Public Health Concerns And Strategies To Reduce Disparities

The misconceptions, attitudes, barriers and lag in breastfeeding practices is a major public health concern and dilemma, and disparities in breastfeeding initiation and duration rates are higher in areas where mothers and their families are from lower socio-economic groups. 

Key strategies and interventions can solve the many  problems surrounding the issue. However, they must be appropriately chosen, and should be based on the target population. In other words, since there is no 'one size fits all' in health care, interventions must be tailored to meet the unique and individual needs of mothers. Funding at the federal, and state levels for continued evidence based research and public health community interventions is also critical.

Key strategies to promote breastfeeding, should include public health community interventions that will help to improve behaviors, perception, stereotypes, misconceptions, knowledge, lactation skills, and overall attitudes regarding breastfeeding. Mothers should receive the appropriate prenatal education which includes breastfeeding skills. In addition, since health care providers are at the forefront of healthcare and can significantly influence mothers, provision of intensive courses for health professionals and health education for mothers regarding the social, cultural, legal, and global aspects of breastfeeding will foster the initiative.

Major interventions should include but not limited to:

• Since early attachment and bonding relationship between mother and child through breastfeeding is very time-sensitive, newborns should be introduced to the mother's breast hours after birth. Evidence-based studies suggest that such infants are more likely to continue breastfeeding than their counterparts who are introduced later.

• Laws and regulations and public health policies should be in place prohibiting posters to be displayed by the manufacturers of baby formulas.

• Increased, intensive collaborative efforts with community-based healthcare agencies, hospitals, gynecologists, obstetricians, family doctors, pediatricians and midwives to display and promote multilingual posters and breastfeeding related pamphlets and steer clear of those relating to baby formulas.

• Mothers should be discouraged from using and relying on pacifiers, since pacifiers could lead to fewer breastfeeding experiences.

• Public health and public service advertisements must be increased to increase public acceptance of breastfeeding, and should include legislation that protects mothers and ensures a mother's right to breastfeed when and where it is necessary.
   
• Unless enforced, laws are moot and redundant. Although every state in America makes it legal for mothers to breastfeed in public, they can still be harassed and the culprits will not be held legally responsible. This is a 'slap in the face' for many mothers , especially poor, and single mothers who can only afford their healthier breast milk and cannot afford lawyers to fight for them in court.

• Workplaces, and businesses should designate 'nursing lounges' and other care facilities for children and mothers.

• Health education on breastfeeding should start as early as possible and incorporated into the schools' curricula to promote early understanding and acceptance.

• Hospitals should refrain from accepting and handing out manufacturers' formula 'care packages' to mothers, and should make every effort to ensure that mothers can be with their babies in a 'room-in' experience for closer and easier access to their babies so they can practice breastfeeding.

• Every hospital experience should be a positive one, and since most babies are born in a hospital, the period of stay for mother and baby should be used to promote a sound breastfeeding initiation and duration.

• Finally, it is necessary to acknowledge and include breastfeeding in discussions about women's reproductive health issues as much as possible. This will strengthen public health efforts to garner more support for women, babies, and breastfeeding in general. Breastfeeding will hopefully become the norm, rather than a deviation from the standard. This will then generate more tolerance, understanding and public acceptance.

Public Health's Commitment To A "Safer Breastfeeding"

In the meantime, public health organizations globally will continue to stay committed to increasing, promoting and supporting breastfeeding initiation and continuation rates, throughout the world. This health promoting stance will go a long way in contributing towards public health's ultimate goal: That of improving the public's health.