It’s been a grizzly week for breastfeeding in the media — Mayor Bloomberg’s “Latch On NYC” initiative has kicked up a lot of dust — but quietly over at Forbes, Kimberly Seals Allers, a journalist and author who focuses on African-American motherhood issues, has written a compelling piece on an important and sometimes overlooked aspect of the breast-bottle debate.
“Truth moment: I discovered something about myself when I was breastfeeding my daughter. I did not really want a white woman to see my breasts. Maybe because of my overly dark areola and large nipples (I had to get a special pump), which seemed exotic and very National Geographic in my own mind. And I certainly didn’t want to tell a white woman some of the comments of my family members, which were really at the root of my insecurities around breastfeeding but may have sounded ‘ignorant’ to anyone else not familiar with our cultural history.”
It turns out there are miserably few black lactation consultants. So few that the Surgeon General’s Call to Action on Breastfeeding includes the goal of “creating opportunities to prepare and train more IBCLCs from racial and ethnic minority groups that are currently not well represented in this profession.” But as it stands there are hardly any. We don’t know exactly how many, but according to Allers, there are two black IBCLC (International Board Certified Lactation Consultants) in New York City.
The promotion of formula by hospitals — in the form of free formula handed to mothers by medical professionals — has been cited as a contributing factor to lower rates of breastfeeding among African-American mothers. (CDC indicates that 54% of African-American women attempt to breastfeed their babies, compared to 80% of Hispanics and 74 %of whites.) Bloomberg’s support of an initiative to remove formula promotions from NYC hospitals is likely inspired partly by research showing this effect. But that’s only one piece of the puzzle.
Sylvia Edwards, co-chair of the Alabama Breastfeeding Coalition, tells Allers, “black women often find it easier to speak to my black lactation consultants or nurses. They understand each other from a cultural perspective and can relate to them in a different way than they are able to relate to me.”
There was a remarkable story in the New York Times a couple years back reporting the benefits of training hospital staff in a Queens hospital to adequately address the specific cultural needs of their incredibly diverse population. Specifically, researchers looked at the assumptions women of various ethnic backgrounds had about breastfeeding and then trained their staff to adequately address these assumptions and concerns. “They found out that in Bangladesh colostrum is considered impure and is usually discarded and that Bangladeshi women had no idea that it is, in fact, highly nutritious. Chinese women planning to send their children to be raised their first few years by relatives in China, a common practice, will not breastfeed. And though breastfeeding is common in rural Mexico, Mexican women here are often eager to give their babies formula.” It was an inspiring piece about how important it is for doctors to listen more attentively to their patients — not just their complaints, but their backstory.
But Allers thinks cultural training is not enough or not the most efficient way to go, anyway: “Can white certified lactation consultants help bridge the racial gap in breastfeeding rates? Perhaps, with a lot of cultural training. Could more African-American consultants get us there much faster? Absolutely.” She wants the International Lactation Consultants Association “to do better” and address the lack of diversity in its organization.