Expert Weighs in: Black Moms Breastfeeding

There have been alarming facts emerging about black maternal mortality and the difficulty of breastfeeding. However, social media has done a great job highlighting beautiful images and testimonies of early black motherhood.

Still, black women have the lowest breastfeeding rate of any racial group. Why is that?

I had the pleasure of asking Ayanna Robinson a few questions about the importance of breastfeeding in the black community. Keep reading to see what Ayanna has to say about the healthcare system, supporting breastfeeding moms, and other related topics.

Ayanna Robinson, Ph.D., MPH, is a public health professional and a maternal and child health advocate with over 10 years of experience conducting research, program evaluation, and program planning.

She founded Black Girls’ Breastfeeding Club, LLC. in 2016. As a public health researcher and evaluator, she is committed to researching and translating that research into initiatives and products that center the voices and experiences of marginalized communities.

In 2020, she launched bEarth work to connect Black women and birthing individuals to online classes taught by Black birth workers. The areas of public health that Dr. Robinson is most passionate about are decreasing maternal morbidities and mortalities and improving breastfeeding rates among Black mothers.

When did you first realize racial and ethnic disparities in breastfeeding?

I started my Master of Public Health (MPH) degree at Morehouse School of Medicine as a breastfeeding mom when my daughter was 9 months old. As a public health student interested in nutrition and women’s health, I began to learn more about the breastfeeding disparities among African American mothers and the barriers to breastfeeding.

I realized that despite the protection breastfeeding provides against many health outcomes that disproportionately affect Black women, this population falls short of meeting national and international recommendations. 

I focused my Master’s and doctoral studies on breastfeeding. As a doctoral student, I explored the use of digital technology to support breastfeeding outcomes. My dissertation research, published in the peer-reviewed journals Digital Health and Journal of Human Lactation, and featured on Baby Center, applied Black Feminist Theory to explore the breastfeeding experience and outcomes of Black mothers who participate in mom-to-mom support groups on Facebook..

Why has the breastfeeding experience been so vastly different for white mothers and African American mothers in the United States?

This is a great question, and the answer is complex. It is helpful to consider the social-ecological model, which looks at factors from the individual to the societal level when considering breastfeeding disparities in the U.S.

For example, barriers among African American mothers commonly identified in the literature include sociocultural norms and attitudes, embarrassment with public breastfeeding, returning to work, self-efficacy, implicit and explicit bias, and lack of culturally congruent support among health care providers, as well as, the lack of social support from family, peers, and workplaces.

 The differences in experiences can also be attributed to structural barriers rooted in systemic racism. I mentioned that experiencing apathy and bias from health care providers is more often reported among Black mothers.

For example, Black women more often report receiving encouragement from providers to formula feed, in comparison to White mothers. In one study, Black women were significantly more likely to be offered formula at the hospital in comparison to white mothers, which can impact breastfeeding duration.

Finally, at the community and societal level, we can further explore historical factors, like wet nursing and targeted formula marketing, which has had lasting effects on how African American communities view breastfeeding and still impact norms surrounding breastfeeding among African Americans today.

How can the black community benefit from black women giving their children breast milk rather than choosing to give their children formula?

Breast milk is the optimal food for infants because of its many nutritional and immunological properties, which lead to short- and long-term benefits for mothers and their children.

As I mentioned, the benefits of breastfeeding include protection against multiple chronic illnesses and other health outcomes in which African Americans are disproportionately represented, including diabetes, sudden infant death syndrome or SIDS, gastrointestinal infections, asthma, childhood obesity, breast cancer, and ovarian cancer.

Black mothers also have the highest rates of preterm births. Therefore, the benefits of breastfeeding are even more essential for preterm infants and include ease of protein digestion and lower incidence of serious infectious disease. In addition, cognitive and neurological benefits of breastfeeding have also been observed in preterm infants.

Based on the improved health outcomes observed among breastfed infants, efforts to increase breastfeeding among Black infants have the potential to improve health outcomes and have significant lasting effects.

Moms also receive benefits from breastfeeding, including lowering the risk of high blood pressure and diabetes, again chronic diseases where we observe high rates among African Americans. So breastfeeding is an investment in health.

How can the black community better support black women in their breastfeeding journeys?

