For Ayesha Robinson and her daughter Zoay, 11, breastfeeding is an art.
They were a picture of harmony at a virtual Black Breastfeeding Week celebration on Tuesday, showing off Zoay’s drawing of a baby swaddled in its mother’s hair.
“I thought that maybe the hair is like what carries you,” explained Zoay, who was breastfed by her mom who also breastfed Zoay’s older brother. “The baby… just carries your love”. An accompanying poem “What a Spectacular Thing” paid tribute to the experience.
It is an experience, however, not as common in the Black community, and UCSF organized a virtual conference this week to underscore the systemic barriers and discrimination that have resulted in this disparity.
Nearly 15 percent more white mothers than Black mothers were breastfeeding at three months after birth, and that difference increased to 17 percent at six months, according to a recent survey by the Centers for Disease Control and Prevention.
These gaps matter because at least six months of exclusive breastfeeding is regarded as the gold standard for infant feeding, imparting critical health benefits for both the mother and baby.
“We celebrate this week to promote and educate the importance of breastfeeding in our community,” said panelist Ameerah Thomas, program director for San Francisco Black Infant Health, “but also to uplift the history of Black women in the U.S. and our journey of breastfeeding.”
That journey includes one in which enslaved Black mothers were forced to serve as wet nurses. “And this was followed by generations of systemic barriers to breastfeeding.”
While healthy children may be raised on formula or a combination of formula and breastfeeding, exclusive breastfeeding is recommended because it is free and may provide protective health benefits that fight diseases like type 2 diabetes, hypertension, and certain types of cancer.
Thomas and other panelists noted the lack of investment in and access to culturally appropriate services for Black birthing people is compounded by the legacy of breastfeeding and slavery.
Barriers include lack of knowledge about and support for breastfeeding among Black birthing peoples’ families and social networks.
Mothers without paid leave, who return to work earlier, and who live in communities where healthcare facilities do not encourage breastfeeding or provide culturally appropriate guidance and resources may find it more difficult to nurse their babies.
Having access to healthcare workers and providers who are members of the community, who understand and share the experience of Black birthing people, is also crucial.
Malia Cohen, Member of the California State Board of Equalization and former Board of Supervisors president, served as event emcee and spoke candidly with Mission Local about her experience as a new, Black breastfeeding mother.
She said she relied on the care of skilled professionals, including a doula and lactation consultant, during her pregnancy, childbirth, and breastfeeding experience. From getting her baby to “latch” immediately after birth to navigating clogged milk ducts, she had the support she needed.
“My experience is unique, and I don’t forget that,” she said. She would like to see everyone have the same access to health care that she had.
Cohen offered doulas as an example of how support across the continuum of a Black birthing person’s experience — or wraparound services from pregnancy to birth to breastfeeding — is tied to key maternal and child health outcomes.
“If we are going to make a positive impact on decreasing the number of maternal deaths and babies that don’t make it, we need to be mindful of pre-term care,” she said.
One such effort featured at the event was EMBRACE, a UCSF-based program founded in 2018 to support Black families during pregnancy and up to one year after birth from a culturally-specific, “intentional angle of racial consciousness”.
Prior to the event, EMBRACE co-founder Dr. Andrea Jackson, UCSF obstetrician-gynecologist and associate professor, provided a health provider’s perspective on breastfeeding support.
“I think there’s a misconception…that people think that [Black birthing people] don’t want to breastfeed,” Jackson said, “It’s harder [for them], which is why we need Black Breastfeeding Week, why we need things like EMBRACE, why we need all these support groups.”
She said that hospitals and health care centers have to check their priorities: “The work that we are doing is not about the numbers or cost, it’s about justice … and justice is going to require that you invest both in the providers who are doing this work … and directly in the patients in the community.”