This post was written by Desiray Tynes, dietetic student and reviewed by Christina Iaboni, RD
Black Breastfeeding Week 2024 runs from August 25-311. This annual event celebrates and supports Black mothers in their breastfeeding journeys. Despite the health benefits of breastfeeding, Black mothers often face unique challenges. To help, we need to address these barriers and advocate for improved support.
This post contains sensitive topics. You may find some of the hard truths below triggering, specifically surrounding the historical content. Please proceed with care for yourself and refrain from reading if you feel uncomfortable.
Why Breastfeeding Matters
Breastfeeding has well-established health benefits for both mothers and babies. It contains all the nutrients babies need for the first six months of life (except for Vitamin D) and has beneficial effects on their immune system2.
Breastfeeding mothers have a lower risk of chronic illnesses such as ovarian and breast cancer, Type 2 diabetes, and high blood pressure3,4. Exclusive breastfeeding aids postpartum weight loss and reduces postpartum depression3. These benefits are particularly crucial for Black women, who face higher rates of obesity, diabetes, and cardiovascular disease compared to White women in North America5,6. Knowing these significant health benefits, it’s essential to address why Black women have the lowest breastfeeding success rates and how to improve them.
Disparities by the Numbers
Canada is behind other countries in collecting racial and ethnic health data which is a huge disservice to our diverse Canadian population7. Race and ethnic-specific data are essential in identifying disparities, assessing the gaps in current policies, and determining the need for targeted public health interventions. Since we do not collect breastfeeding rates by race in Canada, here is a look at data from the United States.
Despite breastfeeding being the ideal choice, racial and ethnic disparities are significant. The CDC reported in 2022 that among children born in 2021 in the US, 84.1% of mothers reported initiated breastfeeding, 59.8% were breastfeeding at 6 months, and 27.2% were reported to be exclusively breastfeeding8. When we compare this to rates of Black mothers, only 75.4% reported any initiation of breastfeeding, 51.7% reported breastfeeding at 6 months, and 24.4% exclusively breastfed at 6 months8. Not only are these rates much lower than the national averages, but they are the lowest for any racial group.
These numbers show that although Black women’s intent to breastfeed is relatively high, many who do initiate do not continue to breastfeed up to 6 months. This suggests that Black breastfeeding families need better support systems to reach and maintain their breastfeeding goals.
What are the Barriers?
In order to improve the health outcomes for Black mothers and children, we need to understand the barriers they face.
Historical and Cultural Barriers
Although many African cultures have strong traditions of breastfeeding, many of these cultural practices were stripped and tarnished for Black women during slavery. For example, it wasn’t uncommon for Black women to act as “wet nurses” and be forced to breastfeed their enslavers’ children9, 10. All while their own babies were taken from them, causing them to become very sick or malnourished10,11.
As slavery was abolished, Black women often needed to help provide for their families. The demanding work conditions did not allow time or access to breastfeed10. Many children were watched by other family members, and therefore continued to receive breastmilk substitutes. This generational trauma led to a cultural disconnect from Black mothers naturally breastfeeding their children and continues to impact Back women’s decisions about breastfeeding.
Systemic Barriers
Black mothers are often inadequately supported by the healthcare system. Many Black women report differential treatment from healthcare providers regarding breastfeeding and a lack of breastfeeding education and supports12. This perpetuates greater disparities, as research shows that encouragement from healthcare professionals is a facilitator in breastfeeding success.
Social and Economic Barriers
Black women are more likely to need to return to work sooner than other racial groups12. Many face inflexible hours or lack the resources to breastfeed or pump at work. Black women are also twice as likely than White women to report being given formula-feeding advice rather than breastfeeding advice from healthcare providers11.
These are only some of the many barriers that Black women face when deciding to breastfeed. It is clear that more awareness, support, and advocacy are needed for this community. So how can we achieve this?
Advocacy
Whether you are a Black mother yourself, a healthcare professional, or an ally looking to support the community, there are ways to support Black mothers. Educating yourself and getting involved in initiatives like Black Breastfeeding Week is a great step to help build a community that empowers Black mothers. Closing the breastfeeding gap requires healthcare providers to check their biases and be mindful of the added barriers that impact Black women in healthcare. Organizations and institutions can diversify their staff to include more Black dietitians, lactation consultants, and healthcare workers to increase representation for our Black women. Canada’s data collection practices should be updated to accurately display racial and ethnic data. Collecting this data would allow for more culturally relevant research to be performed and lead to more evidence-based resources that support the unique needs of the black community.