Supporting Black women in their decisions to breastfeed for as long as they desire is critical. Breastfeeding support is a factor in predicting breastfeeding success or if a mother will achieve her breastfeeding goals.

The maternal grandmother and child’s father can be particularly influential in a mother’s breastfeeding decisions.For family members, support can look like helping a breastfeeding mother with household tasks or providing encouragement and reassurance for her decision to breastfeed. Ask her how you can support her. She will let you know.

On a community level, the more we see a behavior practiced and encouraged, the more it is reinforced as the norm. Unfortunately, mothers still receive negative feedback when breastfeeding in public, which can deter a mother from breastfeeding. Instead, we should be celebrating mothers breastfeeding whenever, wherever.

What role can social media play in positively changing breastfeeding rates amongst black women?

Across studies examining the use of social media among mothers, social media was used by mothers to exchange peer support. Therefore, social media, and specifically support groups for breastfeeding mothers on social media, can provide an alternative method to receiving breastfeeding support to overcome challenges.

Social norms are sociocultural beliefs and implied group rules about appropriate behavior. Social norms for breastfeeding influence breastfeeding outcomes as well. Whereas several studies conducted with African American mothers highlight the lack of breastfeeding images of African American women in the media as factors that contribute to social norms that support bottle feeding over breastfeeding, seeing images of Black women breastfeeding on social media can reinforce breastfeeding as the norm.

This is one reason why imagery, specifically the representation of Black breastfeeding mothers in the media, is essential. Like other forms of mass media, social media exposure can positively influence breastfeeding outcomes.

What can one expect from a breastfeeding support group for black moms?

In my study on social media support and breastfeeding outcomes, I found that a significant reason moms joined these social media groups and received support was for the community and connections formed with other Black moms.

You can gain community and peer support in these groups, including breastfeeding information, support, and encouragement. In addition, certified lactation support professionals moderated many breastfeeding support groups on social media, which helps ensure that group members receive accurate information and helpful resources along their breastfeeding journeys.

Participants in my study also described the convenience of social media breastfeeding support groups. For example, your doctor’s office or even your IBCLC may only be available during business hours, but you can log onto your social media group at any time and ask questions, receive feedback, or even praise for reaching your breastfeeding milestone or overcoming a challenge.

It was a positive experience for the women who participated in my study, and some described how their groups influenced their thoughts about how long women should breastfeed, i.e., breastfeeding norms, and enhanced their confidence in continuing breastfeeding.

Finally, African American mothers in this study reported significant support for breastfeeding within their social media support group compared to their other sources of breastfeeding support. Social media support groups, therefore, may compensate for lower amounts of support received in other settings and may also be used to support mothers in breastfeeding long-term.

What can Black breastfeeding mamas and black pumping moms do to ensure they are breastfeeding in the most beneficial way?

Breastfeeding moms, whether pumping exclusively or feeding from the breasts, should know that although breastfeeding is natural, it is still a learned skill. Therefore, I recommend taking a prenatal breastfeeding education class.

Prenatal breastfeeding education is recommended during the third trimester of pregnancy, and mothers who receive breastfeeding education are more likely to breastfeed.

These classes provide information to get mamas off to the best start, including signs of effective breastfeeding and correct latching positions. You can gain knowledge, skills, and confidence in your breastfeeding ability, which are all crucial factors for meeting breastfeeding goals.

It is helpful to know where to get help if you experience challenges, so locating a lactation support professional, e.g., International Board Certified Lactation Counselor or IBCLC, who can provide support if you experience challenges is also essential. We have more information on preparing for breastfeeding on our website.

Where Can Black Women find Black Lactation Consultants, lactation support, and other support for breastfeeding mothers?

We have several resources for locating peer breastfeeding support groups for Black moms and lactation support from professionals on our website.

You can find our directory of breastfeeding support groups here.

You can also find online prenatal breastfeeding education classes and postnatal breastfeeding support from Black lactation professionals on our bEarth Work app.

Supporting BlackBreast Feeding Moms

Black breastfeeding week is a great time to support the black pumping and breastfeeding mammas in your life. But, there are plenty of ways to support a breastfeeding mama. Especially during what can be the most beneficial decision for her and her child’s life.

I hope you were able to take away a few gems from this interview. Please connect with Ayanna through her website or take advantage of the educational services she offers on her bEarth Work app

Check out our other bloom interviews with BIPOC experts:

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