For this assignment, you will write a 2-3 page proposal paper that introduces a health or risk behavior you intend to explore in-depth throughout the semes

September 24, 2024

Breastfeeding in Marginalized Communities

Introduction

Breastfeeding is one of the most effective health interventions for ensuring infant development and promoting maternal health. It lowers the chance of childhood obesity, diabetes, S.I.D.S., and respiratory infections in children (Prentice, 2022). Breastfeeding moms can reduce their risk of cardiovascular disease, type 2 diabetes, and ovarian and breast malignancies (Office of the Surgeon General (US) et al., 2011). Despite these advantages, breastfeeding remains extremely difficult for many moms due to social and cultural hurdles, especially in marginalized groups (Segura-Pérez et al., 2021).

Despite the fact that 83.2% of babies in the United States begin nursing, only 55.8% of them are still being nursed at six months, with 24.9% being exclusively breastfed, according to the C.D.C. Breastfeeding Report Card (2022). While economic challenges and obstacles at work play a part, cultural influences, societal expectations, and a lack of information or assistance are the leading causes of breastfeeding obstacles (World Health Organization, 2023). Not breastfeeding has serious health consequences for both moms and their babies, making it a significant public health issue. These are problems that a public health campaign can solve by emphasizing attitude modification and giving moms the assistance they need to have excellent breastfeeding outcomes.

Barriers to Breastfeeding

Affected Populations

Low-income, minority, and rural populations are disproportionately affected by breastfeeding barriers (Tomori, 2022). The C.D.C.'s 2020 Breastfeeding Report Card shows that 84.1% of U.S. infants start breastfeeding, but only 58.3% continue at six months, highlighting mothers' daily struggles. According to the 2010 National Immunization Survey, Black mothers initiate breastfeeding at 54.4% and continue at 26.6% at six months, compared to 74.3% and 43.2% for White mothers (Segura-Pérez et al., 2021). Complex factors like socioeconomic disadvantages, limited healthcare and support systems access, cultural influences, and historical trauma contribute to these disparities (Tomori, 2022).

Geographically, the south of the United States has historically had lower breastfeeding rates because there is frequently less access to lactation consultants and Baby-Friendly hospitals there (Raju, 2023; Tomori, 2022). For example, breastfeeding rates fell sharply from 41.2% at birth to 20% between 4-6 months after delivery in a study done in rural Kentucky (Barton, 2001). Reducing these regional differences requires a multipronged strategy that includes education and the development of community-based solid support networks.

Health Implications

Breastfeeding infants greatly reduces their health risks. The World Health Organization advises that breastfed infants have a lower risk of S.I.D.S., making breastfeeding a crucial infant mortality intervention. Breastfeeding reduces the risk of respiratory infections and diarrhea, major infant mortality causes, especially in underserved populations (World Health Organization, 2023). Breastfeeding reduces the risk of childhood obesity and type 2 diabetes, which are becoming more common in the U.S.U.S. (C.D.C., 2022; Rupnicki, 2020). In these areas with limited healthcare access, these health risks are higher, making breastfeeding even more critical.

Breastfeeding benefits maternal health beyond postpartum. The report Breastfeeding from the public health perspective (2011) states that each month of breastfeeding reduces the risk of breast and ovarian cancers, women's leading cause deaths. It also states breastfeeding reduces the risk of type 2 diabetes, which disproportionately affects minority women. Mother-infant bonding and reduced postpartum depression risk are also linked to better mental health, according to the C.D.C. Breastfeeding Report Card (2022). These serious health implications show why breastfeeding rates, especially in underserved communities, must rise to improve public health.

Causes and Motivations

Several factors contribute to the causes that prevent mothers from breastfeeding for the recommended duration. Social norms are a major obstacle. In many communities, predominantly Black and Hispanic, formula feeding is normalized, while breastfeeding is less convenient or culturally appropriate (Rupnicki, 2020). These communities may also stigmatize breastfeeding, especially in public (Raju, 2023). Culturally sensitive public health campaigns that promote breastfeeding as a healthy and modern option are needed to change these attitudes. Reaching Our Sisters Everywhere, or ROSE, has shown that community-based breastfeeding programs can change cultural norms and increase breastfeeding rates (Sriraman & Kellams, 2016).

