Over the past 20 years, we have made tremendous progress in promoting and supporting breastfeeding, and you are much more likely to encounter a mother breastfeeding her child in public now than in years past. It is important that our community embrace this progress and make it easy for moms to feed their babies anytime and anywhere with ease and without restriction or negative remarks.

Breastfeeding has many health benefits for children and mothers, and the Centers for Disease Control and Prevention strongly encourages breastfeeding as "a key strategy to improve public health." Benefits for children include lower risk for asthma, obesity, type 1 diabetes, pneumonia, ear infections, sudden infant death syndrome (SIDS), and gastrointestinal infections (diarrhea/vomiting). For mothers, benefits include a decreased risk of high blood pressure, type 2 diabetes, ovarian cancer, and breast cancer.

The American Academy of Pediatrics recommends that infants be exclusively breastfed for the first 6 months with continued breastfeeding along with complementary foods for one year or longer. The World Health Organization has a similar recommendation but advises breastfeeding for two years or longer.

Fortunately, over the past several years mothers and infants have been gaining rights, and breastfeeding in public is now legal in all 50 states. State law now requires all employers to provide reasonable breaks and a dedicated private space for nursing or pumping - that is not in a bathroom - for up to one year after childbirth. Most insurance plans now cover breastfeeding support and supplies such as breast pumps for nursing mothers. All of these protections are making it easier for families to provide optimal nutrition to their infants and improve the health of women and children.

U.S. Surgeon General Dr. Jerome M. Adams has made remarks on the progress.

"Given the importance of breastfeeding on the health of mothers and children, it is critical that we take action to support breastfeeding," he said. "Only through the support of family, communities, clinicians, healthcare systems, and employers will we be able to make breastfeeding the easy choice."

In Carlton County, we are fortunate to have Community Memorial Hospital, which is both a Breastfeeding Friendly Maternity Center and a Breastfeeding Friendly Workplace. We also have an excellent Breastfeeding Friendly Health Department which is also a Breastfeeding Friendly Workplace, all designations from the Minnesota Department of Health awarded for the work these organizations have done to support breastfeeding in our community.

Carlton County Public Health and Fond du Lac Community Health both have wonderful home visiting programs with nurses who provide breastfeeding support to pregnant and postpartum women, in addition to other education and resources to support families in their parenting journey.

The Women, Infants and Children Supplemental Food Program, better known as WIC, is increasingly promoting and supporting breastfeeding families, and as a result we are seeing improving rates across the state. Breastfeeding initiation rates have increased steadily from 40 percent in 1990 to 90 percent in 2018. Despite this, we continue to struggle with improving the length of time that babies are breastfed. In 2018, while 80 percent of mothers were breastfeeding at 2 weeks of infant age, this decreased to 60 percent at 3 months, and only 42 percent were still breastfeeding at 6 months, which is still far below the Healthy People 2020 goal of 60 percent. By normalizing breastfeeding, increasing awareness of the important medical benefits, and supporting and encouraging mothers as they return to work, we hope to continue to see improvement in the length of time that babies in our community are breastfed.

The Carlton County Breastfeeding Coalition is actively working to recognize organizations and businesses who are making changes to support breastfeeding in our community and we hope to celebrate them with you all over the coming months.

Please remember when you encounter a nursing mother in public that she and her child have protected rights to nurse in any place of their choosing with or without a cover, and afford them the respect they deserve. Remember that they are making an important choice for their health and well-being.

Dr. Melissa Robey is a Family Physician and Internationally Board Certified Lactation Consultant with Community Memorial Hospital Raiter Family Clinic. She is passionate about taking care of families through pregnancy, delivery and the postpartum period and especially enjoys providing breastfeeding support to young families.