The new year began without creation of a separate, state-run court in Jackson that some lawmakers lobbied as a solution to crime and advocates see as a threat to residents’ civil and voting rights.
Under House Bill 1020, the Capitol Complex Improvement District Court was supposed to be established Jan. 1, but at the 11th hour a panel of the U.S. 5th Circuit Court of Appeals issued a temporary administrative stay until the end of the week, Jan. 5.
“The NAACP stands firm in our belief that this legislation is inherently undemocratic,” the organization, who sued on behalf of several Jackson residents, said in a Monday statement.
“We will continue to do everything in our power to fight for Jackson residents’ rights to have control over their own institutions and live free from state-driven discrimination.”
The NAACP appealed after U.S. District Judge Henry Wingate issued his order the evening of Dec. 31 in which he rejected requests to block the court’s creation through a preliminary injunction.
Wingate wrote the plaintiffs failed to show that they were in “actual or imminent danger” of experiencing concrete or particular injury from the CCID court’s establishment or appointments of a judge and two prosecutors to that court.
Attorneys from the NAACP have argued in court hearings and filings from throughout 2023 that the CCID court prevents local voters from voting for judges and prosecutors from the community who would be accountable to them and can be held accountable by local officials.
The state’s attorneys have said in court and filings that residents’ voting rights would not be affected by the court’s creation, and that none of the plaintiffs has or plans to appear before the CCID court.
A majority of the majority-white, Repubclican-controlled Legislature passed HB 1020 during the previous session, seeing it as a solution for Jackson’s crime and a way to bolster public safety. Many Black lawmakers and those who represent the majority-Black Jackson and Hinds County spoke out against the legislation and its approach to crime and public safety.
The state Supreme Court Chief Justice Michael Randolph is directed under the law to make appointments to the CCID court, which to date have not been made.
Under the law, Randolph also was empowered to appoint temporary judges to the Hinds County Circuit Court. He was prevented from doing so under a temporary restraining order Wingate approved in May and, because up until September, he was still a defendant in the lawsuit against HB 1020.
The Mississippi Supreme Court ruled these appointments unconstitutional in a state lawsuit against HB 1020. Like Wingate, the justices ruled that creation of the CCID court did not violate the state constitution.
To date, Wingate has not ruled on several other motions before him regard HB 1020, including a request from the U.S. Department of Justice to intervene in the lawsuit.
The Mississippi River drains more than 40% of the continental U.S. – just how much trash does it take along with it?
That’s what a group of researchers and environmental advocates wanted to find out when they began a litter analysis of a handful of cities along the river a few years ago. This fall, they released what they’re calling the “first-ever snapshot of the state of plastic pollution along the Mississippi River.”
Between 2021 and 2022, volunteers from St. Paul, Minnesota; the Quad Cities area in Iowa and Illinois; St. Louis, Missouri; Greenville and Rosedale, Mississippi; and Baton Rouge, Louisiana; logged trash they found into the University of Georgia’s Debris Tracker app. The study came on the heels of a 2018 commitment from mayors along the river to reduce plastic and trash.
Although many people might think oceanside cities bear the responsibility to keep plastic and trash out of the water, the Mississippi River can act as a funnel for that trash from the heart of the country to the Gulf of Mexico.
The study was also meant to raise people’s awareness of the river’s role in keeping other waters clean, said Jennifer Wendt, plastic waste reduction campaign manager for the Mississippi River Cities and Towns Initiative — the mayors’ group that worked on the study.
For example, a piece of litter that someone tosses on the ground in Missouri could theoretically make its way through storm drains, to tributaries, to the Mississippi, to the Gulf and then to the ocean.
“It may not look like a plastic beverage bottle by the time it gets to the ocean, but it’s still there,” Wendt said.
Here’s what to know about the study results, what’s next for reducing plastic and trash along the river and how you can keep plastic out of important waterways.
What was the top trash found in the Mississippi River?
About 80,000 litter items were logged during the study’s data collection period.
Plastic was the top material found in and around the river, making up 75% of the total trash. Paper and lumber was next at 9%, followed by metal at 7%, glass at 5%, and personal protective equipment like masks at 2%.
The top 10 most commonly found items included:
11,278 cigarette butts
9,809 food wrappers
6,723 beverage bottles
5,747 foam fragments
4,239 hard plastic fragments
4,210 paper and cardboard items
3,882 plastic bags
3,640 aluminum or tin cans
3,260 foam or plastic cups
3,149 film fragments
Other notable finds include 825 masks, 480 items of clothing and shoes and 291 pieces of fishing gear.
