Removing barriers to breastfeeding among African American women

Breastfeeding improves the health of infants, children and mothers. In particular, breastfeeding has been proven to help address many of the health risk categories where African-Americans rank the lowest in the United States. Despite these benefits, African American women appear to face significant societal barriers that keep their breastfeeding rates far below other ethnicities, especially in the southeastern United States.

It is more important than ever to make sure all mothers have access to resources that can support breastfeeding. Although more African American women are breastfeeding today than in past decades, only 58 percent of African American women are likely to breastfeed at all, compared to 77 percent of whites and 80 percent of Hispanics. So what’s preventing more African Americans from breastfeeding?

Some of the most commonly cited barriers to breastfeeding include:
• Lack of information provided during the prenatal period;
• Negative opinions of breastfeeding expressed by female relatives and the infant’s father;
• Fear of pain;
• Reluctance to breastfeed in public;
• Accepting formula feeding as the norm;
• Having to return to work or school full-time;
• Lack of employer support for breastfeeding;
• Inadequate lactation support in the hospital and at home during the postpartum period; and
• Not being sure that the baby is receiving an adequate supply of milk.

There is no one quick fix to eliminate these barriers, as many of them are supported by a variety of socioeconomic factors. But as health care providers, we can do our part to equip mothers with the education and counsel they need to initiate – and continue – breastfeeding while under our care.

In addition to helping new mothers breastfeed while under our care, new resources and community programs continue surfacing nationwide that provide everyday support for this demographic. It’s Only Natural, a new U.S. Department of Health and Human Services campaign, uses video testimonials and practical educational materials to promote breastfeeding awareness and to help dispel common myths held within the African American community.

Community-based approaches such as doulas (trained professionals who provide physical and emotional support to mothers during pregnancy, at birth, and during the postpartum period) and peer counselors have also been demonstrated to increase the likelihood of breastfeeding initiation and continuation among African American women.
Additionally, women who give birth in hospitals such as Vidant Medical Center that practice according to the UNICEF and WHO Baby-Friendly Hospital Initiative standards and follow the evidence-based Ten Steps to Successful Breastfeeding are more likely to initiate breastfeeding while in the hospital or birth setting.
Breastfeeding has been proven to get children off to a healthy start, reduce their risk of later health problems and even boost their IQ. In fact, it is estimated that $13 billion per year in health care costs could be eliminated if 90% of all mothers breastfeed their infants. In honor of World Breastfeeding Week, let’s all make a commitment to tout its great benefits year round.

Pamela J. Reis, PhD, CNM, NNP-BC
Assistant Professor
East Carolina University College of Nursing


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