These women of color tackle lactation disparities one belly bump at a time

This article is part of Made in Philly, a series about young residents shaping local communities.

It wasn’t until Ileana Berrios was 24 that she received any advice on motherhood — and it was after searching “How to take care of a baby” on the internet.

“Once I became pregnant, I thought about what I needed to do as a mother," said Berrios, now 37 and a mother of three. "But I realized that I knew nothing.”

Berrios’ path to motherhood had challenges, as well. By the time she was 6, her family was traveling constantly from Puerto Rico to New Jersey to Philadelphia as her parents looked for better job opportunities and living conditions. At 16, her parents separated, and she went to live with her father in Bayamón, Puerto Rico, where Berrios started college and got married. By the time her daughter was born, she didn’t have a mother figure to help her.

It’s what eventually led her to a career as a lactation consultant, and to the creation of Breastfeeding Latinas — a five-year-old Philadelphia project that educates expecting mothers before they are in labor, and empowers women of color to become breast-feeding specialists themselves.

Overall, Pennsylvania mothers meet many breast-feeding objectives as laid out in the national Healthy People 2020 goals, according to the CDC’s 2018 Breastfeeding Report Card: About 84 percent breast-feed their newborns (82 percent is the target), about 59 percent still breast-feed by the sixth month (with a 61 percent target), and by the first year of a child’s life, it’s 39 percent (with a 34 percent target).

But in Philadelphia, there are disparities: Fewer African American and Hispanic mothers start breast-feeding before they leave the hospital (less than 75 percent) compared with other mothers (almost 82 percent for white mothers and 85 percent for Asians), according to the state Department of Health. And rates fall drastically once families return home, due to a unique set of barriers that also affect infant and maternal health rates in the city, experts say.

For example, some of these women don’t have breast-feeding role models; their families gives them negative feedback about nursing; they’ve been taught stereotypical concepts of what constitutes beauty; they have a history of trauma with men that impacts their ability to feed their babies; their access to resources and support, including in a preferred language, is limited; or they generally distrust programs and institutions.

Berrios, who earned her bachelor’s degree in human services in 2014, is the only Spanish bilingual lactation consultant at Temple University Hospital’s Maternity Care, where she sees two to four mothers between ages 14 and 19 a week.

“You have young mothers receiving all these mixed messages: that breast-feeding hurts, that it spoils your kid, that you will never produce enough milk," said Berrios, an international board-certified lactation consultant. "They don’t know what they’re doing.”

In her experience, younger mothers sometimes think of their bodies “more like a sexual thing” and less in a maternal capacity. Yet one positive development with these women is that they’ve found a community on social media with which to share experiences, something older mothers of color do less of, Berrios said.

In any case, Berrios says, her 12 years of experience have shown her the best way to reach these women is to physically go where they are, whether at their homes, on social media, or to their doctor appointments. It’s one of the initiatives Breastfeeding Latinas’ recent $15,000 grant from the Kellogg Foundation is funding: having two peer counselors stationed at two North Philly clinics to reach women before they have their babies and to set a foundation for after care, as well.

The City of Philadelphia’s Public Health Department is running a breast-feeding campaign, “Philly Loves Breastfeeding,” since August, specifically aimed at African American and Latina mothers to communicate that breast-feeding is a natural thing.

“We statistically focused on these populations with the goal to normalize breast-feeding and provide support for African American and Latina women,” said Lauren Ryder, director of health marketing at the health department. These ethnic groups also present higher rates of late or no prenatal care, low birth weight, and infant mortality than any other groups in the city, she said.

Nine billboards have been posted around the city; its Facebook page has nearly 3,000 followers, and it has distributed 13,500 family postcards, posters, and educational pamphlets in Spanish and English at the request of healthcare providers. Its website offers tips and a list of places that offer free sessions with certified lactation counselors.

Zuly Ortiz, 22, benefited from having Berrios help her when she was ready to give up two months into breast-feeding.

“It was really frustrating to not satisfy [the baby] and have to go through so much pain in the process,” Ortiz said. Having to give supplement milk at such an early stage made her feel like she wasn’t being a good mother.

Berrios met Ortiz at her home in Northeast Philadelphia, where the new mother learned the baby was tongue-tied, which didn’t allow her to latch properly. The baby underwent surgery and learned to latch.

Ortiz said Berrios’ advice made a huge difference, both when she was breast-feeding full-time and when her supply was running low after she returned to work. Some of Berrios’ tips? Put warm towels around your breasts, drink lots of fluid, and eat more oatmeal during the day.

Nyra Zaracho, 34, a doula in North Philadelphia — who visits clients’ homes and attends doctor appointments to provide information and emotional support before, during, and after childbirth — met Berrios in 2014 at a local peer counseling training session. She considers Berrios a friend and partner; they teamed up for other initiatives, when they both worked for Maternity Care Coalition, trying to provide a holistic experience for mothers during pregnancy and after delivery.

Zaracho hopes Berrios can at some point create a network for local doulas, midwives, lactation consultants, social workers ,and case managers, as she knows few experts dedicated to understanding and working with women of color.

“It takes a village of people to understand the circumstances that these women go through when pregnant," Zaracho said, "and having a system, a network of people, would make a huge difference.”