In an optional survey after logging the trash they found, participants were asked if they cleaned it up. Close to three-fourths said yes.
What do the results tell us about litter habits?
People may not know that cigarette filters are made of cellulose acetate, a type of plastic, Wendt said. They can take up to 10 years to decompose. And cigarettes can also leach other toxic chemicals into the water, according to the report.
Another intriguing finding was the amount of plastic beverage bottles and aluminum cans found, Wendt said — both of which are recyclable.
She noted that of the cities that took part in the study, only one of their states, Iowa, has a so-called “bottle bill,” in which people pay a five-cent deposit when they purchase a beverage container and get a five-cent refund if they return the container to a store or redemption center. Bottles were lower down on the litter list in the Quad Cities than in other places.
Legislation like that “is not very popular politically,” Wendt said, “but it does work.”
Some states along the river prohibit local bans of plastic bags, she pointed out.
What’s next for keeping plastic out of the river?
River-wide data collection has wrapped up, but Wendt said the next step is carrying out city-specific projects to reduce plastic pollution.
Those include providing funds to underserved neighborhoods in St. Louis and Baton Rouge so they can pursue what they see as integral to reducing waste, like installing water-filling stations, or developing a curriculum for schools to teach about recycling.
The mayors’ group will continue to work with the University of Georgia to do a comprehensive assessment of waste management in a few cities, Wendt said, and they’re also planning to work with cities that don’t have recycling programs to provide people a way to recycle.
Wendt maintained that while recycling is part of the solution, it’s not the only solution.
“(The discussion is) moving in the right direction, from ‘Oh, we just need to clean up litter…’ to, ‘Oh, we actually need to reduce the source if we’re going to have any real impact,’” she said.
What can people do to reduce plastic into waterways?
The biggest step people can take is to stop using plastic bags, Wendt said. That also goes for single-use plastic water bottles, she said, except for those who need to drink out of them because of water contamination.
Beyond that, talk to local retailers and see if they’d be willing to ask customers if they want a bag instead of assuming they do, she said, and ask if restaurants could switch to sustainable materials for carryout containers and leftovers. Consumers can push retailers to make changes like this, she said, though she acknowledged it works best when people approach retailers as a group.
Nationally, Wendt said more attention is needed for the role the Mississippi River plays in carrying plastic and trash.
When she attends events about reducing plastic, representatives from coastal cities are often the only ones at the table.
“There’s this whole rest of the middle of the country that needs a little bit of focus,” she said.
This story, the last in a three-part series, published in partnership with the Mississippi Center for Investigative Reporting, part of Mississippi Today, is a product of the Mississippi River Basin Ag & Water Desk, an independent reporting network based at the University of Missouri in partnership with Report for America, funded by the Walton Family Foundation.
Rev. Charlton Johnson only joined Together for Hope as leader of its Delta region in September, but he began thinking about Medicaid expansion long before that.
Together for Hope, an organization that works with people in the poorest counties in the country, has ramped up its efforts advocating for Medicaid expansion in Mississippi. The nonprofit hosts summits all over the states to bring together faith leaders, medical experts and health care advocates to raise awareness about Medicaid expansion. The policy, which would provide health insurance for an additional 200,000 to 300,000 Mississippians, would greatly improve health care access for the communities they work with, according to the organization.
But Gov. Tate Reeves remains steadfast in his opposition, despite support from a majority of Mississippians, and has derisively referred to Medicaid expansion as adding more people to “welfare rolls.”
Mississippi is one of only 10 states that has not expanded Medicaid. Over its first few years of implementation, research shows expansion would bring in billions of dollars to Mississippi and help the state’s struggling hospitals.
Johnson, who was born in Greenville and who has worked as a chaplain for hospitals in Memphis and Jackson, acknowledges its financial benefits. But expansion is about more than that, according to Johnson — it’s really about helping your neighbor.
Johnson spoke with Mississippi Today about the need for Medicaid expansion, and what the Governor’s refusal to consider the policy says about morality in Mississippi.
This interview has been edited for clarity and length.
Mississippi Today: Talk to me a little bit about what Together for Hope is and what it does for people who have not heard of it.
