Some African-American Mothers “Just Don’t Want to” Breastfeed, Study Claims
But experts think the right techniques can change attitudes
Stephanie Warren • December 9, 2010
Anankhka Roger breastfed all four of her children. But in her African-American neighborhood in Middletown, New York, she was an anomaly.
“They’d say, ‘Why would you do that?’” she remembers. “Out of 10 or 15 moms in my church group, maybe two or three would breastfeed. Sometimes I was by myself.”
The majority of black women have opted for formula for generations, say breastfeeding advocates. Until recently, researchers have only been able to guess at why, but a study presented at the October 2010 national conference of the American Academy of Pediatrics in San Francisco may provide some fresh insight.
Two doctors at an inner-city hospital in Camden, New Jersey asked formula-feeding mothers a simple question: Why did you decide not to breastfeed? What they found surprised them. Fifty-five percent of black women reported “lacking a desire to breastfeed” (as compared to 27 percent of all other mothers studied). Typical answers were: “I think it’s disgusting,” “I just don’t want to,” and “Nobody I know does that.”
The study tested only a small population—145 mothers, 62 of them black—and leaves many important questions unanswered. But the researchers think that their findings get at a new and unexplored aspect of the breastfeeding problem. “We just thought there would be similarities between why formula-feeders formula-feed. We didn’t know their answers would differ by race and ethnicity,” says Cooper University Hospital pediatrician Dr. Lori-Feldman Winter, one of the study’s authors. And they didn’t expect that attitude would play such a big role.
Educating moms about the health benefits of breastfeeding is the focus of most advocacy groups. But the study indicates that more education might not solve the problem, says Feldman-Winter. “The black women in our study seemed to be aware of the benefits,” she says. “Pounding away that there are benefits is not the answer.” Instead, she thinks using motivational techniques—trying to convince formula-feeders one-on-one to change their minds, rather than just presenting them with the evidence—might work better.
Many professional breastfeeding advocates agree on the importance of working with women one-on-one, but they think that spreading the word about breastfeeding’s benefits is still the answer. The federal Women, Infants, and Children (WIC) program, for example, funds advocates who provide individual counseling that helps educate moms-to-be and their spouses and families about the benefits of breastfeeding. Many advocates don’t think that the new data provides any reason to modify their approach. The evidence of the health benefits, they think, does the convincing for itself.
Research has indicated that African-American babies are more likely to be underweight and to suffer Sudden Infant Death Syndrome. Later in life, they’re at higher risk for diabetes and asthma. These are all problems that have been associated with lower rates of breastfeeding in some medical studies. It’s also thought that babies who aren’t breastfed may have an increased risk of getting infectious diseases like bacterial meningitis and respiratory tract infections, and of developing certain cancers, according to the American Academy of Pediatrics.
Low breastfeeding rates aren’t only a problem among African-Americans. The World Health Organization recommends that mothers breastfeed exclusively for the first six months of the baby’s life and continue breastfeeding—supplementing with appropriate foods—until the baby is two years of age or more. However, a recent report by the federal Centers for Disease Control and Prevention shows that while 75 percent of new mothers start out breastfeeding, only 43 percent are still nursing by the time their babies are six months old. The numbers for black mothers are significantly lower. According to the most recent CDC data, from 2009, only 49 percent initiated breastfeeding, and just 20 percent were still at it when their babies were six months old.
Whether they support or question current education strategies, experts believe that longstanding cultural barriers are the main reason many African-American women refuse to nurse. “Black women were used as wet nurses for the wealthy,” says Feldman-Winter. “When they were no longer slaves, not breastfeeding was seen as a source of freedom.” After generations of shunning the practice, there’s no cultural framework for breastfeeding, say experts, and so new moms lack role models and supportive communities.
Many breastfeeding advocates believe that whether or not attitude is the cause of the problem, the only way to change a cultural pattern is to empower individuals with knowledge and let them make their own decisions. “That black women don’t want to breastfeed—that’s not the point,” says Stephanie Sosnowski, deputy director of the New York-based Maternal-Infant Services Network. “It just comes down to raising mom’s awareness and raising the awareness of the people around her.”
