Breastfeeding provides infants and mothers with lasting health benefits. Breastfed infants have reduced risk for ear, respiratory, and gastrointestinal infections and may be less likely to develop asthma, obesity, and diabetes. Mothers who breastfeed have a lower risk of developing type 2 diabetes, hypertension, and breast and ovarian cancers.
Even though numerous studies have shown the benefits of breastfeeding, only about two-thirds of Mississippi mothers report ever breastfeeding—the lowest in the nation. And the breastfeeding rates among Black mothers are even lower. The disparity in breastfeeding initiation and duration in Mississippi has been known for a while, but the question Aleshia Jones, a Gulfport lactation counselor, asks is: why?
Although the Mississippi Gulf Coast population is approximately 40 percent African American, there are few Black clinicians in Gulf Coast hospitals and clinics, and this lack of representation has been cited as a reason for lingering trust issues between Black women and healthcare providers.
Jones has made it a part of her lifework to offer her services and words of encouragement to her community at no cost. Neighbors, members of her local church, and many women often find her by word-of-mouth referrals, noting her reputation as a staunch advocate for the health and well-being of Black babies and mothers. Her reputation and commitment are also a large part of the reason she was the first recipient of the SHEA (Sharing Health Education and Awareness) Myrtle Evelyn Davis Public Health Trailblazer Award in 2019.
Breaking Down the Barriers to Breastfeeding
According to a 2015 survey conducted by the National Immunization Survey-Child, Black women were more likely than their white counterparts to have incomes at or below the federal poverty level and receive Special Supplemental Nutrition Program for Women, Infants, and Children benefits. The Centers for Disease Control and Prevention (CDC) shares these and other statistics on its website as contributing factors to the racial breastfeeding disparity in the United States. However, this selection of data points only tells part of the story. Jones adamantly asserts “feeling like you have that support and encouragement” is the main barrier Black mothers face, and it is not represented in the majority of surveys.
These data points do not display or demonstrate the sustained and significant barriers of entry Black women face when it comes to breastfeeding. For example, some Black women may not be prepared to breastfeed after delivery because they have not been provided adequate information or support. A recent PBS NewsHour article cites CDC research that shows hospital maternity wards serving larger Black populations are less likely to help Black women initiate breastfeeding after giving birth or offer lactation support following delivery. Black mothers are more often offered formula, which is often seen as convenient, especially when Black mothers tend to have to return to work shortly after giving birth and are confronted with “inflexible work hours” that make nursing and expressing milk extremely difficult.
Jones says that having two children under the age of three at home also makes breastfeeding more challenging, and she urges healthcare providers and community advocates to change their perspective on who needs breastfeeding support and who faces obstacles. “We have to get out of the mind-frame that African American women on the Gulf Coast are automatically low-income and that they’re the only ones suffering,” says Jones. She emphasizes that there are plenty of women from various backgrounds facing the same barriers.
Healthcare providers and advocates need to understand the specific cultural and social norms for Black women across the socioeconomic spectrum. Jones explains that a lack of diversity in hospitals and healthcare settings, specifically a lack of Black women in key roles, is a hindrance to Black women breastfeeding.
“It can be difficult when you don’t have somebody helping you that looks like you,” Jones reasons. “Sometimes you might not feel like they truly understand what you’re going through.” According to data from the American Association of Medical Colleges, most physicians are white and male, and most Black physicians—more than 40 percent—are primary care physicians, which means they are likely not providing care and counsel to Black women who are pregnant. In response to this, SHEA enlisted Jones to be one of many faces of an educational campaign with content specifically tailored to educate Black mothers.
Stepping Up to Support Black Women’s Decision to Breastfeed
Beyond the systemic and economic barriers, Jones believes the biggest issue Black women on the Mississippi Gulf Coast face is a lack of support: physical and emotional. “Even if you don’t understand, even if you don’t agree with [a woman’s decision to breastfeed], support is the biggest thing,” Jones says. “[That] looks different for every woman. No matter her race. Support may look like washing a load of laundry for the mother, watching the baby while she takes a nap, or simply running her bathwater.”
Jones emphasizes that every mother needs different types and degrees of support because they’re all at different levels. The SHEA campaign was created with the express purpose of providing education and support for Black women on the Mississippi Gulf Coast, using its website and social media channels as platforms to connect and communicate with women from all walks of life.
It Starts With Caring
A woman’s breastfeeding experience, including her needs and challenges, is directly tied to her cultural background and understanding. A critical first step is providing Black women with educational and informational resources that speak to their specific experience, which also means ensuring they can see themselves in the images and language that is used.
One of Jones’ favorite quotes is from former President Theodore Roosevelt, “People don’t care how much you know until they know how much you care.” She believes that statement speaks volumes and should guide the efforts to increase breastfeeding in the Black community. “Black women have to know you truly care,” she adds.
Caring means taking the time to understand the unique challenges Black women experience. Caring means having an open dialogue about how healthcare systems and communities need to change to support Black women and families. Caring means working to reduce health disparities by any means necessary and sustaining efforts with and in Black communities to improve health.
To learn more ways you can support efforts to improve health among Black women on the Mississippi Gulf Coast, visit www.sheahealth.org/advocates.
Find out more about the health benefits of breastfeeding, the importance of getting a flu vaccine, and more fun facts in our SHEA Breastfeeding Mini-Magazine.