Moms and babies playing together at Baby Café San Antonio. Photo by Norma Sifuentes, courtesy of SAMHD WIC.
Moms and babies playing together at Baby Café San Antonio. Photo by Norma Sifuentes, courtesy of SAMHD WIC.

Question: Do all San Antonio babies get an equitable start on a healthy life?

Answer: No.

In short, not all mothers have a strong foundation for health that is crucial to a healthy pregnancy and subsequent healthy weight for their children in infancy and early childhood.

Many Latina moms are committed to breastfeeding, a scientifically proven way to reduce the risk of disease and pave a healthy future for children and mothers. Unfortunately, they face more marketing for formula and have less support for breastfeeding in hospitals, the workplace, and early child care settings than their white peers, according to a recent research review from Salud America!, a national obesity prevention research network based at the UT Health Science Center at San Antonio and funded by the Robert Wood Johnson Foundation.

Federal and state policies are beginning to address support for breastfeeding and childhood obesity prevention, but inequity in compliance among institutions and businesses still exist.

This contributes to San Antonio’s disproportionately high rate of childhood obesity and related chronic diseases among its 65.3% Latino residents. In San Antonio, 32% of Latino high school students are overweight or obese compared to only 21% of non-Latino, white high school students.

One in every two Latino children born in the year 2000 will develop diabetes in their lifetime, according to federal estimates.

These kids are also at risk for additional physical and mental health issues related to childhood obesity, such as cardiovascular disease, asthma, liver disease, stroke, arthritis, sleep apnea, depression, and psychological stress. These lifelong health complications are affected by a number of variables early in life, spanning from the womb to infancy and early childhood.

Studies by the University of New Mexico Bureau of Business and Economic Research have shown that, if all infants on WIC were exclusively breastfed for the first six months, New Mexico would save more than $3 million in taxpayer dollars every year.

So, how can San Antonio support Latina moms and ensure that the growing population of Latino kids enters kindergarten at a healthy weight?

Breastfeeding mothers should feel safe, supported, and welcome to nurse or pump in all public spaces to help meet their personal breastfeeding goals.

One of the objectives in the 2014 Bexar County Community Health Improvement Plan for Healthy Child and Family Development aims to increase rates of exclusive breastfeeding during the first six months. The plan provides strategies to accomplish this through peer-support, the workplace, hospitals, community partnerships, education and training, and outreach campaigns.

Check out these case studies of successful healthy changes in San Antonio and other areas that involves many groups and sectors to improve maternal and infant health through peer-support, the workplace, and hospitals.

Peer-Support: Baby Café

In San Antonio, Norma Sifuentes and Diana Montano, two employees from the San Antonio Metropolitan Health District Women, Infants and Children (SAMHD-WIC) department, took advantage of a funding opportunity to create Baby Café, a comfortable place for breastfeeding mothers to come get support from breastfeeding peer counselors.

The SAMHD had offered peer counselors to WIC mothers for 20 years because there are so many benefits that stem from breastfeeding for babies and for mothers alike. But what about mothers not enrolled in WIC?

Sifuentes and Montano wanted all San Antonio mothers – WIC or not – to be able to access breastfeeding peer counselors to increase local breastfeeding rates.

In 2012, with support from former SAMHD Director Dr. Thomas Schlenker, the pair pursued a formal grant proposal for the funding opportunity through the Texas Health and Human Services Commission (HHSC) and the Centers for Medicare & Medicaid Services (CMS) for population-based prevention projects.

Breastfeeding & Latino kids infographic courtesy of Salud America!
Breastfeeding & Latino kids infographic courtesy of Salud America!

After almost two years of meeting revised grant requirements, searching for accessible locations near the medical center, getting licensed by Baby Café USA, and hiring staff, Sifuentes and Montano opened SAMHD Baby Café in March of 2014.

The SA Baby Café provides free, accessible breastfeeding support for all San Antonio mothers in order to increase breastfeeding duration through 3 months, 6 months, and 12 months to help reduce childhood obesity rates across San Antonio.

The Workplace: Lactation Stations and Institution-Wide Written Policy

Without access to a private, comfortable, sanitary place to express breast milk or breastfeed at work or school, nursing parents struggle to reach their personal breastfeeding goals.

Lactation Station at the University of Northern Colorado. Photo by Alena Clark, courtesy of UNC.
Lactation Station at the University of Northern Colorado. Photo by Alena Clark, courtesy of UNC.

