The Board of Commissioners on Thursday pledged to support programs and policies that make it easier for Black women to breastfeed their babies.
In proclaiming the week of Aug 25 as Black Breastfeeding Week in Multnomah County, commissioners heard from public health experts in the county’s Racial and Ethnic approaches to Community Health (REACH) program, which works to eliminate health inequities for Black and African American residents. The program focuses on equitable access to quality clinical healthcare, nutrition, and safe physical activity.
And a healthy diet begins at birth.
“Breastfeeding is everybody’s business, and we invite you as decision makers and employers to join and support REACH’s efforts to normalize Black breastfeeding,” REACH Program Manager Charlene McGee said. “We invite you to join a movement to build a culture of Black health in Multnomah County.”
There is work to do, the REACH team explained. In Multnomah County, Black mothers initiate breastfeeding at a rate of 92 percent of white mothers. And about 55 percent of African American mothers who breastfeed exclusively still do so after eight weeks, compared to roughly 70 percent for white mothers.
“This suggests that Black mothers may not be getting the support they need from their healthcare providers, family members and employers to meet their breastfeeding goals,” said Keara Rodela, a community-clinical linkages specialist for the REACH team. “REACH community engagement over the last year, through our barbershop talks and community discussions with mothers and lactation professionals, reiterates that point.”
REACH has long partnered with County programs including the Women Infants and Children program (WIC) and the Healthy Birth Initiative, as well as community nonprofits including the Urban League of Portland, the Immigrant and Refugee Community Organization's (IRCO) Africa House, and the Black Parent Initiative.
Last year REACH worked with local barbershops to host talks about the health benefits of breastfeeding and how men can support the women in their lives who wish to breastfeed their children.
The talks drew 35 men, from first-time dads to great-grandfathers, ages 18 to 70, REACH nutrition lead Helen Kidane told the Board. Studies suggest a supportive partner, men in particular, can make up for a lack of structural support that leads fewer Black women to breastfeed. Better support also helps lead to long-term breastfeeding. Men in the barbershop sessions also called out the need for more education for fathers and culturally appropriate education in general on the importance of breastfeeding.
REACH also advocated for a dedicated lactation space at Gresham’s new Rockwood Rising commercial and residential development, leading the architect to redesign a planned market hall to accommodate the addition. And REACH developed its own mobile “lactation station” — a hot pink tent that has been used at community events to support nursing parents.
Also last year REACH sponsored a photo shoot for Black mothers who nurse their children. The images will appear on buses across north and east County in the coming weeks, as a way to normalize and celebrate breastfeeding.
“Your breasts are naturally made to breastfeed your baby. This is the only biological need of a breast; it’s there to give your baby nourishment,” Sherly Paul, a registered nurse with the Healthy Birth Initiative, told commissioners Thursday. “We want to give our babies the best start possible so they can have the best health outcomes in the future.”
Black residents are more than twice as likely as white residents to be diagnosed with diabetes and obesity. Black residents are also more likely to die from heart disease, stroke and cancer. Social, environmental, economic and educational factors are the main drivers of physical health.
Paul called out the history of enslavement, subjugation and sexualization, as well as systemic ongoing racism, as underlying causes why Black women have not had the opportunity to breastfeed at the same rate as white women.
“Nobody likes to talk about it, but it really does change the dynamic of a person’s life and the community,” she said. “There was a time when our bodies didn’t belong to us. We built and nourished America. We had to nourish the babies of our enslavers, who would turn around and enslave us and our own children.”
Even after emancipation the practice continued, with white women hiring African American parents to nurse their children — to the detriment of their own babies, when there wasn’t enough breast milk to share, with cow milk and water working as a paltry replacement.
And the hypersexualization of Black bodies has yet to be overcome in our society, Paul said. That leads many women to feel uncomfortable nursing in a public space, fearing people will stare or view the act as sexual.
“So your mom or grandma will tell you, ‘Don’t do that in public. Put that away,’” Paul said. “That’s something we need to try and make more normal for Black women to breastfeed in public.”
