Beyonce, Blue, Breastfeeding & Blacktating

Did you hear the good news? It seems Beyonce is indeed breastfeeding her newborn baby girl, Blue. A waiter tipped off celebrity magazine US Weekly that Beyonce nursed her baby while out to lunch with hubby Jay-Z. What started off as a blurb on a website for celeb gossip has taken the world by storm.

First there was the awful post on Hollyscoop, likening breastfeeding in public to being milked like a cow and slinging snot at the table. Of course the words "whipping them out" also appeared. For the first time in the history of the Internet, the comments on a breastfeeding in public post were full of win. Moms descended on the post, letting the author know that nursing at a restaurant is natural, legal and of course perfectly appropriate. The smackdown was so harsh the author eventually edited out the most offensive parts of the piece.

By the next day the story had been picked up by ABC News, who quoted veteran breastfeeding experts Drs. Ruth Lawrence and Alison Stuebe. There was even a quote from breastfeeding advocate Emma Kwasnica who you may know for spearheading the movement to get Facebook to stop deleting images of women breastfeeding their babies. Although I was thrilled with such mainstream coverage of Beyonce nursing in public, I was more than a bit confused as to why ABC decided to interview these three women.

Let's see, the hugest celebrity on the planet, who happens to be black, is breastfeeding in public and we interview three white women, one of whom isn't even American, and don't mention race. Color me confused.

So as I am apt to do, I took to Twitter to vent.

Shortly thereafter, Kimberly Sears Allers of Mochamanual.com, published a piece on the same topic. In her post, Dear White Women: Beyonce is OUR Breastfeeding Moment. Please Step Aside she writes,

Meanwhile, with all the news reports about Beyonce, and all the breastfeeding “advocates” talking about its impact on the nursing world, not one advocate mentioned the particular significance to black women–which is so striking since many claim to be interested in our breastfeeding plight.

Shame on you.

The "shame" didn't stop there. Not only did many breastfeeding advocates insist that Beyonce breastfeeding in public was just as much their moment as ours (it's not) they also allowed their fans to post offensive, borderline racist screed on their Facebook pages. Instead of our "allies" rushing to our defense, I was told it was my job to educate the ignorant (it's not) and that my time would be better spent defending the WHO Code instead of criticizing the breastfeeding community for not putting their money where their mouth is when it comes to conversations on race. You can imagine how well that went over.

Kimberly said there was no mainstream press that reached out to an African-American women for her perspective, but that's not true. Both Time and USA Today's writers quoted me for their pieces on Beyonce breastfeeding Blue Ivy (my words even made their way in the March 19, 2012 print edition of Time). Both writers underscored how huge this is for the black community because of our lower initiation rates, and the level of Beyonce's celebrity. This is way bigger than even Angelina Jolie actually breastfeeding on the cover of W magazine and we don't even have proof, photographic or otherwise, that it even happened!

There is no way to deny that Beyonce breastfeeding hasn't had a huge impact. There was an hours-long conversation on black Twitter about breastfeeding in public after these headlines. Yet I cannot tell you how many white advocates insist that it isn't a big deal, or at least shouldn't be. Strangely enough, whenever I see posts about other celebrities who are breastfeeding and are, let's face it, downright D list, I've seen nothing but praise. Even posts about Jenna Elfman haven't elicited any anti-Xenu snark, for God's sake. Yet it's all eye-rolls and move along, nothing to see here's when BEYONCE breastfeeds in a restaurant? Excuse me if I can't help but think that race is playing a part in the attitudes and responses from moms I've seen online.

Still, I'm thrilled. The past few weeks have been amazing for breastfeeding and I give Beyonce all the credit. This story got picked up in major black interest publications from The Grio to Vibe and Essence magazine. The comments that I saw on those pieces were so positive and encouraging. It was so wonderful to see our community rallying around our girl, and to hear from black moms about how much they loved breastfeeding their babies.

This week really showed black lactivists what this community thinks of us and the work we're doing. Because believe me, these folks are quick to trot out the the statistics on how low our breastfeeding rates our. If Beyonce had mixed a bottle of formula at that table, everyone would have come out of the woodwork to say how sad it was, but not surprising since she is black and this is a problem for us. But when she breastfeeds we aren't supposed to celebrate this as our moment?

