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Renbarger KM, Abebe S, Place JM, Goldsby E, Hall G, Kroot A. Perspectives of Infant Mortality from African American Community Members. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2023; 4:423-430. [PMID: 37638331 PMCID: PMC10457606 DOI: 10.1089/whr.2023.0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/27/2023] [Indexed: 08/29/2023]
Abstract
Introduction Infant mortality (IM) is often used to determine overall population health and well-being. Health disparities exist with African American (AA) infants having higher rates of IM than White infants. The purpose of this study was to examine the knowledge, attitudes, and perceptions of members in an AA community regarding IM, which can be used to develop interventions. Methods A qualitative descriptive design guided this study. A county in the state of Indiana was the setting from which the researchers enrolled participants in this study. The participants consisted of 16 AA community members who were recruited from a local agency and who had completed an educational program on IM. Through semistructured phone interviews, participants described their understanding of IM. The data analysis of the transcribed interviews was performed via content analysis to yield overall themes from the data. Results The analysis identified three themes describing AA Community members' perspectives on IM: (1) Shying Away from the Topic of Infant Mortality; (2) Receiving Misinformation from Family Members; and (3) Considering Infant Mortality as Unpreventable. Discussion The findings of this study suggest that participants avoided the topic of IM, often received misinformation from family members, and believed infant death could not be prevented. Health care providers should have an open and culturally competent discussion about issues of IM, engage family members, and support community-based initiatives and education for members in AA communities.
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Affiliation(s)
| | - Sheila Abebe
- Department of Public Health, Ball State University, Muncie, Indiana, USA
| | - Jean Marie Place
- Department of Nursing and Ball State University, Muncie, Indiana, USA
| | - Elizabeth Goldsby
- Department of Nursing and Ball State University, Muncie, Indiana, USA
| | - Gabe Hall
- School of Nursing, Ball State University, Muncie, Indiana, USA
| | - Adam Kroot
- School of Nursing, Ball State University, Muncie, Indiana, USA
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Understanding Breastfeeding Barriers at an Urban Pediatric Practice. J Racial Ethn Health Disparities 2023; 10:581-592. [PMID: 35099765 DOI: 10.1007/s40615-022-01248-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 10/19/2022]
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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Dogan J, Hargons C, Stevens-Watkins D. "Don't Feel Like You Have to Do This All on Your Own": Exploring Perceived Partner Support of Breastfeeding Among Black Women in Kentucky. J Hum Lact 2023; 39:134-145. [PMID: 36511173 DOI: 10.1177/08903344221138101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Few researchers have explored partner breastfeeding support among Black women, who report low breastfeeding rates compared to women of other cultural groups. Ways to encourage partner support of Black women's breastfeeding can be understood from an Afrocentric perspective. RESEARCH AIM To explore perceptions of partner support among Black mothers to develop a culturally relevant framework of partner breastfeeding support. METHODS Secondary data analyses of qualitative data from a larger prospective, cross-sectional mixed methods study were utilized. Participants from Kentucky (N = 14), aged 23-71, who breastfed for at least 6 months, were recruited to participate in individual interviews. Professionally transcribed interviews were analyzed using Braun and Clarke's (2006) thematic analysis. RESULTS By integrating the Breastfeeding Coparenting Framework and Optimal Conceptual Theory, we identified four culturally affirming partner support themes that participants believed impacted their breastfeeding experiences: (a) doing research, (b) offering care, (c) verbalizing praise, and (d) achieving teamwork, and three culturally incongruent partner support barrier themes: (e) withdrawing commitment, (f) politicking bodies, and (g) stripping agency. CONCLUSION Participants who breastfed for at least 6 months largely attributed their breastfeeding success to the support received from their partners. Our findings offer a culturally relevant framework of partner breastfeeding support that can facilitate intervention efforts with participants and their partners to increase breastfeeding rates among this population.
