Healthy You Healthy Hennepin

WIC breastfeeding peer counselors

Moms helping moms breastfeed

January 2019

Breastfeeding benefits the health and wellbeing of moms and babies.

Breastfed babies have a lower risk of asthma, childhood obesity, ear infections, sudden infant death syndrome, Type 2 diabetes, and more. And breastfeeding moms are less likely to develop Type 2 diabetes, ovarian cancer, and certain types of breast cancer.

Despite these well documented benefits, many moms face barriers that prevent them from starting to breastfeed, or limit how long they can continue breastfeeding. Barriers may be logistical, such as lack of access to lactation rooms at work, or lack of employer support to use work time to pump. Emotional barriers, like the absence of role models and family and peer support are another type of challenge.

Among women of color, these barriers to breastfeeding are particularly pronounced.

This story is part one in a two part series that highlights the unique challenges to breastfeeding faced by women of color and two local efforts to help. These efforts include a Hennepin County Women Infants and Child (WIC) breastfeeding peer counselor program and collaborations with community partners, including Chocolate Milk Day.


If 90 percent of the women who gave birth in Minnesota in 2016 had breastfed exclusively for six months and continued for at least one year, an estimated 7,680 ear infections, 35,973 gastrointestinal infections and 38% of child deaths could have been prevented. Among mothers, optimal breastfeeding could have prevented 56 cases of breast cancer, 407 cases of hypertension, 141 cases of diabetes, and 31 deaths.

United States Breastfeeding Committee



When Sunshine Ruiz-Yang got pregnant at 19, breastfeeding wasn’t on her radar. That’s mostly because no one she knew had done it or was doing it.

Ruiz-Yang is Hmong, a community with low rates of breastfeeding initiation and duration. According to the Minnesota Department of Health (MDH), over 40 percent of Hmong mothers in Minnesota never initiate breastfeeding. Only one in eight Hmong mothers is still breastfeeding at six months, and by 12 months, it’s one in 27.

In addition to not having friends and family she could turn to for advice and support, Ruiz-Yang was also dissuaded by the things she heard people in her community say. “Breastfeeding spoils a baby,” is one that sticks out to her.

It was a visit to WIC — and a supportive spouse — that changed everything. WIC connected Ruiz-Yang to a breastfeeding peer counselor. WIC peer counselors are women with experience breastfeeding their own children, and they provide moms with support before and during the breastfeeding process.

Initially, Ruiz-Yang only intended to breastfeed for one month, but the experience with her peer counselor was so positive that she continued breastfeeding for over a year. What’s more, when it was all over, she decided to become a peer counselor herself.

WIC breastfeeding peer counselors



The Minnesota WIC breastfeeding peer counselor program launched in 2005 at three pilot agencies that served 10 counties. Since then, the program has expanded to 29 counties and one tribe.

Peer counselors are typically paired with moms who share the same language, racial/ethnic background, and other life experiences. Ruiz-Yang, for instance, often acts as a peer counselor to Hmong moms and to young moms (since she had her first child at 19). Moms can work with peer counselors from right after they find out they’re pregnant, until their baby is one year old.

Peers are trained in breastfeeding basics and counseling skills, and they strive to help each mom reach her personal breastfeeding goals. The emphasis is on personal, on the idea that each mom’s goals differ and that’s OK.

Interactions between moms and peer counselors usually take place over the phone or through text message.


WIC breastfeeding peer counselors
WIC breastfeeding peer counselors



WIC program research has shown that women who have peer counselors have higher rates of breastfeeding initiation than women who don’t. In 2015, only East African and Hispanic women without a peer counselor exceeded the national Healthy People 2020 breastfeeding initiation objective of 81.9 percent. But among mothers with a peer, all racial/ethnic groups exceeded the goal.

Research also shows that women with a peer counselor breastfeed longer than women without. For example, only 46 percent of moms without a peer counselor are still breastfeeding three months after their baby is born, compared to 62 percent of moms with one.

“There are a lot of women that have a quick transition from hospital to home and not a lot of time off, so having this extra level of support — and being able to provide that support in someone’s own language, in someone’s own culture, and from another mom — makes the difference in bringing up our breastfeeding rates,” explains Jill Wilson, Hennepin County WIC breastfeeding coordinator.

Angela Watts, Hennepin County Public Health Family Services area manager, believes these outcomes are shaping a new narrative for WIC. “People sometimes view WIC as a reimbursement program, but it’s really a reinvestment program,” Watts says. “Breastfeeding and breastfeeding peer counselors are a reinvestment strategy that build capital for babies and for the community.”


WIC breastfeeding peer counselors




Sunshine Ruiz-Yang has now been a breastfeeding peer counselor for seven years. The stories her clients tell her – about feeling empowered to breastfeed in public for the first time, about deciding to continue breastfeeding for a few months longer – motivate her to continue the work.

She’s currently exploring the option of becoming a certified lactation consultant, a health professional who specializes in the clinical management of breastfeeding. That step will require several classes, clinical experience, and passing a board certification test, but Ruiz-Yang said she’s never met another Hmong lactation consultant and is excited by the prospect of representing her community.

Angela Watts believes that the lived experiences of women like Ruiz-Yang make them the future of public health, and she envisions peer counseling as a pathway into the broader public health profession. “We need to give people like Ruiz-Yang whatever career support they need to go forward,” Watts says. “Experience should count. Experience is power. This is a new generation of public health workers.”

To learn more about Hennepin County WIC, visit


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