Breastfeeding, the DR, and Defining My “Why”
Penn Global Seminar: Lactation and Public Health Advocacy in the Dominican Republic
Gloria, one of the Spring 2026 Penn Global Seminar Correspondents, shares her experience abroad during the Spring Break. Follow along with the group of correspondents on our blog and look out for their images on the @pennabroad Instagram feed.
Preparing for this trip has made me ask why I wanted to join the PGS in the first place. I keep coming back to a question that has shaped much of my time at Penn: what if one of the most powerful public health interventions isn’t a vaccine or a medication, but human milk?
I first began asking this question during my freshman year when Dr. Diane Spatz, a leading nurse scientist at Penn Nursing, guest lectured on breastfeeding. Breastfeeding lowers rates of infection and chronic disease in infants, reduces certain cancer risks for mothers, and saves billions in healthcare costs. In contrast, not breastfeeding is linked to higher maternal mortality, myocardial infarction, breast cancer, diabetes, increased infant deaths, and an estimated $3 billion in additional medical costs in the United States each year.
What struck me most was this: despite overwhelming evidence and the World Health Organization’s recommendation to exclusively breastfeed for the first six months of life, only about one in four mothers do so.
I’ve since learned that something that seems so natural and intuitive depends heavily on systems and support. Whether a parent can (or will) breastfeed often has less to do with motivation and more to do with cultural norms, hospital practices, paid leave policies, workplace accommodations, and access to lactation care.
To explore these barriers further, I joined a lab in Australia researching breastfeeding support post c-section. C-sections are associated with worse breastfeeding rates, and Australia’s cesarean rate has more than doubled over the past few decades, mirroring trends in the United States and the Dominican Republic. Through analyzing more than 1,000 survey responses and visiting hospitals, I saw how healthcare systems, geography, and culture influence whether families receive timely breastfeeding support (and the quality of it too)!
These experiences made me realize that improving lactation outcomes requires looking beyond a single hospital, or even a single country.
The Dominican Republic presents a particularly striking case. It has one of the highest cesarean rates in the world and one of the lowest exclusive breastfeeding rates: just 4 percent! This PGS offers the chance to explore why.
During this trip, I hope to explore several questions: How do cultural norms shape infant feeding? Who provides care: OB-GYNs, midwives, or community health workers? How do public health efforts and government policies influence what support is available?
I am especially excited about the fieldwork component. Learning directly from healthcare providers, grassroots leaders, and communities in the Dominican Republic will allow me to see advocacy and care delivery firsthand. It will also give me the opportunity to compare what I’ve observed in the United States and Australia with a system shaped by different resources, cultures, and histories.
As a nursing student and lactation researcher, I want to practice with a global perspective. I enrolled in this seminar because improving maternal and infant health requires understanding the cultural, historical, and structural forces that shape care. I know this experience will help me grow not only as a student, but as a future provider committed to supporting families wherever they are.