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The New Jersey Department of Health (NJDOH) released the 2022-2027 New Jersey Breastfeeding Strategic Plan to focus and coordinate statewide efforts to increase breastfeeding, improve lactation supports, and help reduce inequitable infant health outcomes.
NJDOH officials say the five-year strategic plan provides a roadmap to identify and foster policy, environmental, and system changes to increase breastfeeding initiation, duration, and exclusivity (defined as only receiving breast milk) in New Jersey. The plan results from a partnership among NJDOH, the Central Jersey Family Health Consortium, and the New Jersey Breastfeeding Coalition to focus and coordinate statewide efforts to improve lactation support.
The plan, which lays out a series of goals, serves as a blueprint of concrete actions state government, the healthcare sector, businesses, insurance, education, and the community can take to better promote and support breastfeeding and to create a statewide environment that normalizes breastfeeding.
Providing breastfeeding support to New Jersey women builds on First Lady Tammy Murphy's Nurture NJ campaign, which is committed to reducing infant and maternal mortality and morbidity and ensuring equitable maternal and infant care among women and children of all races and ethnicities. The Breastfeeding Strategic Plan supports several recommendations in the Nurture NJ Maternal and Infant Health Strategic Plan to improve breastfeeding rates across the state.
"The Breastfeeding Strategic Plan directly builds on our Nurture NJ Maternal and Infant Health Strategic Plan to address and combat maternal and infant mortality and morbidity in our state," said First Lady Tammy Murphy. "The benefits of breastfeeding for both mother and baby are endless—from lowering risks of breast cancer and risk of SIDS to encouraging bonding between mother and child. This plan ensures breastfeeding mothers are supported throughout their journey, increasing our breastfeeding rates and bringing us one step closer to making New Jersey the safest and most equitable place in the nation to give birth and raise a baby."
Breast milk provides nutritional and immunological components ideally suited to babies' growth and development needs. According to the American Academy of Pediatrics, breastfeeding reduces morbidity and mortality risk. In addition, its positive impacts on infant and maternal health outcomes make supporting breastfeeding an essential step in addressing the state's racial and ethnic disparities in birth outcomes.
Yet, New Jersey breastfeeding practices lag significantly behind the recommendations of the American Academy of Pediatrics and the World Health Organization, which urge exclusive breastfeeding for the first six months, continuing with the introduction of complementary foods for two years and beyond. While initiation rates in the state are high, the report notes that all breastfeeding rates, particularly exclusive breastfeeding rates, drop sharply in the early months. Exclusive breastfeeding rates in the hospital are declining, while formula feeding and combination feeding (breast milk and formula) are rising. In 2019, only 55.4% of New Jersey infants were breastfeeding at six months, and only 33.8% were breastfeeding at 12 months, despite the recommendations of prominent health organizations that infants be exclusively breastfed for the first six months, according to the report.
In New Jersey, 41.2% of infants were exclusively breastfeeding at three months. Only 23.5% of infants were exclusively breastfed at six months in 2019 – rates which lag Healthy NJ 2020 goals (i.e., 45.0% at three months and 25.5% at six months) and national averages (i.e., 45.3% at three months and 24.9% at six months).
Recognizing that not every birthing parent can breastfeed, the plan aims to encourage and support the use of breastfeeding whenever possible. The plan also includes supporting the first human milk banks in NJ, which will provide pasteurized donor milk to patients in need of breastfeeding support, as needed, including those whose babies are in the NICU. Regulations to effectuate the milk bank law are currently under development.
White women report the highest rates of breastfeeding exclusivity during birth hospitalization, while Black and Hispanic women have the lowest rates. Reducing racial and ethnic disparities in breastfeeding and building a stronger public health infrastructure to coordinate policy to promote and support breastfeeding is imperative in contributing to equitable health outcomes. Collaborative and coordinated efforts across all sectors, including government, business, healthcare, insurance, education, and community organizations, are essential to supporting breastfeeding and breast milk feeding to ensure optimal public health outcomes.
"Encouraging breastfeeding and closing the breastfeeding disparity gap starts with viewing our efforts through an equity lens," said DCF Commissioner Christine Norbut Beyer. "We need to identify barriers to equitable access for breastfeeding supports for families of color, and we need to look at far-reaching strategies across all sectors to improve the rate of breastfeeding in New Jersey, including engaging licensed child care centers as partners in supporting working moms to breastfeed their babies. DCF stands at the ready to support this important initiative, to strengthen the health and connection between mothers and their babies in communities throughout the state."
"Access to paid family and medical leave is critical; new parents, including partners, must be able to take the time they need to establish and support breastfeeding and bonding. We at the Department of Labor are committed to ensuring that every worker knows their rights and has equal access to vital support programs," said Labor Department Commissioner Robert Asaro-Angelo.
The plan sets a series of goals, including:
Provide families with the support they need to breastfeed their babies.
Ensure that maternity practices fully support breastfeeding and lactation and are free of bias.
Ensure that employers and childcare providers accommodate lactation.
Strengthen existing capacity and develop future capacity for conducting research and surveillance on breastfeeding and lactation.
Increase state infrastructure and policymaking in support of lactation.
Improve and institutionalize emergency preparedness measures for pregnant and breastfeeding persons that ensure access to breastfeeding support and services during public health crises and emergencies.
Strengthen maternal and child health social services among communities with the highest risk of poor health outcomes associated with public health crises.
Support, protect, and promote breastfeeding as the biological norm and optimal way to feed infants during global health pandemics and public health crises.
Over half of the year, one action items have been accomplished, and more are underway.
Most of these focus on eliminating systemic barriers in lactation support to reduce racial and ethnic disparities and strengthening maternal and child health social services among communities with higher risk and poor health outcomes associated with public health crises.