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Understanding Breastfeeding Barriers at an Urban Pediatric Practice

Abstract

Breastfeeding is the optimal nutrition for infants given the numerous health benefits that are conferred on mothers, infants, and society in a dose-dependent manner. However, low breastfeeding rates and racial breastfeeding inequities persist for the African American (AA) community due to historic structural racism. The issue is especially salient at the Rainbow Center for Women and Children, an urban health center in Cleveland, Ohio where approximately 90% of their mothers are AA, WIC-eligible, and publicly insured. Our study aims to elucidate factors contributing to breastfeeding practices and identify supports that could be added for women served at RCWC. The study was conducted within 2 cohorts both of exclusively AA  women. Wave 1 of the study included AA mothers who exclusively breastfed, did mixed feeding, or exclusively formula fed. Wave 2 included expectant women at least considering breastfeeding. Breastfeeding attitudes of those who had exclusively breastfed or practiced mixed feeding were not significantly different than those of expectant participants planning to breastfeed; mean attitude scores, however, were in the “neutral” range. Participants endorsed many sources of support for their feeding choices, including the infant’s father, their own parents, and family. However, the data show that even when women feel personally supported in their feeding choices by their partner and family, if additional breastfeeding help is needed, they will benefit from help accessing available resources. Thus, lactation support that helps women achieve their own breastfeeding goals is optimal; customized care ultimately can move the needle on racial inequities in breastfeeding for our society.

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Acknowledgements

We thank the women who participated, the obstetrical providers and CenteringPregnancy™ nurses for their support, and Monica Chavan MS2 for work on the Pediatric Practice Breastfeeding Database.

Funding

The work was supported by a Rainbow Babies and Children’s Hospital Faculty Fund Pilot award to Dr. Furman.

Author information

Authors and Affiliations

Authors

Contributions

Dr. Furman designed the study, was responsible for study oversight and data integrity, and drafted and revised the manuscript. Ms. Feinstein interviewed all participants, aided in data interpretation, and revised and reviewed the manuscript. Dr. DeLozier conducted the statistical analysis and revised and reviewed the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Lydia Furman.

Ethics declarations

Ethics Approval

The University Hospitals Cleveland Medical Center Institutional Review Board approved this research. The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and the Belmont Report.

Consent to Participate

Informed consent was obtained from all individual participants included in the study.

Consent for Publication

Protected health information and identifiable data were not collected.

Competing Interests

The authors declare no competing interests.

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Furman, L., Feinstein, J. & Delozier, S. Understanding Breastfeeding Barriers at an Urban Pediatric Practice. J. Racial and Ethnic Health Disparities (2022). https://doi.org/10.1007/s40615-022-01248-z

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  • DOI: https://doi.org/10.1007/s40615-022-01248-z

Keywords

  • Breast feeding
  • Lactation
  • African Americans
  • Health resources