Journal of Racial and Ethnic Health Disparities

, Volume 5, Issue 6, pp 1180–1191 | Cite as

Experiences of Racism and Breastfeeding Initiation and Duration Among First-Time Mothers of the Black Women’s Health Study

  • Michele K. Griswold
  • Sybil L. Crawford
  • Donna J. Perry
  • Sharina D. Person
  • Lynn Rosenberg
  • Yvette C. Cozier
  • Julie R. Palmer



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.


Breastfeeding Initiation Duration Equity Racism Life course 


Compliance with Ethical Standards

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

This article does not contain any studies with animals performed by any of the authors.

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© W. Montague Cobb-NMA Health Institute 2018

Authors and Affiliations

  • Michele K. Griswold
    • 1
  • Sybil L. Crawford
    • 2
  • Donna J. Perry
    • 1
  • Sharina D. Person
    • 3
  • Lynn Rosenberg
    • 4
  • Yvette C. Cozier
    • 4
  • Julie R. Palmer
    • 4
    • 5
  1. 1.Graduate School of NursingUniversity of Massachusetts Medical SchoolWorcesterUSA
  2. 2.Department of MedicineDivision of Preventive and Behavioral Medicine University of Massachusetts Medical School WorcesterUSA
  3. 3.Department of Quantitative Health SciencesUniversity of Massachusetts Medical SchoolWorcesterUSA
  4. 4.Slone Epidemiology Center at Boston UniversityBostonUSA
  5. 5.BostonUSA

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