Sahira Long

    What Can We Do To Increase Breastfeeding Rates in the African American Community?

    Posted February 23rd, 2012 by

    Recently MedStar Georgetown University Hospital became the first maternity facility in the nation’s capital (in fact the entire Washington Metropolitan area) to achieve elite designation as a Baby Friendly Hospital. As president of the D.C. Breastfeeding Coalition, I applaud this achievement. I personally witnessed the tremendous work and dedication it took for all involved including the hospital’s executive leadership, the lactation services department and the entire maternal and child healthcare team to achieve this honor.

    I’m conflicted, however, because I work on the other side of the city, in an area of the District that consists primarily of African American families that do not benefit from the services provided by MedStar Georgetown. Many of the mothers I counsel choose against breastfeeding, most refuse to even try. These mothers often express that they are comfortable giving formula because it has worked for so many of them and their friends. In fact, 2006 CDC data indicated that while 97percent of non-Hispanic Whites in the District initiate breastfeeding, only about 55 percent of non-Hispanic Blacks do. My fear is that the disparity in breastfeeding rates will only increase unless facilities closer to where I work follow Georgetown’s lead. As Georgetown celebrates, I struggle to find financial support to keep the only lactation support center on our side of town open.

    Many of the women I serve are living proof that the “Breast is Best” message doesn’t resonate in our community. Last week, I actually convinced a mother to try breastfeeding for the first time with her third child after an extensive discussion of the risks of NOT breastfeeding. When she returned with her other children, she disclosed that she was no longer breastfeeding but remarked that I was the first person that was successful in getting her to try. Perhaps her next child will be breastfed for longer than two weeks.

    To the MomsRising community, I’d like to pose a question: What more do you think the African American, breastfeeding and medical communities can do to encourage more African Americans to start and continue breastfeeding?

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    March 27, 2012 at 9:23 pm by Shafia Monroe

    There are numerous actions we can take to promote breastfeeding in the African American community. Personally I breastfed all seven of my children past age one and close to two years. I also would breastfeed my sisters babies when they had to run errands and breastfed my grandson for a short time as well because I was still breastfeeding my own baby at the time, and they were only 6 weeks a part.

    I think systemically we need more girls groups like the International Center for Traditional Childbearing (ICTC), Sistah Care program, a girls program for ages 11-17 after school program, the girls learn about breastfeeding early in life and our successful with when they have babies later in life. I also believe having more Community Based Doula programs also will help increase breastfeeding rates, and lastly, talking to our sons on the benefits of breastfeeding.

    It has gotten better, it will be full circle soon. Black folks breastfed up until the late 1950′s. We all be back soon.



    March 6, 2012 at 12:40 am by Truth B. Told

    My Black mom breastfed me and her Black mom breastfed her. I and many of my friends have breastfed their babies either partially or exclusively. We are all a mix of either high school educated, as well as some graduate or college educated, 27-45 years of age, Black women. The number one reason most of us breastfed was because our babies’ fathers and/or our husbands were educated on the benefits of breastfeeding. They wanted their sons and daughters to perform better in school, not get as sick as much,have better smelling bowel movements in the beginning, and to save on the cost of formula.Once the men were persuaded, the women will comply. There are more Black moms that have breastfed then reported!
    As for the Black mom,when she realizes that 1) breastfeeding will hurt at the beginning 2) supplementing with formula is not a crime so the baby does not drop the 10% in weight , 3) and that their milk will definitely come in after a week or so, she can be a success at breastfeeding. Whether they breastfeed for 2 months or 2 years, breastmilk is good for our babies!
    One thing I have noticed is that Black mothers are reluctant to ask for help. when they do, the breast feeding specialists are either not Black or have not had a baby! Therefore breastfeeding peer counselors who are also Black and who actually BREASTFED their baby would help the new mothers.
    Another suggestion would be advertising. I remember a letterhead with a drawing of a Black mother with an afro breastfeeding her baby in a rocking chair. It was titled,” Breakfast at Mom’s”. Cute and to the point!


    February 24, 2012 at 7:35 pm by A. Hayman

    In my oppinion a new mother has to be committed to bf before she has the baby. It is reaching the mothers at the first prenatal visit or when they register at various baby stores. Having a two column fact card on the benefits of bf over formula with a website for classes would have been helpful. I hear from so many mothers if I had someone to help me /educate me on the benefits bf I would have done it. I can testify that having a friend that was a lactation specialist saved me from giving up after battling thrush for three months which was extemely painful but not knowing what it was I almost gave up. The second thing I heard was women giving up because of pain. Mothers need to be reassured that this pain is temporary and that once you get over the initial hump bf is EASY!!!! No pain at all. Is there a league of bf mothers who volunteer their time to help educate/support future moms?


