Commentary: Closing the Breastfeeding Gap

June 2013Ifeyinwa Asiodu

The World Health Organization has identified breastfeeding as an effective and efficient way to provide nutrition to growing infants and children around the world. Infants who are breastfed are less likely to develop gastrointestinal, urinary tract and respiratory infections, obesity, diabetes and celiac disease. In 2011, the surgeon general of the United States issued a Call to Action to Support Breastfeeding. This pivotal document outlined critical issues concerning infant feeding, specifically addressing breastfeeding initiation and continuation rates.

Here in the United States, breastfeeding rates are on the rise. A Centers for Disease Control and Prevention (CDC) study examining changes between 2000 and 2008, which was released in February 2013, noted consistent increases – almost all of which were significant – in the initiation and continuation rates of breastfeeding among all racial and ethnic groups studied, at birth, six months and a year. However, the persistent racial and ethnic gap between African American and white or Latino infants is cause for concern.

On average, African American infants are breastfed at lower rates than white and Latino infants. With the highest rates of infant mortality, premature birth, low birthweight and very low birthweight, African American infants can benefit greatly from an increase in breastfeeding initiation and continuation rates. Since breastfeeding has been shown to positively improve the health of infants affected by these poor birth outcomes, understanding how infant feeding decisions are made and supported in this community is vital. While the literature in this area consistently illustrates the infant feeding disparity, sparse data exist about what is really at the crux of this infant health problem.

To address this disparity, my dissertation work is focused on understanding and describing infant feeding methods of African American families. Through in-depth interviews and community observations, I am investigating infant feeding perceptions and experiences of pregnant African American women and their support persons, specifically parenting partners, family members and friends. Understanding the barriers and facilitators influencing decisionmaking both during pregnancy and after birth is imperative to developing effective breastfeeding initiation and continuation interventions that will improve the overall health and well-being of African American infants.

Ifeyinwa Asiodu Since the beginning of my doctoral program, I have been fortunate to receive financial support in the form of scholarships, grants and fellowships; in particular, in the spring of 2011, I was awarded a Ruth L. Kirschstein Predoctoral National Research Service Award (NRSA) by the National Institute of Nursing Research (NINR). With this award, NINR was not only saying infant feeding disparities are an important public health issue; they were also reaffirming UCSF School of Nursing’s status as a leader in innovative research on health disparities and validating my potential as a researcher. I’m grateful both for the tuition assistance and monthly stipend and for the mentorship and academic support I have received from my advisor and NRSA mentors.

I am very passionate about my program of research and feel privileged to do the work that I do every day. Infant feeding is an important and exciting public health topic. For me, everything begins and ends with the pregnant and parenting women, infants and families I am fortunate to interact with on a daily basis.

I see my role not only as a student, but as an investigator with an inquisitive mind, always in search of innovative ways to practice nursing, educate others and improve the overall health and well-being of vulnerable populations. Through my program of research, I plan to continue raising awareness about this important health disparity, while empowering young women and families to make healthier infant feeding choices.

Ifeyinwa Asiodu is a doctoral candidate in the Department of Family Health Care Nursing and has clinical experience in both perinatal public health and critical care nursing. Her academic advisor and dissertation chair is UCSF School of Nursing faculty member Audrey Lyndon, who also serves as Asiodu’s NRSA mentor, along with Associate Dean for Research Kathryn Lee.