Cherished Futures for Black Moms & Babies is Enhancing Breastfeeding Support in LA to Reduce Infant and Maternal Mortality

Sourced By: Public Health Institute

Partnership with Antelope Valley Medical Center Helps Boost Black Exclusive Breastfeeding Rates from 40% to 70%

(LOS ANGELES, CA) – As August 25-31, 2023 marked the 11th annual Black Breastfeeding Week, a time to recognize the importance of breastfeeding in improving health outcomes for Black mothers and infants, it’s essential to recognize and support breastfeeding for Black families year-round. There is a measurable cost, both in actual dollars and in overall health, to suboptimal breastfeeding, and we all play a role in advancing and improving lactation support for families.

Cherished Futures for Black Moms & Babies (Cherished Futures), a joint initiative of the Public Health Alliance of Southern California based at the Public Health Institute, Communities Lifting Communities and the Hospital Association of Southern California, in collaboration with Antelope Valley Medical Center (AVMC), are leading the way in greater Los Angeles to address preventable barriers and disparities in breastfeeding support.

Over the past year, Cherished Futures partnered with five participating hospitals (AVMC, Miller Children’s and Women’s Hospital Long Beach, St. Francis Medical Center, Torrance Memorial Medical Center and UCLA Health)  to improve birthing experiences and outcomes for Black moms in several areas, including breastfeeding. AVMC’s efforts have resulted in a striking increase in Black exclusive breastfeeding rates — from roughly 40% to 70%. Additionally, lactation consultations with Black patients have risen from 30% to a complete 100%.

AVMC recently launched a free monthly Community Black Breastfeeding Support Group and is dispatching lactation consultants to rooms designated for formula-only feeding to ensure that all families receive support to make informed decisions.

The efforts of Cherished Futures and AVMC present a viable model of how collaboration between hospitals and Black leaders can create meaningful change in patient experiences and health outcomes in Los Angeles and beyond. During Black Breastfeeding Week, the five cohort members are committed to celebrating connections within Black communities and pushing for change to uplift and support every family’s choice in breastfeeding.

Disparities in Black Breastfeeding Support

While Cherished Futures and AVMC have together helped to improve breastfeeding rates among Black mothers, a number of other challenges still contribute to disparities in breastfeeding in Los Angeles County for Black mothers and their children, such as:

• Areas of LA County with the highest rates of infant mortality also have the lowest rates of exclusive breastfeeding at three months and the fewest lactation support resources.
• Infant formula companies have a longstanding history of aggressively targeting and exploiting Black communities through marketing campaigns. This trend continues today, making it no surprise that in Los Angeles County birthing hospitals, infants of color are often less likely to be exclusively breastfed upon discharge.
• Black mothers in the U.S. are 5 times less likely to breastfeed than white mothers, and nine times more likely to be offered formula by hospitals than white moms.
• Intergenerational and historical trauma still exists from slavery, when Black breastfeeding women were enslaved and forced to nurse their enslavers’ infants, and contributes to low breastfeeding rates.

These disparities present opportunities for hospitals to reassess and rebuild practices to ensure that all families receive the comprehensive care they deserve. Cherished Futures, working closely with AVMC and the other four hospitals in its 2022-2023 cohort, is making these crucial strides.

“We have disparities in breastfeeding because of the disparities we see for maternal and child health, maternal and infant health; they’re very much mirrored to the breastfeeding rates,” said Asaiah Harville, International Board-certified Lactation Consultant (IBCLC) and Birth Equity Manager with Cherished Futures.

Long-Term Benefits of Breastfeeding for Black Mothers and Infants and in Reducing Health Disparities

Breastfeeding offers extensive and lasting health benefits that are particularly vital in the Black community, where infants face higher mortality rates and disproportionate preterm births. Breastfeeding is linked to a decrease in sudden infant death syndrome (SIDS) and helps prevent conditions such as diabetes and obesity later in life.  For mothers, breastfeeding reduces the risk of cardiovascular disease, the leading cause of death among Black women in America, and lowers the risk of breast cancer, ovarian cancer, and type 2 diabetes.

Harville added, “Breastfeeding reduces the risk of postpartum hemorrhage, which is one of the leading causes of maternal morbidities here in this country.”

