A few years ago I attended a lactation consultant conference in San Diego. It was a great event, and I learned a lot.
But something about it has been bugging me ever since.
If I had taken a snapshot of the women attending that conference, and then I took another picture of a group representative of new mothers, you'd note something right away. By and large in the U.S., lactation consultants are white,* and about half of the moms are of color.
I think that this picture should change, and here's why:
The country has changed. It's time to catch up. Back in 1985 when the IBCLC credential was created, lactation consultants worked primarily with white mothers. But in 2008 only about half of the babies born in the U.S. were white. 25% were Hispanic/Latino, 15% were African American, and 6% were Asian. Latinos are the fastest growing ethnic group in the U.S., and in two of the biggest states - California and Texas - over 50% of babies born are Latino.
Better outcomes. Evidence suggests that women of color have better birth outcomes when attended to by midwives of color. Could it be any different with breastfeeding support? The well documented effectiveness of peer counselors is in no small part due to the fact that they are of the same background of the moms they support.
Closing the gap. The biggest issue in breastfeeding, in my opinion, is the glaring disparity in breastfeeding rates among different races. All eyes of leaders in this field should be on the prize of closing those gaps, especially because the women who are least likely to breastfeed are also the most likely to be at risk for health problems alleviated by breastfeeding. How better to work toward that goal than with representation from a diverse group of women, and what is being missed without their participation?
Culture and language matters. Just imagine for a moment that you've moved to another country. You don't speak much of the language there, and the culture is equally foreign. A lactation consultant comes into the room and knows nothing about where you're from or how people do things in the U.S. She doesn't speak a word of your language. And she wants to talk about, and perhaps touch, a part of your body that you consider pretty personal. Are you going to learn much about breastfeeding from this interaction?
Yes, of course women of any background can learn ways of communicating across cultures. But while there are many lactation consultants and nurses who make valiant efforts to do so, I've also seen nurses who seem to think that the way to communicate with someone who doesn't speak English is to just talk LOUDER.
There is one program in California which is actually accomplishing some great change in this area. The University of California, San Diego lactation consultant training program has created what amounts to a career ladder for WIC breastfeeding peer counselors to become IBCLCs. I trained through this program, and my cohort of students was wonderfully diverse. I bumped into a few current students while in California in December, and they too were women of color.
But this isn't enough. Other fields, like nurse midwives and doulas, have made diversity a priority, creating initiatives to increase the number of women of color in their ranks. There is even federal legislation which would, among other things, create an initiative to diversify the maternity care workforce.
Why not us, too?
* While I couldn't find any data on the race of IBCLCs, I know that this is not my imagination. Kathi Barber, founder of the African American Breastfeeding Alliance reported that at a recent national lactation conference, out of 1000 participants, there were only nine black attendees, and of these just four were lactation consultants.
Check out these great posts on our theme of breastfeeding and race:
- Diary of a First Child: Breastfeeding and Race in South Africa
- Motherhood Actually: Breastfeeding and the Cambodian American community
- Slient, but Leading: Breastfeeding in Ghana