It’s not the same thing. The American Academy of Pediatrics recommends exclusive breastfeeding for the first six months of a baby’s life because of the well-known health benefits for infants and mothers. Women, like Wan, who start with the intention of exclusively breast-feeding their babies and then supplement them with formula while still in the hospital, are nearly three times more likely to stop breastfeeding. ‘breastfeed within two months, according to a study.

California has made significant strides in recent years promoting exclusive breastfeeding in hospitals, but many women are not sticking to it. All but a small fraction of the women begin breastfeeding during their hospital stay, but nearly a third introduce their babies to formula before they leave, according to data from the California Department of Public Health.

And significant disparities – both ethnic and socio-economic – persist. While women of color exclusively breastfeed their babies more frequently than in the past, they are still far behind whites: in 2016, almost 82% of white mothers gave their babies only breast milk in hospital. , against 60% of black mothers and 65% of Asian and Latin mothers, according to data from the department. (Data for individual ethnic groups excludes people of Hispanic origin, who can be of any race.)

There are also large gaps between counties and hospitals in California. Some facilities have reported exclusive breastfeeding rates of over 90 percent and others of less than 25 percent. Some of the hospitals with the lowest rates are in low-income communities. The national average is 69 percent.

“Where you give birth… and your race has a huge impact on breastfeeding,” said Arissa Palmer, executive director of nonprofit advocacy group Breastfeed LA. “These are barriers on which we have not scratched the surface.

In order to reduce disparities and improve the health of babies, state law requires hospitals to implement concrete measures to promote breastfeeding no later than 2025.

Research shows that breastfed babies can reduce their risk of obesity, diabetes and asthma. It can also reduce the risk of heart disease and cancer in mothers.

Nationally, non-Hispanic black babies are significantly less likely to breastfeed than non-Hispanic whites or Hispanics, according to the Centers for Disease Control and Prevention. Mississippi, West Virginia, Louisiana, and Arkansas have the lowest breastfeeding rates in the United States. Colorado, Oregon, Idaho, and Washington have the highest rates.

In the United States, about 60% of women stop breastfeeding before they originally planned on it, the CDC said. Some of the reasons include concerns about the weight of their infants, problems latching on, unsupportive policies at work, and a lack of education on the benefits of breastfeeding.

Another factor may be the unintended consequences of patient satisfaction scores, said Carmen Rezak, maternal and child health quality coordinator for AHMC Healthcare, a Southern California hospital chain. Because patient reviews are tied to hospital reimbursement, nurses are sometimes afraid to deny patients’ wishes. They may not want to tell loved ones they can’t visit, for example, although more privacy and quiet time encourages breastfeeding, Rezak said.

Release of statewide data on exclusive breastfeeding rates puts “pressure on hospitals” to really take a look at their policies and practices against their competitors, said Jen Goldbronn of the department public health department.

One of the best known ways to increase exclusive breastfeeding rates is by following the “Ten Steps to Successful Breastfeeding”. These include helping mothers to start breastfeeding within an hour of birth, not giving infant formula unless medically necessary, and educating all pregnant women about the benefits of breastfeeding. feeding with milk.

The Baby-Friendly USA organization is asking hospitals looking for its “Baby-Friendly” label to follow the 10 steps. In California, nearly 100 hospitals have this designation, up from 12 in 2006. State law requiring hospitals to put in place breastfeeding supports by 2025 specifically names the 10 steps, but also allows hospitals to adopt proven alternative practices to encourage breastfeeding.

Baby-Friendly USA executive director Trish MacEnroe said hospitals across the country were inadvertently discouraging breastfeeding by taking babies to nurseries. Now, newborns usually stay in the room with the mother and start sucking immediately after birth. According to a study, urging mothers to hold their babies ‘skin to skin’ right after birth helps encourage breastfeeding because of the physical proximity.

Some of the hospitals with the lowest exclusive breastfeeding rates in the state are Whittier Hospital, at 20 percent, and Monterey Park Hospital, at 22 percent. The two hospitals, both run by AHMC Healthcare, serve large numbers of Asian mothers and others who come to the country for the sole purpose of giving birth, Rezak said.

Foreign parents are among the most difficult to convince of the importance of exclusive breastfeeding, in part because of cultural barriers or myths about the value of infant formula, she said. Education is also important, Rezak said. Hospital staff try to teach all new mothers to recognize when their infants are hungry or tired.

At PIH Health Hospital Whittier, moms who want formula must sign a form acknowledging that they understand their decision, said Valerie Martin, clinical director of maternity care. The hospital’s exclusive breastfeeding rate is 80 percent, compared to 33 percent at its sister hospital in Downey.

At the Beverly Hospital, where Wan gave birth, nurses show patients different breastfeeding positions and reinforce the importance of exclusive breastfeeding. But they also try not to push new mothers, said Melissa Morita, director of maternal and child health.

Peng Peng, who lives in China, arrived in the United States about a month before giving birth to her daughter, Ella Lang, in hospital earlier this month. Peng, 34, said that shortly after Ella was born, a nurse gave her formula because her blood sugar was low.

Peng said she didn’t mind too much but still wanted to breastfeed as much as possible.

“It’s natural and it’s more nutritious,” she says. “But I’m not great against the formula.”