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Affiliation(s)
- Jardin Dogan
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, KY, USA
| | - Candice Hargons
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, KY, USA
| | - Danelle Stevens-Watkins
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, KY, USA
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Hernandez E, Lavner JA, Moore AM, Stansfield BK, Beach SRH, Smith JJ, Savage JS. Sleep SAAF responsive parenting intervention improves mothers' feeding practices: a randomized controlled trial among African American mother-infant dyads. Int J Behav Nutr Phys Act 2022; 19:129. [PMID: 36183135 PMCID: PMC9526457 DOI: 10.1186/s12966-022-01366-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 09/13/2022] [Indexed: 11/29/2022] Open
Abstract
Background/Objective Parents shape children’s early experiences with food, influencing what is served, children’s food choices, and how much children eat. Responsive parenting (RP) interventions such as INSIGHT have improved maternal infant feeding practices, but have only been tested among predominantly White families. This secondary analysis of data from the Sleep SAAF (Strong African American Families) RCT tests the effects of an RP intervention designed to prevent rapid infant weight gain on African American mothers’ infant feeding practices. Methods Primiparous African American mother-infant dyads (n = 194) were randomized to an RP or safety control intervention delivered by community research associates at infant age 3 and 8 weeks. At 16 weeks, mothers completed the Babies Need Feeding questionnaire, the Infant Feeding Styles Questionnaire, and the Babies Need Soothing questionnaire. Logistic regression and general linear models examined the effect of study group on infant feeding practices. Moderation analyses explored whether effects varied by feeding mode (any breast milk versus exclusive formula), maternal age (≥ 20 years versus < 20 years), and maternal pre-pregnancy BMI (with obesity versus not). Results RP mothers reported more responsive feeding (p = 0.005, partial η2 = 0.02), lower likelihood of using beverages other than breast milk/formula to soothe their infant (p = 0.01, OR = 0.42, 95% CI [0.2–0.8]), and less pressure with cereal than control mothers (p = 0.09, partial η2 = 0.02). RP mothers also reported less pressure to finish/soothe than controls (p = 0.007, partial η2 = 0.04); feeding mode (B = 0.74, p = 0.003) and maternal age (B = 0.53, p = 0.04) moderated this effect. There were no significant group differences in bottle-feeding practices (e.g., adding cereal to bottle, using an appropriate nipple/bottle size), or in context-based or emotion-based food to soothe. Conclusions Responsive parenting education influenced some feeding practices of African American mothers. Mothers reported using less pressure, a control-based feeding practice, and more responsive feeding than controls. Trial registration Sleep SAAF: A Strong African American Families Study. www.clinicaltrials.gov NCT03505203. Registered 3 April 2018. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01366-1.
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Affiliation(s)
- Erika Hernandez
- Center for Childhood Obesity Research, The Pennsylvania State University, University Park, State College, PA, USA
| | - Justin A Lavner
- Department of Psychology, Psychology Building, University of Georgia, Athens, GA, 30602-3013, USA.
| | - Amy M Moore
- Center for Childhood Obesity Research, The Pennsylvania State University, University Park, State College, PA, USA
| | | | - Steven R H Beach
- Department of Psychology, Psychology Building, University of Georgia, Athens, GA, 30602-3013, USA.,Center for Family Research, University of Georgia, Athens, GA, USA
| | - Jessica J Smith
- Center for Family Research, University of Georgia, Athens, GA, USA
| | - Jennifer S Savage
- Center for Childhood Obesity Research, The Pennsylvania State University, University Park, State College, PA, USA
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Seiger ER, Wasser HM, Hutchinson SA, Foster G, Sideek R, Martin SL. Barriers to Providing Lactation Services and Support to Families in Appalachia: A Mixed-Methods Study With Lactation Professionals and Supporters. Am J Public Health 2022; 112:S797-S806. [PMID: 36288532 PMCID: PMC9612188 DOI: 10.2105/ajph.2022.307025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2022] [Indexed: 11/04/2022]
Abstract
Objectives. To understand the barriers and facilitators that lactation professionals and supporters (LPSs) in the Appalachian region of the United States experience when providing services and support to families. Methods. We used a mixed-methods explanatory sequential design with a survey of LPSs in Appalachia (March‒July 2019), followed by semistructured interviews with LPSs (January‒April 2020). We summarized survey responses descriptively and analyzed interview transcripts thematically. Results. The survey was completed by 89 LPSs in Appalachia. We conducted semistructured interviews with 20 LPSs. Survey participants most commonly identified challenges with other health care providers, hospital practices, and non‒medically indicated supplementation as barriers. Interview participants described challenges with clients' families not supporting breastfeeding, difficulty reaching clients, limited numbers of LPSs, and lack of racial/ethnic diversity among LPSs. LPSs identified the need for training in lactation and substance use, mental health, and birth trauma, and supporting lesbian, gay, bisexual, transgender, queer or questioning, plus (LGBTQ+) families. LPSs described social media and telehealth as both facilitators and barriers. Social support from other LPSs was a facilitator. Conclusions. LPSs in Appalachia face various challenges. Addressing these challenges has the potential to improve the lactation support and services families in Appalachia receive. (Am J Public Health. 2022;112(S8):S797-S806. https://doi.org/10.2105/AJPH.2022.307025).
