{"id":1318,"date":"2020-09-25T13:13:57","date_gmt":"2020-09-25T18:13:57","guid":{"rendered":"https:\/\/www.indianz.com\/News\/?p=1318"},"modified":"2020-09-25T13:13:57","modified_gmt":"2020-09-25T18:13:57","slug":"cronkite-news-baby-friendly-hospitals-tackle-health-disparities-in-indian-country","status":"publish","type":"post","link":"https:\/\/indianz.com\/News\/2020\/09\/25\/cronkite-news-baby-friendly-hospitals-tackle-health-disparities-in-indian-country\/","title":{"rendered":"Cronkite News: \u2018Baby-Friendly\u2019 hospitals tackle health disparities in Indian Country"},"content":{"rendered":"<img loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"500\" data-attachment-id=\"1319\" data-permalink=\"https:\/\/indianz.com\/News\/2020\/09\/25\/cronkite-news-baby-friendly-hospitals-tackle-health-disparities-in-indian-country\/whiteriverhospital\/\" data-orig-file=\"https:\/\/indianz.com\/News\/wp-content\/uploads\/2020\/09\/whiteriverhospital.jpg\" data-orig-size=\"800,500\" data-comments-opened=\"0\" data-image-title=\"whiteriverhospital\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;One of the birthing rooms at the Whiteriver Indian Hospital on the Fort Apache Indian Reservation. The hospital is teaching new mothers good breastfeeding practices, which research shows improves such conditions as obesity and Type 1 diabetes in kids. Photo courtesy of Laura Gordon&lt;\/p&gt;\n\" data-large-file=\"https:\/\/indianz.com\/News\/wp-content\/uploads\/2020\/09\/whiteriverhospital.jpg\" src=\"https:\/\/indianz.com\/News\/wp-content\/uploads\/2020\/09\/whiteriverhospital.jpg\" alt=\"whiteriverhospital\"   class=\"img-fluid wp-image-1319\" \/><figcaption class=\"figure-caption\"> One of the birthing rooms at the Whiteriver Indian Hospital on the Fort Apache Indian Reservation. The hospital is teaching new mothers good breastfeeding practices, which research shows improves such conditions as obesity and Type 1 diabetes in kids. Photo courtesy of Laura Gordon<\/figcaption>\r\n<div class=\"h3-responsive font-weight-bold\">\u2018Baby-Friendly\u2019 hospitals tackle health disparities by encouraging Native mothers to breastfeed<\/div>\r\n<div class=\"date\">Friday, September 25, 2020<\/div>\r\n<div class=\"byline\">By Franco LaTona<\/div>\r\n[cronkite]\r\n<p><\/p>\r\nPHOENIX \u2013 The Whiteriver Indian Hospital in eastern Arizona is combating health disparities among Native Americans by teaching new mothers strong breastfeeding practices, which research shows improves such ailments as obesity and Type 1 diabetes in kids.<p><\/p>\r\n\r\nThe medical center on the Fort Apache Indian Reservation is one of about 10 hospitals under the Indian Health Service that is classified as \u201c<a href=\"https:\/\/www.ihs.gov\/babyfriendly\/\">Baby-Friendly,<\/a>\u201d which means hospital staff are equipped to train new moms on the benefits of breast milk over formula and provide breast pumps and other resources.\r\n<p><\/p>\r\n\r\nSpecifically, the Baby-Friendly Hospital Initiative promotes breastfeeding as the exclusive feeding choice for the first six months of a baby\u2019s life. Exclusive breastfeeding, according to the Centers for Disease Control and Prevention, means feeding only breast milk and no other foods or liquids \u2013 including formula or water.\r\n<p><\/p>\r\nShawna Ziadah, assistant supervisor of the Whiteriver birthing center, said she tries to be \u201cas real as possible\u201d when educating new moms about the challenges of exclusive breastfeeding.<p><\/p>\r\n\u201cThey&#8217;re tired \u2026 and I always tell them in the beginning, once you have a baby, you&#8217;re never going to sleep until that baby&#8217;s 18 and out of the house,\u201d she said.