During National Breastfeeding Week each year that I’ve been a social worker, I’m amused by the many articles that talk about the benefits of accomplishing the recommended twelve full months of breastfeeding, and the different strategies to keep breastfeeding going.

I’m amused because there are difficulties besides a baby not latching on, or wanting to feed at 3 a.m. when mom wants to sleep. Mothers who have these as their only obstacles can count themselves fortunate. Most mainstream readers don’t know that there is a whole class of mothers in this nation who are essentially forbidden to breastfeed by the assistance programs they participate in, just because they are poor.

Permit me to share these additional difficulties thrust upon women in poverty and their babies. Hundreds of thousands of women in the U.S. are impeded from breastfeeding for more than a few months because the nation’s core income assistance policy for poor mothers and children, Temporary Assistance for Needy Families (TANF or “welfare”), has a severe stance that no activity is more important than reporting to a “job.” The fact that a woman in need is a mother, or even a new mother, does not afford her any additional degree of respect or compassion.

Although federal TANF legislation allows for states to grant women a reprieve from job activities while the baby is fewer than twelve months old (including job searches, and job training and other activities they define as counting as work), virtually every state in the Union makes a mom participate in the paid labor market six months or less after her baby’s birth, thereby making continued breastfeeding pretty impossible.

Every year, the United States Breastfeeding Committee celebrates and does educational outreach as their major strategy for increasing the numbers of breastfed U.S. infants. It has not as yet addressed that fact that U.S. social policy is working at odds with them as they try to increase breastfeeding numbers throughout the nation.

One would think that since breastfeeding to 12 months is an accepted medical standard that needs no further justification, that every state, in an effort to have healthier children, would adopt the federal standard. The meanest states, such as Michigan, make mom leave baby to take any work they assign to her at 6 weeks old. This is not a typo.

Now, a reasonable reader might ask: Why can’t the mother receiving cash assistance just pump, store and give whoever cares for the child while she is working a bottle? That’s what many mothers in the paid workforce do.

Well, while the work requirement of the federal government is 20 hours per week per parent, most state programs take advantage of the fact that moms don’t know this, and require moms to report to 40 hour a week activities. Even mothers who only report for 20 hours a week have serious wrenches thrown in their breastfeeding efforts—the people who run these activities discourage or forbid pumping, or provide no place or breaks for it.

There are 465,000 mostly single-mother-headed families in California alone whose breastfeeding is endangered from the start. Nationally, the children in 2,065,000 families are not being breastfed for the recommended twelve months as per the American Medical Association and, ironically, the Department of Health and Human Services—the same agency that shapes the federal policy, lets states run programs that run counter to federal interests, and counter to every medical and nutritional recommendation.

It’s fair to note that welfare-receiving moms aren’t the only ones facing nearly impossible choices in the U.S. workplace. America has some of the worst maternity leave policies of any developed country. Many jobs don’t offer leave, especially paid leave. Those that do usually cap it at three months. So if you removed the barriers to breastfeeding as they exist in TANF, this counter-argument goes, you’d have women on welfare getting breastfeeding time while women who work full-time and do not receive cash assistance are denied it. Would that be right?

Let’s realize that the rights of all mothers to breastfeed (whether by staying out of the paid market entirely or by being able to feed or pump at work) hinge on the right of poor women to do so: When the lowest-income women are forced to accept any job no matter how few benefits it has, the class above them will have less power to negotiate benefits for themselves. Flooding the recession economy with mothers on welfare (through what’s commonly known as “welfare-to-work” policies) erodes the bargaining power of mothers with higher degrees. A perfect example: in the childcare field (how ironic!), the wages of women with early childhood education degrees have suffered because mothers on welfare have become a pool of involuntary applicants for day care work. The welfare regulations say that they can perform child care for other welfare moms (my guess is they’d all rather be taking care of their own). So these moms take low-paid, and even unpaid, child care jobs, and before you know it, all those women with college degrees just can’t find any well paying work.

Remember that poor children have more asthma, more diabetes, and more obesity. Breastfeeding has been correlated to a lesser incidence of all these illnesses. We will all pick up the tab for treating the children who were denied the possibility of breastfeeding just because they were born poor. For states to ignore that breastfeeding is one way to improve long term health and reap savings on medical care of chronic diseases, is to be kidding (forgive the pun!) themselves and the public.