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Affiliation(s)
- Emily R Seiger
- Emily R. Seiger, Stephanie L. Martin, Heather M. Wasser, Grace Foster, and Ruwaydah Sideek are with the Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill. Stephanie A. Hutchinson is with the Appalachian Breastfeeding Network, Gallipolis, Ohio
| | - Heather M Wasser
- Emily R. Seiger, Stephanie L. Martin, Heather M. Wasser, Grace Foster, and Ruwaydah Sideek are with the Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill. Stephanie A. Hutchinson is with the Appalachian Breastfeeding Network, Gallipolis, Ohio
| | - Stephanie A Hutchinson
- Emily R. Seiger, Stephanie L. Martin, Heather M. Wasser, Grace Foster, and Ruwaydah Sideek are with the Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill. Stephanie A. Hutchinson is with the Appalachian Breastfeeding Network, Gallipolis, Ohio
| | - Grace Foster
- Emily R. Seiger, Stephanie L. Martin, Heather M. Wasser, Grace Foster, and Ruwaydah Sideek are with the Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill. Stephanie A. Hutchinson is with the Appalachian Breastfeeding Network, Gallipolis, Ohio
| | - Ruwaydah Sideek
- Emily R. Seiger, Stephanie L. Martin, Heather M. Wasser, Grace Foster, and Ruwaydah Sideek are with the Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill. Stephanie A. Hutchinson is with the Appalachian Breastfeeding Network, Gallipolis, Ohio
| | - Stephanie L Martin
- Emily R. Seiger, Stephanie L. Martin, Heather M. Wasser, Grace Foster, and Ruwaydah Sideek are with the Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill. Stephanie A. Hutchinson is with the Appalachian Breastfeeding Network, Gallipolis, Ohio
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Stevens-Watkins D, Hargons CN, Dogan J, Malone N, Jester JK, Thorpe S, Linares AM. Social Health Care Determinants of Breastfeeding Black Women: A Multigenerational Study. Breastfeed Med 2022; 17:666-672. [PMID: 35947855 DOI: 10.1089/bfm.2021.0258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Black women encounter many challenges to breastfeeding, including inequitable access to support and resources and medical racism. However, limited research investigates how Black women across generations interface with health care systems to initiate or continue breastfeeding and what factors facilitate or hinder their breastfeeding experiences. Objective: Using the social determinants of health (SDoH) theoretical framework, this study qualitatively explored how a multigenerational sample of Black mothers' interactions with health care systems facilitated or hindered their breastfeeding initiation and continuation. There were three areas of interest: (1) access and quality, (2) professional and personal support, and (3) literacy and resources. Materials and Methods: Four age cohorts and three breastfeeding length cohorts of Black mothers in Kentucky completed semi-structured interviews on their breastfeeding experiences. Responses to research questions (e.g., "What was your experience during the birthing process and how did it impact your decision to breastfeed?") informed by the SDoH were analyzed using thematic analysis. Results: Four themes emerged on how experiences within health care systems influence Black women's breastfeeding initiation and continuation: (1) health care access, (2) health care quality/bias, (3) health care-related support, and (4) health care resource use. Conclusions: Interpersonal and systemic barriers in health care related to access, quality, support, and resources hindered Black mother's breastfeeding across generations. Mothers across each age and breastfeeding cohorts emphasized a need for culturally tailored pro-breastfeeding health care systems to meet their breastfeeding needs.
