Maternal mortality rates are highest among Black women and have recently been highlighted in the news and on social media by celebrities like Amy Schumer after the death of 26-year-old Sha-Asia Washington in New York. With such poor maternal outcomes for women of color, it’s no surprise that our community also has the worst outcomes for breastfeeding.
The Healthy People 2020 goals for breastfeeding are that 81.9% of mothers initiate breastfeeding, with 61% and 34% continuing at 6 and 12 months, respectively. Black women have the lowest rates of both breastfeeding initiation and continuation among all racial/ethnic groups. Compared to white women, Black moms are 2.5 times less likely to breastfeed.
Why are breastfeeding rates so low among Black women? Research points to several factors that influence breastfeeding initiation, including, but not limited to:
- Time and convenience of formula, especially if there is no strong conviction about breastfeeding
- Cultural beliefs/attitudes toward breastfeeding in the Black community
- Lack of support in personal relationships, in healthcare and at the community level
- Socioeconomic factors
- Lifestyle choices
- Lack of lactation resources and education
- Workplace barriers such as little flexibility at work and lack of benefits
- Inequity in access to healthcare
When I (Sierra) think about my breastfeeding journey, beliefs, and attitudes toward breastfeeding within my community had the greatest impact on me. Growing up and even into adulthood, I rarely saw anyone I knew breastfeeding. I recall seeing only one close friend breastfeeding before I had my first child. Luckily, through my graduate degree training, I came to understand the benefits of breastfeeding for both mom and baby so I knew it was something I wanted to try, but I really had no idea what to expect when I began my journey. I breastfed my son for 14 months and my daughter for 11 months. There were many times I wanted to quit, but I felt like I needed to continue to prove to my family, my community, and myself that I could do it.
I found that with both kids, but especially with my first, I was always questioned by my family about breastfeeding. Was he getting enough milk? Are you going to keep breastfeeding? Why don’t you try some formula? At times, the questions felt like a jab at my choice to breastfeed. However, I came to understand that my family didn’t mean harm in their questions. Breastfeeding was just something they didn’t do or really understand. As I learned about all things breastfeeding, I was simultaneously educating my family.
I (Paula) was about 10 or 11 years old when I witnessed a mother nursing her child. I had no idea what she was doing, I honestly thought she was simply holding her son close, maybe to quiet him down or put him to sleep. It wasn’t until months later when I helped babysit her son that I realized she was a breastfeeding mother. I remember asking this mom about the baby’s bottles and she told me that he didn’t take bottles. I was slightly confused, but I didn’t think twice about it.
Fast forward to my first pregnancy. Like many couples, my husband and I were talking about expenses for the nursery, clothes, diapers and I added in baby formula. I mentioned the high cost of formula, he mentioned breastfeeding. It wasn’t totally foreign, but I hadn’t thought about it since that babysitting job. It was my husband who was then the breastfeeding advocate and I was all in because it was free milk. I had no idea of all of the benefits that come with breastfeeding for both my children and me.
When I started my journey, I attended a class at a local hospital; I was the only mother of color. I kept seeing the “breast is best” campaign on my way to the meeting room, but still had no idea why. I sat in that class with those women and felt so out of place. Instead of returning to the class, I turned to Google for my answers. That is where I was able to find resources and groups specifically for women like me, Black women.
In the early weeks of breastfeeding, I (Sierra) had a similar experience to my friend, Paula. I attended a handful of breastfeeding support groups offered at the hospital at which I delivered, but in those groups, I never encountered anyone that looked like me, among the moms or lactation consultants. Even in the Facebook support group, there were hardly any women of color asking questions and/or providing advice and support. The lack of representation made me feel uncomfortable and as if I didn’t belong. I asked myself, “Is there room for me?”
Access to lactation resources and education is so important for breastfeeding success, but Black women are often absent or underrepresented in the spaces where these resources and education are offered. I (Sierra) was lucky that I connected with a woman I knew through my church who happened to be a lactation specialist. She looked like me. She listened to me. She supported me and helped me navigate the first year of breastfeeding. Sadly, that’s not the experience for all Black women.
I (Paula) did not have the same experience as Sierra. I was unable to connect with other women even though I had found the groups online. I had a cesarean that kept me from driving for 8 weeks, then came the snowy and icy winter roads. I went through the journey, all of the highs and lows of breastfeeding for about 16 months. In the beginning, I tearfully scrolled through Google trying to make sense of the information in addition to taking on critical questioning similar to what Sierra had to endure. It was a pretty lonely experience.
Our stories, while unique to us, only give a glimpse into the complex issues Black moms face. If breastfeeding rates are to improve among Black mothers, there has to be a greater effort to ensure that education and resources are targeted towards and inclusive of Black women at all levels, from healthcare providers to leaders in the lactation community, to moms themselves. We have to ensure that the voices of Black women are elevated in spaces dedicated to helping mothers succeed in the amazing, challenging, beautiful journey that breastfeeding is. One day, we hope Black women no longer have to ask “is there room for me?” and that breastfeeding is normalized, accepted, and adopted more among our people.
Breastfeeding resources for Black women:
Black Mamas Matter Alliance / @blackmamasmatter
Chocolate Milk: The Documentary Series / @chocolatemilkdoc
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