Rev. Charlton Johnson: It is a coalition with its focus on fighting rural, persistent poverty. Persistent poverty is defined as an area that has been under the federal threshold for poverty for consistently 30 years, and in Mississippi alone, we have 53 counties that meet that definition of persistent poverty. We are a national group, so I’m serving what we call the Delta region, which comprises the poorest counties in Mississippi, in Arkansas and Missouri; some parishes in Louisiana; Illinois — basically along the Mississippi River.
MT: Can you explain a little more in detail what the organization does, specifically?
Johnson: We serve as a bridge for grassroots organizations and what we call grass-top organizations that are trying to find ways to make an impact on the ground. For instance, there is this group that we partner with out of the Delta called Hands for Hope. They have tried to intervene with the food scarcity in that area because they don’t have a lot of grocery stores and fresh foods. Most people do their grocery shopping at Family Dollar or Dollar General. Now, they have a space where they receive fresh foods, like a distribution. Our job is making that connection between the community and that organization. A lot of grassroots organizations have a mission or idea of how they want to help the community, but they don’t always have the resources to turn something around.
MT: What kind of work does Together for Hope do around Medicaid expansion?
Johnson: It’s largely advocacy, with hosting the summit. Expansion has not been framed the right way. That was even mentioned in our last staff meeting, that we almost need to just pull it back from saying Medicaid expansion versus just starting to meet those who are in the gap. There are so many people who are in that void of not being able to receive health care.
As a chaplain in hospitals, I’ve seen people use the emergency room as their primary care physicians, or they can’t go to the doctor and get sick enough they end up in the ER. That’s because people don’t have insurance. Seeing that was an awakening moment for me — it was when I began to recognize that people are not just running in here because they’re sick. It’s because the hospital has become their only option.
MT: I’m sure you were hearing about expansion long before starting this job. How do you think we have been talking about expansion, and how do you think we should be talking about it?
Johnson: Before coming into this role, I heard conversations about the need to expand Medicaid, which came while President Obama was in office. But there was so much resistance from red states to support that kind of initiative. People were trying to do their best to tear it apart. And Mississippi, of course, being the red state that it has long been, did not accept monies to help make this program more robust in Mississippi. So to hear Governor Reeves saying that he still isn’t interested in expanding Medicaid, to me it is just continuing the talking point that I heard from people who share his political ideology. When I heard that this organization Together for Hope was out there trying to help people better understand how it helps, not just people but the community as a whole and to also fight poverty, I wanted to be on the front lines.
MT: I’m wondering how you, as a pastor, square red states that are really religious with this resistance to helping some of the most vulnerable people in the state?
Johnson: I have a hard time. As a person of faith, it’s so hypocritical to me, because when you look at the 10 commandments, Jesus teaches that all of those commandments can be boiled down to two. The first is loving God, but the second one is loving your neighbor as yourself. And if I love my neighbor, then I recognize that we have a mutual interest in each other doing well.
That’s not something that I readily see in a hospitality state like Mississippi. So that’s hard for me to square for myself personally, but I also recognize that we’re all at different places in our walk of faith. I think if you’re Christian, you walk the walk of Christ long enough at some point, it changes your heart, and it begins to alter the way you see those around you, so I have hope that one day they’ll see that change.
But until that day, it just means that those of us who do see the need for change, need to not only be vocal, but need to be out front with doing those acts of compassion, of grace and mercy.
MT: If you were to explain what Medicaid expansion is to someone who wasn’t familiar with it, or someone who opposes it, what would you say about the policy and its significance?
Johnson: I’ve been holding on to a passage in Psalms 23 which says that “though I walk through the valley of the shadow of death, I will fear no evil: for thou art with me.” It’s not that we don’t have something to fear, but Christ is with us. Christ is with the hurting. And to say that we are Christ’s followers means that we need to follow Christ to where those who are hurting to help, to offer grace, to offer support.
And I see access to health care as a means of offering grace to people, or expanding Medicaid, bridging the gap — whatever phrase people want to put to it.
MT: Together for Hope advocates for expansion because of their work in communities of poverty, as I understand it, so can you talk a little bit about the connection between poverty and poor health outcomes?
Johnson: If people are not getting the medical care they need, the health disparities are going off the charts. People are dying unnecessarily because they don’t even have the option of going to the doctor when they need it. When they get sick, they have to just muster through it and hope that they’ll be okay. And I don’t think that’s what it means to live in a community.