Right.

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Breastfeeding Makes Strong Babies

Although the city of Milwaukee has been villified (and rightly so) for their anti-bedsharing campaign that used images of babies in bed with dangerous items like butcher knives, I have to give props to this breastfeeding video put together by the city's newspaper.

Featuring the awesome Dalvery Blackwell, co-founder of the African-American Breastfeeding Network, this video highlights a program in Milkwaukee aimed at encouraging young African-American moms to initiate breastfeeding.

The video was put together as part of the Journal Sentinel Online's Empty Cradles feature, which covers the city's abysmal infant mortality rates. It's a huge problem for the city that has definitely reached epidemic proportions. From unsafe sleep sleep deaths and lack of breastfeeding to social problems like alcoholism and smoking, black babies in Milwaukee are definitely at an increased risk for death in the first year of life.

Hats off to Dalvery and the great work she is doing. I'm glad she is being recognized as she fights the good fight.

To watch the video, click here.


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The Natural Trend: Is Breastfeeding Next?

Recently there has been a resurgence of the "natural hair" movement in the black community. More and more black women are choosing to stop chemically processing their hair and are wearing it in its natural state, whether that be an afro, dreadlocks, twists or kinky curls. In the last few years, women who’ve gone natural have blown up as beauty bloggers. One look at a site like AfroBella or Curly Nikki will tell you how popular the movement is. There are tons of products on the market now specifically for maintaining natural hair. Creams and conditioners that used to only be available online or in specialty salons are now sold at Target and Walgreens.  Many women have even started their own businesses selling botanical haircare products for their fellow naturalistas.

I have been thinking a lot lately about the connections between natural hair and breastfeeding. In her book At the Breast,Linda Blum conducted some interesting research with low income moms, both black and white. She found that for the black moms, the promotion of breastfeeding as the "natural" way to feed an infant was actually a turn off. The moms equated the term with being dirty and animalistic. Yet this is how we typically advocate for breastfeeding, as being natural. So I am curious now that many black women are embracing being "natural" will this change? Will the natural hair movement extend to pregnancy and birthing and breastfeeding?

The are already parallels between the natural hair movement and breastfeeding advocacy that are almost funny. For example, when actress Kim Coles decided to go natural recently she stated in an interview with Patrice from AfroBella, "I will try to stay away from debating what is more ‘natural.’ Nor will I be pushing others to take the steps that I am taking. I think that you get to choose your kind of beauty. I do however want us all to be honest with ourselves as why we make the choices that we do." On the website Nappturality, the introduction states, “If you are still relaxing your hair you are welcome here, however be warned...We don't debate the wonders of relaxing and we don't talk about the benefits of chemical or heat straightening on Nappturality because frankly, there aren't any benefits to using high heat or that caustic chemical.” 


It's very obvious from some of the discussions you see across the internet that this is a touchy subject. There are the women who say, "I am doing this for my own benefit and whatever choice you make for you is fine" and those who believe that natural hair is so vastly superior that it's obvious that every woman should go natural.

I personally have been natural (besides hair color and bleach) since I was 15. I didn't do it for any reason other than I was tired of the scalp and hair damage I was suffering after getting my hair permed. I didn't particularly love (or even like) my curly hair, but it was wash and wear and made my life simpler. Many of the reasons women give for going “natural” include health benefits (no more inhaling lye at the salon, no more hair loss or scalp damage) and financial costs (maintaining a perm is expensive). Many have never considered going natural until they saw another black woman at work or on the train who had beautiful unprocessed hair.

Again, you can see the parallels between breastfeeding. As more black women choose to breastfeed, their friends and family will be influenced by seeing them do it, as will strangers out and about in public. As more black women choose to breastfeed, they will talk about the health benefits to their babies. As more black women choose to breastfeed, they will how cost effective it is, saving them money on formula and bottles, as well as related medical costs.

So can we let this “natural” trend extend to pregnancy, birthing and breastfeeding? Because, really, it ain't all about the hair.

