Breastfeeding Support: A Geographic Perspective on Access and Equity

J Hum Lact. 2017 Nov;33(4):770-780. doi: 10.1177/0890334417706361. Epub 2017 Jun 11.


Background: Clinical lactation professionals, breastfeeding peer counseling, and mother-to-mother support are important sources of information and guidance for helping mothers initiate and maintain breastfeeding in the early weeks, months, and years postpartum. However, there is limited information concerning the geographic barriers that mothers face when seeking this support. Research aim: This study aimed to identify the geographic barriers to breastfeeding support, delineate gaps in access, assess inequities in the distribution of local support, and highlight the underlying differences in access and equity for different demographic and socioeconomic groups.

Methods: The locations of formal breastfeeding support resources were collected for the state of Ohio for 2016 and were combined with demographic and socioeconomic estimates and derived transportation catchment areas to conduct an analysis of spatial access and equity.

Results: Significant geographic gaps in formal breastfeeding support exist within the state of Ohio. Although urban areas benefit from a higher density of support options, including a wide variety of clinical experts and mother-to-mother support groups, inequities in exurban and rural areas were more strongly aligned with socioeconomic status than geography. In particular, the Special Supplemental Nutrition Program for Women, Infants, and Children offices in rural Ohio offer breastfeeding support to income-qualifying mothers but cannot address the needs of mothers who do not qualify.

Conclusion: Spatial analytical approaches facilitate a more nuanced view of access and equity to breastfeeding support options, helping to both decompose important structural differences in the state of Ohio and identify locations that could benefit from additional breastfeeding support resources.

Keywords: La Leche League International; breastfeeding; breastfeeding support; health services research; lactation counseling; social support.

MeSH terms

  • Adult
  • Breast Feeding / methods
  • Breast Feeding / psychology
  • Catchment Area, Health
  • Female
  • Food Assistance / organization & administration
  • Food Assistance / statistics & numerical data
  • Geography*
  • Health Services Accessibility / standards*
  • Healthcare Disparities / standards
  • Healthcare Disparities / statistics & numerical data
  • Humans
  • Mothers / psychology
  • Ohio
  • Rural Population / statistics & numerical data
  • Self-Help Groups / organization & administration
  • Self-Help Groups / statistics & numerical data
  • Social Support*