MT: If Mississippi continues to forgo expansion, what are the consequences for the communities you work with?
Johnson: Those health outcomes will continue to get worse and worse is the short answer. But I don’t think that robs compassionate people of ingenuity. We’re going to find a way to help people.
Expansion seems the most logical way that it can be done, but if we have to find an I’ll-climb-the-mountain-side way of helping people with health care access, we will.
All Mississippi appellate judges up for reelection in 2024 plan to seek another term on the state’s two highest courts.
Four justices on the Mississippi Supreme Court and three judges on the Mississippi Court of Appeals told Mississippi Today they intend to qualify for a new eight-year term in office.
Below are the judges who plan to campaign next year for reelection:
Mississippi Supreme Court
Justice Jim Kitchens (Central District)
Justice Dawn Beam (Southern District)
Justice Robert Chamberlin (Northern District)
Justice James Maxwell (Northern District)
Mississippi Court of Appeals
Judge Latrice Westbrooks (District 2)
Judge Jack Wilson (District 3)
Judge Joel Smith (District 5)
The qualifying period for the appellate offices opens on Jan. 2 and closes at 5 p.m. on Feb. 1, according to the Secretary of State’s office. Judicial offices are nonpartisan, so candidates do not participate in a party primary. All candidates will appear on the Nov. 5, 2024, general election ballot.
To run for either of the two courts, a candidate must be at least 30 years old, a qualified elector in their respective district, a licensed attorney and a state citizen for at least five years, according to the secretary of state’s office.
Judges on Mississippi’s two highest courts do not run at-large. Instead voters from their respective districts elect them.
The nine members of the Supreme Court are elected from three districts: northern, central and southern. The 10 members of the Court of Appeals are each elected from five districts across the state.
The judges are elected in staggered terms, so not all 19 seats of the two courts are up for election each cycle.
The two courts hear appeals from chancery and circuit courts across the state. The Supreme Court is the court of last resort, meaning its orders cannot be appealed to another state court.
The Supreme Court, in recent years, has issued rulings that invalidated the process for voters to place initiatives on a statewide ballot and gave the governor more power to veto specific items from appropriations bills.
The court next year is expected to rule on a case that questions whether the Legislature can appropriate tax dollars for private schools.
For sports writers, sometimes the trips to cover the games are more interesting than the games themselves, especially for two sports writers named Cleveland with classic cases of attention deficit disorder.
Mississippians love candy corn, they want to buy Nintendo Switch consoles, they don’t get enough sleep, they’re unlikely to work remotely or try to quit smoking and they have the country’s eighth-most beautiful aquarium.
This is the age of the survey, and any reporter’s inbox especially around the holidays is likely overflowing with them.
Surveys and polls were once the domain of large companies that specialized in gathering such data from respondents. And the cost and effort involved — thousands of dollars and hours and hours of calling and collecting responses — limited the subject matter and made it easier to reduce inaccuracy or fraud.
But online platforms now allow most anyone to quickly and cheaply conduct an online survey, aggregate data — or fabricate it — and distribute it. These reports often include scant information on how data was collected, margins of error, or about the company or group conducting it.
Many surveys pushed out by marketing or public relations firms are repackaged data collected from the U.S. Census, Centers for Disease Control and Prevention or various government agencies or bureaus.
October, according to National Highway Transportation Safety Administration data, is the most dangerous time to drive in Mississippi. The most dangerous hours to drive are 8 p.m. to 9 p.m., with the safest between 4 a.m. and 5 a.m. Mississippi saw the eighth-highest increase in car crash fatalities from 2012-2021 — a 27.7% increase.
More than 1 in 10 Mississippians avoid visiting a doctor due to health care costs — we’re the fourth-worst state, according to CDC data gathered by Wealth of Geeks.
Mississippi has the seventh-shortest wait time in emergency rooms, an average of two hours and nine minutes — 28 minutes less than the national average.
Many surveys are simply rankings of online searches for a particular topic. For instance, a recent “survey” report said Mississippians are among the least likely to quit smoking, based on the number of online searches here on how to quit. Never mind we’re one of the least online connected states, according to another survey.
Another surmised that Mississippi has “the lowest interest in learning a new sport,” based on searches. It also reported the most popular new sport in the Magnolia State is pickleball.
Another said the states to which Mississippians most want to move are Texas, Florida and Tennessee, based on Google search data.
Some surveys sound highly questionable if not outright absurd on their face.
Mississippi, according to the Nature and Bloom online CBD store, is the second-most “CBD obsessed” state, behind Alabama.
Mississippi is the state suffering the least from pain, according to a survey from online kratom retailer Happy Go Leafly.
It’s the state getting the third-least amount of sleep, based on the number of online searches about melatonin.
Gulfport’s Mississippi Aquarium is the eighth-most beautiful in America, based on reviews from visitors that mention beauty. An aquarium in picturesque Detroit was crowned most beautiful.
Mississippians most wanted to buy a Nintendo Switch console for Black Friday and candy corn is their favorite Halloween candy, which is just wrong and gross.
Mississippi has long suffered slings and arrows from surveys and rankings on poverty, obesity, mortality, education — you name it. But in the survey age, there has been better news, whether accurate or dubious.
Mississippi is the best state in which to retire, followed by Alabama and Ohio, one survey reported. It has the lowest number of drunk drivers involved in fatal crashes, according to one survey, and it’s the “fifth best state for gamers.”
But one should take note: A Pew Research study suggests opt-in online surveys have 4% to 7% “bogus respondents.” A recent survey of surveys, using a statistical testing method, found that 1 in 5 surveys tested showed a high likelihood of fabricated data.
Mississippi school districts’ average internet bandwidth was 20 times lower than neighboring states in the 2021-22 school year, according to a report from a legislative watchdog committee.
The Joint Legislative Committee on Performance Evaluation and Expenditure Review (PEER) published a report this fall evaluating a sample of 30 school districts across several categories, which included finance, human resources, information technology, nutrition, operations and transportation. The analysis was conducted through a contract with Glimpse K-12, an education efficiency group from Alabama.
Glimpse K-12 has previously evaluated six Mississippi school districts on these same criteria through a contract with the State Auditor’s Office. The PEER committee used a portion of their annual allocation to expand this work at the request of the Legislature.
The volume of the report addressing information technology highlighted deficiencies in the technology used for learning in Mississippi’s schools, proposing several adjustments at the state and local levels. According to the evaluation, more than half of the districts sampled did not have a strategic plan for technology use in the district, while around 40% did not have plans for data recovery in the event of a natural disaster or cyberattack. The report recommends that the Mississippi Department of Education create templates of both plans to aid school districts in developing them.
The report also found that during the 2021-22 school year, the average internet bandwidth capacity in MS schools was 2.55 megabits per second (mbps) compared to 52 mbps in neighboring states. The report recommends increasing bandwidth, but particularly encourages districts to do so in a manner commensurate with device usage since many classrooms were only utilizing devices for each student during state testing rather than throughout the year.
“Districts should provide training, curriculum development, and technology tools to teachers,” the report recommends, as “this balance empowers teachers to utilize online resources effectively, create engaging learning experiences, and align infrastructure with educational goals.”
Multiple sources of funding have recently been allocated to expand bandwidth in the state, which the report highlights as opportunities for districts to increase access. The Legislature formed the Broadband Expansion and Accessibility of Mississippi (BEAM) office in 2022, which will oversee the distribution of $1.3 billion in federal money. While these resources offer promising opportunities for support, the report also notes the implementation of these funds may take time.
An additional area for improvement identified in the report is the structure of tech support services. While nearly 75% of surveyed districts operated one office for traditional IT needs and education technology support, the remaining quarter used the more costly option of operating separate offices for the two functions. While the report did not directly advocate for collapsing the two offices into one, it did suggest that districts evaluate what added benefits justify the additional cost.
I sat down with Warwick Sabin, the new President & CEO of Deep South Today, a networked hub of nonprofit newsrooms, including Mississippi Today and Verite News, serving the Southern region of the United States. We talked about his backstory and the future of nonprofit journalism.
Sabin is a distinguished alumnus of the University of Arkansas who was elected to three terms in the Arkansas House of Representatives and previously served as Publisher of the Oxford American, an award-winning national magazine that focuses on the American South.
Earlier in his career, Sabin was the founding leader of the Innovation Hub in Little Rock, which later became part of Winrock International, which along with the Winthrop Rockefeller Foundation is among the three institutions created to sustain the legacy of Arkansas Governor Winthrop Rockefeller. More recently, he served for four years as the executive director of strategic engagement at the Aspen Institute.