*Photo credit Dio Burto

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Baby Friendly Hospitals Will Improve Black Breastfeeding Rates

A new update on California's breastfeeding rates and hospital policies was released by the California WIC Association and the UC Davis Human Lactation Center. The report, titled "One Hospital at a Time: Overcoming Barriers to Breastfeeding" takes a look at how instituting baby-friendly practices at hospitals through California has impacted the breastfeeding rates.

California is currently home to 34 of the 150 hospitals and birth centers that have been certified as Baby Friendly by UNICEF/WHO. The report paints a very clear picture of how beneficial the Baby Friendly initiative has been to California's breastfeeding rates. Not surprisingly, the hospitals with the lowest breastfeeding rates are those that serve low income women of color and throughout the state, disparities are evident. The report states that in the past, these disparities were chalked up to differences in cultural practices, but the data clearly shows that hospitals that have baby-friendly policies in place were able to greatly reduce those disparities.

The report shows that the breastfeeding initiation rate throughout California for African-American women was at about 78% while the exclusive breastfeeding rate was around 40%. When you look at the exclusive breastfeeding rate for African-American women at the Baby Friendly hospitals, that number jumps from 40% to 60%. And although those numbers are still too low, they are far and away better than the national initiation rate of 54%.

We can also see the benefit of the Baby Friendly Hospital Initiative to African-American women in another state, New York. In New York City, all public hospitals are managed by Health and Hospital Corp., or HHC. HHC has encouraged its hospitals to incorporate all of the Ten Steps to Successful Breastfeeding, but only one, Harlem Hospital, has been certified as Baby Friendly.

Harlem Hospital serves a large population of African-American and African immigrant women. Any hospital that thinks becoming certified would be too difficult or wouldn't work with their population, need only look at Harlem Hospital as proof that it can be done anywhere. In 2007, right before officially becoming Baby-Friendly, 81% of women were breastfeeding when they left Harlem Hospital.

In a recent article in Heart & Soul magazine, a black woman who gave birth at Harlem Hospital talked about her experience. Alicia Lewis-Howard was told by family and friends that breastfeeding would hurt and she didn't think she would nurse for more than a month, but ended up breastfeeding for 6. She credits the nurses at the hospital with showing her how to properly latch the baby on so breastfeeding was not painful and for educating her on the many benefits of breastfeeding both to herself and her baby.

The Baby Friendly Initiative has been proven to increase black breastfeeding initiation and exclusivity rates. It is imperative that healthcare facilities that serve a large population of African-American women begin implementing as many of the Ten Steps as possible. Although the process of becoming Baby Friendly is extremely rigorous, there is no reason that hospitals can't make the smaller changes, like ensuring that all women are breastfeeding within an hour of birth and rooming in with their babies. If we want to see black breastfeeding rates improve, we have to see hospital practices improve. If California and New York can do it, why can't everyone else?


*Photo credit edenpictures


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Should Black women feel guilty for not breastfeeding?

A new article in Science Online rehashed the recent study presented at the American Academy of Pediatrics annual conference this fall. You may recall the study claimed that there was evidence that black women "just don't want to breastfeed" and was based on surveying 62 black women in Camden, New Jersey.

The new article emphasizes again that some black women just don't seem to have the desire to breastfeed, and that the authors of the study think we need to find other motivational factors to "convince"  black women to breastfeed, since education doesn't seem to be the key here. The black women knew that breastfeeding was better, but still chose to formula feed. The authors suggest that black moms would benefit from one-on-one counseling in order to change their minds. Class is not mentioned overtly, but I can only assume we are talking about working class and/or very poor women here, since Camden, NJ is one of the poorest, most violent cities in America, having the distinction of having the highest crime rate in the country in 2009.

Now, I want to increase the black breastfeeding rates as much as any other breastfeeding advocate, but I'm curious as to what could be said to working class black women to convince them to try breastfeeding? Although it wasn't stated, would guilt tripping and shaming be a part of the techniques employed? I can't help but wonder what could be said to a woman who has no desire to breastfeed, even after understanding the benefits, in part because she probably doesn't have the kind of life that makes breastfeeding feasible in the first place.