By understanding the benefits of breastfeeding, recognizing and addressing the disparities and barriers, and advocating for better support systems we can work towards a future where Black mothers feel just as supported as the rest of Canadian mothers, and are empowered to give their babies the best possible start in life.
For more information and resources on supportng Black breastfeeding mothers, check out Reaching Our Sisters Everywhere (ROSE) and Black Mother’s Breastfeeding Association. If you are in the Kitchener region, Breastfeeding Buddies is a wonderful culturally inclusive resource for breastfeeding support.
Desiray Tynes is a dietetic student and aspiring dietitian. She seeks to help her community improve its nutrition goals through food literacy and programming initiatives. As a BIPOC woman, she is passionate about increasing representation and cultural competence in healthcare. She loves cooking and trying new foods and is a firm believer of “everything in moderation”.
References:
1. Celebrating the Significance and Impact of Black Breastfeeding Week – USLCA [Internet]. [cited 2024 July 31]. Available from: https://uslca.org/amplify/celebrating-the-significance-and-impact-of-black-breastfeeding-week/
2. Canada PHA of. Breastfeeding your baby [Internet]. 2002 [cited 2024 July 31]. Available from: https://www.canada.ca/en/public-health/services/child-infant-health/breastfeeding-infant-nutrition.html
3. Gyamfi A, O’Neill B, Henderson WA, Lucas R. Black/African American Breastfeeding Experience: Cultural, Sociological, and Health Dimensions Through an Equity Lens. Breastfeeding Medicine. 2021 Feb;16(2):103–11.
4. Muro-Valdez JC, Meza-Rios A, Aguilar-Uscanga BR, Lopez-Roa RI, Medina-Díaz E, Franco-Torres EM, et al. Breastfeeding-Related Health Benefits in Children and Mothers: Vital Organs Perspective. Medicina. 2023 Sep;59(9):1535.
5. Jones KM, Power ML, Queenan JT, Schulkin J. Racial and Ethnic Disparities in Breastfeeding. Breastfeeding Medicine. 2015 May;10(4):186–96.
6. DeVane-Johnson S, Giscombe CW, Williams R, Fogel C, Thoyre S. A Qualitative Study of Social, Cultural, and Historical Influences on African American Women’s Infant-Feeding Practices. J Perinat Educ. 2018;27(2):71–85.
7. The Royal Society of Canada [Internet]. 2020 [cited 2024 Aug 2]. Race and ethnicity data collection during COVID-19 in Canada: if you are not counted you cannot count on the pandemic response. Available from: https://rsc-src.ca/en/race-and-ethnicity-data-collection-during-covid-19-in-canada-if-you-are-not-counted-you-cannot-count
8. Results: Breastfeeding Rates | Breastfeeding | CDC [Internet]. [cited 2024 July 31]. Available from: https://www.cdc.gov/breastfeeding/data/nis_data/rates-any-exclusive-bf-socio-dem-2020.htm
9. Aderibigbe O, Lucas R. Exclusive breastfeeding in African American women: A concept analysis. Journal of Advanced Nursing. 2023 May;79(5):1699–713.
10. Black Breastfeeding Week: The importance and resilience of Black breastfeeding mothers – The Lactation Network [Internet]. [cited 2024 Aug 1]. Available from: https://lactationnetwork.com/blog/the-reslience-of-black-breastfeeding-mothers/
11. Mieso BR, Burrow H, Lam SK. Beyond Statistics: Uncovering the Roots of Racial Disparities in Breastfeeding. Pediatrics. 2021 May 1;147(5):e2020037887.
12. Tran V, Masterson AR, Frieson T, Douglass F, Perez-Escamilla R, Duffany KO. Barriers and facilitators to exclusive breastfeeding among Black mothers: A qualitative study utilizing a modified Barrier Analysis approach. Maternal and Child Nutrition. 2023 Jan;19(1):e13428.
