Baby-Friendly Practices Help Reduce Racial Gaps in US South

One of the most confounding issues facing breastfeeding advocates in recent years has been the significant differences in breastfeeding rates between African American and white babies.

In 2006, the Centers for Disease Control and Prevention (CDC), using data from the 2004 National Immunization Survey (NIS), concluded that 71.5% of non-Hispanic white children were ever breastfed compared with 50.1% of non-Hispanic black children.

In 2011 the Surgeon General’s Call to Action to Support Breastfeeding included a call to better understand and address breastfeeding disparities, stating that:

Despite overall improvements in breastfeeding rates, unacceptable disparities in breastfeeding have persisted by race/ethnicity, socioeconomic characteristics, and geography. For example, breastfeeding rates for black infants are about 50 percent lower than those for white infants at birth, age six months, and age 12 months, even when controlling for the family’s income or educational level.

Policy makers and practitioners alike have been seeking ways to reduce these disparities so that all children have a better chance of getting the benefits of breast milk.

Now, we have strong evidence that successful implementation of Baby-Friendly practices leads to a decrease in racial disparities in breastfeeding.

In recent years, groups of hospitals have worked together in large-scale collaborative improvement projects designed to support the widespread implementation of Baby-Friendly practices. One of these initiatives is CHAMPS (Communities and Hospitals Advancing Maternity Practices), a program out of Boston Medical Center’s Center for Health Equity, Education and Research and supported by the W. K. Kellogg Foundation. CHAMPS specifically targets hospitals in southern states where the differences in breastfeeding rates between black and white infants are greatest.

In a study published this month in Pediatrics, leaders of CHAMPS report that breastfeeding initiation rates at the 33 southern hospitals enrolled in the program rose from 66 percent to 75 percent overall, and from 43 percent to 63 percent among African Americans over 3 years. The disparity in breastfeeding initiation between African American and white infants decreased by 9.6 percentage points.

“U.S. breastfeeding rates differ by race,” says Anne Merewood, PhD, MPH, lead author on the study. “This is the first study that links better compliance with the WHO’s Ten Steps to Successful Breastfeeding to lower racial inequities across a large number of hospitals.”

In the beginning of 2014, there were no Baby-Friendly designated facilities in Mississippi and Louisiana. Now, there are 8 in Mississippi and 16 in Louisiana. And those numbers are expected to rise very soon.

See related stories:
Changing the Breastfeeding Culture in Louisiana: Woman’s Hospital
Baby-Friendly Changing Lives in Rural Mississippi
Mothers of Memphis: Celebrating Breastfeeding during Black History Month)