<p><\/p>\r\n<blockquote class=\"twitter-tweet\"><p lang=\"en\" dir=\"ltr\">Four IHS hospitals have recently had their <a href=\"https:\/\/twitter.com\/hashtag\/BabyFriendly?src=hash&amp;ref_src=twsrc%5Etfw\">#BabyFriendly<\/a> Hospital designation renewed, indicating their ongoing commitment to promoting a healthy start for babies. Read more in the latest IHS Blog: <a href=\"https:\/\/t.co\/xXxOgSaUvT\">https:\/\/t.co\/xXxOgSaUvT<\/a> <a href=\"https:\/\/twitter.com\/hashtag\/NativeHealth?src=hash&amp;ref_src=twsrc%5Etfw\">#NativeHealth<\/a> <a href=\"https:\/\/twitter.com\/hashtag\/IndianCountry?src=hash&amp;ref_src=twsrc%5Etfw\">#IndianCountry<\/a> <a href=\"https:\/\/twitter.com\/hashtag\/Breastfeeding?src=hash&amp;ref_src=twsrc%5Etfw\">#Breastfeeding<\/a> <a href=\"https:\/\/t.co\/irhYL39OHA\">pic.twitter.com\/irhYL39OHA<\/a><\/p>&mdash; IndianHealthService (@IHSgov) <a href=\"https:\/\/twitter.com\/IHSgov\/status\/1114250397546315776?ref_src=twsrc%5Etfw\">April 5, 2019<\/a><\/blockquote> <script async src=\"https:\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script>\r\n<P><\/P>\r\nThe American Academy of Pediatrics \r\n<a href=\"https:\/\/www.cdc.gov\/nutrition\/infantandtoddlernutrition\/breastfeeding\/recommendations-benefits.html#:~:text=Recommendations-,Breastfeeding,and%20supports%20growth%20and%20development.\">recommends<\/a>\r\nmothers exclusively breastfeed for six months and then continue to breastfeed for up to and even exceeding two years, while introducing iron-rich foods, such as pureed meats and green vegetables, for optimal health.\r\n<p><\/p>\r\n\r\nFederal statistics show that children who are breastfed are at \r\n<a href=\"https:\/\/www.cdc.gov\/nutrition\/infantandtoddlernutrition\/breastfeeding\/recommendations-benefits.html\">lower risk<\/a>\r\nof obesity, Type 1 diabetes and asthma, conditions that disproportionately affect Native Americans. For example, Native American teens are \r\n<a href=\"https:\/\/minorityhealth.hhs.gov\/omh\/browse.aspx?lvl=4&amp;lvlid=40\">30%<\/a>\r\nmore likely to struggle with obesity than white teens.\r\n<p><\/p>\r\nDirect breastfeeding in particular, as opposed to providing breast milk from a bottle, can help babies self-regulate and better avoid overeating, said Dr. Lori Feldman-Winter, professor of pediatrics at Rowan University in New Jersey and chairwoman of the American Academy of Pediatrics section on breastfeeding.<p><\/p>\r\nFeldman-Winter said new research suggests direct breastfeeding helps regulate the microbiome, which contributes to normal metabolism, thus decreasing the risk of obesity later in life.<p><\/p>\r\n\r\nThe health effects of breastfeeding are not exclusive to children, she noted. Mothers benefit, too. Women who breastfeed typically return to \r\n<a href=\"https:\/\/www.aap.org\/en-us\/advocacy-and-policy\/aap-health-initiatives\/Breastfeeding\/Pages\/Benefits-of-Breastfeeding.aspx\">prepregnancy weight faster<\/a>, which can shield them from associated health complications, and those health benefits increase over time.\r\n<p><\/p>\r\n\u201cThe amount of protection it can offer mothers to prevent Type 2 diabetes or hypertension, it really does matter to actually continue to breastfeed for two years,\u201d Feldman-Winter said.<p><\/p>\r\nDespite these health benefits, just more than a quarter of babies in the U.S. are breastfed exclusively for the first six months, according to CDC data, and just more than 35% of infants are breastfed by age 1.<p><\/p>\r\n<div class=\"embed-responsive embed-responsive-16by9\">\r\n<iframe   src=\"https:\/\/www.youtube.com\/embed\/HOEV6JJJnfA\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen><\/iframe><\/div>\r\n<figcaption class=\"figure-caption\"> Indian Health Service: <a href=https:\/\/youtu.be\/HOEV6JJJnfA>Four Directions of Wellness &#8211; Baby-Friendly Hospital<\/a>\r\n<\/figcaption><p><\/p>\r\nBlack and Native American infants are breastfed less than white and Hispanic infants, studies show. Although research regarding breastfeeding among Native American mothers is lacking, a \r\n<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4410446\/#B2\">2015 study<\/a>\r\npublished in the journal Breastfeeding Medicine said these mothers have lower rates of breastfeeding initiation, duration and exclusivity compared with other racial and ethnic groups, except for Black mothers.