Up Close: Breastfeeding Disparities

A focus on breastfeeding and why breastfeeding peer counseling is important. 

The US is facing a crisis in maternal and child health. Parents of color and their infants have 2-4 times the risk of preterm birth, pregnancy complications, and infant death, and that risk is continuously rising. Breast/chestfeeding can: 

• Significantly reduce the risk of lifetime disease and disability, especially for families experiencing poor birth outcomes. 

• Provide immune protection and support for brain and gut development for infants.

• Reduce the risk for heart disease, and ovarian and breast cancers in breast/chestfeeding parents.

The American Pediatric Association and the Centers for Disease Control and Prevention recommend that infants receive only breastmilk for the first 6 months of life, and continue to receive breastmilk alongside solid foods for at least the first 12-24 months of life. Yet significant disparities in breast/chestfeeding persist in the US, with Black and Latinx parents breast/chestfeeding at reduced intensity (smaller proportion of infant’s diet is breastmilk) and for shorter duration (fewer total weeks providing breastmilk to infant) than non-Black and Latinx parents. Reduced breast/chestfeeding intensity and duration among Black and Latinx families results in 1.5-3.5 times higher risk of illness and death among Black and Latinx infants compared to white infants, and contributes to more than 3,340 excess maternal deaths annually. 

Clinically integrated BPC (ci-BPC), like doula care, supports patients by delivering non-clinical, culturally-relevant education that enhances patient experience. Ci-BPC may be able to reduce breast/chestfeeding disparities by providing breast/chestfeeding care at a time where patients may need it most, yet there is not a lot of research on ci-BPC. This study is important because of the majority of parents’ desire to provide breastmilk to their infants and require support to succeed with their feeding goals. As the largest study of ci-BPC in the US, this project will improve the quality of evidence available for patients and partners to determine the benefits of ci-BPC for all patients, especially Black and Latinx patients. These findings can support the expansion of the ci-BPC model.