by Allison Laverty Montag IBCLC and Anne Eglash MD, IBCLC, FABM
Does racism affect breastfeeding initiation and duration rates among black women? Black women in the USA continue to have lower breastfeeding rates as compared to white women. Based on breastfeeding stats from 34 states for 2010-2013, the breastfeeding rates for initiation, exclusive breastfeeding at 6 months, and breastfeeding at 12 months were 64.3, 14, and 17.1% respectively for blacks, as compared to rates of 81.5%, 22.5%, and 30.8% for white women.
According to the authors of the study for this week’s CQW, experiences of racism have been associated with asthma, obesity, breast cancer, and poor birth outcomes in black women in the USA. Exposure to racism creates adverse physiological responses to the stresses associated with racism, such as poverty, economic and social deprivation, inadequate health care, and many other societal inequities. There has not been much research exploring the association between racism and breastfeeding rates.
This study explored the link between experiences of racism, neighborhood segregation and workplace policies on breastfeeding initiation and duration among 2,172 black mothers who participated in the Black Women’s Health Study. All participants were first-time mothers who completed a racism assessment prior to birth, initiated breastfeeding, and had full-term births.
Which of the following statements do you think were found to be true in this study? (choose 1 or more)
- Living in a predominately black or mixed neighborhood up to age 18 was associated with lower odds of breastfeeding at 6 months.
- Women who reported experiences of racism in the housing setting had lower odds of breastfeeding at 3-5 months.
- Women whose mothers and fathers were born within the USA had significantly higher odds of initiating breastfeeding compared with women whose parents were born outside of the USA.
- African-American women were half as likely to breastfeed for 6 months as white women in the same environment where there were policies in place to support breastfeeding.
- Women reporting experiences of racism with the police had significantly higher odds of initiating breastfeeding compared with women not reporting racism with the police.
See the Answer
A,B,D,E are true. C is false.
J Racial Ethn Health Disparities. 2018 Feb 12. doi: 10.1007/s40615-018-0465-2. [Epub ahead of print]
Experiences of Racism and Breastfeeding Initiation and Duration Among First-Time Mothers of the Black Women's Health Study
Griswold MK, Crawford SL, Perry DJ, Person SD, Rosenberg L, Cozier YC, Palmer JR
Breastfeeding rates are lower for black women in the USA compared with other groups. Breastfeeding and lactation are sensitive time points in the life course, centering breastfeeding as a health equity issue. In the USA, experiences of racism have been linked to poor health outcomes but racism relative to breastfeeding has not been extensively investigated.
This study aims to investigate the association between experiences of racism, neighborhood segregation, and nativity with breastfeeding initiation and duration.
This is a prospective secondary analysis of the Black Women's Health Study, based on data collected from 1995 through 2005. Daily and institutional (job, housing, police) racism, nativity, and neighborhood segregation in relation to breastfeeding were examined. Odds ratios and 95% confidence intervals were calculated using binomial logistic regression for the initiation outcomes (N = 2705) and multinomial logistic regression for the duration outcomes (N = 2172).
Racism in the job setting was associated with lower odds of breastfeeding duration at 3-5 months. Racism with the police was associated with higher odds of breastfeeding initiation and duration at 3-5 and 6 months. Being born in the USA or having a parent born in the USA predicted lower odds of breastfeeding initiation and duration. Living in a segregated neighborhood (primarily black residents) as a child was associated with decreased breastfeeding initiation and duration relative to growing up in a predominantly white neighborhood.
Experiences of institutionalized racism influenced breastfeeding initiation and duration. Structural-level interventions are critical to close the gap of racial inequity in breastfeeding rates in the USA.
Milk Mob Comment by Allison Laverty Montag IBCLC and Anne Eglash MD, IBCLC, FABM
There is much to learn about health disparities and the long reaching effects toxic stress due to racism has during pregnancy, birth, through the mother’s life and the effect on the unborn fetus.
It’s indisputable that experiences of racism in the United States leads to negative health outcomes, putting black mothers and infants at risk. The socioeconomic and psychological outcomes of racism lead to the wear and tear on cardiovascular, metabolic and immune systems which makes individuals more vulnerable to illness and even death.
Simply improving prenatal and postpartum medical care is not sufficient to improve health outcomes. The best preventive strategy is for society to address and mend the other determinants of health highly influenced by racism.
The study authors note, “For black women in the USA who may identify with constructs of cultural strength, resilience and resistance, breastfeeding likely occurs in spite of experiences of racism, not because of experiences of racism.” We can work together to highlight the power and resilience of black women so we can improve the early life experiences of children which can be carried on to the next generation.