Where's the Chocolate Milk? Part 2
Gorgeous Prince Georges. Pretty Girl County.
Prince Georges County, Maryland is THE most affluent area of Black Americans in the country. Yes, even over Atlanta. Residents tend to be more educated than their peers overall, and Black women the most educated out of almost anyone. These are facts. Black women in America are also most likely to die in childbirth, and least likely to breastfeed in the immediate aftermath of childbirth. These are also facts, and PG is no different. Compared to Hispanic and non- Hispanic White women in the county, we are essentially dead last in breastfeeding rates within the hospital at 78%, compared to 90.6% and 81.1% respectively, despite giving birth to over HALF of the counties new babies(1). Most could easily blame this on culture, historical hangups over wet nursing and the "mammy" trope, and the rate of public assistance (WIC) giving out free formula. But with not much searching you'll find that if you wanted to be a breastfeeding mother here in the County you have practically zero help. La Leche League is one of the most well known breastfeeding support and advocacy organizations in the world, and there is not one LLL meetup here. Every county surrounding us and DC has one though. When searching for lactation consultants on the International Lactation Consultant Assoc (ILCA) site, many had incomplete profiles. The two hospitals in the county that still perform deliveries (UMCRH Prince Georges Hospital Center and MedStar Southern Maryland) say they offer breastfeeding help to new moms, but their websites don't list contact information nor seem to offer support groups (compared to MedStar Georgetown in DC, St. Mary's in Leonardtown, MD or Franklin Square in Baltimore.) Needless to say it's frustrating.
Lets look at some numbers though.
The CDC publishes a snapshot* of breastfeeding rates biannually that tracks babies that have been breastfed ever, at 3 months, 6 months, and a year(2). Out of those numbers they further track how many babies were EXCLUSIVELY breastfed at 3 months and 6 months, respectively. They divide the totals by state and by social demographics (aka race/ethnicity). The CDC has a goal of 81.9% of all babies born by 2020 to be breastfed at ANY point in their life. Maryland scored above target at 84.8% but by 12 months that number drops to 40%. Exclusive nursing till 6 months, as recommended by both the AAP and WHO, barely makes it to 25%. Black moms overall in comparison only clocked in at 69%, with only 24% of us making it to a year, and 17% nursing exclusively. In comparison, Asian moms had double those numbers, having the best rates of breastfeeding success across the board(3). I then looked at the clinical support. Per 1,000 births in Maryland, there's less than one La Leche League volunteer available to help a new mom, a little over one Certified Lactation Counselor (CLC) available, and 5 International Board Certified Lactation Consultants (IBCLC). For comparisons sake, teeny tiny Vermont has almost 23 CLC's and 13 IBCLC's and their long term breastfeeding rates are slightly better, after starting almost identical to Maryland. Prince Georges is literally the size of Vermont yet our numbers don't compare.
How does this happen? It comes down to support, education, and accessibility.
