The 5 Worst States for Breastfeeding Moms – And the 5 Best

More moms in the U.S. are breastfeeding than ever before, according to a new report from the Centers for Disease Control and Prevention (CDC). More than 4 out of 5 kids were breastfed at birth in 2013, around 81.1 percent, up from 79 percent in 2011. And almost one-third of children born in 2013, 30.7 percent, were still nursing at 12 months, compared to just 27 percent in 2011.

These improvements of several percentage points (representing hundreds of thousands of benefitting babies) show that a greater number of moms want to nurse and have the resources to keep it up. But unfortunately, doing so is easier in certain parts of the country than others. Some 50 percent of new moms stop nursing by the 6 month-mark and two-thirds by 12 months. It happens most often due to a lack of support from employers, healthcare providers and family.

The CDC pulled together a list of states where breastfeeding for the recommended 12 months is the hardest, based on how well the state’s hospitals integrate breastfeeding practices into maternity care; the number of births in “baby-friendly” hospitals; the number of infants receiving formula within 2 days of life; the number of La Leche league leaders and lactation consultants; and whether childcare facilities support onsite breastfeeding.

(It doesn’t take into account public nursing laws or workplace policies – but know that every state except for Idaho has laws explicitly allowing you to nurse wherever you want, and the Affordable Care Act requires employers to provide nursing employees with a private space to pump that’s not a bathroom.)

These are the worst states to be a nursing mom:

  • Mississippi
  • Arkansas
  • Nebraska
  • Alabama
  • Tennessee

These are the best states to be a nursing mom:

  • Rhode Island
  • New Hampshire
  • Delaware
  • Vermont
  • Massachusetts

Even if you’re living in a state with fewer breastfeeding resources, a dearth of baby-friendly hospitals doesn’t have to keep you from nursing for as long as you want. A recent survey found that asking your care provider about breastfeeding before you give birth, ideally in the third trimester, is a strong indicator of success. And once your newborn has arrived, you get another source of support in your child’s pediatrician.

You can also work with an international lactation consultant in your area. With fewer choices, you’ll be less likely to find one by word of mouth, but a quick search on the International Lactation Consultant Association website should help turn up someone close enough for you to meet with at least once.

And last, talking to moms who’ve been through it before has endless benefits. You might uncover a tip your male OB had never heard, and you’ll be reminded your struggle is totally normal.

U.S. breastfeeding rates are steadily approaching global children’s health goals, but we still need to focus on getting every mom the support she needs to feed her baby exactly the way she wants.

Image Source: Jamie Grill/Getty

Breastfeeding and Returning to Work

It seems like the end of summer is the time when I see so many mothers preparing to head back to work.  Whether it is teachers who took an extended leave, or families who meticulously planned to have their babies arrive in the late spring so that summer would be maternity leave, late August tends to be that fateful time.   Here in upstate New York, most people value summer.  Even if you are someone who truly enjoys the winter weather – cozy nights in, white Christmas, skiing, snowboarding or hockey – winter with a newborn offers its own set of unique challenges.   We can talk about that more in November.

Returning to work after having a baby is difficult.  Overwhelming in many ways.  Mentally you are responsible for doing your job, whatever that may be, when your mind seems to stay with the little bundle of joy that was left behind for the day.  Physically you are still in a state of recovery (unless you are going back a year after the baby was born, but many in our society do not have that benefit) you are feeling sleep deprived and your breasts will fill with milk every few hours.  Getting milk stains out of your work clothes might be a new skill you never realized you’d need.  Not to take away from spouses who most definitely hold down the fort while mom is on maternity leave, being a working mother is a whole different routine.  Babies miss having that bonding time, and some mothers find that babies will spend the duration of the evening wanting to nurse.  Babies that were sleeping longer stretches at night might wake more frequently again, trying to make up for lost time during the quiet hours of the night.

Yet as mothers, we do this.  We stay dedicated to both employer and family.  We are able to multi-task in new, imaginative ways (raise your hand if you have ever pumped milk while driving).  I am beyond proud of the women I meet who are returning to work.  The challenges of figuring out how and when to pump milk, worrying about milk supply.  Afraid to upset the delicate balance of work life and family life, concerned that colleagues won’t understand the distraction.

The other day I met with several women who were preparing for this transition.  One had already returned to work, but had concerns about supply and needed to talk openly about the negativity she is experiencing from coworkers.  Others are concerned how they will make this work – the logistics of it all.   I know that they will all find a way to make this work.  They are fantastic mothers with amazing resiliency.  I just can’t help but wish that we didn’t live in a society where so many women are in a position where we have to make it work.  Having the choice would be ideal.  Unfortunately, the United States is resting at the bottom of the list when it comes to maternity leave.   I hope this improves by the time my daughter has children of her own.  Until then, let’s support each other, lift each other up, and remind each other daily of how remarkable we really are.

Some good resources for the mother who is returning to work.

Breastfeeding a Distracted Baby

I saw one of my favorite babies the other day (who am I kidding??  I adore all my mamas and babies).  Mom reached out to me because her little one was changing up her nursing routine, acting fussier, and mom was pumping less volume.  Baby is almost 5 months old.  The first thought for this mom was that her supply had dropped and baby was not getting enough milk, which is why she was fussier at the breast.

As soon as I saw the baby nursing, I knew what was happening.  She was so distracted.  Typical of a baby her age.  She was whining and wiggling and would only nurse for a minute or two before pulling away.  Mom did her best to keep her focused, switched her from side to side and talked to her.  After only a few minutes, it was obvious that baby was done.  Mom admitted to me that when she is feeding at home, after a couple minutes of this routine she would give in and just give her a bottle.   We weighed this little girl before and after the feeding.  Mom was shocked to see that baby was 2 ounces heavier after the feed than she was before.  This changed everything.  It gave mom the confidence she needed to feel positive about her milk supply and her baby’s ability to get that milk.  It helped her realize how much her baby is developing and how she is changing.

