What’s behind MAHA’s new strategy to boost breastfeeding in the US?
Two weeks after giving birth to her son in 2015, Alex Thompson returned to work as an elementary school teacher. The separation was difficult.
“I would FaceTime him or watch videos of him and just sob. It was horrible,” she told Straight Arrow News (SAN). Thompson was committed to breastfeeding, which meant pumping her breast milk in the school’s laminating closet or the bathroom.
She’s not alone. One in four new mothers returns to work within 10 days of giving birth, according to the non-profit organization Thousand Days.
The United States lags behind global breastfeeding rates: While 50% of the world’s infants are breastfed at six months old, only 25% of American infants receive breast milk exclusively at six months old.
The U.S. wants to change that. In early September, Department of Health and Human (DHS) Services Secretary Robert F. Kennedy Jr.’s Make America Healthy Again Commission (MAHA) released a strategy report that promised to increase America’s breastfeeding rates.
But critics worry it won’t do enough to overcome obstacles that mothers like Thompson face.
“People need to have money to put food on the table, which means that they have to return to work often before they’re ready, before they’ve recovered from childbirth, before they’ve established breastfeeding, before they are…ready,” said Liz Morris, co-director of the research and advocacy organization WorkLife Law, in an interview with SAN.
What does the MAHA strategy to increase breastfeeding promise?
Scientific evidence supports breastfeeding as the best nutritional and physiological start for a newborn and mother. A breastfed baby has a lower risk of sudden infant death syndrome, and is less likely to develop infection, be hospitalized, or develop allergies, diabetes or asthma, according to a joint statement from Sara Brenner, principal deputy commissioner at the U.S. Food and Drug Administration, and Dorothy Fink, both of whom are physicians.
Breastfeeding also lowers mothers’ risk of postpartum depression and anxiety, high blood pressure, type 2 diabetes, breast and ovarian cancer, and encourages mother-infant bonding, according to the doctors.
“Every new mother should receive encouragement, practical assistance, lactation support, and feel empowered at home, at work, and by society to prioritize optimal health, wellbeing and nourishment for herself and her baby,” Brenner and Fink said.
Their departments will work to provide better access to “pumps, lactation consultants and donor milk,” as well as stronger employer policies to support lactating workers and policies for milk banking, they said. They will also support mothers and families through programs like the Healthy Start Program, which funds state resource centers providing community-based breastfeeding education, prenatal and postpartum care and other support.
But the public promises have not come with a concrete roadmap illustrating how the current administration will increase breastfeeding rates.
Tina Sherman, National Director of Maternal Justice at Moms Rising, told SAN she is cautiously optimistic. But, she said, it will take a multi-pronged approach focused on overall maternal and child health to move the needle on breastfeeding rates.
Where do experts see gaps in breastfeeding support?
Elizabeth Gedmark, vice president at A Better Balance, a national nonprofit legal advocacy organization promoting workplace justice, told SAN she finds it encouraging that a federal agency wants to increase breastfeeding rates. Yet she is concerned that President Donald Trump’s proposed budget for the 2026 fiscal year will likely impact the very programs the MAHA strategy proposes to tap.
For instance, currently breastfeeding moms enrolled in the Women, Infants, and Children (WIC) program receive $52 a month to spend specifically on fruits and vegetables. The 2026 budget proposes reducing that benefit to $13, according to the Food and Research Action Center. This, Gedmark told SAN, could make it hard for mothers to sustain a healthy milk supply — affecting the very population who needs the most lactation support.
Funding cuts to Medicaid, which covers nearly 40% of all U.S. births, could also have a “disproportionate impact on vulnerable families,” Sherman told SAN.
What protections does the PUMP Act offer employees?
This isn’t the first big policy change proposed to help pregnant and postpartum moms in recent years. The 2022 Pregnant Workers Fairness Act requires employers to provide reasonable accommodations for conditions related to pregnancy and childbirth. The passage of the PUMP Act that same year guaranteed breastfeeding employees a reasonable break time and access to a private lactation space located somewhere other than a bathroom for the first year after giving birth.
Many employers are complying with the new law, thanks in part to guidance and education from the U.S. Department of Labor, according to Morris. But she said the Labor Department could benefit from additional funding to educate employers about their legal obligations.
Some new moms, like Monique Moran, are unaware of their employee rights. After saving up enough money to take an unpaid eight-week maternity leave from her night shift at a fast food restaurant in Phoenix, Moran returned to work determined to continue breastfeeding.
Using a $20 handheld pump, she took twice-nightly breaks to pump for her 2-month-old child in the public bathroom. She had no idea she had a right to a private space, or that her insurance likely would have provided her an electric pump under the Affordable Care Act, she told SAN.
Even employees who know their legal rights can find it difficult to pump at work.
Registered Nurse Rachel Brantley told SAN that the Phoenix hospital where she works had a nursing room downstairs. But getting there twice each 12-hour shift felt impossible. Instead, Brantley pumped while charting, or in the nurse’s breakroom, plastering a sticky note on the door to warn her co-workers she was pumping.