As stated in my initial post, I've met many a mom who who sees me nursing and says things like "oh, I tried but it was too hard/ painful/ my milk dried up/ wasn't making enough/ my baby was greedy, etc". Typically I go, "oh, I'm sorry that happened/ was your experience" because I know 98% of the time their struggles could have been prevented with breastfeeding classes, hands on IBCLC support, not listening to their non breastfeeding mamagrandmama and'nem saying they were starving their babies... But to just start spouting off "well, what you should have done was..." comes off as insensitive and judgey; and as someone who aspires to be an LC, part of the job is being empathetic and meeting your client where they are and respecting their goals and choices. Maybe she already feels guilty and seeing me is a trigger, maybe she was that mom that really did try but is battling a genetic issue, maybe it was a botched breast reduction... I don't know. But I always wonder would the outcome be better if there were resources IN OUR COMMUNITIES to better support our moms. During my pregnancy I got a lot of suggestions to apply for WIC. Most offices have a Peer Counselor that can help encourage and educate moms (AWESOME, AND FREEE), but stops short of clinical advice, they could then refer you to the staff LC that usually oversees a few areas. Sounded great, but our household income was too high, and the more concierge type services that come with Doulas were too much of a luxury. Rollbacks on the ACA are seeing the lists of insurance covered lactation consultants shrink. Many of my peers, myself included, fall into this lost middle class, and there aren't many programs to bridge that gap. Low- income mommies often can't afford to take extended leave, and while breastfeeding is "free", they often don't have the job support to pump or nurse to continue breastfeeding successfully. Lastly, for the few moms that GENETICALLY, PHYSICALLY struggle to breastfeed (the actual like 2% who can't...) often have a hard time acquiring the drugs that can help induce lactation, or aren't made aware of donor milk programs that could either completely sustain or supplement their babies. As descendants of Black women who kept civilizations alive at their breast, in 2018 we're struggling. One of my biggest goals is to just simply educate and let my sisters know what is out here to help them reach THEIR goals, and that breastfeeding isn't a white thing, or a rich thing, and it's a whole lot of us out here doing the damn thing. (Check my girl's blog above on common pitfalls)
As the first week ofNational Breastfeeding Month/ World Breastfeeding Week comes to a close, the theme being "Foundation of Life", did you feel supported in laying this "foundation" for your baby? How could you have been better supported? Did you know help was available, but couldn't access it; or didn't know services existed at all, compounded by being out of your area? Drop your comments below, and follow my next post to see what resources ARE available in and near the county.
*The report is based on the information gathered from the National Immunization Survey, which was a tiny portion of the total number of babies born in any given year, and obviously excludes un vaccinated children. The 2018 results are not yet published
(1)Prince Georges County Health Dept., Maternal and Infant Health Report, 2015. Accessed 8/3/18
(2)Center for Disease Control, Breastfeeding Report Card, Published 2016. Accessed 8/3/18
(3) Center for Disease Control, Rates of Any and Exclusive Breastfeeding by Socio-demographics among Children Born in 2015, 2015. Accessed 8/3/18
Prince Georges County, Maryland is THE most affluent area of Black Americans in the country. Yes, even over Atlanta. Residents tend to be more educated than their peers overall, and Black women the most educated out of almost anyone. These are facts. Black women in America are also most likely to die in childbirth, and least likely to breastfeed in the immediate aftermath of childbirth. These are also facts, and PG is no different. Compared to Hispanic and non- Hispanic White women in the county, we are essentially dead last in breastfeeding rates within the hospital at 78%, compared to 90.6% and 81.1% respectively, despite giving birth to over HALF of the counties new babies(1). Most could easily blame this on culture, historical hangups over wet nursing and the "mammy" trope, and the rate of public assistance (WIC) giving out free formula. But with not much searching you'll find that if you wanted to be a breastfeeding mother here in the County you have practically zero help. La Leche League is one of the most well known breastfeeding support and advocacy organizations in the world, and there is not one LLL meetup here. Every county surrounding us and DC has one though. When searching for lactation consultants on the International Lactation Consultant Assoc (ILCA) site, many had incomplete profiles. The two hospitals in the county that still perform deliveries (UMCRH Prince Georges Hospital Center and MedStar Southern Maryland) say they offer breastfeeding help to new moms, but their websites don't list contact information nor seem to offer support groups (compared to MedStar Georgetown in DC, St. Mary's in Leonardtown, MD or Franklin Square in Baltimore.) Needless to say it's frustrating.
Lets look at some numbers though.