Anankhka Roger has seen firsthand that good education can overcome cultural barriers. Once a recipient of WIC food stamps herself, she now works for the program, educating moms and moms-to-be about the benefits of breastfeeding. “One mom came in and told us “I’m going to feed formula because of x,y, and z,” she laughs. “By the time she was ready to leave, she was saying ‘You guys have me convinced!’”
This study is not surprising to me. As a young African mother myself I was discouraged to breastfeed my first child. I really had to put up a fight with family members unaware of the benefits of nursing. They thought I was starving my baby!!! My child was even Sneeked formula behind my back! I was looked at weird while in public etc.0It wAs very discouraging because of the lack of knowledge surrounding the African American community. But I continued to breastfeed. I even breastfed my second child.
Thank u for the info.
Education is the key to empowerment.
As Anankhka’s colleague, I need to say that I definitely agree with this article… It brings up many points and sheds some light on the “why’s?” I have heard everything from “It’s nasty…it’s not me…I just don’t feel comfortable” to “I just don’t want to” even after watching a video on the benefits and talking to us about how much healthier it is for mom and baby to breastfeed. Only after really having a long one-on-one conversation with her, does she reconsider her attitude towards breastfeeding. I think we have a lot of work ahead of us in trying to make breastfeeding “the normal thing to do”.
This is very interesting to me because I work with many African American mothers. In our county, WIC has done more to improve their education and support for breastfeeding. The one on one counseling has been a positive step in helping mothers make an informed decision about how to feed their infants. I would like to see OB doctors do more breastfeeding promotion in their offices/clinics. Women make decisions about feeding long before they come in to deliver. OB docs should not simply ask them if they plan to breast or bottle feed, but they should encourage them to consider breastfeeding and why it is so important. They can encourage them to attend a breastfeeding class and put them in touch with a local IBCLC if there are concerns about whether a mother will be able to breastfeed.
This article does not surprise me. As a breastfeeding mom for two and a half years, I was not supported in this. I was questioned about the age of my child, told I should be ashamed of myself and that he is too old. My friend is head of the LaLeche League (breast feeding organization) and runs a small group out of our church. The church which is 99% African American does not have any AA attendees. We frequently ask each other how we can increase these numbers. I think a lot has to do with the lack of support for breastfeeding. Many AA women, have to go back to work quickly after having the baby and it becomes a hassle to pump the milk. The sad part is that breastfeeding could increase the children’s immune system, help prevent certain diseases as well as reduce cancer rates in the moms and help the uterus contract. We continually try to spread this knowledge because without wisdom and informtion the people will perish.
I’m an African American WIC Nutritionist in FL, and its because of WIC I became interested in breastfeeding. Before I got the job, I talked to my mom, and she revealed the joy she felt at breastfeeding me and my brother and sister. She gave me great information, and also told me it was her mom who helped her with breastfeeding. Yet her sisters did not. I think its generational. I was blessed. My grandmother and probably her mother (my great grandmother) nursed their kids….Now my husband (who wasn’t breastfed) insists I nurse our kids (when we have them), and all of my friends have nursed from at least 2-36 months. Many of them are my WIC clients…..Each AA woman who decides to nurse is like a beacon of light, slowly influencing her circle to consider and/or decide to nurse…..
African Americans have so many things stacked against them, including the need to go back to work quickly, lack of family support due to just plain ignorance, and unfortunately fear of the unknown. I am asked constantly about breastfeeding, and even though I haven’t nursed my own baby, I have helped dozens of moms nurse theirs. I work with IBCLC’s in our community, and I refer clients if needed. I conduct some of the Breastfeeding support groups, and I am just a sounding board for breastfeeding. Thats what we have to do, slowly, surely, bring breastfeeding back as the norm, the best way to feed infants, while slowly being that LIGHT to shine on others, and hopefully changing minds, and increasing Breastfeeding awareness and understanding……
I can’t believe that something so true to nature, so fundamental and obviously nature’s intention could be viewed as something to be ashamed of. How did this happen? I can’t believe people are so out of touch that they actually have the audacity to think that to ask the question “Is it appropriate to breastfeed in public?” is appropriate!!! It’s ridiculous. Think about it! I feel like saying… Are you some kind of idiot? Is breasfeeding appropriate? Come on…