    Sahira Long Reply:

    @A. Hayman,
    Our lactation support center offers free prenatal breastfeeding education classes, postpartum lactation consultations including back to work, and mom-to-mom?support groups. Families are invited for all components because we want to do our best to educate the mom’s support system as they will be crucial to her success outside of our center. Although I wholeheartedly agree with the need for and importance of workplace support, many of the moms who refuse to try breastfeeding are unemployed. Fortunately, there is a law in DC that requires employers to provide time and a sanitary non-bathroom location to pump (this provision was in place before the same support was made available through the Affordable Care Act). We do, however, have work to do in order to ensure that moms are aware of these rights when they are making feeding decisions during the pregnancy.


    Gia Daniel Reply:

    @Sahira Long, I would like to add that we are seeing more and more hospitals making it difficult for women to NOT breast feed their infants. The goal is admirable, but the method is not. We cannot be “nipple nazis” springing on the newly post partum women that there will be rooming in, they are responsible for the newborns’ care, and the lone lactation consultant nurse who works five days a week and is only part time is their sole support system because the bedside nurses are busy running around doing other things. I’m very much pro breast feeding, but I also get mothers who are pre-eclamptic and on Magnesium Sulfate, mothers who come in with positive urine toxicology screens, and women who just don’t want to start breast feeding because they will be returning to work in six weeks and won’t be able to easily continue.
    And now … now the information about GMO (genetically modified organisms) is coming forward more … and baby formula is produced by the companies who are making these substances and they are getting fed to newborns, on top of what their mothers ingested during pregnancy.
    There has to be a better way, to guide the women to want to breastfeed and to feel comfortable doing so, short of guilting and making it inconvenient for her in the hospital to do anything else.


    February 24, 2012 at 11:53 am by J. Britt

    Education is key. I was a postpartum RN in St. Louis before moving to TX in Nov. 2011. Most African American moms(and their families) that i cared for were very ignorant about breastfeeding. Many didn’t want to try, mostly because of the lack of support from their families. I’d often try explaining the benefits of breastfeeding WHILE the family was present, because I knew that they had to be educated as well if the patient was going to be successful at home. I had one father encourage formula use because he thought it had “better stuff in it” than breastmilk did, like DHA. Then, there is this entire negative image of a baby on the breast that many of them didn’t like. It was often frustrating, so I often tended to give my all to those who really wanted to nurse.


    February 23, 2012 at 10:47 pm by Allison Espeseth

    Breastfeeding – particularly for first time moms – requires so much positive support. It can be such a time-intensive, delicate process, particularly in the beginning, that it is so easy to give up thinking either it’s not working or it’s not worth it. I imagine the support community and the belief that others will not look sideways at you both need to be developed over (most likely) a long period of time and dogged investment.


    Anita Reply:

    I was completely committed to breastfeeding, but in the haze of postpartum and continuing pain, I absolutely depended on every positive supportive comment and piece of advice I got. From friends, family, the community, church members, lactation consultants– anywhere I could get support, I soaked it in. Sometimes it was all that kept me trying! But I did, and I’m so glad.


    February 23, 2012 at 5:38 pm by Carmen

    I think this is an important public health issue to address too. I have the same questions as Cindy- on community and partner support. I think the work question is a BIG one- how many of these mothers return to work at the 6 week or earlier mark, often to jobs that are not friendly or conducive to pumping breaks? There might be a “why even start” attitude, if you know that in a few weeks you won’t be able to continue. I admire you, Dr. Long for addressing this important issue. Education is crucial, and I believe in this case it has to come from within communities, not from “outsider” educators. And educating fathers is perhaps equally important- without the support of my husband breastfeeding would not have been an easy journey. But the “you can do it” attitude, in addition to simple acts like doing dishes while I nursed or bringing me cups of Mothers Milk tea made all the difference.


    February 23, 2012 at 2:39 pm by Cindy Johnson

    Do women who feel they don’t want to consider breastfeeding have a reasonable place to pump, once they go back to work?
    Do they have spouses or partners or family members who are also being educated about the importance of breastfeeding? Sometimes it takes a lot of support.
    14 years ago when I was breastfeeding my baby, I had a phone number for Nursing Mothers. I called a volunteer, and she helped me with problems I was having. I nursed my baby into toddlerhood, and she is doing great as a teenager now. But it took help from Nursing Mothers and support from my husband to get there.



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