Structural Racism and Barriers to Breastfeeding on Chicagoland's South Side

Abstract

For African American (AA) families on Chicagoland's South Side who choose to breastfeed, finding and receiving services needed to reach their goals are difficult. The disparities in breastfeeding support across Chicagoland are symptomatic of inequitable health care access shaped by persisting structural racism. A number of community hospitals that once served AA families by providing easy access to care no longer exist. Recently, South Side obstetric unit and hospital closures have increased. Simultaneously, funding is increasingly competitive for community health organizations and federally qualified health centers. Institutions and agencies that do receive funding or adequately allocate funding to include lactation services cannot address breastfeeding barriers within socioeconomically marginalized communities. The unmet funding needs not only affect breastfeeding families but also impede the growth of a multilevel lactation care workforce. Finally, inconsistencies persist between breastfeeding information provided by lactation providers and delivery team care received in the hospital. Despite these barriers, we believe pathways exist to improve breastfeeding rates among South Side AA communities, such as perinatal home visiting services. Stakeholders must recognize the longstanding effects of structural racism and address the inequitable distribution of perinatal care across Chicagoland. Stakeholders must also place value in and be supportive of lactation care providers and the families they serve through both funding and policies. These changes, in addition to community-level collaboration, can improve breastfeeding rates for AA families on Chicagoland's South Side.

Pandemic policies and breastfeeding: A cross-sectional study during the onset of COVID-19 in the United States

“…Notably, these benefits were more pronounced for higher-income, married, and white parents (Huang and Yang, 2015 ; Hamad et al, 2019 ). In contrast, we know from other research that childbearing people in communities of color are most negatively affected by structural racism in the U.S. and have fewer opportunities to leverage political economic, social, and legal resources that might buffer against the harmful effects of extreme economic pressures that force a return to work soon after giving birth (Ehrenreich and Siebrase, 2014 ; Hawkins et al, 2015 ; Johnson et al, 2015 ; Asiodu et al, 2021 ; Butler et al, 2021 ; Hemingway et al, 2021 ; Morrow et al, 2021 ). COVID-19 has only exacerbated these longstanding structural inequities that contribute to ongoing breastfeeding disparities in the U.S.…”

Racial Inequities in Breastfeeding Counseling Among Pregnant People Who Use Cannabis

“…Specifically, maternal-child health researchers have highlighted the need to address the effects of structural racism on breastfeeding outcomes. [13][14][15]17,18 Finally, policies and accountability practices are needed to prevent inequitable access to appropriate breastfeeding advice and support, especially for Black people in the United States; there remains a need for federal policies to directly address breastfeeding equity. 19 -…”

Speaking the Same Language: A Call for Standardized Lactation Terminology in the United States

“…Use of the terms lactation care providers, lactation support providers, or lactation support professionals not only misuses terminology but also gives the false impression that all lactation personnel are equivalent, and excludes many other important contributors to the field. Although frequently used by others within an umbrella term (Butler et al, 2021; USLCA, 2020b), we have purposefully omitted the term “care” from the proposed terms because, in the healthcare arena, the word “care” implies direct patient care or clinical care. Many people in this field do not provide clinical care.…”