Addressing Historical and Intergenerational Trauma Linked to Breastfeeding Among Black Mothers 

AVMC, in collaboration with Cherished Futures, has initiated programs to bridge the gap in Black breastfeeding rates, recognizing it as a strategy to improve short- and long-term health outcomes. The center has taken new measures to educate staff about the historical trauma and stigma around Black breastfeeding, stemming from when enslaved women were forced to nurse their enslaver’s infants, often at the expense of their own infants. This intergenerational trauma, along with a lack of societal support for mothers and birthing people in the United States, are all factors in the suboptimal breastfeeding rates seen in this country.

“We really have to start to bring together the narrative with the data, identify the gaps, identify opportunities for improvement, but also dispel myths that have now been passed down as a result of chattel slavery,” Harville emphasized.

Yvonne Reifenstahl, a registered nurse at AVMC, shared insights about these collaborative efforts: “It’s really important for our nursing staff to understand that history and how that history has shaped Black culture in regards to the choice to breastfeed. Our goal is that the efforts that we’re doing here will be creating ongoing change within our community.”

Supporting lactation is not solely the responsibility of the family but also of the community, including healthcare systems and institutions, as well as public health entities and policymakers. Below are ways diverse stakeholders can promote the initiation and prolongation of Black breastfeeding year-round:

Recommendations for Policy Makers

• Enact Federal Paid Maternity Leave: The United States is one of the only industrialized nations without federal paid leave. Paid leave is offered in some states, but the length and compensation amount can vary. This inconsistency directly affects infant feeding choices, particularly among Black women and other women of color. These women often face a difficult decision between receiving a full paycheck to support their family and seeking additional postpartum breastfeeding support. Lack of paid leave also directly impacts infant mortality. According to the United Nations (UN), longer maternity leave is associated with lower infant mortality rates and has a direct impact on breastfeeding initiation and duration. The UN reveals that for each additional month of paid maternity leave, infant mortality is reduced by 13 percent.

Recommendations for Healthcare Institutions and Providers

• Implement Lactation Education: No mandated lactation education is included in medical and nursing schools. This means that lactation-specific knowledge is not common unless nurses or physicians independently seek education and clinical experience. Without standardized lactation education for medical personnel, families can receive subpar education and support. Lactation education should be integrated into medical and nursing school curricula so that all healthcare professionals who interface with breastfeeding mothers, lactating people, and families have sufficient knowledge to support breastfeeding.
• Increase Lactation Staff Capacity and Diversity: Healthcare institutions must ensure they have enough lactation staff to support patients. To achieve this, institutions should evaluate and analyze their current lactation staff capacity to determine whether the numbers are sufficient and reflect the diversity of their patient population. Cultural congruency is ideal, but not always possible. Institutions can and should be strategic with outreach for hiring while also ensuring existing staff have received continuous equity education beyond a one-time class or training. Institutions should also ensure that lactation education materials represent diverse patient populations. Institutions can and should highlight and celebrate Black breastfeeding within their departments year-round.

Recommendations for Local and State Public Health Departments

Suboptimal breastfeeding is a public health issue and responsibility. It impacts the health of communities, which in turn affects the health of society as a whole. Public health departments can support Black breastfeeding by:

•  Innovating Data: Ensure data on Black breastfeeding is regularly collected and reviewed to identify gaps and opportunities for increased support.
•  Cross-Collaboration: Work more closely with hospitals in their service areas to enforce and support lactation policies.
• Advocacy: Support legislation and policies that support lactation and breastfeeding at the local and state level.

About Cherished Futures for Black Moms & Babies

Cherished Futures is a multisector collaborative effort to reduce Black infant deaths and improve patient experience and safety for Black mothers and birthing people in Los Angeles County by driving systems change at the clinical, institutional and community levels. Cherished Futures is a joint initiative of Communities Lifting Communities, the Public Health Alliance of Southern California, and the Hospital Association of Southern California, and is based at the Public Health Institute.

Cherished Futures for Black Moms & Babies is funded in part by Ballmer Group; Centene Foundation for Quality Healthcare; First 5 LA, a leading public grantmaking and child advocacy organization; and L.A. Care Health Plan, which will benefit low-income and uninsured residents of Los Angeles County.

About Antelope Valley Medical Center

Antelope Valley Medical Center (AVMC), the only full-service, acute-care hospital in the Antelope Valley. AVMC has been delivering exceptional care to the community since 1955.  It offers the region’s only Level II Trauma Center, Pediatric unit, Level IIIB NICU, Inpatient Behavioral Health Department, Labor and Delivery, Accredited Chest Pain Center/STEMI Receiving Center, Advanced Primary & Comprehensive Stroke Center and Comprehensive Community Cancer Center. AVMC is now a Thrombectomy Capable Center.