Well what about the pumping?  Mom had returned to work about 6 weeks ago.  Her pumping output has dwindled.  It is not unusual for that to happen, but it doesn’t mean baby is getting less when they feed at the breast.  We discussed her pumping schedule and switched things up to include a few shorter sessions.  All in all, a pretty successful day.

What’s the moral to this happy ending?  Trust your baby and trust your body to provide for your baby.  Babies become very distracted around 4 months and things become very exciting for them!  Developmentally so much is happening for them.  This doesn’t mean the baby doesn’t want to breastfeed anymore, but we may need to change how things are done.  Don’t just throw in the towel mamas…call in the professionals.

Here’s more on feeding a distracted baby and what to expect when your baby hits this magical age.

Breastfeeding. At what cost?

I admit, the title of the following article intrigued me enough to spend a few minutes reading it. Of course, my first thought was “breastfeeding is FREE, why wouldn’t someone be able to afford it?” As I read on, I had a better understanding of what the writer was telling me.

Our society can make it difficult for some to adapt to life with a new baby. Let’s face it, becoming a parent is hard. It’s hard without the added stress of work and day care and just trying to get by. I get it. I’ve been there, more times and for longer than I care to remember. The writer of this article had to return to work at a ridiculously early time and then try to balance working and pumping and, well, life. At 4 weeks post partum, a new mother is not even healed from the trauma that birth can trigger, not only physically, but emotionally as well. Babies aren’t sleeping longer than a couple of hours at a time and they rarely want to be put down. Breastfeeding on demand is still every couple of hours. Mothers (and their partners) are tired. Returning to work at this stage of the parenting game should be reserved for use as a type of torture method.

I live in New York, where breastfeeding laws are pretty generous. Unfortunately it is not like that in all parts of the country (and even in NY, many women still have to fight for this benefit). If your job isn’t supportive of your pumping efforts, a new mother will really struggle. Not only because she wants to be able to leave the milk for her baby, but also because her body will continue to make the milk and if there is no way out, it will be very uncomfortable. Anyone who has not been a nursing mother may not understand that at all.

This article made me sad. Sad for the mom who felt that she was forced to wean her baby earlier than she wanted because of her need to return to work. This is all too common. It made me sad that she wasn’t able to access the support she needed to find a way to make it work. I have been a Lactation Consultant for almost 10 years, and I have seen breastfeeding come a long way in that time. Laws have changed, support has increased, education has become more abundant, and breastfeeding rates have increased. It’s still not enough. In a society where mothers have to leave their baby at 6 weeks (for this mother it was 4) or go without a paycheck, we are not going to make the strides we need to make.

I give this mother all the credit in the world for going back to breastfeeding with her next baby, and the next. I imagine that she is a great source of support for other mothers she knows, just because of her struggle.

You can read the article here:

Epidurals & Breastfeeding, with Dianne Cassidy (The Birthful Podcast: Episode #40)



Usually, when we think epidurals, we wonder how they will affect birth, but it turns out that they can have an impact on your breastfeeding relationship as well. What do you need to know? Dianne Cassidy is here to tell us the facts, so you can make an informed decision.

To listen here, click the play button on the player above, or click here to listen in iTunes.

What we talked about:

  • What’s in an epidural? Getting our facts straight
  • What are the direct effects to the baby?
  • How does the impact of epidurals on birth affect breastfeeding?
  • IV fluids: making you and baby swell up beyond the first 24 hours
  • Fever and separation from baby
  • What about the oxytocin flow?
  • If you have an epidural, can you counterbalance the effects?
  • Teaspoons, probiotics, skin-to-skin, and other tricks that can make things better

More about epidural effects on breastfeeding:


Tongue and Lip Ties, with Dianne Cassidy (The Birthful Podcast: Episode #13)



In this episode of the birthful podcast, we’re going to be talking about tongue ties and lip ties. If you have no idea what those are, you’re in luck, because Dianne Cassidy will tells us all about them, along with why there seems to be a tongue tie resurgence, how it can affect your best breastfeeding intentions, and what you can do about it.

To listen here, click the play button on the player above, or click here to listen in iTunes.

What we talked about:

  • What are tongue and lip ties?
  • Is it a fad or higher awareness?
  • Why are they are problem for breastfeeding?
  • Beyond breastfeeding: other tongue and lip tie problems
  • How babies try to compensate for a tongue tie
  • Signs of a tongue tie
  • Is there an ideal time to identify a tongue tie?
  • Procedures to correct tongue and lip ties
  • Taking care of a tongue tie after a laser procedure
  • Do nipple shields mask tongue ties?
  • Bonus: epidurals and their effect on breastfeeding

Helpful links:


Epidurals & Breastfeeding, with Dianne Cassidy (Prenatal Yoga Center Podcast: July 5th, 2016)



Epidurals can be a wonderful and sometimes much needed way to manage pain during birth, but how much do you know about them? Today Deb talks to Dianne Cassidy of Dianne Cassidy Consulting about the effects of epidurals on Momma and Baby during labor and after birth.

Dianne is a lactation consultant in Rochester, New York. She became interested in this work after breastfeeding her own children. She’s an International Board Certified Lactation Consultant (IBCLC), has an Advanced Lactation certification and BS in Maternal Child Health/Lactation, an MA in Health and Wellness/Lactation, and is a board certified Child Birth Educator. To learn more about Dianne or work with her visit:


Instagram: @dianneocassidy

To learn more about epidurals: