Jessie Coggin, a Merced mother of two, didn't know what was wrong when her newborn daughter, Sophia, wouldn't cooperate at feeding time.
Coggin was determined to breast-feed Sophia, but the baby girl wasn't drinking enough milk. And she'd get sick after feeding.
After she threw up, little Sophia would want more food, which began to take a toll on her mom's mind and body. "She was biting me. It was painful," Coggin said. "She would eat and get sick over and over again.
"I called Emily, crying, and luckily she made a house call," Coggin recalled this week.
Emily Lindsey, a board-certified lactation consultant, came to the rescue. After some study, she figured out that Sophia suffers from an intolerance to corn and wheat, which were being passed through her mother's milk and making her sick.
It's a story that's been played out dozens -- if not hundreds -- of times at Lindsey's one-woman clinical practice on Alpine Drive. Lindsey has worked with hundreds of clients, ranging from teens to older women, rich and poor, black, white, brown and yellow. She often sees mothers just once, to correct small issues, but she also serves as a regular sounding board for previous clients. "I have her on speed-dial now," Coggin laughed.
Her work, and that of others who mirror her beliefs, is crucial in America's battle against obesity. We are becoming a nation of fatties -- and it all starts at infancy. Breastfeeding is one of the most critical interventions against obesity throughout a lifetime, said Laurie True, executive director of the California WIC Association.
Children who are breast-fed exclusively for the first six months of life are exposed to anitbodies in their mother's milk that make them healthier and tend to weigh less because they control when they stop drinking, according to the U.S. Department of Health and Human Services.
To be sure, some disagree with the notion that healthy babies and formula-filled bottles don't mix. Among them, for example, are a subset of women who simply can't breastfeed for health reasons.
In Merced County, a growing number of activists have set their sights on creating a healthier, leaner community where more women who can breastfeed, do. Today, Merced ranks well down the list of healthy counties in the state, due in no small part to so many of our residents weighing too much.
To boost Merced's wellness, Lindsey opened up shop in 2006. In the years since, she's coaxed mothers through problems with sore nipples, poor milk production and has even detected medical problems in their children. The illnesses ranged from ankyloglossia (a condition in which the tongue is held to the bottom of the mouth by a membrane called the frenulum) to cleft palates.
Both here and outside Merced, she's become an ambassadress for more breast-feeding. Lindsey and other local leaders are also keenly aware that building a healthy life must start at birth if today's children are to grow healthier, leaner and lead longer lives.
In recent months, several reports have been released that directed attention to breast-feeding as a way to improve a baby's health:
An April study, published in the journal Pediatrics, concluded that the U.S. could save $13 billion a year in medical costs and prevent more than 900 deaths if 90 percent of U.S. families breast-fed exclusively for six months. The study examined 10 pediatric diseases that are less commonly found in breast-fed babies, then estimated how many hospital visits, instances of illness and deaths could be avoided if breast-feeding were more common and prolonged.
In May, the White House unveiled a report called "Solving the Problem of Childhood Obesity within a Generation."
The White House action plan proposes policy and lifestyle changes that could return to a childhood obesity rate of 5 percent by 2030, which was the rate before childhood obesity first began to rise in the late 1970s. Today, one in every three children between 2 and 19 years old is overweight or obese, according to the report.
That the waistlines of children and adults have grown is well-known, but the number of overweight babies is also on the rise. Between 1980 and 2001, the prevalence of overweight infants under 6 months old in the U.S. almost doubled, from 3.4 percent to 5.9 percent, according to the White House report, 12 pages of which are aimed at curbing obesity in the earliest months of life.
The report calls for federal policies that would strengthen prenatal care and promote breast-feeding through policies at health care centers, workplaces and insurance providers.
"Breast-feeding tends to be a political topic that some people want to talk about and some people don't. In the last few years, at least, we've built a big national push," Lindsey said. "We can't pretend that these kids just show up at age 2 in preschool. What's nice about Michelle Obama's 'Let's Move!' campaign is that she sees that to have healthy middle-school children and healthy high school children, you have to start early."
There aren't reliable statistics for obesity among Merced County's youngest population. What is known is that exclusive breastfeeding is far less common here than in other parts of the state.
More than 37 percent of Merced County mothers get late or no prenatal care, according to the California Department of Public Health.
In Merced County, 87 percent of women perform "some" breast-feeding in the hospital after birth, yet only 26 percent of women exclusively breastfeed while they are in the hospital for one day after birth, according to a report by the California WIC Association and UC Davis Human Lactation Center.
At Mercy Medical Center, 28 percent of women exclusively breast-feed; at Memorial Hospital Los Banos, 16 percent of women provide breast-only milk.
By comparison, the statewide average for exclusive breast feeding in the hospital is 43 percent.
Of 33 Central Valley hospitals ranked in the July 2009 report for their breast-feeding performance, Mercy Medical Center ranked 20th and Memorial Hospital Los Banos ranked 30th.
The California WIC Association is looking to close the gap between mothers who breast-feed only sometimes and those who breast-feed exclusively in hospitals.
Laurie True said California WIC will hold a tour this summer to drum up support for legislation that would make the World Health Organization's Baby-Friendly Hospital Initiative a state standard. The baby-friendly framework is a worldwide program sponsored by the World Health Organization and the United Nation's Children's Fund that encourages hospitals to pay special attention to infant feeding.
There are 27 Baby-Friendly Hospitals and Birth Centers in California, but only three of them are in the Central Valley -- and they're all three clustered in the Sacramento-Davis region.
"This is a very clear 10-step framework that can be easily implemented and followed," True said. "It does take work and it does take resources, but once hospitals get over that hump, it's a very good transformation for overall health."
One of the first steps to create a more breast-feeding-friendly hospital environment is removing free formula samples, True said.
"We fought really hard starting in 2007 to get formula gift bags out of hospitals in Merced County. And that just happened within the last year or so," Lindsey said. "Those bags used to be given regardless of whether you were breast-feeding or not, so Merced County can say that it has made progress."
This year, Lindsey was given a Cultivator Award by the Central California Regional Obesity Prevention Project for her promotion of breast-feeding and her work to remove free baby formula giveaways at Mercy Medical Center.
She is also a board member on the California Breastfeeding Coalition, works with the United States Breastfeeding Committee and is chairwoman of the Merced County Breastfeeding Coalition.
Day and night, she is contacted by frantic mothers by phone, text, e-mail or Facebook. "Emily! I need you! Call me!" one mother recently posted to the Before and After Baby Facebook page. A few nights ago, Coggin texted Lindsey at 10:30 p.m. for advice. Even though it was late, she responded.
Said Lindsey: "I try hard to keep an open door policy."
This story is the first in a series of three that will look at obesity during various stages of life in Merced County and the Central Valley. Danielle E. Gaines wrote this story while participating in California Endowment Health Journalism Fellowships, a program of USC's Annenberg School for Communication and Journalism.
Reporter Danielle E. Gaines can be reached at (209) 385-2477 or firstname.lastname@example.org.