I always thought that the most powerful elements of breast milk were the unparalleled immunological and anti-inflammatory properties that protect against several illnesses and diseases for both mothers and children. This is what we tell women. This is what I have told women. I tell them that breast milk is preventive medicine and that extensive research provides compelling evidence that breastfeeding reduces the incidence of asthma, pneumonia, acute ear infections and obesity in children.

This is all true.

But the real transformative power of nature’s complete first food became clear to me when I met Theresa and her two beautiful sons outside a health clinic in New Orleans. She had one child in her arms and one by the hand. Her 3-year-old couldn’t go to day care that day because his asthma was flaring up. She suspected her 9-month-old had yet another ear infection and here she was again at the clinic. It was clear from her pained face that the stress of taking care of two unhealthy children was taking its toll. She was visibly anxious about missing another workday at her job at a hotel downtown, and mentioned she had already lost a job because she had missed too many days tending to her sick children. “But what are you going to do?” she asked me.

We cannot expect mothers to breastfeed without providing supportive environments where they live, eat, play, work and worship.

What are we going to do?

In that moment, I couldn’t help but see the full picture. Yes, when infants are given optimal nutrition from birth they have improved chances for a healthier early childhood. But there’s more. Healthier infants grow into healthier children with lower rates of school absenteeism due to illness which, in turn, can increase the likelihood for improved early education outcomes. When mothers breastfeed – in addition to receiving proven health benefits such as a reduced risk of certain cancers – both mothers and fathers are relieved of the stress of caring for chronically ill children – the very same stress I observed in Theresa’s eyes that day.

In vulnerable communities where “job security” is an elusive concept and hourly wages are more common, unwell infants and children can severely impact a family’s already tenuous financial situation. In turn, our communities are weakened by financially insecure mothers and families. Yes, breastfeeding yields healthier infants, but it is only when you consider how that single fact affects the lives of everyone who loves, cares for and lives near that infant that you see the full landscape. Indeed, the cumulative impact of healthier infants is hard to ignore.

Yet too many infants, particularly those in vulnerable communities, don’t receive the best food possible, not because their mothers don’t want to breastfeed, but because that choice is suffocated by complex cultural barriers and thwarted by unsupportive environments that can be aptly described as “first food deserts.” While a desert may be a thriving ecosystem, I use the term in recognition of the severe sense of “lack” present in many communities. Just as a desert’s lack of moisture results in extremely limited vegetation and food options, far too many vulnerable communities have seen a systemic failure to provide the resources and social support mothers need to successfully breastfeed. I’m referring to areas without easily accessible breastfeeding support groups or culturally relevant lactation specialists, where public places which mothers frequent like shopping malls and libraries lack nursing mother facilities. I’m referring to communities where breastfeeding is invisible, perpetuating cultural myths about who actually breastfeeds and deepening socioeconomic disparities in breastfeeding rates. I’m referring to places with child care facilities that haven’t been properly trained in handling human milk, and with employers who lack a nursing mothers policy – both critical supports for breastfeeding mothers returning to work.

Just as the good food movement has come to realize that overly simplistic messaging such as “eat well and exercise” is ineffective when healthy food and safe places to exercise are not readily available, so it must be with breastfeeding. We cannot expect mothers to breastfeed without providing supportive environments where they live, eat, play, work and worship. Every mother with the determination and will to give her baby the best first food possible deserves full support in doing so.

This lesson came to me street by street and conversation by conversation as I canvassed neighborhoods in New Orleans, Birmingham, Ala., and Jackson, Miss., talking to residents, visiting doctor’s offices and malls, and examining the levels of existing community support for mothers who choose to breastfeed. Despite many notable improvements at area hospitals, far too many mothers and babies in these communities leave the hospital after two or three days only to return to desert-like conditions in terms of first food support. It is no coincidence that these areas also suffer from some of the highest infant mortality rates in the country. We can do better.

The Greek philosopher Plato said, “The beginning is the most important part of the work.” In our work to create a better world where mothers and children thrive, we must start at the beginning – at birth and with first food as the earliest preventative health measure. If we are looking at the inequities of food access, we must start at the beginning, by facing the sobering reality that in many communities these inequities begin not with school lunches, but at birth, and that our youngest citizens pay the price with their health and their precious, young lives. If we want to strengthen families and empower communities we must begin at the beginning by examining all the structural factors and health disparities that affect the day-to-day lives of mothers and children. We must go to the beginning – the most important part of the work.
I used to tell women that breastfeeding changes health outcomes for mothers and babies. Now I also tell them that breastfeeding is the beginning of the possibility for a completely different life and holds the beautiful potential to help transform our communities, one child and family at a time.

This is what I know.

Kimberly Seals Allers, is a journalist, author, breastfeeding advocate and WKKF Food & Community fellow