Dr. Christina Glick, director of Mississippi Lactation Services, poses for a portrait at her breastfeeding clinic in Jackson, Miss., Tuesday, Dec. 19, 2023. Credit: Eric J. Shelton/Mississippi Today
Dr. Christina Glick is a retired neonatologist who runs Mississippi Lactation Services, one of the only free-standing breastfeeding clinics in the Jackson area. She is an advocate of family-centered care, a system of practice that incorporates the family in therapeutic, management and even diagnostic decision-making, and a proponent of breastfeeding as medicine.
Research around breastfeeding – which lowers the incidence of numerous diseases, infections and depression in both mother and baby – has made strides in the last few decades. Still, Glick says she sometimes encounters colleagues who joke that she “quit practicing real medicine” when she opened her clinic in 2015.
With the highest rate of preterm birth, Mississippi could stand to benefit from increasing its breastfeeding rate – one of the lowest in the country. Mississippi Today spoke with Glick about the science and stigma of breastfeeding, the multi-billion dollar infant formula industry, and what would be needed to eradicate unnecessary pharmaceutical intervention in baby feeding practices.
Editor’s note: This Q&A has been edited for length and clarity.
Mississippi Today: How did you first get into breastfeeding research and, at the time, did you feel like it was a rather underappreciated or niche area?
Dr. Christina Glick: When I first did my training back in the early ‘80s, there was no breastfeeding training in medical school at all. It wasn’t even mentioned. And one of the things we were regularly losing babies from was malnutrition. So, the smallest babies were the hardest ones to be able to feed. And so there was some early work in the late ‘80s that breast milk was maybe a solution for some of our malnutrition issues in the tiniest, sickest babies who had chronic lung disease and just weren’t able to get enough nutrition. I got certified as a lactation consultant by the International Board of Certified Lactation Consultants, IBCLC, in the early 2000s. I started working with breastfeeding for my NICU patients at that time, and when I was in private practice I began to do a lot of breastfeeding medicine in the NICU.
When I opened my clinic, I thought ‘well I know a lot about breastfeeding and it’s going to be a pretty easy adjustment from intensive care medicine to lactation,’ and it was not – at all. I found that I knew very little about breastfeeding – and I’ve breastfed three children of my own. It’s a very confusing thing: you think it’s natural so it’s going to be simple, but it’s a very complex field of work. I have found that it’s absolutely critical to be able to coordinate the teamwork between the provider and the family to be able to successfully advocate for breastfeeding.
It is an extremely underrepresented field, still to this day. It’s getting more and more recognition but I still get people kidding me, ‘well, you quit practicing real medicine’ and stuff like that.
MT: Tell us a little bit about the research around breast milk and how breastfeeding has been shown to be mutually beneficial for mother and baby.
CG: There are so many aspects of breastfeeding that are just, seemingly magical. There’s the nutritional part of it – it’s the perfect food for the baby. So it’s exactly matched to the proteins that babies need. And we’ve found that breastfed babies actually need less volume, less protein, less calories when they’re fed breast milk – because it’s the perfect food.
Babies that are breastfed, we know, have a lower incidence of some of the diseases that are the most common causes of adult bad outcomes including cardiovascular disease, heart attack and stroke. So breastfed babies have less of that. And we always thought it was a nutritional thing but as we’ve been discovering, the human genome is actually affected by breastfeeding. So the epigenome, which is the part of our genetics that is changeable, is actually impacted greatly by breastfeeding. And so we think now that breastfeeding changes the likelihood of having heart attacks and strokes, based on the changes in the genome, not as a nutritional result – which I find pretty amazing. The breast milk actually turns off bad genes and turns on good genes.
And as we studied the microbiome, we found that breastfeeding dramatically changes the microbiome and probably has a really big effect on our overall long-term health as well as the epigenome. So breastfed babies have completely different colonies of bacteria in their gut and we think that affects their overall health and their immunological response to infections. So it’s not just the nutritional benefit but also the microbiome that helps fight infections.
MT: Aside from all the benefits for the baby, what are some of the benefits for the mother? Can it help with things like postpartum depression?
CG: Yes. And one of the confusing things about breastfeeding is that the first couple of weeks are usually pretty stressful. We always paint it as a time of bonding and rainbows and unicorns or whatever but establishing breastfeeding in the first couple of weeks can be extremely stressful.
