Infant Formula Crisis Highlights Breastfeeding Barriers in Southern States

Despite all efforts by the federal government in recent weeks to address the ongoing infant formula shortageHowever, formula is still elusive for many parents.

The Food and Drug Administration announcedThis week, nearly two million cans infant formula from a UK-based company arrived in the United States. Abbott Laboratories — the Illinois-based company whose alleged unsanitary conditions led to a voluntary recall of baby formula, the deaths of two infants, and the closure of a large formula manufacturing plant in Michigan, sparking the crisis — announced it will release about 300,000 cans of EleCare infant formula that will undergo extensive testing before being distributed nationwide, according to the FDA.

The U.S. formula crisis has been attributed to supply chain disruptions caused by pandemics and a market that has limited competition, exclusive contracts and very few large suppliers. In April, infant formula producers were allowed to go to market. speed up the manufacturing processAccording to a White House Statement,, the Biden Administration called on state attorneys generals to crackdown on price gouging formula.

Some pundits responded to the shortage in formulas advised mothers to breastfeed instead. However, this advice, no matter how well-intentioned it may be, doesn’t take into account not only medical realitiesHowever, there are many structural barriers to breastfeeding. These barriers are especially high in the Black community, as well as in Southern states where breastfeeding rates tend to be lower.

“Breastfeeding is a reproductive choice issue,” said Kimarie Bugg, the founder and CEO of Reaching Our Sisters Everywhere (ROSE) a national organization based in Georgia that aims to decrease racial disparities in breastfeeding. “We know there are long-term health benefits to a mother, a child, a family, and society if a woman is successful breastfeeding.”

According to a 2015 study, black people have the lowest rates for breastfeeding initiation of all racial groups in America. study. People who breastfeed less are typically young, low income, Black, unmarried, and recipients of the Supplemental Nutrition Program for Women, Infants, and Children. Andrea Freeman, author of the 2019 book “Skimmed: Breastfeeding, Race, and Injustice,” says another factor behind the racial disparity is a cultural stigma attached to breastfeeding that’s rooted in enslavement, coupled with a concerted push to market baby formula to Black people during the mid-20th century.

There’s also a geographic disparity, as Southern states overall have a lower rate of breastfeeding than the nation as a whole. According to the CDC’s latest breastfeeding report cardFrom 2020, 84.1% U.S. infants were breastfed. This compares to just 76.2% in the Southern states. Louisiana is the state with the lowest breastfeeding rate at 66.2%. Only one Southern state is affected by this rate: Texas and Virginia had breastfeeding initiation rates above the national average.

A Centers for Disease Control and Prevention Report published in 2019 foundBetter maternal health care combined with more support from family members and work could help reduce the racial- and geographic breastfeeding gap. Sociocultural norms, concerns about milk supply, income, and lack of accurate information are among the factors that affect a person’s decision to breastfeed, according to the CDC.

The American Academy of Pediatrics recommends breastfeeding exclusively for the first six months of an infant’s life, noting that it leads to better health outcomes for both the parent and the infant. According to the AAP, infant benefits include improved dental health and neurodevelopment. It recommends against breastfeeding for HIV-infected people and infants with classic galactosemia.

Facing South spoke to Bugg and other experts to discuss what can be done to increase the South’s breastfeeding rates.

Lactation Care Under Medicaid

Expanding Medicaid coverage to include lactation services — think breastfeeding classes or lactation consultants — could be one solution to the racial and geographic disparities in breastfeeding rates.

Only available in the United States one-third of state Medicaid programsAccording to a, the coverage includes breastfeeding education and lactation consultation services. Kaiser Family Foundation reportThis month’s release. Nine states nationwide don’t cover any of those services under Medicaid, and seven are in the South: Arkansas, Florida, Kentucky, Louisiana, Mississippi, Tennessee, and Texas.

According to federal data, the South has Georgia, South Carolina and North Carolina with the highest rates of breastfeeding initiation. Four of those states — Georgia, North Carolina, South Carolina, Virginia — cover certain forms of lactation care through Medicaid. In the Southern states, parents can receive free breast pumps through WIC or Medicaid.

Bugg, a pioneer in lactation advocacy in Black communities, suggested that greater racial diversity within the field of lactation consultants could help reduce the racial disparities when it comes to breastfeeding. “Here in the state of Georgia, we want to make sure mothers are comfortable and the care they’re getting is culturally appropriate,” she said. “We do a lot of referring, depending on what their specific needs are.”

ROSE hosts support groups that address the challenges of breastfeeding in Black communities. Georgia also sued the group over a 2016 requirement that women who want to breastfeed must have the equivalent of an advanced degree. The Georgia courts ruled in favor of the group. ruled the requirement to be unconstitutional. Bugg said that the legal victory would ensure that lactation specialists are available to all parents, not just those who live in the Atlanta metropolitan area.

While South Carolina Medicaid does not pay for breast pumpsThe state Department of Health and Environmental Control noted that WIC has lactation counselors on its staff. support groupsAccording to the DHEC website, there are food packages and food packs for breastfeeders exclusively. All states have WIC offices that employ lactation consultants.

But more could be done in South Carolina as well as other states, according to Tisha Felder, a behavioral scientist at the University of South Carolina’s College of Nursing. Felder co-founded Mocha Mama’s Milk, a virtual breastfeeding support group for South Carolinians that launched this spring.

“If we want to see some changes, we need to invest in these maternal child health policies,” including paid family leave and WIC’s breastfeeding program, Felder said.