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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
Article
  • 88 Downloads

Abstract

Background

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.

Aims

This study aims to investigate the association between experiences of racism, neighborhood segregation, and nativity with breastfeeding initiation and duration.

Methods

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).

Results

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.

Conclusion

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.

Keywords

Breastfeeding Initiation Duration Equity Racism Life course 

Notes

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.

References

  1. 1.
    American Academy of Pediatrics. Breastfeeding and the use of human milk. J Pediatr. 2012; Retrieved from the American Academy of Pediatrics website: http://pediatrics.aappublications.org/content/pediatrics/129/3/e827.full.pdf. Accessed 18 Oct 2011,  https://doi.org/10.1542/peds.2011-3552.
  2. 2.
    Anstey EH, Chen J, Elam-Evans LD, Perrine CG. Racial and geographic differences in breastfeeding—United States, 2011–2015. MMWR. 2017;66(27):723–7.  https://doi.org/10.15585/mmwr.mm6627a3.PubMedPubMedCentralGoogle Scholar
  3. 3.
    Palmer JR, Kipping-Ruane K, Wise LA, Yu J, Rosenberg L. Lactation in relation to long-term maternal weight gain in African-American women. Am J Epidemiol. 2015;181(12):932–9.  https://doi.org/10.1093/aje/kwv027.
  4. 4.
    Schwarz EB, Ray RM, Stuebe AM, Allison MA, Ness RB, Freiberg MS, et al. Duration of lactation and risk factors for maternal cardiovascular disease. Obstet Gynecol. 2009;113(5):974–82.  https://doi.org/10.1097/01.AOG.0000346884.67796.ca.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Stuebe AM, Schwarz EB, Grewen K, Rich-Edwards JW, Michels KB, Foster EM, et al. Duration of lactation and incidence of maternal hypertension: a longitudinal cohort study. Am J Epidemiol. 2011;174(10):1147–58.  https://doi.org/10.1093/aje/kwr227.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Palmer JR, Viscidi E, Troester MA, Hong CC, Schedin P, Bethea TN, et al. Parity, lactation, and breast cancer subtypes in African American women: results from the AMBER Consortium. J Natl Cancer Inst. 2014;106(10):dju237.  https://doi.org/10.1093/jnci/dju237.
  7. 7.
    Palmer JR, Boggs DA, Wise LA, Ambrosone CB, Adams-Campbell LL, Rosenberg L. Parity and lactation in relation to estrogen receptor negative breast cancer in African American women. Cancer Epidemiol Biomarkers Prev. 2011;20(9):1883–91.  https://doi.org/10.1158/1055-9965.epi-11-0465.
  8. 8.
    Victora CG, Bahl R, Barros AJ, Franca GV, Horton S, Krasevec J, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475–90.  https://doi.org/10.1016/S0140-6736(15)01024-7.CrossRefPubMedGoogle Scholar
  9. 9.
    Geddes DT, Prescott SL. Developmental origins of health and disease: the role of human milk in preventing disease in the 21(st) century. J Hum Lact. 2013;29(2):123–7.  https://doi.org/10.1177/0890334412474371.CrossRefPubMedGoogle Scholar
  10. 10.
    Hassiotou F, Hartmann PE. At the dawn of a new discovery: the potential of breast milk stem cells. Adv Nutr. 2014;5(6):770–8.  https://doi.org/10.3945/an.114.006924.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Griswold MK. Reframing the context of the breastfeeding narrative: a critical opportunity for health equity through evidence-based advocacy. J Hum Lact. 2017;33(2):415–8.  https://doi.org/10.1177/0890334417698691.
  12. 12.
    Gee GC, Walsemann KM, Brondolo E. A life course perspective on how racism may be related to health inequities. Am J Public Health. 2012;102(5):967–74.  https://doi.org/10.2105/ajph.2012.300666.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Collins PH. Learning from the outsider within: the sociological significance of black feminist thought. Soc Probl. 1986;33(6):S14–32.  https://doi.org/10.2307/800672.CrossRefGoogle Scholar
