Racial and Ethnic Disparities in Breastfeeding

Abstract

This article's aim is to review the literature on racial and ethnic disparities in breastfeeding rates and practices, address barriers to breastfeeding among minority women, conduct a systematic review of breastfeeding interventions, and provide obstetrician-gynecologists with recommendations on how they can help increase rates among minority women. In order to do so, the literature of racial and ethnic disparities in breastfeeding rates and barriers among minority women was reviewed, and a systematic review of breastfeeding interventions among minority women on PubMed and MEDLINE was conducted. Racial and ethnic minority women continue to have lower breastfeeding rates than white women and are not close to meeting the Healthy People 2020 goals. Minority women report many barriers to breastfeeding. Major efforts are still needed to improve breastfeeding initiation and duration rates among minority women in the United States. Obstetrician-gynecologists have a unique opportunity to promote and support breastfeeding through their clinical practices and public policy, and their efforts can have a meaningful impact on the future health of the mother and child.

Breastfeeding History and Risk of Stroke Among Parous Postmenopausal Women in the Women's Health Initiative

“…Although this study's findings could not establish a causal relationship between breastfeeding and risk of stroke, health disparities surrounding stroke1, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18 and breastfeeding rates52, 53, 54 persist. Stroke is 1 of the leading causes of death among Hispanic and non‐Hispanic black women over 65 2, 4.…”

“…Stroke is 1 of the leading causes of death among Hispanic and non‐Hispanic black women over 65 2, 4. These same groups of women also experience low breastfeeding rates 52, 53, 54…”

“…Additionally, evidence exists that compared with non‐Hispanic whites, breastfeeding that is less than the recommended duration of 6 months is associated with a greater burden of disease among Hispanic and non‐Hispanic black women and their children 69, 70. There are many other documented reasons for the unequal distribution of stroke and nonadherence to the recommended length of breastfeeding including the fact that Hispanic and non‐Hispanic black women tend to work in jobs that are less supportive of breastfeeding, earn less, attain less education, have less social support, and have limited access to healthcare services 53, 71, 72, 73…”

“…51 Also, whereas 83% of US women initiate breastfeeding soon after giving birth, only 55% of these women report any breastfeeding at 6 months postpartum, and 34% report any breastfeeding at 12 months postpartum 51. More importantly, breastfeeding rates vary by race/ethnicity and are lowest among non‐Hispanic black women with 64% initiating breastfeeding, followed by 35% breastfeeding at 6 months and 17% at 12 months postpartum; duration rates for Hispanic women are slightly higher at 51% at 6 months and 26% at 12 months postpartum but well below those of non‐Hispanic white women (56% and 31%, respectively) 52, 53, 54…”

Catholic Social Teaching and America's Suboptimal Breastfeeding Rate: Where Faith and Policy Should Meet to Combat Injustice

“…Reasons given for not breastfeeding for the recommended amount of time-or for not breastfeeding at all-are various and multi-faceted. A 2014 Wall Street Journal article on American breastfeeding trends summarized five of the reasons why some American women do not follow the recommendations for optimal breastfeeding duration (Molla 2014): "100 years of precedent," set by synthetic infant formula manufacturers and their (sometimes false) advertising (Stevens, Patrick, and Pickler 2009); high participation of American women in the workforce (HHS 2011a); socioeconomic inequality (Jones et al 2015;Dagher et al 2016); the fact that formula is often "pushed" in hospitals (CDC 2011); and the decades-long practice of direct-to-consumer advertising by formula manufacturers (Greer and Apple 1991).…”