Experiences of Nurses Providing Breastfeeding Support to Black Families in the Immediate Postpartum

Purpose- To describe how nurses support breastfeeding for black families during the critical immediate postpartum period. Significance- Stark racial disparities in breastfeeding persist, with black families far less likely than other demographic groups to initiate or continue breastfeeding. Though black mothers value breastfeeding support from their doctors, midwives and nurses, they are less likely to receive education and support than white mothers. Emerging literature exploring racial bias in healthcare as well as the experiences of black breastfeeding mothers suggest that healthcare providers can be a barrier to breastfeeding. Nurses are the gatekeepers of breastfeeding support during the hospital stay and are most at the bedside during the postpartum period, so it is important to understand their vital role. Methods- For this qualitative descriptive study, the researcher interviewed fifteenlabor and delivery and postpartum nurses working in hospitals of a major southeastern city. Findings- Themes emerging from the research include (1) on the job training, where nurses report that their educational programs only minimally addressed breastfeeding support, and they learned support techniques from their peers. (2) Feeling inadequate; nurses are aware of racial disparities in breastfeeding, but don’t know how to address those disparities. (3) A continuum of bias exists, where black patients are not provided the same level of support as white patients. Racism and bias are most often demonstrated in subtle and indirect ways, through peer-to-peer interactions rather than directly with patients. (4) Careful language with nurses using coded or minimizing language to talk about racism and bias. Discussion- Racism and bias impact breastfeeding support for black families. Black families are often deemed unlikely to breastfeed and don’t receive adequate support. As these practices are most often subtle and indirect, addressing racism and bias directly during nursing education and through continuing professional education may help promote equitable breastfeeding support practices.