PolicyLab

In August, we celebrate World Breastfeeding Month. The first week, traditionally known as World Breastfeeding Week, is an international event coordinated by the World Alliance for Breastfeeding Action. This year’s theme, “Empower Parents, Enable Breastfeeding,” speaks to the need to examine our communities’ progress in making breastfeeding achievable for every woman who intends to breastfeed, regardless of her background or socio-economic status. It aligns well with Black Breastfeeding Week, recognized as the last week of August, when we specifically focus on how to reduce disparities in breastfeeding rates, high infant and maternal mortality in African American women and the lack of diversity among lactation providers.

Nationally, breastfeeding rates are on the rise. The most recent Centers for Disease Control and Prevention (CDC) Breastfeeding Report Card tells us that four out of five moms now start out breastfeeding in the United States, with a national breastfeeding initiation rate of 83.2%. Even more exciting, for the first time, our national breastfeeding initiation rate surpassed the Healthy People 2020 target rate of 81.9%.

However, when you break down these overall numbers, you see rampant disparities exist between racial/ethnic groups. For example, 74.4% of non-Hispanic black infants start out breastfeeding compared with 81.8% of non-Hispanic white infants and 74.8% of Hispanic infants. Here in Philadelphia, 66.9% of African American mothers start out breastfeeding, significantly below the national average. Furthermore, breastfeeding continuation rates remain a public health challenge with 60% of mothers not meeting their self-determined breastfeeding goals.

Thankfully, there are significant resources available to individuals, providers and communities to increase breastfeeding initiation and continuation rates. Notably, the Surgeon General’s Call to Action to Support Breastfeeding contains actions for communities to help make breastfeeding easier for mothers, including recommendations to:

1. Strengthen programs that provide mother-to-mother support and peer counseling
2. Use community-based organizations to promote and support breastfeeding

Here in West Philadelphia, we drew upon the Surgeon General’s recommendations to develop a new, unique, community-based program called BAE Café (Breastfeeding Awareness and Empowerment). BAE Café has made a significant impact in reaching women of color who historically have not had access to traditional breastfeeding support programs. Founded on a reproductive justice framework by lactation consultants Jabina Coleman and Rebecca Duncan, BAE Café’s mission is to “educate, empower and support families and communities on their journey into parenthood while working on systemic barriers impeding on a culture of health.” 

BAE Café grew through a partnership with a community pediatrician involved with the CATCH grant program of American Academy of Pediatrics, as well as the Blackwell Library Branch of the Free Library of Philadelphia. Starting in the fall of 2018, groups of women have met twice per month at the Blackwell Library to discuss breastfeeding challenges and build community among participants. These women have shared success stories, trials and supported other women to meet their breastfeeding goals. The group is facilitated by Jabina Coleman, who is a licensed clinical social worker in addition to her role as a lactation consultant.

BAE Café is particularly unique in that it fosters a space for women to talk openly about their parenting transition. Women of color are more likely to face peripartum mood changes and less likely to receive support for postpartum depression, so BAE Café has become a safe space where women can receive support and information about other resources to address these conditions.

Attendance at BAE Café has surpassed typical turnout for breastfeeding support groups with an average of 9-10 moms per session, highlighting the tremendous need for this type of work in our community. As maternal and infant mortality rates have reached crisis levels in this country, a program such as BAE Café offers a community-based model that draws on the strength of the community to address both breastfeeding and peripartum mood disorders, key determinants in the goal to improve the health of mother and infants.

“BAE Café is a place where I can be my genuine self in my motherhood, in my blackness, in my femininity, in my experience. . . I can bring my kid, and don’t feel awkward or anxious if he’s making noise or being a baby. We can both be ourselves and be free and comfortable with other women of color and participate in this breastfeeding journey together.”  (Pam, frequent attendee)

For us to achieve true health equity and improve maternal and infant health, it will take new, creative community partnerships such as BAE Café. Let this year’s World Breastfeeding Month be our call to action to amplify and expand the work of our community professionals who are hearing the voices of mothers and responding with much needed support.

Meg Kawan, MD, MPH, IBCLC, received the American Academy of Pediatrics' CATCH grant and collaborated with Jabina Coleman and Rebecca Duncan to bring BAE Café to the Blackwell Library. Dr. Kawan is also an attending pediatrician at Children's Hospital of Philadelphia's Karabots Pediatric Care Center and an international board-certified lactation consultant.