Group focuses on better education for African American mothers

Our modern world was not built to support a breastfeeding mother, according to Farah Antoine-Mayberry, a Certified Lactation Counselor and Birth Doula. She is among a movement of birth workers and advocates trying to transform community understanding of and behavior towards new and expectant mothers.

“For a lot of moms, the goal when it comes to breastfeeding sounds like this: ‘I'm going to try to breastfeed, but I know that it can be hard, so I may just need to formula feed,’” Antoine-Mayberry said. “Thank goodness, we do have an alternate way to feed if we need it, but so many moms don’t feel confident in their bodies and in what their bodies can do because we're not really teaching them.”

In full disclosure, Antoine-Mayberry was part of a team of birth workers my wife and I used while navigating pregnancy, birth, and postnatal care. We needed every bit of that support as we reshaped our lives to care for a freshly minted human, running into new hurdles seemingly every day.

Antoine-Mayberry helped found the nonprofit For The Village, Inc. to ensure the support network and wealth of information that my wife and I benefited from is equally available to the African American community in Oklahoma, which faces higher infant mortality rates according to the Oklahoma State Department of Health. A report by the US Department of Health and Human Services/Centers for Disease Control and Prevention shows a 15 percent difference between African American and white communities in breastfeeding initiation for children born between 2010 and 2013.

Education initiatives on sudden infant death syndrome, the dangers of alcohol and smoking, and other efforts have proven successful in lowering the infant mortality rate overall, but those initiatives have failed to reach every mother, Antoine-Mayberry said and added that she’s shocked by how many African American mothers aren’t even encouraged to attend lactation classes.

For The Village was created to change that and began accepting applications in September to build a team of five African American birth workers. Those accepted will undergo a three-year program to become certified as lactation professionals, childbirth educators, and doulas. The goal is to recruit five more applicants every year to create an entire industry of birth workers focused on serving African American families.
“For the Village is committed to enhancing the birth and maternal outcomes within the black community by raising awareness about all of the things connected to helping to support and foster healthy pregnancies and healthy delivery for black women,” Antoine-Mayberry said.

She added that the value of diverse representation within the healthcare industry is often overlooked. CNN reported on a George Mason University study that found that “the mortality rate of Black newborns in hospitals shrunk by between 39 percent and 58 percent when Black physicians took charge of the birth.”
Increasing the population of African American birth workers is critical for better health outcomes for baby and mother, according to Antoine-Mayberry. “I've been part of those organizations where they're looking to make a difference in the black community. As I’ve made suggestions, I kept getting met with ‘No, that's not going to work.’ Well, I look like them—I am them. And there are certain things that you really need to understand about this community before you can hope to serve them.”

The American Academy of Pediatrics recommends exclusive breastfeeding for the first six months of life and continued breastfeeding with complementary foods through at least the first year. Antoine-Mayberry said that many organizations, such as the World Health Organization, recommend breastfeeding for two years and beyond due to the unique health and immunity benefits breastfeeding offers the child and mother.
Yet, Oklahoma has been lagging behind the nation in breastfeeding. In a recent conversation with the Oklahoma Gazette, Executive Director of The Coalition of Oklahoma Breastfeeding Advocates Heidi Russell and lactation specialist Alexis Boryca discussed their efforts to strengthen community support for breastfeeding across the state.

“The CDC puts out a breastfeeding report card each year,” Boryca said. “In Oklahoma, we know that about 75 percent of our babies are at least initiated with breastfeeding. That means, day one, they've at least tried to breastfeed. By six months old, that number drops to about 17 percent. So we have to ask ourselves, ‘What is happening?’”
The national average for exclusive breastfeeding at six months, according the CDC report card, is 25.6% while breastfeeding with nutritional supplement at six months is 58.3%.
Boryca said that Kansas and New Mexico have much higher breastfeeding rates, so the problem isn’t regionwide. Differences in policy and culture within Oklahoma impact the numbers.

Breastfeeding remains particularly difficult for new mothers for a host of reasons. According to the Centers For Disease Control and Prevention, mothers often abandon breastfeeding because of issues with lactation and latching, unsupportive work environments or hospital practices, and cultural norms and lack of family support. Antoine-Mayberry encourages expectant mothers to build a network of peers and professionals to help provide the support, space, and time to breastfeed.
“When both parents are working or if it’s a single mom, they are sometimes returning to work at only two weeks postpartum,” Boryca said. “And then you look at employers that are not supporting breastfeeding or not providing adequate pump schedules and time, or mom doesn't want to clock out to pump because she really needs that money.”
Russell told the story of a restaurant manager who struggled to work with her employer to accommodate pumping.

“She doesn't want to quit because she's trying to save money to buy a home,” Russell said. “And they basically gave her a room to pump in that has windows everywhere and cameras in it. I don't think she took a full 12 weeks at all. But how could she afford to? So she went to the State Health Department. They referred her to the Labor Department and she said the Labor Department was awesome. She talked about having problems with the company’s HR rep who told her to just put a cup on the camera because they said they can’t take the camera out.”

The mother contacted Russell while still working with her employer to figure out better accommodations and receiving suggestions to pump in her car or drive home to pump, which would take 20 minutes round trip and leave only a short 10 minutes to pump, when 20 minutes every few hours is more typical.

“You could tell that she was probably a younger mom, but, wow, she was on it,” Russell said. “She had everything written down. She was doing all the right things, documenting everything. She said ‘I can handle putting cups on the cameras, but when I tell the men that I’m going to go pump, I get all these snide remarks. It’s just not worth it.’”
Antoine-Mayberry does say that formula is an important tool for mothers, especially when there are issues with lactation and latching or nutritional and weight issues, but educational resources, a supportive work environment, and a supportive community will give the mother the best chance at successfully breastfeeding, not just for the first 12 weeks, but for as long as the child needs to breastfeed. Efforts by For The Village and COBA are all a part of the greater mission to ensure that all families, regardless of background, are positioned to support mother and child during this critical stage of development.

Yet, to create the kind of community wide transformation in support and understanding, Antoine-Mayberry believes that these efforts need to begin much earlier for all Oklahomans.

“All five of our kids were breastfed, and they all had their different strengths and challenges,” she said. “It started to occur to me that this isn't something that we talk about. Breastfeeding is not really a part of our schooling. This needs to be something that we're learning about long before we are giving birth. I personally feel like education, to normalize it, really needs to start in middle school. ” 

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