The Role of Lactation Doulas and the History of Breast/Chestfeeding for Black Women

Role of Lactation Doulas for Black Women

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Breast/chestfeeding is more than just a method of feeding infants; it’s a deeply rooted practice with cultural, historical, and health implications. For Black women, the history and ongoing journey of infant feeding is marked by systemic inequities and racial disparities. In this post, we explore the critical role of lactation and postpartum doulas in supporting infant feeding and honor the rich history of breast/chestfeeding within our communities during Breastfeeding Awareness Month.

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The Benefits of Breastfeeding

Breastfeeding provides essential nutrients and antibodies, lowering the risk of various infections, including ear infections, asthma, lower respiratory infections, diarrhea, and vomiting helping the baby build a stronger immune system (Cleveland Clinic, 2023). The physical contact involved in chestfeeding helps build a strong emotional bond between the parent and the child. For the parent, it can reduce their risk of breast and ovarian cancer, type 2 diabetes, and high blood pressure (Cleveland Clinic, 2023). 

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The Importance of Lactation and Postpartum Doulas 

A doula is a non-medical professional trained to provide physical, emotional, and informational support before, during, and after childbirth. Serving as a support system, educator, and advocate, doulas can specialize in specific services that best fit the client's needs.

A doula can help encourage early breastfeeding initiation and provide 24/7 care including overnight and after the parents have left the hospital. Doulas are not constrained by time whereas medical professionals like nurses, OBGYNs, and midwives potential can be (Acquaye and Spatz, 2021). Research shows that women who had doula-supported births had near-universal breastfeeding initiation (97.9%). Among African-American women, 92.7% of those with doula support initiated breastfeeding, compared with 70.3% of the general Medicaid population (Kozhimannil et.al, 2013).

Doulas provide culturally competent care, understanding the historical nuances and history of breastfeeding to help inform families of latch techniques, positioning, breast pumps, and methods to eliminate pain (Marie Closson Torres, 2014). Doulas listen to the parent's concerns identifying and eliminating myths while normalizing breastfeeding (Gavine et al., 2023).

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Barriers and History of Breastfeeding 

The CDC reports that the average breastfeeding in the United

States are 83%, but 26% of Black babies are breastfed during infancy (CDC, 2022).  Disparities in breastfeeding among black women vary based on lack of maternal access to information and support, language and literacy barriers, lifestyle choices, and lack of support or social acceptance (Holland, 2023).

The history of enslaved Black women being forced to breastfeed the children of slave masters and later serve as wet nurses for little compensation has shaped the current discrimination and experiences of Black breast/chestfeeding people (DeVane-Johnson et al.). Stigmas and stereotypes influenced the early marketing of infant formulas to Black communities depicting them as unsophisticated, uncivilized, and incapable of caring for their children (Scheffer, 2024).

Systemic barriers and racialized bias among healthcare professionals continue to influence Black breast/chestfeeding practices (Scheffer, 2024). Nurses and healthcare providers must be aware of the cultural and historical phenomena that exist for Black parents and the historical trauma that derives from slavery to the medical-industrial complex (DeVane-Johnson et al.)

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Conclusion

Lactation and postpartum doulas are crucial in supporting Black women through their breastfeeding journeys, offering continuous, culturally competent care and significantly increasing breastfeeding initiation rates. Black breast/chestfeeding people face significant barriers rooted in a history of exploitation and systemic racism. Therefore, as we celebrate Breastfeeding Awareness Month, it's critical to acknowledge the history and ongoing challenges of breast/chestfeeding and the advocacy needed for the support of doulas throughout pregnancy.  

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To find support, visit our online Doula Resource Guide

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1. Acquaye, Stephanie N., and Diane L. Spatz. “An Integrative Review: The Role of the Doula in Breastfeeding Initiation and Duration.” NCBI, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7819475/
2. CDC. “Breastfeeding Report Card | Breastfeeding.” CDC, 11 July 2024, https://www.cdc.gov/breastfeeding/data/reportcard.htm.
3. Cleveland Clinic. “Benefits of Breastfeeding for You & Baby.” Cleveland Clinic, 2023, https://my.clevelandclinic.org/health/articles/15274-benefits-of-breastfeeding.
4. DeVane-Johnson, Stephanie, et al. “A Qualitative Study of Social, Cultural, and Historical Influences on African American Women's Infant-Feeding Practices.” NCBI, 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388681/.
5. Gavine A, Shinwell SC, Buchanan P, Farre A, Wade A, Lynn F, Marshall J, Cumming SE, Dare S, McFadden A. Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database of Systematic Reviews 2022, Issue 10. Art. No.: CD001141. DOI: 10.1002/14651858.CD001141.pub6. 
6. Holland, Delaney C., "The Impact of Doulas on Breastfeeding in Black Women: a Literature Review" (2023). Capstone Experience. 272. https://digitalcommons.unmc.edu/coph_slce/272
7. Kozhimannil, Katy B B., et al. “Doula care supports near-universal breastfeeding initiation among diverse, low-income women.” NCBI, 9 July 2013, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3742682/.
8. Marie Closson Torres, Jennifer. “Negotiating Care: The Role of Lactation Consultants and Doulas in the Medical Maternity System.” University of Michigan Library, 2014, https://deepblue.lib.umich.edu/handle/2027.42/107201.
9. Scheffer, Blue Tapp. “A History of Black Breastfeeding - GenerateHealth.” Generate Health, 5 February 2024, https://generatehealthstl.org/a-history-of-black-breastfeeding/.

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