I found this particularly interesting in light of a recent book I read, At the Breast by Linda Blum. Blum spent some time interviewing both white and black working class mothers on their attitudes about breastfeeding. The book was published in 1999, yet Blum found the same to be true: black working class women knew breast was best, had been educated by WIC counselors and their doctors, were surrounded by white colleagues who breastfed and still chose to formula feed. What was most intriguing for me was that the white working class mothers were wracked with guilt, while the black mothers were perfectly fine with their decision. She writes:

The Black mothers who rejected exhortations to breastfeed, seemed, in their telling, to be relatively free of the emotional anguish many of the white mothers expressed. In fact, as sociologist Carter suggested, rejecting medical advice may enhance some mothers' feelings of autonomy and well-being. Much of the mothers' discussion, however, was similar to that of the white mothers; they spoke of difficult life circumstances and a lack of the time, space and health that would help make breastfeeding a positive experience. This raises the question again of whether some mothers are better off rejecting breastfeeding--like these Black mothers--than feeling that they have failed at their motherly duty.

I can't help but agree here. Until we can change the circumstances for working class moms, how can we expect to convince them to breastfeed? Isn't energy better spent securing real paid maternity leave for women and laws to protect a woman's right to express milk at work, even at blue collar jobs? The women interviewed in Blum's book were janitorial staff at a large hospital, where the nurses were able to take breaks to express milk but they were not. When it comes to the working poor there is not even the guise of an even playing field. How do we expect breastfeeding rates to change when the life circumstances for these moms is still the same?

I also often hear breastfeeding advocates repeat this quote by Elizabeth Gene:“Women should not feel guilty if they are unable to nurse their baby, but they should feel guilty if they are unwilling to do so, and they should be intellectually honest enough to know the difference.”

So is this really where we are now? That even if you are being intellectually honest about why you chose not to breastfeed, we still want you to feel guilty? Only those moms who try hard enough get a pass? How does this help us increase breastfeeding rates, particularly for working class moms of color?


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Essence Magazine, Do Better

When I saw the October issue of Essence magazine at Publix, I about choked and died.

Now, if you know me, you know how much I love Blair Underwood. Like a fine wine, the man just gets better with age. I have watched some really craptastic TV just to stare at Blair. When that whole Chris Brown and Rihanna debacle happened, Blair Underwood was the ONLY black male celebrity to speak out against domestic violence and to condemn Chris Brown's behavior. None of that mealy-mouthed celeb doublespeak from Blair. No sir. Accompanying this gorgeous photo was also an article where Blair was going to talk about loving black women? Well, Essence tempted me for the first time in YEARS to buy a copy.

So as I picked up the magazine to flip through it while in line to check out, I also noticed the cover story, "7 Breast Cancer Tips to Save Your Life." Now I just knew that Essence was hitting it out of the ballpark with this issue because this article was bound to be chock full of information on breastfeeding, right?

But Essence let me down. The article actually doesn't mention really breastfeeding. The "tips" are really 7 mistakes that black women make when faced with a lump that could be breast cancer. They are: Ignoring the signs, Thinking we can't afford reconstruction, Not being strategic about clinical exams, Failing to assemble a team, Letting size get in the way of our health, Automatically opting for mastectomy and Refusing the assistance of loved ones. So the article wasn't about prevention as much as it was about dealing with the reality of a breast cancer diagnosis.

Now while I think these are important things to discuss, particularly the link between obesity and breast cancer, is there really no room for information about breastfeeding in Essence magazine? Strangely they used a stock photo of a woman nursing a baby with the caption, "It's the number of kids you have that can lead to sagging breasts--not breastfeeding" but didn't actually discuss how breastfeeding can lower your risk of getting cancer in the first place.

Essence magazine has been getting a lot of flak lately for not covering issues pertinent to young black women well. And I think that by not covering breastfeeding in their magazine, they are doing their readers a huge disservice. An ounce of prevention is worth a pound of cure and I think we should be talking to women about the importance of breastfeeding before they become mothers. Breastfeeding is just as much a part of a healthy lifestyle as eating your fruits and vegetables, exercising and being a non-smoker are. I'm sure Essence has covered these topics in their Body & Soul section.

I did a database search of Essence magazine going back to 1988 and I found two articles about breastfeeding. A paragraph on how breastfeeding benefits moms from 2004 and a piece on breastfeeding after returning to work written in 1993.

