Rural Parents Give Up on Breastfeeding Sooner

The many benefits of breastfeeding are well-studied and documented—but that doesn’t mean it’s easy. As a mom of a seven-week-old, I am currently living through those challenges—for instance, I don’t have time to do much else besides breastfeed! Luckily, I have had support throughout my breastfeeding journey thus far, including access to a lactation consultant at the hospital where I gave birth, which happens to be in a suburban area of a big city in Florida. My husband and I also work from home, making the task far more manageable.

But sadly, that’s not the case for parents who live in rural areas of the country, as one new study recently outlined.

What Does the Research Say About Breastfeeding in Rural Areas?

The new University of Missouri study, published in the Journal of Obstetric, Gynecologic and Neonatal Nursing, found that many nursing parents living in rural settings don’t always benefit from resources that might help them breastfeed. The result is that they end up not breastfeeding for as long as suburban and urban-based parents.

Karry Weston, PhD, RN, led the research team behind the study; she and her team determined that rural parents lack pragmatic knowledge about breastfeeding (in other words they don’t have a realistic understanding of the hard work that goes into breastfeeding once their children are born), and have a poor understanding of a newborn’s nutritional needs. These issues are only exacerbated by the fact that parents in rural areas are more likely to have limited or no support in continuing to breastfeed. 

As a result, parents living in rural areas were more likely to stop breastfeeding and turn to formula feeding in the first days or weeks of their child’s life. 

A Lack of Resources and Support Leads to Lower Rates of Breastfeeding Success

To create the study, Dr. Weston and her team looked at first-time moms living in rural areas, and with low socio-economic status, for the study. They learned that in addition to feeling unsure about the basics of breastfeeding, such as proper latching technique and whether the baby was getting enough breast milk, parents felt that the pressure to return to work soon after giving birth was also a major hurdle toward realizing long term breastfeeding success.

Another surprising challenge that parents who want to breastfeed run up against in rural communities has to do with social and cultural norms in these areas. According to Dr. Weston, many rural families and communities—especially among older generations—frown upon breastfeeding. 

“This can add an extra layer of pressure onto a mother working to establish successful breastfeeding,” she tells Parents. “We all need to be more supportive of new mothers—no matter how they choose to feed their infants,” Dr. Weston urges.

How Rural Parents Can Achieve Their Breastfeeding Goals

Parents who live in rural areas shouldn’t feel forced to give up breastfeeding if they don’t want to. More support from family and friends is obviously one important key that will help them breastfeed for a longer stretch.

Education from day one is also essential in reversing the trend of rural parents giving up on breastfeeding early on—and that could like more information given out at hospitals, or more affordable access to lactation consultants. 

“I think we need to make sure that rural mothers are equipped with breastfeeding information and resources before being discharged from the hospital,” Dr. Weston tells Parents. 

From being comfortable with latching their newborn, to learning how to use a breast pump or self-express their breast milk, there are a lot of practical tips rural parents should be taking home with them that they simply are not, according to Dr. Weston.

“Another major finding from my study was that women were not aware that the normal amount of breast milk produced in the first week is only 1 to 2 ounces,” she adds. “They would give up if they only pumped that amount because they thought their infant was not getting adequate nutrition.” 

Dr. Weston explained that none of the women knew that counting wet diapers was an easy way to determine if your baby is getting enough breast milk early on.

In addition to gaining practical knowledge at the hospital, Dr. Weston says all families should have information about breastfeeding resources available to them, both in-person and online-doctors, pediatricians, nurses, and other healthcare professionals can guide breastfeeding parents toward literature that can keep them informed and up-to-date with the latest breastfeeding education, for instance.

What Is Being Done to Support Rural Parents on a Larger Scale

Clearly inroads must be made 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-scale programs can help combat the problem as well.

The reality is that rural areas are slower to receive outreach and updated information, and therefore slower to experience change when it comes to stigmas around breastfeeding.

“Educational initiatives targeting both healthcare providers and the community are crucial for promoting breastfeeding in rural areas,” Solaiman tells Parents. “Training healthcare providers to offer consistent and supportive breastfeeding advice can bridge the knowledge gap, while community education campaigns can shift cultural perceptions and normalize breastfeeding.”

Compounding the problem is that designated lactation consultants may not be available at many small hospitals in rural communities, according to Willow spokesperson (a company that makes a hands-free pump), Dr. Laurie Jones. Jones is a pediatrician and clinical Assistant Professor of Pediatrics at the University of Arizona School of Medicine, and the founder of Dr. MILK (Mothers Interested in Lactation Knowledge), a breastfeeding support network.

“The cost of having International Board Certified Lactation Consultants (IBCLC) may be too high,” Dr. Jones explains, which is why they are fewer of these professionals working in rural areas.

Nicole Peluso, IBCLC and Manager of Lactation Services and Perinatal Education at Aeroflow Breastpumps, would add that lack of insurance coverage is another huge hurdle rural parents face. 

“In most states, Medicaid and Blue Cross Blue Shield policies generally do not cover lactation support by a lactation consultant,” she explains—a policy may cover support via a doctor or midwife, but while these professionals specialize in some postpartum care they are not always experts in breastfeeding.  

Even when a parent has coverage, a lactation consultant may not be within a reasonable driving distance. That’s where the increasing use of telehealth services comes in handy. Still, as Peluso notes, “Many moms do not know about it.” Getting more parents informed about telehealth services is key in those circumstances—many more services might be available remotely than parents realize.

Finally, Medha Nicky Rishi, Founder of MissPoppins, an online parenting support resource, points to non-flexible work schedules among lower-income individuals as a reason for breastfeeding rates dropping off. 

Current Resources for Breastfeeding Parents in Rural Areas

The good news is that there are some resources that are currency available for anyone who wants breastfeeding help. 

Sascha Mayer, Cofounder, 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 contact your local WIC clinic to make an appointment or the Office on Women’s Health also offers a helpline at (800) 994-9662 with trained breastfeeding counselors who will answer the phone,” she advises.

Peluso advises anyone currently looking for help to consider telehealth options, which may be especially beneficial for parents who are experiencing challenges around breastfeeding upon returning to work, but have other caregiving duties, don’t drive or don’t have gas money, or any other reason that might make it easier to receive help at home.

Lactation specialist with Miss Poppins Valentina Guzman agrees, saying, “In small towns, lactation consultants are simply harder to find, but the internet is filled with valuable information—from blogs and research articles to instructional videos.”

How To Advocate For Change

Overall, important steps toward positive change are being made, even if resources in these rural areas still have a long way to go.  

“We’re seeing progress with the PUMP Act and other legislation to protect and support breastfeeding moms in the workplace,” says Dr. Jones.

But breastfeeding parents who live in rural parts of the country will still face many challenges if they want to nurse their babies. Peluso encourages patients and providers to band together and lobby for insurance coverage for lactation support. And Guzman urges parents to advocate for better workplace lactation policies to support breastfeeding efforts.