Understanding Breastfeeding Barriers at an Urban Pediatric Practice
Lydia Furman1, Julia Feinstein2, Sarah Delozier3
1Division of General Academic Pediatrics, Case Western Reserve University School of Medicine and Rainbow Babies and Children's Hospital, 11100 Euclid Avenue, MS 6019, Room 784H, Cleveland, OH, 44106, USA. Lydia.Furman@uhhospitals.org.
Insights
African American mothers face breastfeeding inequities. Customized lactation support, beyond family help, is crucial for achieving breastfeeding goals and reducing disparities.
Area of Science:
- Public Health
- Maternal and Child Health
- Health Equity
Background:
- Breastfeeding offers significant health benefits for mothers, infants, and society.
- Historic structural racism contributes to low breastfeeding rates and racial inequities, particularly within the African American community.
- The Rainbow Center for Women and Children (RCWC) serves a predominantly African American, WIC-eligible, and publicly insured population, highlighting the need for targeted support.
Purpose of the Study:
- To investigate factors influencing breastfeeding practices among African American mothers at the RCWC.
- To identify potential supports that can be implemented to enhance breastfeeding success.
- To address racial inequities in breastfeeding within this specific urban health center context.
Main Methods:
- A two-cohort study was conducted with exclusively African American women.
- Wave 1 included mothers with diverse feeding practices (exclusive breastfeeding, mixed feeding, formula feeding).
- Wave 2 included expectant mothers considering breastfeeding.
Main Results:
- Breastfeeding attitudes among mothers who had breastfed (exclusively or mixed) were similar to expectant mothers planning to breastfeed, with overall neutral attitude scores.
- Participants reported support from partners and family for their feeding choices.
- Despite personal support, women require assistance in accessing available resources for breastfeeding help.
Conclusions:
- Personal and familial support are important, but access to additional lactation resources is vital for breastfeeding success.
- Tailored lactation support, focused on helping women achieve their individual breastfeeding goals, is optimal.
- Customized care strategies hold the potential to reduce racial disparities in breastfeeding rates.
Abstract:
Breastfeeding is the optimal nutrition for infants given the numerous health benefits that are conferred on mothers, infants, and society in a dose-dependent manner. However, low breastfeeding rates and racial breastfeeding inequities persist for the African American (AA) community due to historic structural racism. The issue is especially salient at the Rainbow Center for Women and Children, an urban health center in Cleveland, Ohio where approximately 90% of their mothers are AA, WIC-eligible, and publicly insured. Our study aims to elucidate factors contributing to breastfeeding practices and identify supports that could be added for women served at RCWC. The study was conducted within 2 cohorts both of exclusively AA women. Wave 1 of the study included AA mothers who exclusively breastfed, did mixed feeding, or exclusively formula fed. Wave 2 included expectant women at least considering breastfeeding. Breastfeeding attitudes of those who had exclusively breastfed or practiced mixed feeding were not significantly different than those of expectant participants planning to breastfeed; mean attitude scores, however, were in the "neutral" range. Participants endorsed many sources of support for their feeding choices, including the infant's father, their own parents, and family. However, the data show that even when women feel personally supported in their feeding choices by their partner and family, if additional breastfeeding help is needed, they will benefit from help accessing available resources. Thus, lactation support that helps women achieve their own breastfeeding goals is optimal; customized care ultimately can move the needle on racial inequities in breastfeeding for our society.
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