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  • Writer's pictureChardá Bell, IBCLC, CBE, CD

Blactivism - The Blog Series: Racial Bias in Lactation Support Vol. 1

This is a blog series focusing on anti-racism, anti-blackness, and bias in the field of clinical lactation. These blogs discuss critical issues within the field of clinical lactation, offering insights into how anti-racism efforts can be applied to improve equity and inclusivity in breastfeeding support services.

Breastfeeding is universally acknowledged as one of the most beneficial practices for infant health, yet racial disparities persist in access to and quality of lactation support services. The impact of racial bias on breastfeeding support cannot be overlooked, particularly for Black mothers and families who often face systemic barriers in accessing adequate care.

Understanding the Impact

I became a lactation consultant because I saw firsthand systemic biases undermining the quality and accessibility of lactation support for Black mothers in a number of ways. 1) Racial disparities in healthcare access mean that Black women are less likely to receive prenatal education about breastfeeding which hinders their preparedness for breastfeeding postpartum. 2) Biases (explicit and "implicit") held by healthcare providers far too often influence the care and advice given to Black mothers, leading to less encouragement and support for breastfeeding compared to their white counterparts. As a Black lactation consultant who works with a high number of Black families, I hear this every day....a parent saying they didn’t feel heard or validated by their non-Black provider before coming to me. The sad truth is, Black mothers are treated worse than white mothers in healthcare settings and this has to change.

Challenges Faced

Black mothers also encounter unique challenges due to historical and social factors that negatively affect their breastfeeding experiences. Yes, I'm talking about wet nursing forced upon enslaved Black people in America, and therefore, generations of women choosing not to breastfeed their own children in the present day due to these traumatic and heinous acts on our ancestors. Another challenge includes limited access to lactation consultants who understand their cultural context. Less than 5% of IBCLC (international board certified) lactation consultants are Black, this isn't because Black women don't want to be lactation professionals, it's because of the barriers placed all around us that prevent us from entering the white cisgendered female dominated field of lactation. Lastly, workplace environments and jobs that simply do not support breastfeeding and societal stereotypes that undermine confidence in breastfeeding. Black women return to the workplace sooner than white women and make less income due persistent wage disparities. Black women often don't see other Black women breastfeeding, or even hear them talk about it. This might be due largely in part to our rates being low due to lack of access to support (for a number of reasons) and the fact that formula marketing preys on the Black community. Black mothers are offered formula at a rate of 9x higher than white mothers.

Initiatives for Change

I’m not writing this shame or blame or to tell folks what to do, but rather to give my two cents on how I think things can change for the positive with these recommended implementations to address disparities and promote equitable lactation care. Far too often people, especially white women, look for the “easy solution” they just want to “fix it” themselves to be the one to say they “saved us” and somehow single handedly made the world a better place, but that is not what this is about. There is no magic wand, this will take real work, candid open conversations and persistence is key.

Cultural Competence in Lactation Training Programs: Lactation consultants should receive training that mirrors cultural competence in practice. This is to help them to better understand and address the cultural needs of diverse communities. Lactation training should always include sensitivity training to help recognize and combat biases that affect the support they provide.

Black Disapora Led Community-Based Support Programs: Providing tailored breastfeeding support to Black mothers, led by lactation professionals and peer counselors who share similar cultural backgrounds. These type of programs offer vital emotional and practical support which can improve breastfeeding rates for Black families and strengthen positive health outcomes for Black babies and future generations.

Black & BIPOC Led Advocacy Efforts: Pushing for policy changes to mandate better breastfeeding support in healthcare settings and workplaces for all is crucial. This includes advocating for extended maternity leave and workplace accommodations for breastfeeding mothers. These efforts should be Black led, white women need to ask how they can help, instead of taking charge. Simply put, For US, by US, this is our battle and we will win but good support is welcome. Unsure if you should be leading an initiative on Black women health? if you are not Black or Brown, please sit down.

Photo Credit: Melanin Milk SD; Black led support group being held at the Southeast San Diego Breastfeeding Clinic

So, where do we go from here?

Addressing racial bias in lactation support requires a multi-faceted radical approach that combines education, policy reform, and community engagement. By promoting culturally competent care, expanding community-based support programs, and advocating for policy changes, we can create a more inclusive and equitable environment for all mothers to receive the breastfeeding support they deserve.

Fostering equity in lactation care is essential for ensuring that all mothers, regardless of race or background, have the support they need to make informed decisions about breastfeeding. Through these efforts, we can continue dismantling systemic biases and create a more nurturing and inclusive environment for Black mothers and families.

To those who are already doing the work, I see you and I thank you.

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