Background Millions of people today live in contaminated environments. Often, these environments disproportionately affect nonwhite, racialized families who are low-income, pregnant, and/or feeding young children. Despite the overwhelming recognition among scholars and practitioners of these realities, however, few lactation or other health professionals center socially disadvantaged families’ perspectives in their work. Community expertise is therefore often absent from the credentialed lactation and associated support that tends to be advanced in contaminated environments. Research Aims The aims of this study were to: (1) Describe how vulnerable community members experience toxic environments, and (2) Explore the strategies vulnerable community members themselves employ and seek out from professionals to achieve resilience in these environments. Methods The research design for this study was prospective and cross-sectional. We surveyed 62 Milwaukeean African American women of childbearing age and their close networks of support from predominantly low-income census tracts, and we engaged 14 women in a community conversation on their experiences, strategies, and desires generated from living in Milwaukee during a lead contaminated drinking water crisis. Results Participants were aware and concerned about toxic poisoning in their environment, especially as it affects their children. Nonetheless, societal factors constrained their levels of preparedness and action in response, including around chestfeeding, breastfeeding, expressed milk feeding, and artificial feeding methods. Conclusion Lactation providers and other health professionals can better support at-risk families by integrating their perspectives into dominant frameworks for information-sharing, preventative resource distribution, and supporting community self-determination.
BackgroundBlack birthing people experience disproportionately higher rates of morbidity and mortality, and poorer infant health outcomes than all other racial and ethnic groups. Statewide in Wisconsin, an alarming disparity exists between Black and Non-Hispanic White (NHW) breastfeeding initiation rates (54% and 87%, respectively). For the last fourteen years, the African American Breastfeeding Network (AABN) has operated in Milwaukee County, where 70% of the state’s Black population lives. AABN’s mission is to improve maternal health and champion breastfeeding equity for Black birthing families. In 2018, AABN received more referrals than could be served by their team of doulas, lactation consultants, and advocates, leading our team to pursue ways to expand their reach through technology-based approaches. With the onset of COVID-19, the need for telehealth support increased drastically, as referrals for AABN services tripled. In this study, we explore the use of technology to support Black birthing families in Wisconsin and beyond, in the hopes of expanding the capacity of organizations like AABN.MethodsA survey was conducted amongst 21 Black women who were pregnant or had given birth in the last year, regarding perceptions of technology. Women were split equally into three focus groups to discuss survey results further and provide context. Focus groups were recorded, transcribed, and coded for themes.ResultsParticipants were “Likely” to use their phone or the internet to look for general or health-related information, but only “Somewhat Likely” to trust either general or health-related information. Participants were “Somewhat Likely” to trust the information on the phone or the internet as much as their healthcare provider (doctor, nurse, doula) in person. In the focus groups, all participants agreed that the phone or the internet was the first place looked to for information, ahead of consulting a healthcare professional. A comprehensive list of desired features was generated to guide the development of a resource to support AABN.ConclusionsStudy findings support exploring mobile technology-based approaches for breastfeeding support and education. Participants emphasized that to be relevant for them, a telehealth resource would need to: 1) Build meaningful connections between patients and providers, 2) Treat diverse opinions with trust and respect, and 3) Offer multiple sources and formats for information that can be easily cross-referenced.
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