‘Band together’: Businesswoman broaches subject of racial disparities among breastfeeding moms

There is a disparity between resources offered to Black mothers who choose to breastfeed and women of other races, and it is Gerria Coffee’s mission to educate and foster understanding on those differences in the community.

There is a difference not only in the number of Black women who initiate breastfeeding, but also in the length of time they continue, said Coffee, owner of Genesis Birth Services, 1307 Park Ave., Williamsport.

“The idea is to make resources available to all of the needs and beliefs and cultural practices that are in the area,” Coffee said during a virtual meet and greet.

“While Black families are in the minority population-wise in this area, it doesn’t change the fact that there are diverse backgrounds…So, it’s important to me that we band together and work together to be able to provide the resources and the support that’s necessary to families in the community,” she said.

Statistically, Black women have the highest maternal mortality rate, and Black infants have the highest infant mortality rate, as well as the lowest rates of breastfeeding initiation and duration.

According to the CDC, in 2015, 69.4% of Black women initiated breastfeeding, compared with 85.9% of white women.

Among all infants, Black infants had a significantly lower rate of any breastfeeding at age 3 months at 58% than did white infants at 72.7%. At six months, the rates were 44.7% among Black infants and 62% among white infants.

Rates for exclusive breastfeeding for three-month old babies were 36% among Black infants and 53% among white infants; at six months, the rates were 17.2% among Black infants and 29.5% among white infants.

“A lot of these families are going through the same systems as everyone else when it comes to healthcare,” Coffee said.

The difference between the experiences a white woman might have compared to a Black woman interacting with the healthcare system is that one is less likely to have a role model or support system for instruction and encouragement while the other is working from a history that encourages breastfeeding.

“Imagine a family who’s experiencing the trauma that’s passed down. No mirroring — they have not seen anyone breastfeed, and they don’t even know who they can ask about their questions. They don’t even know where to start with their questions,” Coffee said.

Black women who were enslaved were used to breastfeed the children of their owners, forcing them to neglect the nutrition of their own children, who often died from a lack of food.

Coffee shared that the slaves weren’t allowed to feed their babies from the same breast they used for nursing their owner’s baby.

“So, all the milk that they were producing, because they too had just given birth, was reserved only for the person who was enslaving them (and for) their children,” she said.

“Imagine a newborn baby is hungry. You can’t feed them at the same time, you can’t even though you have two breasts, you can’t feed them off the same breast. What happens is the baby is hungry and oftentimes, when the mother is going to the house, she can’t take her baby with her,” Coffee said.

Some might think what happened almost 200 years ago could hardly have an impact on women planning to breastfeed now, but nothing in history happens in a vacuum.

“The fight to protect the choices that individuals make regarding reproductive care has a long and nuanced history. One very important part of this history is the negative experiences had by women of color when it comes to breastfeeding. In many different contexts, these individuals face structural barriers and stigma that complicate their decision whether or not to breastfeed in the first place and hinders their ability to breastfeed if they choose to do so,” according to Victoria Gonzalez, visiting assistant professor of sociology at Lycoming College.

“Part of the reason for this lies in intergenerational trauma,” Gonzalez said. “This type of trauma stems from the transmission of historical oppression from one generation to the next. Intergenerational trauma can impact the psychological, social, neurobiological, biological and cultural well-being of those who experience it. Therefore, in terms of breastfeeding, a woman does not have to first-hand experience the traumatic history of wet-nursing to still feel the pain of it. Wet-nursing, in many ways, was a form of reproductive slavery. Women were not given a choice; they were forced to feed individuals who would ultimately oppress them.”

Coffee admitted that this is perhaps one of the factors that has had the greatest impact, and it’s not possible to go back and change it.

“Think about the children who witnessed their siblings dying of starvation. If there were surviving children, neighboring children who lived in that space as well witnessing that and then passing on, ‘Don’t breastfeed, breastfeeding is terrible’ or ‘breastfeeding is associated with oppression.’ That ‘mammy’ image gets passed on because that’s a traumatic experience,” Coffee said.

Coffee cited three main themes when summarizing Black women’s

breastfeeding experiences: cultural, which would encompass family, peers and community support or misconceptions and personal factors; sociological, which might include, prejudice, racism, home environment, financial status and sexuality issues, breastfeeding role models, employment and employment policies; and finally, health dimensions, which could include family involvement, timely and honest information from staff, baby-friendly hospital admission and post-natal follow-up.

The federal Break Time for Nursing Mothers law requires employers covered by the Fair Labor Standards Act to provide basic accommodations for breastfeeding mothers at work. These include a private space, other than a bathroom, where a lactating mother can pump or express milk during the workday.

“It’s federal law for the first year,” Coffee stated.

“That goes back to the education piece and the support piece — if you have someone say, hey, you can breastfeed. You can do this. I’ll support you and you can do this at work too,” she added.

She noted that this helps take away the fear of a mother losing her job if she chooses to breastfeed.

There is also a disparity in the delivery of health care to Black women, which affects their access to such things as lactation support, lactation education, lactation counselors, breast pumps, supplies and even culturally competent support, which addresses their specific cultural needs.

“I think that to fully understand the current issues that women of color have with breastfeeding, you must consider both the history of intergenerational trauma and the current system of systemic racism,” Gonzalez said. “In general, women of color experience higher rates of both maternal mortality and infant mortality. They often breastfeed less because hospitals in predominantly minority neighborhoods do not often encourage them to do so or teach them to do so. Therefore, there need to be more programs and policies that are designed to target these specific issues.”

In her role as a doula, or trained professional who supports people through pregnancy, birth and postpartum, and a lactation professional, Coffee is able to reach some families either early in a pregnancy or even before while the family is considering the pregnancy.

“Having those early conversations is a great way to engage someone in the conversation. Having been a breastfeeding mother — and still am a breastfeeding mother myself, I’m able to say, this is what works for me, but now I’m also a lactation professional, so not only does this work for me, but this is what works in general,” she said.

“Then it becomes being available and not making someone feel like a burden, answer all the questions, spend the time understanding the psychosocial, social implications of what they’re experiencing and why they probably are experiencing hesitation in the first place,” Coffee said.

She stressed the importance of community partnerships in the work that needs to be done.

“What community partnerships look like is having communication across organizations who are caring for the same people,” Coffee said.

How this would work is when a family goes to the hospital, the hospital would make them aware of the resources in the community and would refer out.

“So we need a system for communication to be able to not only get support, but to track outcomes, successes and to identify other resources that might be needed to make the outcomes that we’re looking for possible,” she added.


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