This program is helping Black women in Mississippi breastfeed

INDIANOLA — Kaylyn Walker never intended to breastfeed either of her two daughters.

Like nearly a third of new mothers in Mississippi, breastfeeding wasn’t high on her list of postpartum priorities. And when nobody taught or encouraged her to do it, formula was a simple substitute.

But last year, at a brief encounter with a lactation specialist for help with a different postpartum issue after her second daughter’s birth, Walker, 24, learned about the benefits to breastfeeding — things she had never considered with her first daughter, like improved nutrition, emotional bonding and long-term health benefits. She decided to give it a try and her second daughter, Kylie, is now a one-year-old and still breastfeeding.

“It definitely was a new experience for me but I’m used to it now,” Walker said. Echoing many new mothers, she said it was intimidating at first, not knowing if she was doing it correctly or producing the right amount of milk. But as she’s gotten more comfortable with it, she’s already seeing the health and emotional benefits, Walker says. “It grows a strong bond with her as well, like she’s more attached now.”

That’s where the Delta Baby Cafe came in — which, despite the pandemic and necessary shift to virtual support, is busier than ever partnering new parents with real-time physical and emotional support to feed their newborns. As a public health intervention under the non-profit Delta Health Alliance’s breastfeeding support program in Sunflower County, the Baby Cafe is part support program, part medical intervention — but all community-based, meeting moms where they are.

Through the Baby Cafe, Walker is one of about 20 moms a week who not only gets logistical tips — like how to position the baby to help with feeding — but also help accessing resources, like a breast pump and education.

“I started attending the breastfeeding classes, then it just got easier and easier,” Walker said. “It’s definitely a different experience (than with her first daughter). So like I said, I didn’t plan on going this long but, you know, with my daughter, if it’s something she likes then I’m okay with it. And it helps her as well with her immune system. Anything that’s helping her, I’m okay with it.”

The Baby Cafe is a piece of Delta Health Alliance’s partnership with South Sunflower County Hospital to increase breastfeeding rates, and in turn improve infant and maternal health outcomes, called BUILD Health Challenge (which stands for: bold, upstream, integrated, local, and data-driven). Launched November 2019, the program aims to connect community stakeholders such as businesses, childcare, social services and health care providers, to better partner to support moms early and consistently.

Research shows the health benefits to both mom and baby from breastfeeding, including decreased likelihood of asthma, obesity and sudden death for babies, and reduced risk of high blood pressure, some cancers and Type 2 diabetes for mothers.

But barriers to breastfeeding are high in Mississippi — including lacking education, high-cost supplies and stigma. Black moms are less likely to breastfeed, and advocates say understanding why should inform the strategies to help increase it.

Research reiterates that the decision to or not to breastfeed is a dynamic choice and should be supported as one. It’s not a one-size-fits all, and complex histories, stigma and pre-existing health inequities play into it. Though breastfeeding is a crucial piece to reversing trends of poor maternal health outcomes for Black women, it’s also an opportunity to prioritize women’s choice and autonomy over decision making, says Jacqueline Lambert, who launched the Baby Cafe in Indianola last year.

“Most of our workforce consists of women, and when you start by having programs and having things available for women, you begin to see that this is a part of a woman’s health,” Lambert said. “I think most of it, the stigma, is because we just don’t see it. And when you don’t see a thing, you don’t think it’s normal.”

Because Black women are over-represented in low-wage jobs in Mississippi, they tend to go back to work after birth before other groups, and once they do, they encounter less flexible work conditions, according to research. BUILD aims to close that gap by educating workplaces on the economic and social benefits of supporting breastfeeding mothers.

Legally, Mississippi mothers have the right to breastfeed wherever they want, but stigmas and lack of workplace support are still barriers, adds Lambert. Since the Mississippi Legislature codified the right to breastfeed in 2006, multiple bills to support the practice by promoting it throughout social services and licensing lactation specialists have failed to gain momentum.

