Come for the free lactation consultation. Stay for the fellow moms.
BROOKLYN—Evelyn Velasquez sat in the basement multipurpose room of the Brownsville Neighborhood Health Action Center with her 11-month-old son, Jonathan, at her breast. A mother of four, she’s a regular attendee of the Baby Cafe in the Brownsville Neighborhood of Brooklyn, the third to open in New York since January 2018, where she receives free lactation services and a support group made of facilitators and other moms in her community.
For Velasquez, the cafe meets a critical need for new moms. “You need that extra support behind you, that guidance, and to release some stress,” Velasquez said. “It’s a place where you can come, let your hair down, and talk to the other mothers about breastfeeding and other things.”
Stemming from a model that originated in the U.K. in 2000, these New York City cafes are part of a broader, citywide effort to support new mothers, combat the stigma of breastfeeding, and educate employers and the general public about laws protecting a woman’s right to breastfeed in public, and especially in the workplace. The goal is to decrease the barriers to breastfeeding, which experts say has significant health benefits for both mother and baby.
Over the years, New York State has adopted a slate of laws that provide for pregnant and nursing mothers, from a law to protect breastfeeding in public, to access to lactation support and counseling via the Affordable Care Act, to time and a private space to pump in the workplace.
Despite this, low breastfeeding rates remain common across all demographics. They’re especially prevalent in black and brown communities, where access to breastfeeding support is limited.
“The higher the percentage of African Americans that live in a community, the less likely they are to receive lactation education,” says Shameika Williams, the program coordinator for Brooklyn Breastfeeding Empowerment Zone (BFEZ), which launched in 2013 by the Center for Health Equity (CHE), part of the NYC Department of Health, with funding from the W.K. Kellogg Foundation. “When you live in a community that’s been historically not invested in, you’re not receiving the same type of services and support in the hospital.”
While state laws ostensibly make these services available for free, bureaucratic loopholes mean they remain inaccessible, and getting the answers to basic breastfeeding questions can be expensive. A consultation alone can cost around $300 for an in-home visit. Factoring in the potential for a follow up visit ($250), a back-to-work plan ($250), and a weaning consult ($125), lactation consultants begin to look like more of a luxury than a necessity to some moms, especially ones in lower-income neighborhoods.
In New York City in particular, breastfeeding rates are lowest among the non-Hispanic black community, with 26.3 percent of women exclusively breastfeeding their children eight weeks after birth. But they can’t be considered high among any demographic, with 31.7 percent of Hispanic women and 38.4 percent of white women reporting breastfeeding at eight weeks after birth, below the six months of breastfeeding recommended by the American Academy of Pediatrics (AAP).
Many of the hospitals that service black and brown communities don’t have certified lactation consultants. Finding accessible support postpartum is also a challenge. The Brownsville Baby Cafe helps to “address systemic racism and ensures that communities that have been historically not invested in now can provide equitable choices for people who reside in the community,” says Williams.
Women at the Baby Cafe said that despite the health benefits, there are a number of reasons why they might opt for formula over the breast, including questions about whether or not they’re producing enough milk, how to get their baby to latch on, and how to deal with pain while breastfeeding.
Although the Baby Cafe model has been in practice for nearly twenty years, the UK still has one of the lowest breastfeeding rates in the world. However, 75 percent of the 6,300 mothers UK Baby Cafes supported in 2017 said that the cafes helped them to breastfeed longer, and 81 percent said that they breastfed for as long as they intended to.
Tamara Hawkins, a certified lactation consultant and nurse practitioner who operates the Harlem Baby Café, said the cafes also help confront social stigma by empowering women and educating families.
“Mothers often have to contend with their mothers, their grandmothers, their uncles, who are maybe not as educated but are the main support groups in their households,”said Hawkins. “They grew up feeding their babies bottles of six to eight ounces at a time, adding cereal to it, putting jars of peaches in it. That’s what was normal then, so learning a new normal takes time.”
Funding was provided by the Bernard van Leer Foundation to support our project, “Room to Grow,” about raising tiny humans in the city.