Breastfeeding Awareness and Empowerment (BAE): A Black Women-Led Approach to Promoting a Multigenerational Culture of Health

Abstract

(1) Background: Critical gaps in the U.S. healthcare system perpetuate adverse reproductive health outcomes for Black people. Grounded in reproductive justice and trauma-informed care, Breastfeeding Awareness and Empowerment (BAE) has developed a program titled BAE Cafe to directly address these gaps by providing community-based lactation and perinatal mental health support. A literature review identified key programmatic gaps, namely, access to knowledge relevant to troubleshooting breastfeeding, peer support, community support and healthcare system support, and system-level factors that impede families and communities from accessing lactation support. (2) Methods: This paper describes BAE Cafe through a group process observation and participant survey. (3) Results: The observation of groups highlighted the core elements of the BAE Cafe model: knowledge, support and mental health support in a peer driven format. Participant survey feedback was overwhelmingly positive and highlighted the critical importance of lactation support for Black women by Black women and BAE’s role in participants’ decisions to continue breastfeeding. (4) Conclusions: BAE Cafe is a replicable, scalable, peer-driven and low-barrier intervention that has the potential to improve outcomes for Black families. Additional research and investment are now needed to assess large-scale implementation to reduce disparities and address health inequity across different contexts and settings.

Commentary: Disparities and Racial Barriers Among African American Women Despite Breastfeeding Workplace Policies

“…2,5 Systemic racism may be a root cause of inequities faced by employed African American women, such as breastfeeding initiation and duration rates. 6 An example of how systemic racism and implicit bias are manifested is the assumption made by health care providers such as nurses, physicians, and/or counselors that Black women will not breastfeed and thus do not provide breastfeeding education and recommendations. 2 Workplace racism is also associated with lower odds of breastfeeding among African American women, even in workplaces with breastfeeding policies in place.…”

“…12,13 Addressing myths and creating a sense of belonging An effective communication strategy reflects African American women's cultural beliefs and attitudes and has the potential to inform, promote literacy-level appropriate messaging clearly, and influence key stakeholders (ie, policymakers) to improve health outcomes through advocacy. 6 It is recommended that educational workshops or lactation training programs be held at the workplace or community centers (ie, church) so that the African American can form more robust social support systems (ie, family and friends) with women from similar cultural backgrounds and appreciate medical services made available to them during the health care decision-making process for their families. They can socialize with other women, learn about their experiences and methods for balancing work and breastfeeding their infants, and encourage active participation in questionand-answer sessions to increase knowledge and self-efficacy about breastfeeding.…”

Stress, social support, and racial differences: Dominant drivers of exclusive breastfeeding

“…Structural issues including unpaid maternity leave and racism are major sources of stress among birthing people (Troxel et al, 2003) and it is necessary to address these issues among birthing people. In many cases, stress could likely be reduced if parents had extended paid leave, easy access to breastfeeding support in hospital and after discharge, and access to racially concordant care from birth workers (Duncan et al, 2022; Lauzon‐Guillain et al, 2019). In addition, maternal stress reduction interventions such as prevention of breastfeeding complications, prenatal lactation counseling, preparation, especially among new parents and relaxation therapy to induce milk production during breastfeeding are effective interventions that can be explored (Shukri et al, 2018).…”

“…Structural issues including unpaid maternity leave and racism are major sources of stress among birthing people (Troxel et al, 2003) and it is necessary to address these issues among birthing people. In many cases, stress could likely be reduced if parents had extended paid leave, easy access to breastfeeding support in hospital and after discharge, and access to racially concordant care from birth workers (Duncan et al, 2022;Lauzon-Guillain et al, 2019).…”