August 25-31 marks Black Breastfeeding Week, a week established to raise awareness of the gaping racial disparity in breastfeeding rates. Recent CDC data show that 75% of white women have ever breastfed versus 58.9% of black women.
Common breastfeeding challenges black moms face
In a 2014 study on breastfeeding disparities impacting African American and Hispanic women, research revealed several challenges black moms face that lead them to give up breastfeeding, including:
- A lack of understanding of how much milk the baby needs
- Limited knowledge about the “supply and demand” concept of milk production
- Unaware of the benefits of exclusive breastfeeding in the first month
- Challenges getting the baby to latch on
- Unexpected pain
- Unexpected complications during birth1
- Lack of paid family/medical leave
Inadequate breastfeeding education and support
Brittany Clay admits she was inadequately prepared, mentally, for how difficult breastfeeding could be. After enduring challenge after challenge, she ultimately made the decision to pump exclusively. But she still wishes moms were offered breastfeeding education from the start of pregnancy. “I would have loved to learn about what I was fully getting myself into and how I could prepare mentally beforehand,” she says. “I wish I knew what lactation consultant support I would have after I left the hospital.”
Lack of lactation support and education is one of the most common reasons for introducing formula. According to Tina Sherman of Moms Rising, while many moms may seek guidance from a lactation consultant, these supports are often inaccessible and/or unaffordable for low-income women. Discomfort breastfeeding in public and lack of workplace accommodations also impact these moms’ intended breastfeeding plans.
Returning to work while breastfeeding
Many participants in the 2014 study reported their to return to work adding to their breastfeeding difficulties. Many lacked adequate family leave, returning to work just a couple of weeks after giving birth. The knowledge that they would have to soon return to work caused some moms to forgo breastfeeding entirely, while others weaned their babies before returning to work. Some attempted to continue, but found difficulty juggling pumping and child care, as well as insufficient pumping accommodations in the workplace. Clay recalls having to pump in the printer room of her workplace, the fear of someone walking in on her looming over her.
Many new moms are unprepared for the physical pain sometimes associated with the first few days of breastfeeding. In the 2014 study, participants seemed unaware that pain could be alleviated with different positioning or better latch, or that the pain would subside. Moms reported pain due to dryness and cracks in the nipples, as well as engorgement.
Findings also showed a lack of understanding of how much the baby needs and the “supply and demand” concept of milk production, causing a perceived lack of supply. Clay says cluster feeding her daughter at three weeks was especially challenging and demoralizing. “My nipples were raw and my daughter was screaming because she was hungry,” she says. “I felt like such a failure.”
While many moms may face unexpected complications, black moms in the NICU have additional stress and may receive fewer support resources and guidance. A study from University of Pennsylvania School of Nursing’s Center for Health Outcomes and Policy Research found “nurses in hospitals [the study spanned 1,000 staff nurses in 134 NICUs in California, Florida, New Jersey, and Pennsylvania] with one-third or more percent black infants missed 50% more nursing care than those in hospitals with less than one-tenth percent black infants.”2 Cares missed included teaching and counseling patients and discharge preparation, both of which address the parents’ abilities to care for their infant at home.
The challenges black moms face in breastfeeding contribute to increasing health disparities, leaving children at greater risk for disease. A recent study shows black babies who received suboptimal breastfeeding reported three times the number of excess cases of necrotizing enterocolitis (NEC) and two times the number of excess child deaths.3
Sherman emphasizes that public policies that provide paid family and medical leave will have positive impacts on breastfeeding rates for black families, ensuring that “moms, babies, and partners have the opportunity to heal, bond and set them off on a great start in their breastfeeding journey.”
Moms also need access to breastfeeding supplies and support, including frequent visits from lactation consultants in the hospital and access to a breast pump for working mothers or mothers who are having difficulty breastfeeding.
Working mothers also need access to breast pump supplies, adequate break time for pumping and a private space to do so in the workplace.
NICU moms need confidence their babies are being cared for, along with proper guidance and counseling, including frequent visits from a lactation consultant directly after birth and at baby’s bedside.
Support, education, and access are all key to breastfeeding success, both in the hospital and once at home. By ensuring moms, particularly black moms, have access to the lactation support, education, and access they need, we can help close the gap in breastfeeding rates and give all babies a healthier start.
Don’t miss this video from Moms Rising that highlights stories from from other moms about the difficulties they faced meeting their breastfeeding goals.