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There’s a grassroots effort in Memphis to encourage more mothers to breastfeed, and a national expert recently visited the city to evaluate the initiative and encourage the “troops” to press on.

Pediatrician Audrey Naylor, a clinical professor at the University of California San Diego and founder of the Wellstar Foundation, an affiliate of Wellstar Health system of Marietta, Ga., works with the foundation to promote healthier living with focuses on heart disease, cancer, diabetes and women’s health. But Naylor’s greatest passion is the role that breastfeeding has on child health and development. More than 103 million children ages 5 and under die annually, primarily from ailments that could have been prevented through better nutrition, Naylor said.

“We count the kids that die, but we don’t even know how many are sick,” she said. “These children don’t have to die or be sick. Breastfeeding would keep most of them healthy.”

As healthcare has evolved in America over the last five decades, it’s become compartmentalized and often organized around the convenience of providers. The natural state of affairs is to deliver a baby, and let it be warmed by the mother as she feeds it, not place the baby in a warmer.

“Nature assumes a mother will lactate and a baby will suckle,” Naylor said.

The issue is particularly cogent in Shelby County, where the infant death rate is 11.5 per 1,000, but that statistic masks the real problem: infant deaths among white residents is 5.5 while it’s 15.5 among blacks, according to the Tennessee Department of Health.

It’s no coincidence that black mothers are far less likely to breastfeed.

A local coalition of advocates is implementing a strategy to change that. It ranges from teaching future doctors about breastfeeding to producing a CD backed with gospel music. Participants are also working with area birthing centers to change the way they operate. A baby should breastfeed exclusively for six months before new foods are added. The ideal is two years, but most American women who do breastfeed stop at six to eight weeks, mostly because of custom and job demands. Hospitals begin the weaning process on Day One by giving newborns supplemental formula. Gift baskets go home with the new mother full of formula samples provided by manufacturers.

Even if a woman is adamant about not breastfeeding, the baby should still suckle for the first day and get the colostrum to strengthen the immune system.

“The colostrum has all of the mother’s antibodies,” Naylor explained. “The baby gets colonized to all the bugs it will encounter when it goes home. The baby goes from a sterile environment to non-sterile environment, and nature has a plan.”

Practicing physicians are also being approached, but the structure of allopathic medicine makes it difficult. Obstetricians concentrate on delivering a baby, and by the time a pediatrician enters the circle, it’s often too late. So the Academy of Breastfeeding Medicine is asking medical schools to include breastfeeding in their core curriculums, alongside anatomy and physiology. That has the added benefit of teaching future specialists in every field. So if an orthopedic surgeon knows his patient is pregnant, he’s more likely to broach the subject.

A faculty member here and there has been persuaded, Naylor said, but when faculty moves, the lessons go away. Nursing schools have been more receptive to the idea, which reaches those who will work in birthing centers, as well as future nurse practitioners in primary care settings.

One major success has come by communicating with soap opera writers. Major characters on both “All My Children” and “The Young and the Restless” now breastfeed their babies and talk about it on the shows.

When Melody Engberg, a lactation consultant who works at three birthing centers, attends birthing classes, she makes a point of talking to fathers.

“The most influential person in a woman’s life is the father of her baby,” Engberg said. “There’s nothing like a family for validation of what to do for a baby.”

Too often, she discovers that fathers consider the breasts not for feeding the baby but for personal pleasure. Engberg tries to get fathers to see that they can be both.

After several days of evaluation, Naylor said Memphis advocates are well organized, dedicated and working hard, but there is still a long way to go.




November 2007

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