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News Article

Social and cultural barriers to breastfeeding in African American community

Experts say consistent, comprehensive, and culturally relevant care is needed to support breastfeeding

While breast feeding initiation rates in the USA are high overall, at over 83%, rates are much lower in African American women at 69%. A study in Journal of Perinatal and Neonatal Nursing finds that stereotyping and racism are prevalent in breast feeding care alongside lack of resources and access. It calls for consistent, comprehensive and culturally relevant care for this group of women and advocates paid maternity leave alongside interventions to increase support in the community. Breast feeding is associated with better infant health and lower rates of initiation are setting African American children at a disadvantage.

Previous work on breastfeeding by the lead author Tyonne Hinson and others, finds that while women acknowledge benefits to infants from breastfeeding, there are many cultural and social influences that make it less likely that they act on the information they have. For example there is a lack of role models, bottle feeding is seen as ‘normal’, and there is a lack of support to breastfeed.

The study in Journal of Perinatal & Neonatal Nursing and led by Tyonne Hinson at Boston Childrens hospital, talked to 7 experts in the field and compared their responses to those from a focus group of African American mothers interviewed in the previous study by Hinson.

Examples of stereotyping by providers, judgement, racism and equity concerns were frequent in the findings. The informants provided evidence of a lack of resourcing for assisting breast feeding initiation, lack of access and resources in specific communities and disparities in care based on culture.

To turn the situation around, the researchers say  “consistent, comprehensive, and culturally relevant care practices for African American mothers by all providers that span antepartum to intrapartum to postpartum are critical.” They emphasize three interventions. First, interventions focussed on education and exposure of mothers, grandmothers, and fathers in the community. Second, development of peer networks and support groups. Third, and more fundamentally, the researchers say community and public health leaders must all address the need for paid maternity leave. This leave has a direct influence on willingness and ability to breastfeed. In their conclusions the researchers also call for more lactation consultants of colour to support breastfeeding and inclusion of their support in insurance coverage.


“This study reinforces the premise of the social ecological model, supporting the realization that the decision to initiate breastfeeding by African American mothers is not solely determined by the individual, but is contingent on multiple levels and factors external to the individual,” says co-author Diane Spatz, of the University of Pennsylvania School of Nursing


To find out more

Search for breastfeeding and “African Americans”



Subject Matter Experts Identify Health Equity Concerns in Breastfeeding for African American Women. Tyonne D. Hinson; Asheley Cockrell Skinner, Diane L. Spatz,. 2020. Journal of Perinatal & Neonatal Nursing.  doi: 10.1097/JPN.0000000000000486


Article details

  • Author(s)
  • I. Hoskins
  • Date
  • 11 February 2021
  • Subject(s)
  • Nutrition & health