milk as food,” said Carole Peterson a lactation consultant based in Indiana who helps train new lactation consultants around the country. She’s also the former chair the National WIC Association Breastfeeding Committee. Instead they viewed formula as food, so it was viewed as giving people containers of baby food.
That thinking has changed in the last few decades at WIC.
“They started realizing, ‘Well, yes, we’re giving formula. Yes, we’re getting rebates on formula. But the optimal nutrition for infants is human milk.’ So they had to make a big change,” said Peterson.
But low-income families had become used to feeding their babies formula, and WIC had developed a reputation as the formula giveaway program.
Here in Appalachia, that’s a lot of infants. About half of all the babies born in West Virginia, Pennsylvania, Kentucky and Ohio are supported by WIC, according to federal data.
Peterson said WIC is implementing a program that will train staff how to support women with breastfeeding in every WIC office around the country.
“Let’s say you decided you were going to breastfeed and you don’t think it’s working, which is 90 percent of what happens,” she said. “And it means when you walk in the door, let me take you to somebody to help you resolve those concerns and help you meet whatever your goals are. And your goals may only be until you go back to work, or your goals may be six months or a year, but you need somebody there to give you the information to meet those goals and not to just offer you formula.”
Peterson said the program should help bridge some of the access-to-care issues that rural, low income women struggle with.
Appalachia Health News is a project of West Virginia Public Broadcasting, with support from Marshall Health and Charleston Area Medical Center.