Important points
- Parents living in rural areas are more likely to stop breastfeeding before they wish to do so for several reasons, including pressure to return to work and community disapproval of breastfeeding.
- Parents in rural areas also often lack basic knowledge about practical aspects of breastfeeding, such as how much milk a newborn needs to drink, how to properly suck, and how to count wet diapers as a means of figuring out how much milk a newborn is drinking.
- Experts agree that parents should be provided with more educational materials on how to breastfeed before leaving the hospital, and more information about remote appointments with lactation consultants to help them stay on track.
The many benefits of breastfeeding are well-researched and documented, but that doesn’t mean it’s easy. As the mother of a 7-week-old, I am currently living through these challenges. For example, I don’t have time to do much else. On top of that Breastfeed! Luckily, I’ve had support throughout my breastfeeding journey, including access to a lactation consultant at the hospital where I gave birth. The hospital happened to be located on the outskirts of a large city in Florida. My husband and I both work from home, which makes our job much easier.
But sadly, that’s not the case for parents living in rural areas of this country, as one new study recently outlined.
What does research show about breastfeeding in rural areas?
A new study from the University of Missouri Journal of Obstetrics, Gynecology and Neonatal NursingWe found that many breastfeeding parents living in rural areas do not always benefit from resources that could help with breastfeeding. As a result, they end up not breastfeeding for as long as parents living in suburban or urban areas.
Karry Weston, Ph.D., RN, led the research team behind this study. She and her team determined that rural parents lack practical knowledge about breastfeeding (in other words, they have no realistic understanding of the hard work that goes into breastfeeding after a child is born) and a poor understanding of the nutritional needs of newborns. These problems are compounded by the fact that parents in rural areas are likely to have limited or no support to continue breastfeeding.
As a result, parents living in rural areas were more likely to stop breastfeeding and switch to formula feeding in the first few days or weeks of their child’s life.
Lack of resources and support leads to lower breastfeeding success rates
To create this study, Dr. Weston and her team surveyed primiparous women who lived in rural areas and were of low socio-economic status. They learned that in addition to feeling anxious about the basics of breastfeeding, such as proper latching techniques and whether the baby is getting enough milk, parents also feel that the pressure to return to work immediately after giving birth is a major hurdle to achieving long-term breastfeeding success.
Another surprising challenge encountered by parents who wish to breastfeed in rural areas has to do with the social and cultural norms of these areas. Dr Weston said many rural families and communities, especially older generations, frowned upon breastfeeding.
“This can put additional pressure on mothers striving for successful breastfeeding,” she says. parents. “We all need to do more to support new mothers, no matter how they feed their infants,” recommends Dr. Weston.
How rural parents can achieve their breastfeeding goals
Parents who live in rural areas should not feel forced to give up breastfeeding if they don’t want to. It’s clear that more support from family and friends is one of the keys to breastfeeding for the long term.
Education from day one is also essential to reverse the trend of rural parents giving up breastfeeding early. This could include more information provided in hospitals and more affordable access to lactation consultants.
“I think we need to make sure that rural mothers have information and resources about breastfeeding before they leave the hospital,” Dr. Weston says. parents.
From how to safely hold a newborn to learning how to use a breast pump and express breast milk yourself, Dr. Weston says there are many practical tips rural parents should take home with them, but they don’t.
“Another important finding from my research is that women don’t realize that the normal amount of breast milk produced in the first week is only 1 to 2 ounces,” she added. “Even if you pump that much milk, you’ll think your baby isn’t getting enough nutrients and give up.”
Dr. Weston explained that none of the women knew that counting wet diapers was an easy way to determine if a baby was getting enough breast milk early on.
In addition to gaining practical knowledge at the hospital, Dr. Weston says information about breastfeeding resources should be available to all families, both in-person and online. For example, doctors, pediatricians, nurses, and other health care professionals can provide information to breastfeeding parents and direct them to literature where they can stay up-to-date on the latest breastfeeding education.
What is being done to support rural parents at scale?
We clearly have to make inroads to support rural families at the grassroots level. Meanwhile, Anjana Solaiman, DNP, NNP-BC, IBCLC, C-EFM, assistant professor at the University of Maryland School of Nursing, says larger programs can also help combat the problem.
The reality is that rural areas are slower to receive support and updates, and therefore slower to experience change in the stigma around breastfeeding.
“Educational efforts targeting both health care providers and communities are essential to promoting breastfeeding in rural areas,” says Solaiman. parents. “Training health workers to provide consistent and supportive advice on breastfeeding can help fill knowledge gaps, and local education campaigns can change cultural perceptions and normalize breastfeeding.”
Compounding the problem is that many small rural hospitals may not have a designated lactation consultant, said Dr. Laurie Jones, a spokeswoman for Willow, a company that makes hands-free breast pumps. Jones is a pediatrician and clinical assistant professor of pediatrics at the University of Arizona College of Medicine and founder of Dr. MILK (Mothers Interested in Lactation Knowledge), a breastfeeding support network.
“The cost of hiring an International Board Certified Lactation Consultant (IBCLC) may be too high,” explains Dr. Jones. This is the reason why there are so few professionals working in rural areas.
Nicole Peluso, IBCLC and manager of lactation services and perinatal education for Aeroflow Breast Pumps, adds that lack of insurance coverage is another major hurdle faced by rural parents.
“In most states, Medicaid and Blue Cross Blue Shield policies typically do not cover lactation support from a lactation consultant,” she explains. Your policy may cover support from doctors and midwives, who specialize in some postnatal care but are not necessarily experts in breastfeeding.
Even if parents have insurance, a lactation consultant may not be within a sufficient driving distance. This is where the increased use of telehealth services can help. Still, says Peluso, “a lot of mothers don’t know that.” In this situation, it is important to provide more parents with information about telehealth services. More services may be available remotely than parents realize.
Finally, Medha Nikki Rishi, founder of online parenting support resource MissPopins, points to less flexible work schedules among low-income people as a reason for lower breastfeeding rates.
Latest resources for breastfeeding parents in rural areas
The good news is that there are several resources available as currency for anyone seeking breastfeeding help.
Sascha Mayer, co-founder and chief experience officer at Mamava, wants parents to know that the USDA WIC office offers lactation support through peer counselors and certified lactation consultants (CLCs).
“You can also contact your local WIC clinic to schedule an appointment. The Department of Women’s Health also offers a helpline with trained lactation counselors at (800) 994-9662,” she advises.
Peluso advises those seeking help now to consider telehealth options. This may be particularly beneficial for parents who have breastfeeding challenges upon returning to work, but have other caregiving obligations, are unable to drive, don’t have money for gas, or other reasons that make it easier to receive support at home.
Miss Poppins lactation expert Valentina Guzman agrees, saying, “It’s simply difficult to find a lactation consultant in a small town, but the internet is full of valuable information, from blogs and research articles to educational videos.”
How to advocate for change
Although the resources of these rural areas still have a long way to go, overall important steps are being taken towards positive change.
“We are seeing advances in the Pump Act and other laws to protect and support breastfeeding mothers in the workplace,” says Dr. Jones.
However, breastfeeding parents in rural areas of the country still face many challenges if they want to breastfeed their babies. Peluso encourages patients and health care providers to come together to lobby for insurance coverage for lactation support. And Guzman encourages parents to advocate for improved workplace breastfeeding policies to support breastfeeding efforts.