And sometimes the first few weeks are so stressful that people imagine that postpartum depression is increased by breastfeeding – but the data shows that it’s actually protective. One of the best things that happens with breastfeeding is the hormonal changes that breastfeeding brings on are really unique. So, breastfeeding moms have really high levels of prolactin. And they have huge oxytocin surges which is what stimulates the transfer of milk to the baby. And it turns out that the oxytocin surges are pretty unique in breastfeeding mothers, and those oxytocin surges help reduce the incidence of cardiovascular disease long-term in the mother. So, we see less heart attacks and strokes in mothers who have breastfed for any significant time that is more than a matter of weeks.
In addition, breastfeeding helps reduce breast cancer. So breastfeeding mothers have a lower risk of developing breast cancer throughout the rest of their lives.
MT: Why do you think Mississippi has one of the lower rates of breastfeeding in the country?
CG: One of the things that gave formula such a strong foothold early on in the ‘50s and ‘60s was that it was called formula, so it was like the perfect scientific formulation of milk for a baby that was going to make babies healthier than breast milk. And so it became a socioeconomic incentive that well-off people can feed their babies with this new, special formulation of milk. So, it became a status symbol, if you will, that formula-fed babies are better off than breastfed babies. And that lingers in our culture today in America that it’s considered an advantage to be able to formula feed babies.
And one of the things that has happened is that one of the programs that serves lower socioeconomic groups, particularly single women, is the WIC program – Women, Infants and Children Program – and that has really translated to a sort of formula chain. There are some lactation consultants who work on supporting breastfeeding, but it’s not a perfect system and it tends to be sort of a knee-jerk to offer women formula instead of breastfeeding. It just seems easier, so if there’s any bump in the road they tend to switch to formula.
Breastfeeding is a cultural thing. If your mother breastfed you and your sisters and your cousins and everyone is breastfeeding their babies, then there is a lot of community support. If you come from a culture where everyone is formula feeding, there’s no one there who really understands. So when you hit problems, the answer is formula.
And unfortunately, the indigent population in Mississippi, and in the country as a whole, is still on the formula highway. There’s not support in our culture by a long history of breastfeeding. So, if you’re in a formula culture, you tend to formula feed and that is the case in Mississippi.
MT: Mississippi also has one of the highest rates of cesarean sections in the U.S. Are these two things, high rate of cesareans and high rate of formula use, connected?
CG: Right, great question. With a cesarean, there are a number of things that interfere with the initiation of breastfeeding. So, one of the big things is that a woman who has a C-section gets a big bolus of fluids, and that translates pretty quickly straight into the baby. So babies born of C-sections have higher water content in their bodies. And when we’re water overloaded what we do is pee it all out pretty quickly. And so babies born by C-section tend to lose weight really quickly. And we have this 10% cutoff, based on a terrible study that said that babies who lose more than 10% of their birth weight are in danger, and immediately supplement them with formula. So, just the weight loss piece of surgical deliveries makes them be at higher risk of formula supplementation recommendation right off the bat.
And then the second thing that happens is that surgical delivery delays the milk coming in. So, there’s breast milk and there’s colostrum. And normally, we transition from colostrum to regular milk by the second or third day, but with surgical deliveries that’s delayed to the fourth or fifth day. And oftentimes when a breastfed baby is only getting colostrum for four or five days, they’re pretty darn hungry by the time the milk comes in. And they’ve lost a lot of weight. So you have a crying, fussing baby who is acting unsatisfied and the natural response is to give the baby supplementation, instead of saying ‘it’s ok for that baby to cluster feed for 10 or 15 times a day to get that milk.’ And the data is that if you use more than four ounces of formula in a 24-hour period in the first month, it dramatically interferes with sustainability of breastfeeding in the long term.
MT: In your view, do you think more Americans are using formula than need it? What would be needed to shift the paradigm?
CG: Absolutely. That is completely, absolutely true. And one of the unfortunate things that has happened as a result of the move toward formula is the companies who have produced formula are very powerful political forces in this country. So it’s an economic incentive for hospitals and doctors to push formula. And that’s become a real driver in the supplementation of formula in our country. And breastfeeding is not a powerful money-making industry, right? So it’s very hard to fight the pharmaceutical intervention in infant feeding practices in our country.
We would need to strip the pharmaceutical power and make that not a factor anymore … Most mothers are given a sample of formula when they register at the prenatal clinic. So that’s a huge tool to get formula in your front door by sending you free formula. That should be banned. It should be illegal to do that.