Mothers who participate in the County’s Healthy Birth Initiative, along with any of their partners in the Black Parent Initiative, all receive education on health implications, advanced training on how to breastfeed, and support for fathers. And when then they have these things, Paul said, they report a feeling of empowerment. So it’s no surprise that 98 percent of those moms choose to breastfeed.
Health officials also suspect more Black and African American parents might seek support for breastfeeding if more hospitals employed lactation consultants who look like them and who come from the same cultural backgrounds.
So this year REACH is teaming up with the Black Parent Initiative to launch a training program for Black women who want to become certified lactation counselors, said Linda Bryant-Daaka, a board-certified lactation consultant herself.
She learned her skills by nursing her own 10 children. Health experts say nursing can build up a body’s defenses to cancers, heart disease, diabetes and osteoporosis — even as it builds up babies’ immune systems and protects them against everything from ear infections to cancers.
“This can be the difference between a premature baby making it and not making it in life,” Bryant-Daaka said. “It is lifesaving fluid.”
It’s no wonder that the protective power of breastfeeding to prevent illnesses saves the Medicaid system $30 million a year, along with saving a typical family $1,500 a year in formula purchases.
The training partnership, between Black Parent Initiative and REACH, will support women who want to seek accreditation as lactation consultants, a lengthy and costly process. And it will also work to help those women find jobs in hospital systems, which usually require that certified location consultants also have degrees in nursing. The partnership will work with hospital systems to hire consultants of color who may not be dual-licensed.
Lived experience, after all, can’t be learned in class. And sharing the lessons of lived experience can make the difference between a mother nursing or not.
Dominique Shelton said she had a terrible experience with doctors who dismissed her health concerns, even when she showed signs of preeclampsia. She found support and an advocate through the Black Parent Initiative.
“Fear was a driving force in me not being able to breastfeed, fear of losing my job,”she said. “BPI helped me understand medication. They created a space for me not to feel alone.”
Courtney Gilmore worked with the Health Birth Initiative when she was pregnant with her daughter Lucy. And she has been able to nurse her baby for 18 months.
“I decided to breastfeed, mainly for the health benefits. I wanted to make sure Lucy got a fair start,” she said. “This has been the best experience ever to provide something to my daughter you can’t buy. And the body experience. I feel super close to her and we have our own moments together.”
But I wouldn’t have been able to do it without HBI and the Black Parent Initiative. So I just want to give a shoutout to Linda, because she helped me a great deal at the hospital.”
Commissioner Lori Stegmann said it’s been more than 20 years since she last nursed her daughter, but she still remembers the challenge. She agreed more hospitals should employ lactation specialists from communities of color, and praised the efforts of REACH and the Black Parent Initiative to make that happen.
Commissioner Jessica Vega Pederson said she too struggled to breastfeed her first child, even with all the gadgets and pillows she had that were supposed to make things easier.
“Breastfeeding is so important; it’s such a personal experience, and in a lot of ways it can be an isolating experience, she said. “When you’re a new mom, everything is new, and you’re dealing with all these weird things happening to your body and you have to take care of this new life.”
A location consultant came to her home — and the first thing she did was get rid of the pillows. Just keep it simple: parent and baby.
“Just having someone who has that confidence and can be there for you in a way that you need is such a powerful thing,” she said. “Such powerful work is happening here, and we need to keep supporting it. The lifetime benefits and normalizing breastfeeding are at the heart of the work you’re doing. Having people from your community share that experience is the most impactful way to address barriers.”
Kafoury teared up at a series of images of nursing parents and recalled her own struggle with breastfeeding.
“It’s a pretty remarkable position we’re in, that we are, right now, a Board of five moms. And we are so incredibly supportive of the work you are doing,” she said. “And I want to know, Charlene, what can we do to support you? What can our Board do? What policies can we implement? What do you need from us?”
McGee, REACH’s program manager, promised to let the Board know — and soon. The REACH team is working with the Public Health Advisory Board and community partners on a list of policy, administrative and legislative recommendations to better support Black mothers. She said Public Health plans to present those final recommendations to the Board when they’re ready.
“I’m honored to support all of you in the great work you are doing,” Kafoury said. “Anything we can do to keep our babies healthy, sign us up for that.”