Breastfeeding Among African American Women

Support is key when it comes to breastfeeding

Mother breastfeeding her baby
KidStock/Getty Images

Monique Baker lives in California with her fiancée and their 6-week-old daughter, Alexandria Nicole. As a mother and baby nurse, Monique sees firsthand both the joys and challenges that come with breastfeeding after a baby is born. So when it came time for Monique to consider her own options as a mom, while she knew the benefits, she remained nervous during her pregnancy because she didn’t know if she would be successful at breastfeeding.

“In the beginning of my pregnancy, I wasn’t sure I wanted to try it because of seeing other mothers struggle with it and get frustrated. I think most mothers have to realize there is an initial adjustment period you have to get through to be successful at breastfeeding. Even though it’s not easy in the beginning, it’s the best thing for the baby. It’s made specifically for them.”

Monique’s feelings aren’t unique. It is well documented that one of the best preventive measures a mother can take to protect the health of her baby is to breastfeed. The American Academy of Pediatrics recommends that infants be exclusively breastfed for the first six months and continue breastfeeding with solid foods for at least one year or as long as the mother desires. Support from family, friends, the community, healthcare providers, and employers are also important to improve breastfeeding rates.

CDC’s new estimates of national breastfeeding rates indicate that among babies born in 2014, four out of five (82.5 percent) infants started to breastfeed, over half (55.3 percent) were breastfeeding at six months, and one third (33.7 percent) were breastfeeding at 12 months.

Lower Breastfeeding Rates for African American Women

Overall, breastfeeding rates are consistently improving, but they remain lowest among African Americans. For infants born between 2010 and 2013, the gap in breastfeeding initiation between black and white infants was 17.2 percentage points.

Researchers don’t completely understand the reasons for the lower rates but they may be linked to several factors:

  • African American women tend to go back to work earlier after giving birth than white women, and they are more likely to work in environments that do not support breastfeeding.
  • Workplace conditions, like a lack of break time and a designated space for pumping and inadequate storage for expressed milk, can create a barrier to breastfeeding.
  • Women with lower incomes or hourly jobs and those that work in the service industry may find breastfeeding particularly challenging because of a lack of paid leave and flexibility.

However, women can talk to their employers about their workplace environments and options to continue breastfeeding after returning to work.

Hospital practices also play a major role in either supporting or creating barriers to a woman’s decision to breastfeed. CDC data indicate that on average, U.S. hospitals only scored a 79 out of 100 possible points on an overall measure of breastfeeding-supportive maternity care practices.

Additional research indicates that healthcare facilities located in zip code areas with higher percentages of black residents were less likely to meet recommendations supportive of breastfeeding than those with lower percentages of black residents. These recommendations include:

  • Early breastfeeding start
  • Limited use of formula
  • Baby and mother sharing a room in the hospital
  • Limited use of pacifiers
  • Support when the mother and baby leave the hospital

Mothers can ask healthcare providers about breastfeeding support practices, if there is a baby-friendly designation when choosing a hospital, and how to get help or additional resources.

Monique says that finding support has been crucial when it comes to breastfeeding. “My mother and fiancée have really encouraged me to breastfeed and they ultimately played a big role in my decision to do so. They also have been really supportive during these first weeks.”

And, Monique had several lactation consultants see her in the hospital after her daughter was born. “I’m glad Alexandria Nicole was born in a baby-friendly hospital. They helped get me started and even gave me information about free lactation classes I could attend after I left.”

Monique isn’t sure what the future holds for her breastfeeding journey. She wants to continue breastfeeding after returning to work in a few weeks, but worries she won’t find time to pump as often as she needs to and the logistics of transporting and storing milk may be hard. “It will definitely be more challenging to continue breastfeeding when I return to work, but not impossible. I think it’s making my baby healthier overall. I know it’s the best thing for building and strengthening her immune system. I encourage all mothers to at least try it.”

Benefits of Breastfeeding

Breastfed babies have lower risks of:

  • Asthma
  • Leukemia (during childhood)
  • Obesity (during childhood)
  • Ear infections
  • Eczema (atopic dermatitis)
  • Diarrhea and vomiting
  • Lower respiratory infections
  • Necrotizing enterocolitis, a disease that affects the gastrointestinal tract in premature babies or babies born before 37 weeks of pregnancy
  • Sudden infant death syndrome (SIDS)
  • Type 2 diabetes

In addition to helping with a mother’s healing after childbirth, benefits for mom include a lower risk of:

  • Type 2 diabetes
  • Certain types of breast cancer
  • Ovarian cancer
  • Heart disease

Tips for Breastfeeding Mothers

  • Learn more. Take time to learn about the many benefits of breastfeeding, how it works, and common challenges you may face. It helps to do this before the baby is born.
  • Tell people. Tell your family, friends, employer, and healthcare providers your plans for breastfeeding. Discuss your needs and offer suggestions on how they can help you.
  • Find support. As mentioned above, support comes in many ways when it comes to breastfeeding. Find other breastfeeding moms in your community, check out La Leche League International to read more about common breastfeeding issues, and/or consider finding an International Board Certified Lactation Consultant (IBCLC) to work with.

Sources:

American Academy of Pediatrics. (2012). Breastfeeding and the use of human milk. Pediatrics; 129(3): e827-e841.

Anstey, E. H., Chen, J., Elam-Evans, L.D., Perrine, C. G., (2017). Racial and Geographic Differences in Breastfeeding – United States, 2011-2015. Morbidity and Mortality Weekly Report, 66 (27).

US Department of Health and Human Services. The Surgeon General's Call to Action to Support Breastfeeding. Washington, DC: US Department of Health and Human Services, Office of the Surgeon General; 2011.

A Practitioner's Guide for Advancing Health Equity: Community Strategies for Preventing Chronic Disease. Centers for Disease Control and Prevention.

Lind, Jennifer N., Perrine, Cria G., Li, Ruowei, Scanlon, Kelley S., Grummer-Strawn, Laurence M. (2014). Racial Disparities in Access to maternity Care Practices That Support Breastfeeding – United States, 2011. Morbidity and Mortality Weekly Report, 63(33).

Continue Reading