The Centers for Disease Controls just released their Breastfeeding Report Card 2018, an annual report that provides some insight into how new parents are doing in establishing and maintaining breast/chestfeeding goals currently in the United States.  Referring to the report, one can determine how well their state is doing in comparison to the entire nation and other states. Here are some observations and takeaways that childbirth educators and other birth professionals should be aware of.

Where are we now?

• Among infants born in 2015 (the data that goes into the 2018 report) in the United States, 4 out of 5 (83.2%) started to breast/chestfeed, over half (57.6%) were breast/chestfeeding at 6 months, and over one-third (35.9%) were breast/chestfeeding at 12 months. (note, this is not exclusive rates).
• Less than 50% of infants were exclusively breast/chestfed through 3 months
• Approximately 25% were exclusively breast/chestfed through 6 months
• 1 in 6 (17.2%) of breast/chestfed infants born in 2015 received formula supplementation within the first 2 days of life.

How is your state doing?

Over 25% of U.S. births occurred in facilities that are designated through the World Health Organization/UNICEF Baby-Friendly Hospital Initiative as “Baby-Friendly”.

Healthy People 2020 Objectives

The Healthy People 2020 Objectives for breast/chestfeeding indicate that in some categories, the goals have been met and in others, there is an opportunity for improvement as we strive to increase the exclusivity and length of breast/chestfeeding dyads in the United States.

Why are parents having a hard time meeting their breast/chestfeeding goals?

60% of parents do not breast/chestfeed for as long as they intend to.  How long a parent breastfeeds their baby (duration) is influenced by many factors including:

• Issues with lactation and latching.
• Concerns about infant nutrition and weight.
• Parents' concern about taking medications while breastfeeding.
• Unsupportive work policies and lack of parental leave.
• Cultural norms and/or lack of family support.
• Unsupportive hospital practices and policies.

Childbirth educators play an important role

What can childbirth educators do to help the families they work with be prepared to have a successful breast/chestfeeding relationship and meet their goals.

• Talk about breast/chestfeeding throughout your childbirth classes, not just during the feeding portion. Spiral the topic throughout your curriculum.
• Offer many visual tools (videos, images) of a diverse collection of families breast/chestfeeding.  This includes people of color and variation in breast characteristics (large, small, etc.).
• Normalize breast/chestfeeding as the physiological norm for a parent- baby dyad.
• Share resources to qualified lactation professionals in your community that families can seek help from both prenatally and postbirth.
• Provide online and print resources for families to use when they are having difficulties starting off.
• Share new parent groups and other peer to peer support for families to connect with others who are having similar experiences.
• Make yourself available as a resource for new families, so that you can offer emotional support along with helpful tools and resources when they do face challenges.
• Identify a return to work breast/chestfeeding class or resource in your community for families that need it.  If there is not such a program, consider starting one. 

While the state of breast/chestfeeding in the U.S. is improving slowly but steadily, there are many things that childbirth educators can do to help get families off to a strong start. Reports indicate that breast/chestfeeding goals set by parents are not being met.  Educators can acknowledge that and set families up for success with some of the above suggestions.  What are you doing in your classes to help families who want to breast/chestfeed get off to a strong start?

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