Unspoken struggles: Breastfeeding and postpartum needs in the Black community
By Petra McEwan, MD, FAAP, IBCLC
As an African American International Board Certified Lactation Consultant, pediatrician, and mom of five breastfed babies, I’ve had a front-row seat to the world of breastfeeding and infant care. I’ve seen firsthand how important breastfeeding is for a child’s health and development. Yet, I’ve also had personal experience with the struggles Black mothers face when trying to get the breastfeeding support they need. From not having many examples of breastfeeding to follow, to not having access to the support I need to succeed, I can say that I truly understand the plight of the Black breastfeeding mom.
Black breastfeeding rates have historically been lower than other racial groups, and there are a lot of reasons for that — cultural, socioeconomic, and systemic barriers that just make things harder for Black families. That’s why it’s so important to focus on empowering Black families — breaking down the stigmas around breastfeeding, and making sure that the care they get is culturally relevant and sensitive to their needs.
One thing that often gets overlooked is that breastfeeding symptoms can look different on darker skin. Issues like nipple pain, infections, or skin damage from a bad latch do not usually show up the same way they do on lighter skin. For example, nipple damage — which usually looks like pale or white patches on lighter skin, can be hard to spot on dark skin. Similarly, conditions like thrush or mastitis, which usually appear as red areas on lighter skin, can also be harder to see on darker skin. It’s important for lactation consultants and healthcare providers to be trained to really pay attention in order to notice these differences and provide the right support when Black mothers need it. We cannot just say, “it’s not mastitis because it’s not red,” when a mother has all of the other symptoms of mastitis.
Postpartum needs of Black parents and mothers
Postpartum care for Black moms also has its own set of challenges. Black women face higher rates of complications and even death after childbirth compared to other racial groups. Much of this has to do with systemic inequities in maternal care, lack of access to care, and bias (whether perceived or not). On top of that, many Black moms feel pressure to go back to work quickly after having a baby — leaving little time for the rest, recovery, and bonding they need to support breastfeeding. As providers, it’s important that we remind our mothers that it’s okay to take time for themselves and to ask for help. It’s also important to ensure Black families have access to the right resources — whether that’s breastfeeding help, mental health support, or just having people who understand their unique experiences and needs.
Representation in healthcare also matters. When healthcare providers reflect the backgrounds and experiences of their patients, it makes a huge difference in the quality of care. Black families often feel more understood and supported when they have providers who “get” where they’re coming from. It helps build trust, opens up communication, and ensures that recommendations are more in tune with what Black mothers and babies actually need. In my roles, I always try to provide that reassurance and comfort for the families I serve — knowing that culturally competent care can make a real difference in how they feel about their breastfeeding journey and their ultimate success with breastfeeding.
It’s essential for Black mothers to have access to accurate, culturally sensitive information about breastfeeding and feel empowered to make the best decisions for their own health and the health of their babies. By continually striving to address the issues our families face, we can help Black mothers breastfeed successfully, support their postpartum health, and build a healthcare system that truly serves them with respect and understanding.
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