Editor's note: This is the first in a three-part series. Here's part two and here's part three.
The health benefits of breastfeeding are widespread and long-lasting. While the vast majority of women at least try to breast-feed their infants a surprising percentage turn to formula within a few days of birth picked in the first part over a three-part series on the challenges of breast-feeding, KPBS health reporter Kenny Goldberg takes a look at the role hospitals played in encouraging the practice. Reporter: Catalina was determined to breast-feed her first job. When Kai was born last June things did not work out what she planned. First it was very challenging. I had a difficult delivery with a bunch of issues and Kai ended up being in the NICU. Reporter: Kai was in intensive care for a few days. As soon as he got out, Alban-Stoughton tried to breast-feed him. Her nipples worst sort. Kai could not much on. Alban-Stoughton started to panic. It is amazing how emotional breast-feeding can be pick we have -- going crazy, where overwhelmed, we want to feed our babies and where losing perspective. Kai is born at Scripps hospital in Anthony's with a have six certified lactation consultants. Vicki was the lead lactation consultant at Scripps Encinitas. She passed away after we interviewed her. Consultants of this hospital checking with every new mom and make sure they are not having any problems with breast-feeding. Did this one get to get on the skin to skin and get on the breast in the first hour? How did that go? Reporter: All of the staff have been trained on best practices to promote breastfeeding. Will from these include helping moms to initiate breast-feeding within an hour of birth. If the baby is placed skin to skin a lot of times the baby will try to screech over to the rest them will actually latch on all by themselves. It doesn't always happen and in those cases the nurse of course will help but if she is not having success than she will come and get the lactation consultant. Reporter: Scripps Encinitas has adopted the 10 steps to become a baby friendly Hospital picked the World Health Organization introduced the baby friendly Hospital initiative in 1991. It is based on research that shows breast-fed infants have lower rates of asthma, childhood obesity and a number of other adverse health conditions. Scripps Encinitas became the first baby friendly hospital in the county in 2004. Nurse Judy Mills has worked at the hospital for 18 years. She says some women have a lot of problems with breast-feeding. We can certainly work with those moms and we have and we do help them to succeed we have all kinds of things we pull out of our how to make them be able to breast-feed and be successful. Took the California Department of Health issues and annual report on in-hospital rest reading rates for the latest report reveals nearly 91% of women exclusively breast-feed their babies. Just 15 miles away here at Tri-City medical Center in Oceanside, the in-hospital breast-feeding rates are much lower.'s fault is that? Tri-City is not a baby friendly hospital. Tri-Cities Marissa Allen Center staff does encourage breast-feeding but she admits only 57% of moms exclusively breast-feed work We have moms like him and that want to exclusively breastfeed and we try to support them the best we can and someone's Gamen if they ask for formula we give them the risks of formula but it is ultimately there choice -- of their choice. The World Health Organization say staffs trained discreetly -- Bella Kaufmann Senior Director of clinical services at Scripps Encinitas. She points out not all women come in wanting to breast-feed. There are a lot of bombs who really do not know the difference still. The formula company doesn't excellent job of marketing. Novy markets breast-feeding. Nobody gets paid for marketing breast-feeding. Reporter: Nonetheless California law requires all hospitals that have a birthing center to be baby fronted by 2025. Only for hospitals in San Diego County currently have that designation. After many failed attempts, Carolina Alban-Stoughton was finally able to breast-feed Kai. A lactation consultant at Scripps Encinitas helped her position him just right. He latched on and it didn't hurt. Jenny Ms. Stephanie Laurean a La Leche League grenade for Imperial Counties WIC program. Welcome to the program. We heard in Kenny's feature that the so-called baby friendly hospitals have breast-feeding rates up to 90%. I hear that is a far cry from the race in Imperial County. Imperial County has one of the lowest breast-feeding rates in California right? Yes, second from the bottom. How many moms in the wake of ground that you oversee exclusively breast-feed? At the newborn age it is about 20% to 25% but it falls drastically at two months, 10%. I mentioned you also a group leader for La Leche League. Can you tell us what that means? La Leche League is peer to peer breast-feeding supports. We have monthly meetings where breast-feeding interested people can go and hang out with others that are interested in breast-feeding. On like a class, we do present information that there is also a wonderful time, with questions and answers of what is on your mind at this moment in you learn not only from the leader who is facilitating the group at all of the other people who have also been breast-feeding. They get a lot of different perspectives in one sitting. What are the challenges mothers in Imperial County have in terms of breast-feeding? I think there is in general a big distortion between the expectations of what life is going to be like with a newborn and the reality of it. It is a very family centered culture out here so there is a lot of support for caring for the BB but nobody likes to hear a crying baby and if the concern is that your baby is still hungry you get a lot of input to just formula feed the baby because that is important to get your baby fat wreck it is important to get your baby said that, there is the huge gap, that every time a baby cries is a crime because it is hungry. There is lots of family pressure. With such a big emphasis on family you would think there would be a support group for a new mother of mothers, grandmothers, mothers-in-law who would perhaps help a new mother learn how to breast-feed and help them with that process. That doesn't normally happen you are saying? Always. Breast-feeding rates and certainly attention for breast-feeding is a lot bigger these days then 20 or 30 years ago. The grandmothers of the generation right now are more often having formula fed their on children. When breast-feeding is in going well or at least if it is perceived not to be going well, grandma saying I formula fed you and you turned out okay. It is okay to use formula. There is that concern about rabies crying because they are hungry. How much should a newborn baby eat? Is there misperception about linking crying with feeding? Yes. There is lots of misperceptions with a baby crying and it equals hunger. Most parents assume, certainly brand-new parents at the baby is crying, baby is hungry I have got to feed it. In society that is what they do, eat, sleep and food. Even the lactation Center did a big study and they came out with these great tools for understanding BB behavior which is used at WIC. It helps teach parents that babies cry for other reasons and there is some really good cues that babies used to convey their needs. WIC also provides formula to mother so you are in a situation where you can provide the formula but as breast-feeding coordinator you want to encourage mothers to breast-feed. How do you go about encouraging mothers to breast-feed at WIC? That is a hard balance. In 2006 I believe it was the WIC program in California got a food package overhaul. For a new mom, recently postpartum, she has an option of three different food packages, if she is fully breast-feeding, if she is combination breast-feeding or fully formula feeding. With the exclusive breast-feeding which is what we want to encourage because we know it is best for the babies and the moms, that food package gets the most amount of food in it. It is a better monetary value versus the Formula One. Even for the infants, if we are expecting breast-feeding exclusively for six months so there is no food for baby other than moms milk until six months of age, when we start providing solid foods on the program. The ones that are exclusively breast-feeding get so much more foods and a greater variety of foods than the ones that are combination feeding in that is still even more variety and value than the ones that are receiving formula. I've been speaking with Stephanie Laurean. She is a La Leche League leader and breast-feeding coordinator for Imperial County WIC program. Thank you so much.