\r\n<p><\/p>\r\n\r\nThe \r\n<a href=\"https:\/\/www.unicef.org\/nutrition\/index_24806.html#:~:text=The%20Baby%2DFriendly%20Hospital%20Initiative%20(%20BFHI%20)%2C%20launched%20in,become%20centers%20of%20breastfeeding%20support.&amp;text=A%20list%20of%20Baby%20Friendly,a%20country%20by%20country%20basis.\">Baby-Friendly Hospital Initiative<\/a>, which was launched by the World Health Organization and UNICEF in 1991, is global in scope. The \r\n<a href=\"https:\/\/www.babyfriendlyusa.org\/for-facilities\/practice-guidelines\/10-steps-and-international-code\/\">U.S. program<\/a>\r\npromotes a 10-step list of guidelines hospitals follow. Those include having a written breastfeeding policy, helping mothers initiate breastfeeding within one hour of birth and restrictions on giving infants artificial nipples or pacifiers.\r\n<p><\/p>\r\nThe Whiteriver hospital first earned its Baby-Friendly designation in 2014 and again in 2019.<p><\/p>\r\n\u201cA lot of people think that breastfeeding is just sort of this natural process and it comes very easily to both the mom and baby, and it really isn\u2019t,\u201d said Dr. Tony Ogburn, chairman of the department of obstetrics and gynecology at the University of Texas Rio Grande Valley.<p><\/p>\r\nOgburn, who worked for the Indian Health Service for six years in the 1990s, said historical factors influence current breastfeeding practices.<p><\/p>\r\nUntil the 1980s, common belief held that formula was superior to breast milk.<p><\/p>\r\n<div class=\"mt-1 mb-1\"><ins class=\"adsbygoogle\"\r\n     style=\"display:block; text-align:center;\"\r\n     data-ad-layout=\"in-article\"\r\n     data-ad-format=\"fluid\"\r\n     data-ad-client=\"ca-pub-8411603009680747\"\r\n     data-ad-slot=\"6394965691\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n  <\/script><\/div><p><\/p>\r\nThe Special Supplemental Nutrition Program for Women, Infants and Children, or SNAP \u2013 a \r\n<a href=\"https:\/\/www.fns.usda.gov\/wic#:~:text=The%20Special%20Supplemental%20Nutrition%20Program,to%20age%20five%20who%20are\">federal program<\/a>\r\nthat provides support to needy families \u2013 gave more financial assistance to mothers buying formula than breastfeeding exclusively, Ogburn said. That has since \r\n<a href=\"https:\/\/doh.dc.gov\/sites\/default\/files\/dc\/sites\/doh\/publication\/attachments\/Wic_Food_Packages_For_Moms__Babies_English.pdf\">changed<\/a>, and mothers who exclusively breastfeed get more help through the program.\r\n<p><\/p>\r\n\u201cFor a lot of people the mentality was \u2026 it must be good because the government&#8217;s paying me to do it, so I should do this,\u201d he said.<p><\/p>\r\nThe result was many generations of women who didn\u2019t know how to support young mothers wanting to breastfeed.<p><\/p>\r\n\u201cIf you don&#8217;t have a mom that breastfed and your aunt didn&#8217;t breastfeed and nobody knows how to support you, it makes it far more likely that you would continue to (formula feed),\u201d Ogburn said.<p><\/p>\r\nThese days, Ogburn said, a supportive hospital environment is critical in helping mothers establish strong breastfeeding habits.<p><\/p>  \r\n<div class=row><div class=col-md-6><img loading=\"lazy\" decoding=\"async\" width=\"2514\" height=\"2560\" data-attachment-id=\"1328\" data-permalink=\"https:\/\/indianz.com\/News\/2020\/09\/25\/cronkite-news-baby-friendly-hospitals-tackle-health-disparities-in-indian-country\/lauragordon\/\" data-orig-file=\"https:\/\/indianz.com\/News\/wp-content\/uploads\/2020\/09\/lauragordon.jpg\" data-orig-size=\"2514,2560\" data-comments-opened=\"0\" data-image-title=\"lauragordon\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;\u201cI don\u2019t know if people really realize how much stress these young mothers can be under,\u201d says Laura Gordon, who co-supervises the birthing center at Whitewater Indian Hospital. \u201cWe don\u2019t always know what their home life is like. Are they going to be supported at home? I don\u2019t know.