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Affiliation(s)
- Danelle Stevens-Watkins
- Educational, School, and Counseling Psychology Department, College of Nursing, University of Kentucky, Lexington, Kentucky, USA
| | - Candice N Hargons
- Educational, School, and Counseling Psychology Department, College of Nursing, University of Kentucky, Lexington, Kentucky, USA
| | - Jardin Dogan
- Educational, School, and Counseling Psychology Department, College of Nursing, University of Kentucky, Lexington, Kentucky, USA
| | - Natalie Malone
- Educational, School, and Counseling Psychology Department, College of Nursing, University of Kentucky, Lexington, Kentucky, USA
| | - Jasmine K Jester
- Educational, School, and Counseling Psychology Department, College of Nursing, University of Kentucky, Lexington, Kentucky, USA
| | - Shemeka Thorpe
- Educational, School, and Counseling Psychology Department, College of Nursing, University of Kentucky, Lexington, Kentucky, USA
| | - Ana Maria Linares
- Educational, School, and Counseling Psychology Department, College of Nursing, University of Kentucky, Lexington, Kentucky, USA
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Aderibigbe O, Lucas R. Exclusive breastfeeding in African American women: A concept analysis. J Adv Nurs 2022; 79:1699-1713. [PMID: 35621344 DOI: 10.1111/jan.15301] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/25/2022] [Accepted: 05/07/2022] [Indexed: 11/29/2022]
Abstract
AIM To report an analysis of the concept of exclusive breastfeeding (EBF) in African American women. BACKGROUND EBF is the gold standard for infant nutrition from birth until 6 months. The rate of EBF in United States is low-26%, with African American women having the lowest rates. The low rates of EBF in this population are strongly attributed to bias, racism and generational trauma. Therefore, clarifying the concept of EBF with respect to these factors is important for promoting EBF rates of this population. DESIGN Concept analysis. DATA SOURCES Search was conducted in four databases (CINAHL, PubMed, PsycINFO and Scopus) for articles published between 2001 and 2021. A total of 30 articles (20 quantitative, seven qualitative and three mixed methods) clarified the concept. Relevant literature emanated from diverse disciplines examining historical and present maternal and infant health. METHODS Concept analysis using Rodger's evolutionary method. RESULTS An operational definition of the concept of EBF in African American women was developed from the identified antecedents (modifiable and non-modifiable), defining attributes and consequences of the concept. Access to breastfeeding resources, maternal (prenatal intention to breastfeed, smoking status, attitude towards breastfeeding), infant (skin-to-skin care, successful latching and weight) and contextual factors (socioeconomic, occupational and cultural) predict EBF. The primary attributes of EBF were physiological, physical, psychological and relational. Consequences of EBF were positive health outcomes for, and increased bonding between, mother and infant. CONCLUSION This concept analysis is the first identifying modifiable and non-modifiable antecedents of EBF. The analysis provides an operational definition for EBF in African American women which is useful to promote understanding of breastfeeding. This new concept examines the historic societal trauma associated with wet nursing and reframes breastfeeding as a positive maternal and infant health behaviour.