Lambert, the 14-year Women, Infants, and Children (WIC) counselor and lactation specialist at Baby Cafe, said Black moms aren’t “seen” nursing and often don’t equate their milk as nourishment for the baby, which can cause the stigmas to persist in Black communities.

“In our communities, we don’t always see people nursing that look like us. And so that stigma is nobody does it. Nobody’s nursing or people don’t nurse anymore, or they don’t have to do it because formula is there,” Lambert said.

“When babies are in the hospital, moms readily nurse because they see it as ‘quote unquote’ medicine. Because you view it as a medicine, and not as nourishment or nutrition, it takes on a different stance as well.”

Only Alabama and Louisiana have lower rates of breastfeeding than Mississippi, where 70% of infants are ever-breastfed — compared to 84% nationally. The American Academy of Pediatrics recommends that infants be exclusively breastfed for the first six months of life and then weaned into other foods, while still partially breastfed, through the rest of the first year. Less than 40% of infants are still breastfeeding at six-months in Mississippi.

But for it to be sustainable, plans need to start before the baby is born and the breastfeeding needs to happen immediately after birth. So hospital staff and support needs to kick in right away, and that isn’t always happening in Mississippi. And like lactation specialist Lambert says, the hospital support for breastfeeding needs to go beyond its medicinal effects.

Of the more than 40 birthing hospitals in the state, about half qualify as “baby friendly,” meaning they have committed to helping new moms initiate breastfeeding as infants’ primary nutrition source and encourage “skin to skin” time after birth. South Sunflower in Indianola is the only baby-friendly hospital in the Delta. Research shows hospitals with a baby-friendly designation are more likely to help moms start and sustain breastfeeding.

This wasn’t the case nine years ago, when nurses warned Janesiya Brooks against breastfeeding with her first son, Dequan, because of a previous breast reduction. She tried again with her second son, Jahmar, but failed. So, she stopped and fell into depression, she said.

Janesiya Brooks, 26, outside her Greenwood, Miss. home discusses her upcoming wedding and the support system she’s gained from the Delta Baby Cafe.

Brooks, 26, decided she wanted to push forward with breastfeeding while pregnant with her third child and only daughter, Trinity. This time she reached out for help. Last year, she joined the Baby Cafe breastfeeding classes, where she received consistent support, education and proper latching techniques — for the first time.

“(Lambert) would always give helpful information. She showed a video so that has the visual of how babies are supposed to latch on,” she said. “Anytime you needed her, if you needed any resources or anything, she helped you make your journey easier.”

This is one of the many reasons why Lambert launched the Baby Cafe, hoping the center offered physical and emotional support for new moms who might not get it elsewhere and might otherwise abandon breastfeeding.

A former WIC support counselor, she knows that the journey to sustainable breastfeeding is more than simply showing mothers how to get the baby to latch and drink. And that the benefits that come from consistent breastfeeding — like bonding and better nutrition — take time.

“When something seems like it’s forced, most moms won’t even think about it,” Lambert said. But the opposite approach can make a world of difference, she says. “When you listen to a mom about her feeding decisions, and she sees that you’re listening and you’re concerned … You start that dialogue… so my goal is there.”

For some women who have the support at home but need more physical training to learn the process, Lambert works as a support person — usually a partner or parent — trainer. In Brooks’ situation, Lambert helped her fiance learn how to support her and their new child while at home.

For Walker, the young mother, Lambert first encouraged her to breastfeed when they met at the local health department — an example of why it’s important to meet mothers where they are to fill in gaps left by other services.

A year later, it’s Lambert who’s still Walker’s biggest cheerleader. Walker doesn’t always attend the weekly breastfeeding support groups anymore now that she’s got the hang of it, but she says Lambert is on speed-dial to help with anything that arises — breastfeeding-related or otherwise.

As for when she’ll stop breastfeeding after the so-far year of success: “Well, it’s up to her,” Walker said. “I’m just on my daughter’s time.”