Carolina Alban-Stoughton was determined to breastfeed her first-born child. But when Kai was born last June, things didn’t work out like she had planned.
“At first with Kai, I’m not gonna lie, it was very challenging," Alban-Stoughton said. "I had a difficult delivery, with a bunch of issues, and Kai ended up being in the NICU.”
Kai was in the neonatal intensive care unit for a few days. As soon he got out, Alban-Stoughton tried to breast-feed him.
Her nipples were sore. Kai couldn’t latch on. Alban-Stoughton started to panic.
“It’s amazing, how emotional breast-feeding can be," she said. "Our hormones are going crazy, we’re overwhelmed, we want to feed our babies, and we are losing perspective.”
The importance of well-trained staff
Fortunately, Kai was born at Scripps Memorial Hospital in Encinitas, where they have six board-certified lactation consultants on staff.
Lactation consultants at this hospital check in with every new mom and make sure that they aren’t having any problems with breastfeeding.
Vicki Wolfrum was the lead lactation consultant at Scripps Encinitas. She died in October.
All of the staff at Scripps Encinitas have been trained on best practices to promote breast-feeding. Wolfrum said these include helping moms to initiate breast-feeding within an hour of birth.
“So if the baby is placed skin to skin, a lot of times the baby will try to scooch over to the breast, and will actually just latch on all by themselves," she said. "It doesn’t always happen, and in those cases, the nurse, of course will help. But if she’s not having success, then she’ll come and get the lactation consultant.”
Baby-friendly
Scripps Encinitas has adopted the ten steps required to become a “Baby-Friendly” hospital.
The World Health Organization introduced the Baby-Friendly Hospital Initiative in 1991. It’s based on research that shows that breastfed infants have lower rates of asthma, childhood obesity and a number of other adverse health conditions.
Scripps Encinitas became the first Baby-Friendly hospital in San Diego County in 2004.
Nurse Judy Mills has worked at the hospital for 18 years. She said some women have a lot of problems with breastfeeding.
“But we can certainly work with those moms," Mills said. "And we have, and we do help them to succeed. We have all kinds of things we pull out of our hat to make them be able to breastfeed and be successful at it.”
The numbers
The California Department of Public Health issues an annual report on in-hospital breastfeeding rates.
The latest report reveals nearly 91 percent of women at Scripps Encinitas exclusively breastfeed their babies.
But just 15 miles away, at Tri-City Medical Center in Oceanside, the in-hospital breastfeeding rates are much lower.
Tri-City is not a certified Baby-Friendly Hospital.
Marissa Allen, registered nurse supervisor at Tri-City's lactation services, said her staff encourages breast-feeding. But she admits only 57 percent of moms exclusively breast-feed at Tri-City, the lowest rate of any hospital in San Diego County.
“We have moms that come in that want to exclusively breast-feed and we try to support them the best that we can," Allen said. "And some moms that come in, and if they ask for formula, we give them the risks of formula. But ultimately, it’s really their choice.”
According to the World Health Organization and the Centers for Disease Control and Prevention, hospital staff that are trained in baby-friendly techniques greatly increase the percentage of moms who exclusively breastfeed.
Bella Kaufman, senior director of clinical services at Scripps Encinitas, points out not all women come in wanting to breastfeed.
“There are a lot of moms who really don’t know the difference, still," Kaufman said. "And the formula companies do an excellent job of marketing. Nobody markets breastfeeding because no one gets paid for marketing breast-feeding.”
Nonetheless, California law requires all hospitals that have a birthing center to be Baby-Friendly by 2025.
Only four hospitals in San Diego County currently have that designation.
Success
After many failed attempts, Carolina Alban-Stoughton was finally able to breast-feed Kai. A lactation consultant at Scripps Encinitas helped her position him just right.
“And he latched on," she said, smiling. "And it didn’t hurt.”