And honestly, it's not just that they need to be covering this topic more, but Essence also needs to make sure when they do, they get the information fact-checked by a lactation professional. In March of this year they published a piece online only about the study that suggested that black moms were more comfortable with formula feeding, and that this could explain the disparity in breastfeeding rates. The author (whose name isn't listed) to decides to throw in that while breastmilk is touted as complete nutrition, it is low in Vitamin D. Her solution to this problem is "regimen that combines breastfeeding and formula-feeding with an added vitamin supplement. This could also be the way to go to get mothers who aren't enthusiastic about nursing all the time to incorporate it into their feeding routine."

Now TRUST there was no place to leave a comment on this tripe or I would have. It's completely and totally inaccurate and um, who asked this anonymous blog writer for her opinion on how to get black mothers to breastfeed? Yet and still, this bad information is sitting on Essence's website to this day. That's a problem.

So while I know that Essence magazine probably thinks they have bigger fish to fry at this point (their Editor-In-Chief Angela Burt Murray has just left, after all of the controversy surrounding her hiring of a white woman as Fashion Editor) I do hope they will try to write about breastfeeding more frequently, or at the very least, with accuracy.

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Black women have no desire to breastfeed?

The American Academy of Pediatrics held their annual conference recently and information about the conference is now beginning to slowly emerge in the blogosphere. One of the things I've heard is that Nestle Nutrition, the largest sponsor of the conference, has now partnered with the AAP on a Healthy Active Living Initiative which you can read more about on PhD in Parenting.

Apparently some new information on black breastfeeding was also presented, based on a recent study conducted at a hospital in Camden, NJ. I initially wasn't going to write about the study because only the abstract is available online and I didn't think it was a great study or really told us anything useful. But since everyone is posting links to it on Facebook now I figured I should probably tackle it.

So this study looked at the barriers to breastfeeding as reported by exclusively formula feeding mothers. A whopping 62 black women were queried with the open-ended question, "Is there any particular reason why you chose not to breastfeed?" I can't tell from the abstract whether or not these women ever attempted or initiated breastfeeding, but my guess from the conclusion drawn from the study that the answer is "no." See, 55% of the respondents said they chose not to breastfeed because they simply had no desire to do so.

Now, I may never understand why women choose not to breastfeed. But is it really a revelation that a large percentage of women who never even tried to breastfeed just didn't want to? And why are the headlines screaming "Black women have no desire to breastfeed"? Because there are plenty of women of every race who have no desire to breastfeed. In fact, about 25% of women of other races never initiate breastfeeding. So while it would appear that a much greater percentage of black women don't want to breastfeed, there are often a lot of other factors at play, which even this study based on a handful of women living in one of the most blighted urban cities in America illustrates.

The answers respondents gave were coded into two categories: easily modifiable barriers and not easily modifiable barriers. The easy barriers were things like, fear of pain, worry about supply and misinformation. Twenty-three percent of the black women offered these easily modifiable barriers. But 89% gave reasons that were NOT easily modifiable, including having to return to work or school. So of the women who had a not easily modifiable reason to not breastfeed, half simply didn't want to, but half had a barrier outside of their own personal belief system preventing them from breastfeeding. Yet the headlines are just screaming, "Black women don't want to breastfeed!" with all of the value judgments about black women that a statement like that implies.

There are a lot of things that make this a complicated issue, but I'm not ready to say, based on this study, that the reason black breastfeeding rates are low is simply that black women don't want to do it. I'm also guessing that if you took any group of women, regardless of race and class, who never breastfed and asked them why not, that their answers would look the same. We have a lot of work to do, but I'm not sure that oversimplifying complex issues that involve race, class and culture, is the best way to go about it.

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Surgeon General's World Breastfeeding Week Statement

Surgeon General Dr. Regina M. Benjamin released a statement on Friday in honor of World Breastfeeding Week about her hopes to reduce disparities in breastfeeding rates. Dr. Benjamin is an African-American woman from Alabama, a state with one of the lowest breastfeeding rates, particularly among black women. Currently, less than 45% of black mothers in Alabama initiate breastfeeding. The CDC's Healthy People 2010 goal is for a breastfeeding initiation rate of 75%, with 50% still breastfeeding at 6 months, and 25% at one year. We've got a ways to go.