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Affiliation(s)
| | - Ruth Lucas
- University of Connecticut School of Nursing, Storrs, Connecticut, USA
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Schindler-Ruwisch J, Aluc A. The Relationship of Race and Ethnicity to the Perception of Visual Images of Breastfeeding Mothers. Breastfeed Med 2022; 17:459-465. [PMID: 35180357 DOI: 10.1089/bfm.2021.0296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Introduction: Breastfeeding biases, both implicit and explicit, can impact perceived norms of breastfeeding appropriateness in a variety of contexts and influence breastfeeding behaviors. The purpose of this research was to uncover breastfeeding biases, norms, patterns, and perceptions that potentially affect the decision to initiate or sustain breastfeeding and investigate how a diverse group of women perceive images of racially/ethnically similar and different women breastfeeding. Materials and Methods: Using a panel of nationally representative respondents (oversampling key racial/ethnic subpopulations), an online mixed-methods survey was completed by a sample of women who were primary caregivers of children under 3 in November 2020. The survey included diverse images of individuals breastfeeding in various settings and respondents were asked to generate word associations and indicate perceived appropriateness and ease of breastfeeding for each image in direct, timed comparisons. Results: Respondents (N = 144) racial/ethnic identity influenced perceptions of breastfeeding ease and norms surrounding breastfeeding in public settings or in front of others. Furthermore, respondents perceived breastfeeding to be more or less appropriate based on racial identity, in particular, respondents of color seeing breastfeeding as less appropriate among racially and ethnically similar others. Conclusions: While respondents readily acknowledged the health benefits of breastfeeding and were generally supportive of images of others breastfeeding, biases about breastfeeding in public or in front of others and by race/ethnicity were apparent. Community, policy, and societal interventions are necessary to dismantle breastfeeding biases that may inequitably impact mothers' and infants' health.
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Affiliation(s)
- Jennifer Schindler-Ruwisch
- Marion Peckham Egan School of Nursing and Health Studies, Public Health, Fairfield University, Fairfield, Connecticut, USA
| | - Aika Aluc
- Milken Institute School of Public Health, Department of Prevention and Community Health, The George Washington University, Washington, District of Columbia, USA
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9
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Miller EM. A critical biocultural approach to early growth in the United States. Am J Hum Biol 2022; 34:e23726. [PMID: 35122658 DOI: 10.1002/ajhb.23726] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 01/19/2022] [Accepted: 01/21/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES A critical biocultural anthropology seeks to link perspectives from social theory and ethnography to human biology. In the United States (U.S.), multiple forms of structural inequalities affect early growth, including racism and poverty. The goal of this paper is to test the effects of social inequalities on birth weight and later height in the U.S. National Health and Nutrition Survey (NHANES), and to contextualize potential pathways of embodiment that link social structure and biology. METHODS This study used data from 8392 children ages 0-5 years from the 2005 to 2016 NHANES. Reported birth weight and measured length/height (converted to height-for-age z-scores) were used as outcome variables, while various measures of socioeconomic status and the NHANES-defined race and ethnicity categories were operationalized as social variables. Structural equation modeling (SEM) was chosen to represent the data. RESULTS The final model represented an excellent fit to the data. Higher birth weights were associated with higher height-for-age z-scores. The Black racial category was associated with lower birth weight and higher height-for-age z-score, while the "Other" racial category was also associated with lower birth weight. The socioeconomic status factor variable was significantly associated with birth weight and height-for-age z-scores. There were also multiple indirect effects of social variables on height-for-age z-scores mediated via their effects on birth weight. CONCLUSIONS Inequalities in race and socioeconomic status persist in birth weight and early childhood stature in the U.S. These findings can be contextualized by a critical biocultural anthropology that integrates lived experiences and pathways of embodiment.
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Affiliation(s)
- Elizabeth M Miller
- Department of Anthropology, University of South Florida, Tampa, Florida, USA
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10
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Asiodu IV, Bugg K, Palmquist AE. Achieving Breastfeeding Equity and Justice in Black Communities: Past, Present, and Future. Breastfeed Med 2021; 16:447-451. [PMID: 33979550 PMCID: PMC8418442 DOI: 10.1089/bfm.2020.0314] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background: Breastfeeding is protective of maternal and infant health across the life course. Increasing breastfeeding rates in Black communities is an important public health strategy to address maternal and infant mortality and morbidity. Methods: Data trends for the past 10 years suggest that Black-led community efforts; local, state, and national initiatives; and maternity care practices that are supportive of breastfeeding have been effective in improving and increasing breastfeeding rates among Black women. Results: Yet breastfeeding disparities and inequities in Black communities persist. Systemic and structural barriers, such as racism, bias, and inequitable access to lactation resources and support continue to be issues in the United States. Conclusion: Going forward, significant investments are needed to decolonize breastfeeding research and clinical practice. Public health and policy priorities need to center on listening to Black women, and funding Black, Indigenous, and People of Color (BIPOC) organizations and researchers conducting innovative projects and research.
