Experiences of Racism and Breastfeeding Initiation and Duration Among First-Time Mothers of the Black Women's Health Study

Publication Date


UMMS Affiliation

Graduate School of Nursing; Department of Medicine, Division of Preventive and Behavioral Medicine; Department of Quantitative Health Sciences

Document Type



Health Services Administration | Maternal and Child Health | Nursing | Race and Ethnicity | Women's Health


BACKGROUND: Breastfeeding rates are lower for black women in the USA compared with other groups. Breastfeeding and lactation are sensitive time points in the life course, centering breastfeeding as a health equity issue. In the USA, experiences of racism have been linked to poor health outcomes but racism relative to breastfeeding has not been extensively investigated.

AIMS: This study aims to investigate the association between experiences of racism, neighborhood segregation, and nativity with breastfeeding initiation and duration.

METHODS: This is a prospective secondary analysis of the Black Women's Health Study, based on data collected from 1995 through 2005. Daily and institutional (job, housing, police) racism, nativity, and neighborhood segregation in relation to breastfeeding were examined. Odds ratios and 95% confidence intervals were calculated using binomial logistic regression for the initiation outcomes (N = 2705) and multinomial logistic regression for the duration outcomes (N = 2172).

RESULTS: Racism in the job setting was associated with lower odds of breastfeeding duration at 3-5 months. Racism with the police was associated with higher odds of breastfeeding initiation and duration at 3-5 and 6 months. Being born in the USA or having a parent born in the USA predicted lower odds of breastfeeding initiation and duration. Living in a segregated neighborhood (primarily black residents) as a child was associated with decreased breastfeeding initiation and duration relative to growing up in a predominantly white neighborhood.

CONCLUSION: Experiences of institutionalized racism influenced breastfeeding initiation and duration. Structural-level interventions are critical to close the gap of racial inequity in breastfeeding rates in the USA.


Breastfeeding, Duration, Equity, Initiation, Life course, Racism

DOI of Published Version



J Racial Ethn Health Disparities. 2018 Feb 12. doi: 10.1007/s40615-018-0465-2. [Epub ahead of print]. Link to article on publisher's site

Journal/Book/Conference Title

Journal of racial and ethnic health disparities


Michele K. Griswold undertook this study as a doctoral student (view her dissertation) in the Graduate School of Nursing at UMass Medical School.

Related Resources

Link to Article in PubMed

PubMed ID