  14. 14.
    Spencer B, Wambach K, Domain EW. African American women's breastfeeding experiences: cultural, personal, and political voices. Qual Health Res. 2015;25(7):974–87.  https://doi.org/10.1177/1049732314554097.CrossRefPubMedGoogle Scholar
  15. 15.
    Black LL, Johnson R, VanHoose L. The relationship between perceived racism/discrimination and health among black American women: a review of the literature from 2003 to 2013. J Racial Ethn Health Disparities. 2014;2(1):1–10.  https://doi.org/10.1007/s40615-014-0043-1.Google Scholar
  16. 16.
    Coogan PF, Yu J, O’Connor GT, Brown TA, Cozier YC, Palmer JR, Rosenberg L. Experiences of racism and the incidence of adult-onset asthma in the Black Women’s Health Study. Chest. 2014;145(3):480–5.  https://doi.org/10.1378/chest.13-0665.
  17. 17.
    Cozier YC, Yu J, Coogan PF, Bethea TN, Rosenberg L, Palmer JR. Racism, segregation, and risk of obesity in the Black Women’s Health Study. Am J Epidemiol. 2014;179(7):875–83.  https://doi.org/10.1093/aje/kwu004.
  18. 18.
    Taylor TR, Williams CD, Makambi KH, Mouton C, Harrell JP, Cozier Y, Palmer JR, Rosenberg L, Adams-Campbell LL. Racial discrimination and breast cancer incidence in US Black women: the Black Women’s Health Study. Am J Epidemiol. 2007;166(1):46–54.  https://doi.org/10.1093/aje/kwm056.
  19. 19.
    Collins JW Jr, David RJ, Handler A, Wall S, Andes S. Very low birthweight in African American infants: the role of maternal exposure to interpersonal racial discrimination. Am J Public Health. 2004;94(12):2132–8.  https://doi.org/10.2105/AJPH.94.12.2132.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Hogan VK, Rowley D, Bennett T, Taylor KD. Life course, social determinants, and health inequities: toward a national plan for achieving health equity for African American infants—a concept paper. Matern Child Health J. 2012;16(6):1143–50.  https://doi.org/10.1007/s10995-011-0847-0.CrossRefPubMedGoogle Scholar
  21. 21.
    Krieger N. Methods for the scientific study of discrimination and health: an ecosocial approach. Am J Public Health. 2012;102(5):936–44.  https://doi.org/10.2105/ajph.2011.300544.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Rosenberg L, Adams-Campbell L, Palmer JR. The Black Women’s Health Study: a follow-up study for causes and preventions of illness. J Am Med Womens Assoc (1972). 1995;50(2):56–8.Google Scholar
  23. 23.
    Williams DR, Mohammed SA. Racism and health I: pathways and scientific evidence. Am Behav Sci. 2013;57(8):1152–73.  https://doi.org/10.1177/0002764213487340.CrossRefGoogle Scholar
  24. 24.
    Adedinsewo DA, Fleming AS, Steiner M, Meaney MJ, Girard AW. Maternal anxiety and breastfeeding: findings from the MAVAN (Maternal Adversity, Vulnerability and Neurodevelopment) Study. J Hum Lact. 2014;30(1):102–9.  https://doi.org/10.1177/0890334413504244.CrossRefPubMedGoogle Scholar
  25. 25.
    Stuebe AM, Grewen K, Meltzer-Brody S. Association between maternal mood and oxytocin response to breastfeeding. J Women's Health (Larchmt). 2013;22(4):352–61.  https://doi.org/10.1089/jwh.2012.3768.CrossRefGoogle Scholar
  26. 26.
    McCarter-Spaulding D, Gore R. Breastfeeding self-efficacy in women of African descent. J Obstet Gynecol Neonatal Nurs. 2009;38(2):230–43.  https://doi.org/10.1111/j.1552-6909.2009.01011.x.CrossRefPubMedGoogle Scholar
  27. 27.
    Belanoff CM, McManus BM, Carle AC, McCormick MC, Subramanian SV. Racial/ethnic variation in breastfeeding across the US: a multilevel analysis from the National Survey of Children’s Health, 2007. Matern Child Health J. 2012;16(Suppl 1):S14–26. https://doi.org/10.1007/s10995-012-0991-1’.Google Scholar
  28. 28.
