I would like to comment about the low rates of breastfeeding in African
American women. I think that it is crucial to look at the context of the
everyday lives of these women. In the Northeast, inner-city environment where
I conducted my research, Black women enrolled in WIC certainly had the lowest
rates of breastfeeding. I came to understand the complex reasons for this
when I spent time with them in their communities, observing and listening to
them in their homes, at hospitals, in the WIC clinic, at the mall and at fast
food outlets. It was very disturbing to witness the levels of stress in the
lives of these young women. It was unbelievable how much loss these women had
to endure in their short lives. Almost every one of my key informants had
high risk pregnancies. These women struggled to survive on a daily basis and
I heard directly of their efforts to cope with poverty, drugs, violence and
discrimination in their communities. Trust was a big issue with the women
that I encountered and it is one that health care professionals need to
consider more deeply.
These women had virtually no exposure to breastfeeding in their communities.
Their mothers, relatives, friends and neighbors had predominantly used
formula. Health care professionals gave inconsistent support for
breastfeeding. What was interesting was that if the woman had a trusting
relationship with her provider she was more likely to listen to professional
encouragement to breastfeed. WIC was the most effective because of this. Some
of the women initially distrusted BF promotion and thought that WIC was
trying to save money on formula. However, the WIC providers were consistently
kind, supportive and sensitive to the needs of the women and for many of the
women this was their first exposure to the benefits of breastfeeding. I
clearly remember one of my study participants saying, "WIC makes me want to
try it." Considering all of the stumbling blocks in their paths it was
amazing to me that almost half of the key informants initiated breastfeeding.
It demonstrated to me how much influence health care providers can have when
they take the time to listen, offer kindness and be sensitive to the everyday
needs of women.
The infant mortality rate of Black infants is more than twice that of White
babies in the USA. Breastfeeding can help to ameliorate these rates and
deserves more attention from all health care providers.
Roberta Cricco-Lizza RN PhD, MPH

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