Alena Clark, nutrition and dietetics associate professor, and Yvette Lucero-Nguyen, director of the Women’s Resource Center (WRC) at the University of Northern Colorado (UNC), coordinated with faculty and staff in different departments as well as with students to establish three Lactation Stations to provide breastfeeding parents a private, comfortable place to express breast milk or breastfeed.

Although federal law requires employers to provide time and adequate accommodations for nursing parents, many employers struggle to identify unused space in their facility, and therefore, don’t usually comply with this law.

The UNC campus, for example, has 10 academic buildings and over 15 administrative and services buildings, which are managed by different departments and different building managers. There were only four private offices in the entire Women’s Resource Center building, where Lucero-Nguyen worked, meaning the WRC didn’t even have a private room to provide.

“Space is a really big commodity on our campus, as on every college campus,” Lucero-Nguyen said. “Being creative with space is always a challenge.”

Clark and Lucero-Nguyen reached out to each department and discussed creative ways to utilize space.

While written policy may cover employees in academic institutions, this protection often does not extend to students. Therefore, Clark, Lucero-Nguyen, and others also drafted an institution-wide written policy for breastfeeding support to protect students in addition to employees. The policy was adopted in November 2015.

Clark and Lucero-Nguyen continue to help other departments understand the importance of supporting breastfeeding and continue developing creative ways to use limited space.

A physician speaks to a mother about breastfeeding. Photo courtesy of Baby Friendly USA.
A physician speaks to a mother about breastfeeding. Photo courtesy of Baby Friendly USA.

Prior to returning to work or school, new moms need breastfeeding support from delivery.

Maternal experiences during birth hospitalization show that a hospital’s policies and practices affect a mother’s ability to establish and maintain breastfeeding. Thus, it is critical for hospitals to adopt evidence-based policies to ensure that the growing number of Latina mothers have access to maternity care policies and practices supportive of breastfeeding.

Hospitals: Baby-Friendly Hospitals

In 2012, the New Mexico Breastfeeding Task Force teamed with the global Baby-Friendly Hospital Initiative to remove barriers and help hospitals adopt more breastfeeding-friendly policies and achieve official Baby-Friendly Designation, with funding from the WK Kellogg Foundation. Since then, eight of 30 hospital facilities with maternity care units in New Mexico have been designated as Baby-Friendly.

Maternity Practices in Infant Nutrition and Care Survey. Image courtesy of CDC.
Maternity Practices in Infant Nutrition and Care Survey. Image courtesy of CDC.

Baby-Friendly Hospital Designation is an initiative of the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) to encourage and recognize hospitals and birthing centers that offer an optimal level of care for infant feeding and mother/baby bonding based on the Ten Steps to Successful Breastfeeding.

These are the kind of projects and policy changes that residents, businesses, health departments, academic institutions, and hospitals in San Antonio can adopt to support working families and build a culture of breastfeeding and a culture of health.

Currently, 17 hospitals and birthing centers in Texas have been designated Baby-Friendly.

Unfortunately, San Antonio has zero.

On Aug. 2, 2016, during World Breastfeeding Week (#WBW2016), National Breastfeeding Month (#NBM16), and the 5-year anniversary of the U.S. Surgeon General’s Call to Action to Support BreastfeedingSalud America! will host a #SaludTues Tweetchat about how individuals, hospitals, employers, and communities can improve awareness of and access to breastfeeding support for Latinas.

Our Salud America! website has fantastic resources and stories to help you protect, promote, and support breastfeeding to make your community a healthier place for families.

Become a Salud Leader and get started today.

You will instantly join a local and national movement of people like you interested in healthy changes for Latino moms and kids, and you’ll get free perks like a spot on our national map, the ability to connect with other leaders who might support you (or vice versa), customized data about local health issues, and personal assistance from our team of curators.

See you at Salud America!

Top image: Moms and babies playing together at Baby Café San Antonio.  Photo by Norma Sifuentes, courtesy of SAMHD WIC.

Related Stories:

Salud America! Keeping Latino Children Fit and Healthy

Salud America: How to Make Space for Physical Activity

The Feed: Salud America Weighs in on Latino Childhood Obesity

How the Children’s Hospital is Revolutionizing Health Care with Food

Healthy Inspiration from Traditionally Prepared Mexican Cuisine

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Amanda Merck

Amanda Merck is a content curator/research area specialist for Salud America! at the Institute for Health Promotion Research at the UT Health Science Center at San Antonio. She also is a VIA board member.