\u201d Photo courtesy of Laura Gordon&lt;\/p&gt;\n\" data-large-file=\"https:\/\/indianz.com\/News\/wp-content\/uploads\/2020\/09\/lauragordon-1006x1024.jpg\" src=\"https:\/\/indianz.com\/News\/wp-content\/uploads\/2020\/09\/lauragordon.jpg\" alt=\"shawnaziadah\"  class=\"img-fluid wp-image-1328\" \/><\/div>\r\n<div class=\"col-md-6 align-self-end\"><figcaption class=\"figure-caption\">\u201cI don\u2019t know if people really realize how much stress these young mothers can be under,\u201d says Laura Gordon, who co-supervises the birthing center at Whitewater Indian Hospital. \u201cWe don\u2019t always know what their home life is like. Are they going to be supported at home? I don\u2019t know.\u201d Photo courtesy of Laura Gordon<\/figcaption>\r\n<\/div><\/div>\r\n<p><\/p>\r\nIn addition to the Whiteriver facility, two other Arizona hospitals are designated as Baby-Friendly, according to the IHS website: Chinle Comprehensive Health Care Facility on the Navajo Nation Reservation and Phoenix Indian Medical Center. Also part of the program are Northern Navajo Medical Center in Shiprock, N.M., and the Gallup Indian Medical Center, where Ogburn once worked.<p><\/p>\r\nBecause Whiteriver Indian Hospital is baby friendly, mothers often are able to breastfeed relatively easily during their stay, but that can change after they\u2019re discharged, said Laura Gordon, who supervises the birthing center.<p><\/p>\r\n\u201cI don\u2019t know if people really realize how much stress these young mothers can be under,\u201d Gordon said. \u201cWe don&#8217;t always know what their home life is like. Are they going to be supported at home? I don&#8217;t know.\u201d<p><\/p>\r\nTo help mothers maintain healthy breastfeeding habits after returning home, the Whiteriver hospital has two public health nurses who are also lactation consultants. They go out into the community and make home visits upon request.<p><\/p>\r\nZiadah said young mothers have different perspectives on breastfeeding on the Fort Apache Indian Reservation. Some want to formula feed because it\u2019s easier, while others prefer doing what\u2019s most natural.<p><\/p>\r\nShe speaks from experience. Ziadah has five children, four of whom she breastfed exclusively.<p><\/p>\r\n\u201cIt was hell, but it was very well worth it,\u201d she recalled.<p><\/p>\r\nTwo of her children had health issues at birth and had difficulty learning to breastfeed, especially her youngest, who was delivered by cesarean section.<p><\/p>\r\n\u201cThere were times when I just wanted to give up,\u201d she said, \u201cjust having to deal with that pain and deal with him.\u201d<p><\/p>\r\n<div class=row><div class=col-md-6><img loading=\"lazy\" decoding=\"async\" width=\"1975\" height=\"2366\" data-attachment-id=\"1324\" data-permalink=\"https:\/\/indianz.com\/News\/2020\/09\/25\/cronkite-news-baby-friendly-hospitals-tackle-health-disparities-in-indian-country\/shawnaziadah\/\" data-orig-file=\"https:\/\/indianz.com\/News\/wp-content\/uploads\/2020\/09\/shawnaziadah.jpg\" data-orig-size=\"1975,2366\" data-comments-opened=\"0\" data-image-title=\"shawnaziadah\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Shawna Ziadah, who co-supervises the birthing center at the Whiteriver Indian Hospital, says mothers on the Fort Apache Indian Reservation live in multigenerational families under a single roof and may feel uncomfortable breastfeeding at home. Photo courtesy of Shawna Ziadah&lt;\/p&gt;\n\" data-large-file=\"https:\/\/indianz.com\/News\/wp-content\/uploads\/2020\/09\/shawnaziadah-855x1024.jpg\" src=\"https:\/\/indianz.com\/News\/wp-content\/uploads\/2020\/09\/shawnaziadah.jpg\" alt=\"shawnaziadah\"  class=\"img-fluid wp-image-1324\" \/><\/div>\r\n<div class=\"col-md-6 align-self-end\"><figcaption class=\"figure-caption\">Shawna Ziadah, who co-supervises the birthing center at the Whiteriver Indian Hospital, says mothers on the Fort Apache Indian Reservation live in multigenerational families under a single roof and may feel uncomfortable breastfeeding at home. Photo courtesy of Shawna Ziadah<\/figcaption>\r\n<\/div><\/div>\r\n<p><\/p>\r\nZiadah said many White Mountain Apache mothers on the reservation live in multigenerational families under a single roof and may feel uncomfortable breastfeeding at home. Because of that, she and Gordon try to make the birthing center as welcoming as possible.