World Breastfeeding Week provides an opportunity to highlight the benefits of breastfeeding and to make people aware of how we can lend support to mothers who want to breastfeed.

I am committed to promoting and supporting optimal breastfeeding practices with the ultimate goal of improving the public's health. This is because breastfeeding is the best source of infant nutrition, and it provides immunologic protection and health benefits both to breastfeeding mothers and to the children they nurse. 

The Affordable Care Act that was enacted earlier this year takes some significant strides in support of breastfeeding.  The new law requires employers to provide time and a safe space for women employees who want to express their milk.  It also requires health plans to offer certain preventative services without cost-sharing requirements, including counseling and support for mothers who want to breastfeed and for nursing mothers. 

This fall, I will release a Surgeon General’s “Call to Action” that will draw from the best available science to explain how all sectors of the community can help create an environment that is supportive of mothers who choose to breastfeed.  It will show how a community-wide approach can help reduce disparities among breastfeeding mothers and children of all backgrounds, and how to improve support for nursing women in their workplaces and communities.

I hope World Breastfeeding Week will help Americans become more aware of these resources and use them throughout the year.

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A Crisis in the Crib & A Blogging Challenge

I have written twice, quite briefly, about a campaign created by the Office on Minority Health starring Tonya Lewis Lee about the disparate rates of infant and maternal mortality in this country called "A Healthy Baby Begins With You." The campaign was created to help raise awareness of the fact that black babies are three times as likely to die in their first year of life as white babies. In addition, a recent NY Times article stated that black women in New York are seven times more likely to die in childbirth than white women. In fact, a recent article in a University of Wisconsin alumni magazine offered up the sobering statistic that babies born in Sri Lanka have better health outcomes than black babies born in Milwaukee do.

These unacceptable statistics are what prompted Ms. Lewis Lee and the Office on Minority Health to create the documentary Crisis in the Crib: Saving Our Nation's Babies in 2009. I have been wanting to see the documentary for a while and although there were screenings held in NYC, I never saw any screenings in my area. But the 36-minute documentary is now available for you to watch online and if you are about issues like women's health, motherhood, birth advocacy, breastfeeding and feminism, then you should watch it. And not only should you watch it, but you should blog about it.

I, along with Jill of The Unnecesarean and Courtroom Mama*, want you to take 36 minutes to watch this documentary and then write a blog post about any aspect of the film that speaks to you the loudest. After you've written your post, link to it here by July 2. Jill & Courtroom Mama will choose their favorite post, and on July 4th it will appear on The Unnecesarean blog, along with links to all of the bloggers who participated.

Are you up for the challenge?

*Thank you to Courtroom Mama for writing this excellent blog post and inspiring a host of bloggers to write about this issue that is so important, yet is not being discussed enough. 

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Racial Gap in Breastfeeding Rates Widens

This morning the CDC released a new report, "Racial and Ethnic Differences in Breastfeeding Initiation and Duration, by State," which lists the breastfeeding rates amongst the various racial groups from 2004-2008. The news for black women doesn't look good. According to this report, black breastfeeding initiation rates actually went down from about 60% to about 54% since the CDC's Breastfeeding Report Card came out in 2009, which was based on data collected in 2006. In fact, everyone's rates appear to have taken a hit, with white women's breastfeeding rates going from 78% initiation in 2006 to about 74% and Hispanic women's rates dropping from 82% to 80%.

I'm not sure what to make of these numbers. At first glance, the 2% drop for Hispanic women seems to be statistically insignificant, but what of the drop for black moms and white moms? Is this just a matter of overlapping years when the data was collected fudging the numbers a bit? Or is this something to be concerned about? At a time when breastfeeding promotion seems to be a priority of the government what with the health care reform bill including a provision for time and space to pump at work and the retooling of the WIC food packages, not to mention a cultural shift to breastfeeding in the US, I expected the numbers to be much higher.

So now I'm feeling a bit depressed. When people ask what percentage of black moms choose to breastfeed, I'll no longer be able to say we're at an all-time high with a 60% initiation rate.