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Affiliation(s)
- Ifeyinwa V. Asiodu
- Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, California, USA
| | - Kimarie Bugg
- Reaching Our Sisters Everywhere, Lithonia, Georgia, USA
| | - Aunchalee E.L. Palmquist
- Department of Maternal and Child Health, Gillings School of Global Health, University of North Carolina, Chapel Hill, North Carolina, USA
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Abstract
Introduction: The World Health Organization recommends 6 months of exclusive breastfeeding for infants. Racial disparities exist, where only 27.9% of black women exclusively breastfeed at 6 months compared to 45.1% of white mothers. Previous research suggests that these disparities are due to a variety of factors, including poor paid leave policies, racism, and bias, but few studies have looked specifically at the experience of black millennial mothers. Methods: This qualitative study aimed to understand the racialized experiences of breastfeeding among black millennials and whether or not there are factors to mitigate the effects of racism. Three focus groups were conducted (N = 15) with black millennial mothers. Participants were recruited through social media sites, emails to breastfeeding/black maternal health organizations, and local partnerships. Inclusion criteria included self-identification as a black/African American woman, born between 1981 and 1996, and having at least one child 5 years or younger. Results: Five major themes emerged from the analysis as follows: (1) institutional racism and barriers, (2) challenges to motherhood, (3) black experiences, (4) breastfeeding in the millennial age, and (5) hopes for the community. Results showed that black millennial mothers expressed being treated differently and poorly due to race. While participants reported supporting each other through their breastfeeding journey, this was not specifically a strategy to impact racism/bias. Discussion: Results also showed that black millennials feel a desire to succeed in breastfeeding to change the narrative about past generations. Further research should explore differences between the breastfeeding experiences and perceptions of black millennials in comparison to that of previous generations.
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Affiliation(s)
- Yasmeen I Lee
- Department of Public Health Studies, Elon University, Elon, North Carolina, USA
| | - Stephanie Baker
- Department of Public Health Studies, Elon University, Elon, North Carolina, USA
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Woods Barr AL, Austin DA, Smith JL, Schafer EJ. "…[T]his is What We are Missing": The Value of Communicating Infant Feeding Information Across Three Generations of African American Women. J Hum Lact 2021; 37:279-288. [PMID: 33632016 PMCID: PMC8120634 DOI: 10.1177/0890334421995078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Breast/Chestfeeding remains a public health issue for African Americans, and increased rates would mitigate many health disparities, thus promoting health equity. RESEARCH AIMS To explore the interplay of generational familial roles and meaning (or value) ascribed to communicating infant feeding information across three generations. METHOD This prospective, cross-sectional qualitative study used an asset-driven approach and was guided by Black Feminist Thought and Symbolic Interactionism. African American women (N = 35; 15 family triads/dyads), residing in the southeastern United States were interviewed. Data were analyzed using thematic analysis. RESULTS The older two generations described their role using assertive yet nurturing terms, while the younger generation carefully discussed the flexibility between their familial roles. Emergent themes described the meaning each generation attributed to communicating infant feeding information: "My Responsibility," "Comforting," "Bonding Experience," "She Cared," and "Gained Wisdom." CONCLUSIONS Our findings have potential to contribute to achieving health equity in African American families. Future breast/chestfeeding promotion efforts may benefit from reframing the current approach to including protection language and not solely support language. Lactation professionals should further recognize and support strengths and resource-richness of intergenerational infant feeding communication within African American families using strength-based, empowerment-oriented, and ethnically sensitive approaches.
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Affiliation(s)
- Alexis L Woods Barr
- 414742331 Department of Maternal and Child Health, Carolina Global Breastfeeding Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, USA
| | | | - Jacquana L Smith
- 414742331 Department of Maternal and Child Health, Carolina Global Breastfeeding Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, USA
| | - Ellen J Schafer
- 1791 Department of Community and Environmental Health, College of Health Sciences, Boise State University, Boise, ID, USA
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