    Allen JA, Perrine CG, Scanlon KS. Breastfeeding supportive hospital practices in the US differ by county urbanization level. J Hum Lact. 2015;31(3):440–3.  https://doi.org/10.1177/0890334415578440.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Burdette AM. Neighborhood context and breastfeeding behaviors among urban mothers. J Hum Lact. 2013;29(4):597–604.  https://doi.org/10.1177/0890334413495110.CrossRefPubMedGoogle Scholar
  30. 30.
    Grubesic TH, Durbin KM. Community rates of breastfeeding initiation. J Hum Lact. 2016;32(4):601–10.  https://doi.org/10.1177/0890334416651070.CrossRefPubMedGoogle Scholar
  31. 31.
    Beal AC, Kuhlthau K, Perrin JM. Breastfeeding advice given to African American and white women by physicians and WIC counselors. Public Health Rep. 2003;118(4):368–76.  https://doi.org/10.1016/S0033-3549(04)50264-9.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Cricco-Lizza R. Black non-Hispanic mothers' perceptions about the promotion of infant-feeding methods by nurses and physicians. Matern Child Health J. 2006;35(2):173–80.  https://doi.org/10.1111/j.1552-6909.2006.00033.x.Google Scholar
  33. 33.
    Lind JN, Perrine CG, Li R, Scanlon KS, Grummer-Strawn LM. Racial disparities in access to maternity care practices that support breastfeeding—United States, 2011. Morb Mortal Wkly Rep. 2014;63(33):725–8.Google Scholar
  34. 34.
    Payne SL. A call to action: lactation equity through professional diversification. J Hum Lact. 2014;30(4):396–7.  https://doi.org/10.1177/0890334414550865.CrossRefPubMedGoogle Scholar
  35. 35.
    Mccarter-spaulding D, Lucas J, Gore R. Employment and breastfeeding outcomes in a sample of black women in the United States. J Natl Black Nurses Assoc. 2011;22(2):38–45.PubMedGoogle Scholar
  36. 36.
    Smith-Gagen J, Hollen R, Walker M, Cook DM, Yang W. Breastfeeding laws and breastfeeding practices by race and ethnicity. Womens Health Issues. 2014;24(1):e11–9.  https://doi.org/10.1016/j.whi.2013.11.001.CrossRefPubMedGoogle Scholar
  37. 37.
    Braveman P. What is health equity: and how does a life-course approach take us further toward it? Matern Child Health J. 2014;18(2):366–72.  https://doi.org/10.1007/s10995-013-1226-9.CrossRefPubMedGoogle Scholar
  38. 38.
    Diez Roux AV, Mair C. Neighborhoods and health. Ann N Y Acad Sci. 2010;1186(1):125–45.  https://doi.org/10.1111/j.1749-6632.2009.05333.x.CrossRefPubMedGoogle Scholar
  39. 39.
    Cozier YC, Palmer JR, Horton NY, Fredman L, Wise LA, Rosenberg L. Racial discrimination and the incidence of hypertension in US born women. Ann Epidemiol. 2006;16(9):681–7.  https://doi.org/10.1016/j.annepidem.2005.11.008.
  40. 40.
    Bai DL, Fong DY, Tarrant M. Previous breastfeeding experience and duration of any and exclusive breastfeeding among multiparous mothers. Birth. 2015;42(1):70–7.  https://doi.org/10.1111/birt.12152.CrossRefPubMedGoogle Scholar
  41. 41.
    Williams DR, Yan Y, Jackson JS, Anderson NB. Racial differences in physical and mental health: socio-economic status, stress and discrimination. J Health Psychol. 1997;2(3):335–51.  https://doi.org/10.1177/135910539700200305.CrossRefPubMedGoogle Scholar
  42. 42.
    Mirkovic KR, Perrine CG, Scanlon KS, Grummer-Strawn LM. In the United States, a mother’s plans for infant feeding are associated with her plans for employment. J Hum Lact. 2014;30(3):292–7.  https://doi.org/10.1177/0890334414535665.CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Odom EC, Li R, Scanlon KS, Perrine CG, Grummer-Strawn L. Reasons for earlier than desired cessation of breastfeeding. J Pediatr. 2013;131(3):e726–32.  https://doi.org/10.1542/peds.2012-1295.CrossRefGoogle Scholar
  44. 44.
    Atabay E, Moreno G, Nandi A, Kranz G, Vincent I, Assi TM, et al. Facilitating working mothers’ ability to breastfeed: global trends in guaranteeing breastfeeding breaks at work, 1995–2014. J Hum Lact. 2015;31(1):81–8.  https://doi.org/10.1177/0890334414554806.CrossRefPubMedGoogle Scholar
  45. 45.