Knowledge and support gaps are another obstacle. Many mothers are not adequately educated about breastfeeding's benefits or how to overcome common challenges like latching or milk supply (Office of the Surgeon General (US) et al., 2011). The U.S. Department of Health and Human Services found that many mothers are unaware of breastfeeding's health benefits or the risks of not breastfeeding. Only 36% of respondents believed breastfeeding could prevent diarrhea, and 25% knew formula feeding could make babies sick (Office of the Surgeon General (US) et al., 2011). Educating mothers and families and providing lactation consultants to help mothers overcome these challenges, especially in the early postpartum period, would be beneficial (Whalen & Cramton, 2010). Healthcare provider training must be improved, especially in underserved areas.

Psychological factors also affect breastfeeding success. Whalen and Cramton (2010) found that many mothers hesitate to breastfeed or feel discouraged by initial difficulties. The authors also found that misinformation and inadequate healthcare provider support often exacerbate psychological barriers. According to one study, normalizing breastfeeding challenges by reassuring women that these difficulties are common and can be overcome with the proper support (Sriraman & Kellams, 2016).

Economic and workplace pressures are significant barriers, but mothers often have no control over them. Financial pressures force many mothers, especially those in low-wage jobs, to return to work soon after childbirth, often in unsupportive workplaces without lactation spaces or job flexibility (Kirksey, 2021). Under the Fair Labor Standards Act, nursing employees are entitled to breaks and a private space to pump at work, and mothers should be educated about these rights ('F.L.S.A. protections to pump at work,' n.d.). Public health efforts can reduce these barriers and promote longer breastfeeding by teaching mothers to advocate for themselves.

Conclusion

Cultural and social norms create complex breastfeeding barriers, especially in marginalized and underserved communities. Many of these barriers can be overcome by targeted public health campaigns that change attitudes, educate, and support breastfeeding mothers. Tomori (2022) found that public health initiatives can boost breastfeeding rates and public health outcomes by promoting the health benefits of breastfeeding for infants and mothers and addressing psychological and cultural barriers. A supportive breastfeeding environment will help close this health disparity gap and allow more families to benefit from breastfeeding.

References

Barton, S. J. (2001). Infant feeding practices of low-income rural mothers. MCN. The American Journal of Maternal Child Nursing, 26(2), 93–97. https://doi.org/10.1097/00005721-200103000-00008

CDC. (2022). Breastfeeding Report Card United States, 2022. https://www.cdc.gov/breastfeeding/data/reportcard.htm

“FLSA protections to pump at work.” (n.d.). DOL. Retrieved September 22, 2024, from https://www.dol.gov/agencies/whd/pump-at-work

Kirksey, K. (2021). A social history of racial disparities in breastfeeding in the United States. Social Science & Medicine (1982), 289(114365), 114365. https://doi.org/10.1016/j.socscimed.2021.114365

Office of the Surgeon General (US), Centers for Disease Control and Prevention (US), & Office on Women’s Health (US). (2011). Breastfeeding from the public health perspective. Office of the Surgeon General.

Prentice, A. M. (2022). Breastfeeding in the modern world. Annals of Nutrition & Metabolism, 78 Suppl 2(Suppl. 2), 29–38. https://doi.org/10.1159/000524354

Raju, T. N. K. (2023). Correction: Achieving healthy people 2030 breastfeeding targets in the United States: challenges and opportunities. Journal of Perinatology: Official Journal of the California Perinatal Association, 43(1), 131–132. https://doi.org/10.1038/s41372-022-01561-9

Rupnicki, S. (2020). Breastfeeding Report Card United States. https://www.cdc.gov/breastfeeding/pdf/2022-breastfeeding-report-card-h.pdf

Segura-Pérez, S., Hromi-Fiedler, A., Adnew, M., Nyhan, K., & Pérez-Escamilla, R. (2021). Impact of breastfeeding interventions among United States minority women on breastfeeding outcomes: a systematic review. International Journal for Equity in Health, 20(1), 72. https://doi.org/10.1186/s12939-021-01388-4

Sriraman, N. K., & Kellams, A. (2016). Breastfeeding: What are the barriers? Why women struggle to achieve their goals. Journal of Women’s Health (2002), 25(7), 714–722. https://doi.org/10.1089/jwh.2014.5059

Tomori, C. (2022). Overcoming barriers to breastfeeding. Best Practice & Research. Clinical Obstetrics & Gynaecology, 83, 60–71. https://doi.org/10.1016/j.bpobgyn.2022.01.010

Whalen, B., & Cramton, R. (2010). Overcoming barriers to breastfeeding continuation and exclusivity. Current Opinion in Pediatrics, 22(5), 655–663. https://doi.org/10.1097/MOP.0b013e32833c8996

World Health Organization. (2023). Infant and young child feeding. World Health Organization. https://doi.org/10.25754/PJP.2009.4498