In many Native American cultures, breastfeeding is viewed as more than nourishing babies the way nature intended; it’s viewed as a way to nourish a baby’s mind, body and spirit.
“We believe that breast milk doesn’t just nurture babies, it conveys a mother’s life story, including her knowledge and culture,” explains Amanda Singer, president of the Navajo Nation Breastfeeding Coalition. “Breast milk makes babies strong and healthy, so that they’re ready to face the challenges of their tomorrows,” Singer adds, validating the importance of breastfeeding in Native American communities.
For many Native Americans, however, this belief and the tradition of breastfeeding has lapsed over generations of historical trauma. The U.S. government’s assimilation policies divided families and discouraged or disallowed cultural teachings. The boarding school era, when Native children were separated from their families in the late nineteenth and early twentieth centuries, was especially devastating.
Today, Native mothers and babies have one of the lowest exclusive breastfeeding rates at six months (as recommended by the American Academy of Pediatrics) of any race or ethnicity in the nation. At the same time, they face serious health challenges, including skyrocketing rates of obesity and diabetes, which lead to other health problems.
For Native communities, breastfeeding is a public health issue. Because of the enduring health benefits breastfeeding provides, community leaders and medical professionals are making a concerted effort to reconnect Native women to the cultural tradition of breastfeeding.
First Lady Michelle Obama’s launch of Let’s Move! in Indian Country in 2011 and the call for every Indian Health Service (IHS) birthing hospital in the United States to become Baby-Friendly has spurred the transformation of hospitals in Native communities. As of December 2014, IHS announced all 13 of its birthing hospitals are designated Baby-Friendly, meaning they provide optimal maternity care and breastfeeding support. Now, more than 4,500 Native American babies each year will benefit.
To help make Baby-Friendly a reality in Indian Country, IHS hired Anne Merewood, associate professor of pediatrics and director of Boston Medical Center’s Breastfeeding Center, as a consultant. “We know that breastfeeding can significantly improve the health and well-being of Native American mothers and babies,” explains Merewood. “That’s why we’re partnering with IHS, tribal hospitals and Native communities to increase breastfeeding rates in Indian Country.”
Merewood and her team worked with hospital administrators, doctors and nurses to help them understand the Baby-Friendly Initiative and train them on the 10 Steps to Successful Breastfeeding, required for the designation. A key to her success was collaborating with Native doctors and nurses to serve as advocates and conduct trainings, ensuring cultural relevancy with the content. She also credits IHS for their leadership and commitment to realizing this vision.
“Indian Health Service’s achievement sets a new standard in breastfeeding support to which every birthing hospital in the U.S. ought to aspire,” says Merewood. “If IHS hospitals, which have limited resources and serve high-risk populations, can achieve Baby-Friendly designation, then any hospital can do this.”
“The Breastfeeding Center’s efforts have been instrumental in accelerating a cultural shift to make breastfeeding the norm again in Indian Country,” says Carla Thompson, vice president for program strategy at the Kellogg Foundation. “This shift is critical for the health of American Indian babies and their moms, and for our communities as a whole.”
With funding from the W.K. Kellogg Foundation, the Breastfeeding Center is helping create a network of breastfeeding support in tribal communities and with others who want to improve breastfeeding rates in Indian Country. They launched the Indian Country Breastfeeds website to share resources and connect the people and groups working to support breastfeeding in Indian Country.
In May 2014, the Breastfeeding Center hosted the first-of-its-kind Maternity Care and Infant Feeding in Indian Country conference, bringing together 150 health professionals, hospital administrators and community leaders from 20 tribes to learn about the past, present and future of breastfeeding in Indian Country. In addition to increasing understanding and support for the Bringing Baby-Friendly to Indian Country Initiative, the conference instilled a sense of camaraderie and connection between IHS hospitals who had gained – or were on the pathway to gaining – Baby-Friendly designation.
The Breastfeeding Center’s next focus is on helping tribal birthing hospitals achieve Baby-Friendly designation, which will benefit more than 5,500 Native American and Alaska Native babies and their moms each year.