Amanda Ghent remembers the moment.
Her then 18-month-old daughter, Miriam, was cranky, in her “I want-my-mommy” mood. Her six-week-old daughter Lydia was having trouble feeding.
Ghent was in pain and stressed. “Everything was crashing down on me.”
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She called a cousin to ask what baby formula she used. Ghent’s husband was out the door and in the car, ready to buy formula, when she said, “wait.”
Ghent decided to take a Tylenol, calm down, and remember she didn’t have to be super mom. She decided to continue breast-feeding her baby.
Many other mothers make a different choice at such difficult moments.
Nationally, three out of four moms – 75 percent – say they will breast-feed their baby. But that number falls to one out of three moms – 35 percent – who breast-feed their child exclusively for the first three months. At six months, the figure is 14.8 percent, according to the federal Centers for Disease Control and Prevention. One out of every four children receives formula before they are two days old, according to the CDC.
South Carolina’s percentage of women who breast-feed is well below those averages, ranking 46th among the states and the District of Columbia.
According to CDC data for 2011, 62.5 percent of mothers tried to breast-feed in South Carolina. By six months, the number of moms who exclusively breast-fed their babies was 7.1 percent. The percentage of black mothers who breast-feed is about half the state average, according to the U.S. Surgeon General.
Piedmont Medical Center and four other hospitals in South Carolina hope to improve those numbers. They, along with Carolinas Medical Center and Presbyterian Hospital in Charlotte, are among the 90 hospitals nationwide selected for the Best Fed Beginnings program.
The program is sponsored by the National Initiative for Children’s Healthcare Quality, the CDC and Baby Friendly USA, which accredits hospitals that meet its guidelines for breast-feeding. No South Carolina hospital is accredited by Baby Friendly. One of the goals of the program is to increase the accreditation rate.
The program – which comes with no grant money – wants to increase the number of breast-feeding mothers through education, encouragement and creating a supportive environment at the hospital, home and workplace.
Their focus is promoting breast-feeding not as a lifestyle choice, but as a health choice that yields physical, as well as fiscal, results for moms, babies, families and employers.
Dr. Deanna Threatt breast-fed each of her three children. While she knew some of the things to expect the second and third time around, “each was different, each was a different dance partner.”
The experiences, she said, help her to be a better pediatrician. Like Amanda, she went through the “I can’t-do-this” moments.
“It’s imperative mothers know that this is normal,” she said.
Threat and Rachel A. Miller, a nurse and board-certified lactation consultant at Piedmont, say there are numerous health benefits to breast-feeding for the baby and mother.
Babies who are breast-fed are less likely to have ear infections, colds, fevers and other viruses, and tend to be less fussy and sleep deeper, they said.
As an active, living substance, breast milk “works as an antibiotic,” Miller said. It also teaches a baby’s immune system how to act, she said.
For the mother, the benefits of breast-feeding include bonding with the baby, a decreased risk of breast and ovarian cancer, and better hormonal balance.
Those who breast-feed may also find it easier to lose weight, they said. It takes about 650 calories to produce 25 ounces of breast milk, according to the Institute of Medicine. Weight loss can start by consuming 500 of those calories and using 150 calories of stored fat, thus starting weight loss, the institute says.
Threatt, Miller and others acknowledge breastfeeding is not for everyone. There are medical reasons not to breast-feed. Breast-feeding can be painful, some babies often have problems correctly feeding, and some lack a sucking reflex.
But, Threatt, Miller and others believe through education – beginning with the initial natal visit to a doctor and continuing beyond hospitalization – can make a difference.
“You have to have a sustained message,” Miller said. In the hospital it needs to be part of everyone’s conversation and not a check-list item, she said.
Education is especially important with many mothers wondering if their baby is getting enough nourishment.
“Ten percent loss of birth weight in the two weeks following birth is OK,” said Dr. Threatt.
The scope of Best Fed Beginnings goes beyond the hospital or doctor’s office. It is essential to create a family environment that supports breast-feeding and encourages skin-to-skin contact
Changes in the family environment include when other family members interact with a newborn to getting fathers to understand and encourage mothers during breast-feeding.
Perhaps the hardest practice to change will be the parade of grandparents who want to hold the baby within hours after birth. Miller said the skin-to-skin contact between mother and baby shouldn’t be interrupted so early. The contact, she said, turns on a baby’s reflexes and stimulates an interest to feed. One of the goals of the Best Fed program is to have babies breast-feed within an hour of birth.
Another change Miller and others said is essential is having family members understand that giving formula to stop a crying baby, or giving them a pacifier, is not always the best option.
Unless medically indicated, a baby should not be given a pacifier for at least a month, Miller said.
“It’s a change in culture,” she said. “Thirty years ago it use to be all nursery; we wrapped the babies in blankets.”
Financially, breast-feeding could save a family as much as $1,500 in infant formula in the first year, according to the Surgeon General. If 90 percent of mothers exclusively breast-fed for six months, the savings in health care costs would be $13 billion annually, according to the Surgeon General.
The Best Fed program is also trying to help businesses realize that a healthy baby can affect their bottom line. A healthy baby means more on-the-job time for parents.
The federal Affordable Care Act requires employers to provide a reasonable amount of break time and a space for mothers to pump breast milk as “frequently as needed by the nursing mother,” according to the U.S. Department of Labor. The space cannot be a bathroom and must be shielded from view and free from intrusion by co-workers or the public.
Employers must provide time and space for up to one year following a child’s birth, according to the act.
The Best Fed program recently met with several York County employers to educate them on mothers’ needs and to seek their support.
For the next 22 months, Piedmont and others hospitals will gather and report statistics such as the percent of babies who have skin-to-skin contact, the percentage of babies who had their first breast feeding within an hour of birth, the percentage of moms and babies who are in their own room for the first 23 hours and beyond, and the percentage of babies not using a pacifier.
The data will help Best Fed determine if hospitals are reaching their goals.
For Ghent, however, success will be measured more simply. Amanda is assisting with Piedmont’s Best Fed efforts. For her, it is about surrounding mothers with a community of like-minded people after they leave the hospital. “You can’t breast-feed without support,” she said.
“Breast-feeding is not a science; there is no one book on how it should work,” Ghent said. “It is very much an art. There is no one right way to do it. You do what the body wants.”