There’s a lot to love about breastfeeding. It’s a healthy, free source of nutrients for a baby, and keeping your little one close while they feed facilitates a beautiful early bond. For some mothers, however, the choice to breastfeed—or not—is one that’s fraught with guilt and frustration.

What often gets missed in the emotionally-charged dialogue surrounding breastfeeding is that opportunities to nurse aren’t equally available to all mothers. In fact, socioeconomic factors can profoundly impact a mom’s ability to breastfeed.

Many of the broad social and economic factors impacting individuals and communities worldwide have specific implications that impact equal access to breastfeeding for many potential nursing mothers, such as poverty, hunger, limited health care and education opportunities, as well as economic downturns, poor job quality and limited job growth.

These barriers to entry are referred to by advocates as breastfeeding inequality. August is National Breastfeeding Month, and understanding just how deeply these issues impact successful breastfeeding for women warrants a closer look.

Income inequality is tied to breastfeeding inequality

It’s easy to imagine the ways that being wealthy might make it easier to breastfeed—from being able to afford a private lactation consultant to being able to take time off from work to establish breastfeeding—but individual wealth is no guarantee that breastfeeding will be easy. That said, the actual statistics on nursing among women living below the poverty line make it clear that breastfeeding inequality is directly tied to income inequality.

While 68% of wealthy moms are still breastfeeding when the baby reaches 6 months old, only 38% of mothers below the poverty line are still doing so. This is quite a significant gap.

This gap widens in regions where economic downturn and poverty are especially prevalent, creating an even greater burden for prospective breastfeeding mothers. Wealthier states like California, Oregon and Washington have breastfeeding rates over 90%, while poorer states like West Virginia, Kentucky and Louisiana breastfeed at rates between 61-57%. The national average is 79%.

Educational opportunity is tied to breastfeeding inequality

Education is also an important piece of the breastfeeding inequality puzzle. As it follows, the better an education a mother receives, the more likely she is to eventually find employment offering a livable wage and benefits like paid maternity leave. However, if mom is from a low income family or area, her chances of enrolling in higher education drop—by a lot. In 2016, 78% of college-age students from the highest economic bracket were enrolled in college, compared to 28% of those whose parents were in the lowest income bracket. And while 56% of mothers with advanced degrees breastfeed their babies for at least three months, only 36% of those who state their educational level as ‘high school’ do the same.

So, why do these differences have such a profound impact on a woman’s ability to successfully breastfeed?

  • Lack of good jobs and maternity support in the workplace: For many mothers, access to a period of paid maternity leave can mean the difference between breastfeeding their baby and being unable to create a successful nursing routine. In America, the Affordable Care Act demands a dedicated non-bathroom space for mothers to nurse as well as adequate breaks to do so, but there’s language in the bill that leaves room for unethical employers to skirt the requirements.
  • No community education and support: Supportive and educational groups for moms can make a big difference in helping a new mother feel secure in her efforts to breastfeed, but they’re often run by higher income hospitals and organizations that aren’t present in low-income communities.
  • Lack of lactation support in hospital: While hospitals in high-income areas and with Baby-Friendly designations offer lactation consultants, they may be stretched thin, and if a mom’s time in her room doesn’t coincide with a consultant’s availability, she may leave the hospital without ever receiving help.

Creating equal opportunities for women who choose to breastfeed

If these statistics don’t sit right with you, you’re far from alone.

Organizations like the World Alliance for Breastfeeding Action, La Leche League and other supporters of breastfeeding are constantly promoting legislation to help protect the rights of nursing mothers, while creating awareness of the systemic issues that suppress a mom’s right to accessible breastfeeding. Awareness campaigns like National Breastfeeding Month, World Breastfeeding Week (annually the first week of August) and Black Breastfeeding Week (annually the last week of August) are opportunities for all women to help amplify the message about breastfeeding inequality, and advocate better access and opportunities for all women who choose to breastfeed.

There’s a lot of work to be done in order to close these gaps, end the endless debate over breast and bottle and give every mother the right to choose breastfeeding if she so desires. These focus points are key to the cause:

More lactation support in hospitals: Better lactation support in hospital plays a fundamental role in successful early breastfeeding. The Baby Friendly Hospital Initiative, a UN/WHO program, offers education and support to new mothers as they learn to breastfeed. Improving lactation support in hospitals also means continuing education on the social and practical aspects of breastfeeding for professionals like midwives, nurses and doctors.

Accessible lactation support and education, both professionally and from peers: Professional lactation support as provided by groups, in-person clinic visits, in-home consultations or even online can provide resources and relief for mothers who may be struggling with breastfeeding. Support groups of peers, often led or formed by maternity-focused clinics and organizations, can also offer helpful feedback and guidance as well as essential emotional support.

Support for breastfeeding moms, both from workplaces and childcare centers: For employers, offering support requires moving beyond meeting bare minimum legal requirements when making provisions for new and nursing mothers in the workplace. Enacting proactive policies that support and protect mothers as well as offering comfortable lactation rooms and flexible breaks is key. In a childcare setting, learning the proper storage and handling of breast milk and allowing a mother to come and breastfeed is key.

If you’re eager to learn more about breastfeeding inequality, this informative visualization has some powerful statistics to share, so read on.

image 825 Motherly