Breastfeeding is health care

We tell mothers to breastfeed. We write it into national guidelines, post it in hospitals, and promote it in public health campaigns. But when breastfeeding doesn’t come easily, when the baby won’t latch, the pain is unbearable, or every feed ends in tears; mothers quickly discover a harsh truth: the care they need isn’t covered.

Families are left with two choices: pay out of pocket or struggle alone. Neither should be acceptable in our country.

Feeding challenges are clinical, yet invisible

Every week, I see families doing their best, but not coping. They’re told the latch “looks fine” or that “it gets better”. But feeding challenges are often deeper than what we can see at first glance. They may be caused by:

• Structural or functional issues in the baby’s jaw, tongue, or palate

• Oral fatigue from uncoordinated suck-swallow-breathe patterns

• Overwhelm in the infant’s nervous system

• Insufficient support for maternal milk production, pain, or positioning

These aren’t minor issues. They are clinical problems with real, lived consequences. To the families I work with, they often look like this:

• A baby who screams through the night, not from ‘colic’, but from swallowing air at every feed

• Relentless gas and reflux symptoms, treated with medication but never resolving

• A mother with cracked, blistered nipples, rating her pain a 10/10 but told it’s “normal”

• A baby who feeds constantly, but never seems satisfied, later diagnosed as “failure to thrive”

• A mother so overwhelmed that she dreads feeding, wondering if she’s failing

• Families cycling through formulas, bottles, and medications, trying to solve a problem no one has properly assessed

These are not rare. They are common. And they are exactly the kind of challenges skilled lactation and feeding support can resolve, if families could access it.

Breastfeeding is more than nourishment—it’s an early diagnostic tool

From a clinical perspective, breastfeeding is one of the first functional tests of how a baby is doing neurologically, structurally, and developmentally. How a baby breastfeeds can offer early insight into:

• Future solid feeding challenges

• Airway restrictions and breathing patterns

• Sleep quality and oral tone

• The likelihood of future speech or articulation difficulties

When feeding isn’t going well, it’s not just a feeding issue; it’s often a signpost for other areas that deserve attention. Early feeding challenges are not just stressful; they are clinically significant.

Jamaica’s breastfeeding gap tells the story

According to UNICEF, 33 per cent of Jamaican babies aged 0–5 months are exclusively breastfed, up from 24 per cent in 2011. That means one in every three infants benefits from this healthy start in life, a meaningful improvement, but still far from the global target of 70 per cent by 2030.

New mothers are discharged from hospital without ever seeing a lactation professional. In fact, lactation professionals are not currently staffed at hospitals in Jamaica. That’s a serious gap in our system, but also a major opportunity. When problems arise after discharge, families are left scrambling for private care, only to find out that insurance won’t cover it. All while the mother is on maternity leave, often unpaid, emotionally overwhelmed, and trying to make the best decisions for her baby.

Paediatricians, OBs, and nurses try to help, but specialised care matters

Paediatricians play a vital role. They monitor growth, guide early feeding decisions, and often make the critical referral to a lactation specialist. Many also try to support latch and positioning as best they can. The same goes for obstetricians and nurses, especially in the early postpartum period. Their efforts are valuable, and I work with many of them as part of a collaborative care team.

But feeding challenges are complex. Without specialised training in lactation and infant oral function, well-meaning advice can sometimes fall short, or even delay proper intervention. In some cases, attempts to help without seeing the full picture can unintentionally cause harm, such as worsening nipple trauma, missing a tongue restriction, or recommending unnecessary formula supplementation.

Lactation professionals are trained to assess:

• Latch mechanics and maternal comfort

• Oral motor coordination

• Functional tongue and jaw movement

• Suck-swallow-breathe synchrony

• Feeding patterns across the mother–baby dyad

We work alongside medical professionals to ensure families get comprehensive, functionally informed, and timely feeding support.

THE COST OF SILENCE AND WHAT MUST CHANGE

Lactation support is necessary health care. It improves developmental outcomes, reduces unnecessary medical interventions, and protects maternal mental health. Yet, in Jamaica, insurance plans do not cover it. That gap pushes struggling mothers further into crisis, and often leads to early weaning, not by choice, but by circumstance.

We must:

• Recognise feeding challenges as clinical health issues

• Include lactation consultations in health insurance coverage

• Ensure hospitals offer timely access to feeding support from a lactation professional before discharge.

Families shouldn’t have to choose between pain and affordability. I do my part by offering flexible pricing options in my private practice, but no parent should be financially blocked from essential feeding care.

If we are serious about supporting babies and mothers in Jamaica, insurance companies and policymakers must act. Feeding support is not optional. It is healthcare. And it’s time we treated it that way.

Bianca Chung is a certified lactation counsellor and founder of Raising Good Eaters. Send feedback to columns@gleanerjm.com and bianca@raisinggoodeaters.com.