Charline Ogbeni looks at her weekly schedule of lactation consultations. (Credit: Mikella Schuettler)
When Paula Utilla gave birth to her second child in 2009, she anticipated a day filled with joy. Instead, the Queens mother found herself crying in the hospital bed.
“I just wanted to feed my baby with my milk, from my breast,” said Utilla. Nurses took her son away to feed him formula and now she was struggling to breastfeed.
Utilla’s problem was a common one: failure to latch. It can happen when, for example, a newborn can’t properly attach to the mother’s breast, either due to poor positioning, or when the baby’s tongue is restricted. It often requires assistance from a lactation consultant to correct.
Though that option wasn’t available to Utilla when she had these issues, it sparked her desire to become a lactation consultant herself, she said.
“In the hospital, I literally Googled, ‘How to be a lactation consultant,’ and I said to myself, ‘Not one other woman is going to go through what I did,’” said Utilla.
The Centers for Disease Control and Prevention recommends feeding babies breast milk for at least six months after birth whenever possible. While formula provides the necessary nutrients for babies, studies show breast milk reduces diarrhea, which can be particularly dangerous for newborns. It also lowers the risks of developing obesity, type 2 diabetes, and other chronic conditions later in life.
Diet during the first five days of life are critical for future gut health, meaning breastfeeding support in hospitals after birth is critical. Yet in 2020, fewer than half of the babies born in Queens were fed only breast milk in that period, according to a Department of Health and Mental Hygiene report. This is roughly 10 per cent lower than in Manhattan.
Soon after giving birth, Utilla left her career in fashion merchandising. She now works as a lactation consultant at Jamaica Hospital in Queens, educating hospital staff and helping their breastfeeding rates improve.
As a woman of Black and South Asian heritage, Utilla wants to close the racial gap in breastfeeding rates.
In 2017, 62 percent of Black women in New York City were breastfeeding one month after giving birth, according to the most recent local data available from the CDC. For white women, the number was almost 80 percent.
According to national data from 2021, 50 percent of white mothers in the U.S. said they breastfed exclusively for 3 months, compared to 39 percent of Black mothers – an 11 percent disparity.
The story behind this gap is complex. Racism in the healthcare system, a lack of access to breastfeeding support, and a mixture of socio-economic factors combine to produce barriers for Black and Brown women in New York when it comes to breastfeeding, according to a study published in November by researchers in Albany.
And, nationally, racial disparities in breastfeeding exist across every state, and Black and Brown women are left behind in almost every indicator of breastfeeding success, according to CDC data from 2021.
In Queens, as in other parts of the city and state, there are major differences between the hospitals and the types of resources and trained staff available to help. Some hospitals can only offer lactation consultations over the phone, and three of the eight hospitals in Queens don’t have certified lactation consultants on staff, according to a health department report from 2016.
The Long Island Jewish Medical Centre, for example, only offers virtual lactation support, according to its website. In 2020, the breastfeeding rate had grown less than one percent in the past decade to 35 percent, according to the New York State Department of Health.
At Jamaica Hospital, where Utilla works, babies are fed breast milk exclusively at more than double that rate.
Educating women about breastfeeding before birth is a big part of Utilla’s efforts to tackle the problem. In the community surrounding Jamaica Hospital, many mothers are juggling work with family, or struggling with housing insecurity, and don’t have time before giving birth to learn about breastfeeding, she said.
Insurance, or lack thereof, is another problem.
Medicaid does not cover breastfeeding support provided by International Board Certified Lactation Consultants, a certification which includes over 300 hours of clinical practice and an examination. Doctors or nurses are covered to provide support, but according to Utilla, they’re often overscheduled and rarely available to help new mothers in the hospital.
Almost half of New York City women who gave birth in 2020 were either on Medicaid or had no insurance postpartum, according to data from the CDC.
“If you have Medicaid, trying to find a provider that will help with your lactation issues is extremely difficult,” Utilla said.
Under the Affordable Care Act, all insurance plans are required to cover breastfeeding support, but only some providers will cover IBCLC lactation consultations. Out of pocket consultations can cost between $200 to $400 in New York, according to private practices in the city.
There’s also a shortage of trained lactation specialists in hospitals and communities, Utilla said. She remembers one mother who came to Jamaica Hospital all the way from Brooklyn after giving birth just to access a lactation consultant in-person.
“Exclusively breastfeeding is one of the most important health preventions a mother can offer her baby, yet our system is failing,” Utilla said.
Charline Ogbeni holds up a stuffed toy in the shape of a breast. (Credit: Mikella Schuettler)
“An Outlier”
Charline Ogbeni’s journey to become a lactation consultant also began with giving birth in a New York City hospital.
In 2020, her daughter was born prematurely at the Long Island Jewish Medical Centre. Ogbeni, a Queens guidance counselor at the time, breastfed her newborn for three days in the neonatal intensive care unit.
While the process was smooth for her, she watched as another mother struggled.
“I was showing her with my daughter in my hand, showing her how to do the holds and things like that,” Ogbeni said.
Ogbeni likes to say that was her first lactation consultation.
Once Ogbeni left the hospital, she searched for breastfeeding support groups in her St. Albans community, but found none. So, she took matters into her own hands. That same year, she became an International Board Certified Lactation Consultant, completing her clinical practice at Jamaica Hospital, in a program Utilla started to help minority lactation consultants get licensed.
Ogbeni founded the Supporting Our Mothers Initiative (SOMI) to help families across Queens and The Bronx as a lactation consultant, doula, and breastfeeding educator. These days, she cruises around Queens in a bright purple car, offering at-home support for new mothers.
On any given day, Ogbeni can see up to three clients for at-home lactation support. She offers a sliding scale for clients who don’t have insurance. In the evenings, she hosts virtual support groups and attends community events on weekends.
The belief that higher breastfeeding rates could improve her community’s health makes her intense schedule worth it, Ogbeni said. Many of the chronic conditions linked to lower breastfeeding rates are disproportionately present in Black communities, according to the CDC.
Though she was able to breastfeed her child for three years, Ogbeni knows others are not always as lucky. She calls herself an outlier.
“Not because Black people don’t breastfeed, but because Black breastfeeding success is not supported enough,” Ogbeni said.