“The stress and environment made it nearly impossible,” she said.
Since the PUMP Act does not provide paid breaks, some employees have to clock out each time they pump. As a result, moms are “often forced to choose between their wages and taking these lactation breaks,” Morris said.
Though the PUMP Act is helping, Elena Medo, co-founder and CEO of Leonie Health PBC and the pioneer of modern milk banking, told SAN the legislation is only a band-aid for bigger problems.
What do experts think it will take to increase breastfeeding rates?
Eighty-four percent of U.S. babies receive some breast milk shortly after birth, before declining sharply due to a wide variety of barriers that cut the journey short for many families.
One day after the White House announced its strategy report, the National Academies of Sciences, Engineering and Medicine released its own report detailing a cohesive plan to improve breastfeeding rates. The No. 1 recommendation: paid family leave.
Currently, only 13 states and the District of Columbia offer paid family leave programs, according to the National Conference of State Legislatures. Infants in these states were 41% more likely to be exclusively breastfed, according to the 2021 National Immunization Survey-Child. Paid family leave in these states guarantees at least six weeks off, with many states offering up to 12 weeks, though the breastfeeding study did not analyze whether longer leave made a difference.
Among the 41 wealthy and developed countries in the Organization for Economic Cooperation and Development (OECD), the United States is the only one without a national mandate for paid leave.
Those other countries reap an economic benefit: According to the Global Breastfeeding Collective, every $1 invested in breastfeeding generates a $35 return in lower health care costs for mother and child. And in 2023, the U.S. Department of Labor noted that enacting a universal family leave policy would “reduce poverty by 16% among people in families receiving those paid leave benefits.”
America’s low breastfeeding rates stem from more than parental leave policy; the baby formula industry also wields immense power here.
In 1981, the World Health Organization (WHO) passed an international code that prohibited the advertising of baby formula out of concern for increased mortality rates, malnutrition and diarrhea associated with aggressive formula marketing. The United States was the sole dissenter in a 118-1 vote.
“Unlike most developed countries, the U.S. government has repeatedly acted to defend formula companies’ interests here and abroad, including by lobbying against marketing regulations in other countries,” Medo told SAN. “This stance not only affects global breastfeeding protection but also strengthens the industry’s position at home.”
And it is not in the interest of the $55 billion formula industry to promote breastfeeding, Medo said.
They work hard to sell that formula. Medo pointed to breastfeeding education material that often portrays formula-fed babies as happier than breastfed babies. In 2022, WHO discovered that formula companies target pregnant and lactating mothers by sending them personalized promotions.
Historically, formula has been more aggressively marketed to Black mothers than white mothers, the lasting effects of which can still be seen today. According to the CDC, only 78.1% of Black infants are ever breastfed, compared with 87.7% of white infants.
Breastfeeding advocates like Medo urge the passage of laws that would prevent aggressive formula advertising.
Formula makers Enfamil and Similac did not respond to requests for comment on this story. But Esther Hallam, CEO and founder of Nara, a startup in the space, told SAN that her brand is working hard to redefine the industry.
Nara is the first USDA-certified organic, FDA-registered whole milk formula in the U.S. — a goal Hallam set after struggling to find a formula she felt safe giving her own children.
“Breastfeeding is wonderful when it works, but for so many families — including mine — it isn’t always possible,” Hallam told SAN. “Our goal isn’t to replace breastfeeding, but to offer the cleanest, most nutritious alternative when formula is needed — and to help parents feel confident in that choice. Early parenthood is hard enough without questioning whether your baby is getting the right nutrition.”
Do US hospitals do enough to help new moms breastfeed?
Experts also told SAN that the U.S. needs better hospital and postpartum support for breastfeeding parents.
During the COVID-19 pandemic, Charnise Littles was one of three lactation consultants working at a Washington, D.C.-area hospital. An International Board Certified Lactation Consultant (IBCLC) and founder of Birth and Milk Co., Littles covered labor and delivery, two NICUs and two postpartum units. If one consultant was off, the remaining two provided care for 40 to 50 patients each, Littles told SAN.
If U.S. hospitals were better incentivized to become certified under the 10-step Baby-Friendly initiative developed by WHO and UNICEF, “It would change everything — access to donor milk, no contracts with formula companies, full-time lactation consultants,” Littles said.
Some moms who had hoped to breastfeed ultimately opted for formula because of milk supply issues or medical difficulties. Others choose formula from the start based on parental preference. The important thing is that every baby deserves affordable “safe, nutritious, and wholesome options,” said Brenner and Fink.
But Littles said her time in hospitals has taught her to believe that too often, whether a parent is encouraged to breastfeed depends on the hospital’s culture, especially concerning people of color and younger moms.
Sherman, from Moms Rising, agreed that making that decision without structural support becomes a “false choice” for families. Breastfeeding parents should be able to see lactation consultants who “look like them and understand their background,” she said.
If the federal government really wants to increase breastfeeding rates, Sherman said, its efforts will need to be informed and grounded in the community.
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Ella Rae Greene, Editor In Chief