<p><\/p>\r\n\u201cI always tell them you can always come to us \u2026 because we are open 24\/7,\u201d Ziadah said.<p><\/p>\r\nFeldman-Winter said the adverse effects of giving birth outside a Baby-Friendly hospital are more profound in underserved communities, where there may be less education around the benefits of breastfeeding. But she also noted that bias among health providers within those communities can influence behavior.<p><\/p>\r\nShe said it\u2019s important that health care workers don\u2019t assume women don\u2019t want to breastfeed simply because it\u2019s less common in some communities.<p><\/p>\r\n\u201cWe have to be really in tune with our own implicit bias and really provide equitable breastfeeding care for everyone,\u201d Feldman-Winter said.<p><\/p>\r\nAlthough staff at Whiteriver Indian Hospital encourage all healthy mothers to breastfeed, Gordon said the decision ultimately is the mother\u2019s and always is respected.<p><\/p>\r\n\u201cIt\u2019s not like we put a little black dot on them,\u201d she said. \u201cIt\u2019s not like that at all.\u201d<p><\/p>\r\n\r\n<STRONG>For more stories from Cronkite News, visit <A href=\"https:\/\/cronkitenews.azpbs.org\/?utm_source=referral&amp;utm_medium=referral&amp;utm_campaign=client\">cronkitenews.azpbs.org<\/A>.<\/STRONG>\r\n<HR><EM>Note: This story originally <a href=\"https:\/\/cronkitenews.azpbs.org\/2020\/09\/24\/baby-friendly-hospitals-encourage-breastfeeding-indian-country\">appeared on Cronkite News<\/a>.  It  is published via a <A href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/3.0\/\">Creative  Commons license<\/A>. Cronkite News is produced by the <A href=\"https:\/\/cronkite.asu.edu\/\">Walter Cronkite School of Journalism and Mass Communication<\/A> at <A href=\"https:\/\/www.asu.edu\">Arizona State University<\/A>.<\/EM><HR>","protected":false},"excerpt":{"rendered":"Hospitals are combating health disparities among Native Americans by teaching new mothers strong breastfeeding practices.","protected":false},"author":1,"featured_media":1319,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"ngg_post_thumbnail":0,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_vp_format_video_url":"","_vp_image_focal_point":[],"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[19,1],"tags":[42,46,40,210,342,44],"class_list":["post-1318","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health","category-national","tag-arizona","tag-cronkite-news","tag-food","tag-ihs","tag-wmat","tag-women","no-wpautop"],"jetpack_shortlink":"https:\/\/wp.me\/pcoJ7g-lg","jetpack_sharing_enabled":true,"jetpack_featured_media_url":"https:\/\/indianz.com\/News\/wp-content\/uploads\/2020\/09\/whiteriverhospital.jpg","_links":{"self":[{"href":"https:\/\/indianz.com\/News\/wp-json\/wp\/v2\/posts\/1318","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/indianz.com\/News\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/indianz.com\/News\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/indianz.com\/News\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/indianz.com\/News\/wp-json\/wp\/v2\/comments?post=1318"}],"version-history":[{"count":0,"href":"https:\/\/indianz.com\/News\/wp-json\/wp\/v2\/posts\/1318\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/indianz.com\/News\/wp-json\/wp\/v2\/media\/1319"}],"wp:attachment":[{"href":"https:\/\/indianz.com\/News\/wp-json\/wp\/v2\/media?parent=1318"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/indianz.com\/News\/wp-json\/wp\/v2\/categories?post=1318"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/indianz.com\/News\/wp-json\/wp\/v2\/tags?post=1318"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}