Mama knows breast: August brings breastfeeding awareness

Women in the United States now have the law on their side to publicly provide the most organic form of nutrition. As National Breastfeeding Month kicked off, many mothers were surprised that the final two states – Idaho and Utah – only recently legalized public breastfeeding. This major legislation marks a pivotal shift from stigma to acceptance of breastfeeding in public, although breastfeeding has been around since … forever.

“Laws are just now being passed to protect the rights of women to feed their child,” said Kelli Hulsman, RN, lactation consultant at the Women’s Resource Center in William P. Clements Jr. University Hospital's Maternity Care department. “Breasts are mammary glands; their purpose is to make milk for our babies.”

Reports say sexualization of breasts has long contributed to the negative opinions of breastfeeding in public. Women have been encouraged (or flat-out shamed) to completely cover their breasts during public feedings or scurry into a private area, wherever that may be. Social media provides a platform for advocates to normalize breastfeeding and the breast itself. In 2015, Instagram updated its guidelines to permit photos of “women actively breastfeeding.”

“We have seen celebrities speak up about breastfeeding their babies and how wonderful that special time is,” Ms. Hulsman said. “As we see women breastfeeding in public, we will gradually lose the social stigma that it carries today.”

UT Southwestern has several lactation consultants who provide approximately 20 hours of coverage a day for the women’s services units and are very active in local and statewide education forums to guide other medical professionals. At Clements University Hospital, nurses are required to have at least 15 hours of breastfeeding education and make rounds with a lactation nurse for four to six hours. The lactation nurses, staffed through the Women’s Resource Center, make patient rounds, review teaching, assist with positioning and latching, provide discharge instructions on when to seek breastfeeding assistance, and offer outpatient lactation consultations as need.

“We do a much better job of supporting, promoting, and protecting breastfeeding than we did 25 years ago,” Ms. Hulsman said. “Twenty-five years ago, we had one lactation consultant who worked for several hours and days a week.”

Ms. Hulsman senses an increase in the number of women who supply breast milk to their babies. Despite national strides in lactation support, racial and ethnic disparities in breastfeeding remain. According to the Centers for Disease Control and Prevention (CDC), in the U.S. 64.3 percent of black babies were breastfed between 2010 and 2013, compared to 81.5 percent of white babies. Two significant barriers are financial factors and education by hospitals on nursing.

“We have partnered with Women, Infants, and Children (WIC) and the Lactation Care Center (LCC) to support women,” Ms. Hulsman said. “The LCC can help women get pumps even if they are not on WIC. They are a fabulous group to work with and support our breastfeeding families tremendously.”

Since 2012, UTSW has been a designated Texas Mother-Friendly Worksite. It also is part of the Texas Ten Step Program, which was developed by the Texas Department of State Health Services and the Texas Hospital Association to improve maternity care practices in birthing facilities through methods proven to increase breastfeeding exclusivity and duration and reduce racial and ethnic disparities. Key initiatives are policy development, staff education, and the provision of discharge resources for breastfeeding mothers.

As advocacy groups work toward closing the disparity gap, Ms. Hulsman delights in the comfort lactation consultants can provide to all mothers who wish to breastfeed.

“It’s a natural progression from carrying your baby during your pregnancy, but it is not all instinctive and the nurses and lactation consultants are there to help you learn,” she said. “I feel blessed every day that I get to share this experience with these families. It is a spiritual experience that defies an adequate explanation.”