The CDC publishes a snapshot* of breastfeeding rates biannually that tracks babies that have been breastfed ever, at 3 months, 6 months, and a year(2). Out of those numbers they further track how many babies were EXCLUSIVELY breastfed at 3 months and 6 months, respectively. They divide the totals by state and by social demographics (aka race/ethnicity). The CDC has a goal of 81.9% of all babies born by 2020 to be breastfed at ANY point in their life. Maryland scored above target at 84.8% but by 12 months that number drops to 40%. Exclusive nursing till 6 months, as recommended by both the AAP and WHO, barely makes it to 25%. Black moms overall in comparison only clocked in at 69%, with only 24% of us making it to a year, and 17% nursing exclusively. In comparison, Asian moms had double those numbers, having the best rates of breastfeeding success across the board(3). I then looked at the clinical support. Per 1,000 births in Maryland, there's less than one La Leche League volunteer available to help a new mom, a little over one Certified Lactation Counselor (CLC) available, and 5 International Board Certified Lactation Consultants (IBCLC). For comparisons sake, teeny tiny Vermont has almost 23 CLC's and 13 IBCLC's and their long term breastfeeding rates are slightly better, after starting almost identical to Maryland. Prince Georges is literally the size of Vermont yet our numbers don't compare.
How does this happen? It comes down to support, education, and accessibility.
As stated in my initial post, I've met many a mom who who sees me nursing and says things like "oh, I tried but it was too hard/ painful/ my milk dried up/ wasn't making enough/ my baby was greedy, etc". Typically I go, "oh, I'm sorry that happened/ was your experience" because I know 98% of the time their struggles could have been prevented with breastfeeding classes, hands on IBCLC support, not listening to their non breastfeeding mamagrandmama and'nem saying they were starving their babies... But to just start spouting off "well, what you should have done was..." comes off as insensitive and judgey; and as someone who aspires to be an LC, part of the job is being empathetic and meeting your client where they are and respecting their goals and choices. Maybe she already feels guilty and seeing me is a trigger, maybe she was that mom that really did try but is battling a genetic issue, maybe it was a botched breast reduction... I don't know. But I always wonder would the outcome be better if there were resources IN OUR COMMUNITIES to better support our moms. During my pregnancy I got a lot of suggestions to apply for WIC. Most offices have a Peer Counselor that can help encourage and educate moms (AWESOME, AND FREEE), but stops short of clinical advice, they could then refer you to the staff LC that usually oversees a few areas. Sounded great, but our household income was too high, and the more concierge type services that come with Doulas were too much of a luxury. Rollbacks on the ACA are seeing the lists of insurance covered lactation consultants shrink. Many of my peers, myself included, fall into this lost middle class, and there aren't many programs to bridge that gap. Low- income mommies often can't afford to take extended leave, and while breastfeeding is "free", they often don't have the job support to pump or nurse to continue breastfeeding successfully. Lastly, for the few moms that GENETICALLY, PHYSICALLY struggle to breastfeed (the actual like 2% who can't...) often have a hard time acquiring the drugs that can help induce lactation, or aren't made aware of donor milk programs that could either completely sustain or supplement their babies. As descendants of Black women who kept civilizations alive at their breast, in 2018 we're struggling. One of my biggest goals is to just simply educate and let my sisters know what is out here to help them reach THEIR goals, and that breastfeeding isn't a white thing, or a rich thing, and it's a whole lot of us out here doing the damn thing. (Check my girl's blog above on common pitfalls)
As the first week ofNational Breastfeeding Month/ World Breastfeeding Week comes to a close, the theme being "Foundation of Life", did you feel supported in laying this "foundation" for your baby? How could you have been better supported? Did you know help was available, but couldn't access it; or didn't know services existed at all, compounded by being out of your area? Drop your comments below, and follow my next post to see what resources ARE available in and near the county.
*The report is based on the information gathered from the National Immunization Survey, which was a tiny portion of the total number of babies born in any given year, and obviously excludes un vaccinated children. The 2018 results are not yet published
(1)Prince Georges County Health Dept., Maternal and Infant Health Report, 2015. Accessed 8/3/18
(2)Center for Disease Control, Breastfeeding Report Card, Published 2016. Accessed 8/3/18
(3) Center for Disease Control, Rates of Any and Exclusive Breastfeeding by Socio-demographics among Children Born in 2015, 2015. Accessed 8/3/18
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