    Johnson AM, Kirk R, Muzik M. Overcoming Workplace Barriers: a focus group study exploring African American mothers’ needs for workplace breastfeeding support. J Hum Lact. 2015;31(3):425–33.  https://doi.org/10.1177/089033441557300.CrossRefPubMedPubMedCentralGoogle Scholar
  46. 46.
    Holder A, Jackson MA, Ponterotto JG. Racial microaggression experiences and coping strategies of black women in corporate leadership. Qual Psychol. 2015;2(2):164–80.  https://doi.org/10.1037/qup0000024.CrossRefGoogle Scholar
  47. 47.
    Reynolds-Dobbs W, Thomas KM, Harrison MS. From mammy to superwoman: images that hinder black women’s career development. J Career Dev. 2008;35(2):129–50.  https://doi.org/10.1177/0894845308325645.CrossRefGoogle Scholar
  48. 48.
    DeVane-Johnson S, Woods-Giscombe C, Thoyre S, Fogel C, Williams R. Integrative literature review of factors related to breastfeeding in African American women: evidence for a potential paradigm shift. J Hum Lact. 2017;33(2):435–47.  https://doi.org/10.1177/0890334417693209.CrossRefPubMedGoogle Scholar
  49. 49.
    Abrams JA, Maxwell M, Pope M, Belgrave FZ. Carrying the world with the grace of a lady and the grit of a warrior deepening our understanding of the “strong black woman” schema. Psychol Women Q. 2014;38(4):503–18.CrossRefGoogle Scholar
  50. 50.
    Carter SK, Anthony AK. Good, bad, and extraordinary mothers infant feeding and mothering in African American mothers’ breastfeeding narratives. Sociol Race Ethn (Thousand Oaks). 2015;1(4):517–31.CrossRefGoogle Scholar
  51. 51.
    Vines AI, Baird DD. Stress of caring for children: the role of perceived racism. J Natl Med Assoc. 2009;101(2):156–60.  https://doi.org/10.1016/S0027-9684(15)30829-4.CrossRefPubMedPubMedCentralGoogle Scholar
  52. 52.
    Jackson FM, James SA, Owens TC, Bryan AF. Anticipated negative police-youth encounters and depressive symptoms among pregnant African American women: a brief report. J Urban Health. 2017;94(2):259–65.  https://doi.org/10.1007/s11524-017-0136-3.CrossRefPubMedGoogle Scholar
  53. 53.
    Fabiyi C, Peacock N, Hebert-Beirne J, Handler A. A qualitative study to understand nativity differences in breastfeeding behaviors among middle-class African American and African-born women. Matern Child Health J. 2016;20(10):2100–11.  https://doi.org/10.1007/s10995-016-2029-6.CrossRefPubMedGoogle Scholar
  54. 54.
    Johnson AM, Kirk R, Rooks AJ, Muzik M. Enhancing breastfeeding through healthcare support: results from a focus group study of African American mothers. Matern Child Health J. 2016;20(Suppl 1):92–102.  https://doi.org/10.1007/s10995-016-2085-y.CrossRefPubMedPubMedCentralGoogle Scholar
  55. 55.
    Williams DR, Mohammed SA. Racism and health II: a needed research agenda for effective interventions. Am Behav Sci. 2013;57(8):1200–26.  https://doi.org/10.1177/0002764213487341.CrossRefGoogle Scholar
  56. 56.
    Woods-Giscombe CL, Gaylord SA. The cultural relevance of mindfulness meditation as a health intervention for African Americans: implications for reducing stress-related health disparities. J Holist Nurs. 2014;32(3):147–60.  https://doi.org/10.1177/0898010113519010.CrossRefPubMedPubMedCentralGoogle Scholar
  57. 57.
    Williams DR, Wyatt R. Racial bias in health care and health: challenges and opportunities. JAMA. 2015;314(6):555–6.  https://doi.org/10.1001/jama.2015.9260.CrossRefPubMedGoogle Scholar
  58. 58.
    Bugg K, Bugg G Jr. Reaching our sisters everywhere. Breastfeed Med. 2013;8(5):453.  https://doi.org/10.1089/bfm.2013.0098.CrossRefPubMedGoogle Scholar
  59. 59.
    Asiodu IV, Waters CM, Dailey DE, Lyndon A. Infant feeding decision-making and the influences of social support persons among first-time African American mothers. Matern Child Health J. 2017;21(4):863–72.  https://doi.org/10.1007/s10995-016-2167-x.CrossRefPubMedGoogle Scholar

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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