You Don't Know My Story

In recent years, there has been increased discussion and activity centered on improving breastfeeding rates among African American women. For over four decades, there has been a gaping racial disparity in initiation and duration rates between black women and white women, particularly at the 6-month and 12-month exclusivity milestone, which remain the silver and gold standards for infant nutrition. According to Healthy People 2020, the national breastfeeding goal for 2020 is 81.9% initiation, 60.6% at 6 months and 34.1% at 12 months.  However, according to the National Immunization Survey, in the United States of America, black, non-Hispanics current breastfeeding rates are 54.4%, 26.6% and 11.7% respectively.  As breastfeeding rates among black women stagger, infant mortality among black babies continues to steadily increase. Nationwide, black infants die at 2.3 times the rate of white infants before their first birthday. In New York City, the black infant mortality rate is 2.7% for white infants and 8.5% for blacks, and in Chicago, the death rate is 4.6% and 14.7% for white and black infants respectively. Currently, the infant mortality rate for black infants in Michigan is 14.2 per 1000 births.  This rate is nearly triple the infant mortality rate of 5.5 per 1000 births for white infants.  Immediate and concerted action is required.

The Centers for Disease Control and Prevention (CDC) has outlined that increased breastfeeding among black women could significantly decrease the infant mortality rate—saving the precious lives of infants who are born too small, too sick or too soon and need the immunological properties and protective health benefits of breast milk the most. All infants can benefit from the reduced risks of ear infections, Type II diabetes and childhood obesity that mother’s milk have been proven to cause.

Many interventions, including increased prevalence of breastfeeding support groups, have been proposed and or implemented to address reducing this disparity and therefore, the disproportionate death of vulnerable black infants. Hospitals, WIC offices and community health organizations across the country have created various support groups in an attempt to buoy black breastfeeding rates.  However, an identified gap in current breastfeeding support models has been their ability to maintain and sustain attendance and mother engagement. By and large, breastfeeding support groups for black women remain ineffectual.

The limitations of current models include a lack of a social cultural context, a lack of mother leadership and community input and a void of dialectical interaction. These critical lapses have heretofore hindered transformational and authentic support for breastfeeding success. 

The Black Mothers’ Breastfeeding Club model, however, is distinctly different for several key reasons. Unlike most stand-alone support groups, the mother-to-mother model created by BMBFA is based on a collective impact framework which involves a centralized infrastructure, a dedicated staff, and a structured process that leads to a common agenda, shared measurement, continuous communication, and mutually reinforcing activities and action plans by club facilitators and members.

In addition to the unique culturally relevant and appropriate structure and framework of BMBFA clubs, BMBFA fully understands that increasing breastfeeding engagement among Black women, like other social problems, is not just a technical challenge, it is also an adaptive challenge. Reaching an effective solution requires culturally-grounded learning by the stakeholders involved in the problem, who must then change their own behavior in order to create a solution.

BMBFA takes much pride in asserting that its club model is far removed from the isolated approaches that often dominate breastfeeding support initiatives and inhibit any major effort at comprehensive, large-scale change in reducing racial disparities in breastfeeding rates.  After seven years of successful and long-standing support groups, with robust attendance and continued connections with parents beyond the time a member is breastfeeding, BMBFA has begun to codify what it has learned so that other organizations can build and maintain successful support groups more rapidly.  Processes and culturally nuanced knowledge that took BMBFA years to develop can now be adapted and replicated by other communities and organizations nationwide in significantly less time.

During the video, two breastfeeding mothers describe how Black Mothers’ Breastfeeding Club was a significant factor in the survival of their infants.