Jessica Olson, PhD, MPH; Dalvery Blackwell, BA; Anna Palatnik, MD; Elisha Jaeke, MD; Ronald Anguzu, MD, PhD; Christopher Simenz, PhD; Katinka Hooyer, PhD, MS; Reiauna Taylor, BS; Melinda Stolley, PhD
WMJ. 2026;125(4):467-474. Published November 1, 2026.
ABSTRACT
Introduction: Black birthing individuals have lower breastfeeding initiation and duration rates than non-Hispanic White birthing individuals. Breastfeeding provides health benefits for both mothers and infants, and increased access to breastfeeding support may help reduce disparities in infant mortality and chronic disease. Understanding perceptions, motivators, barriers, and knowledge related to breastfeeding in Black birthing communities is vital to improving breastfeeding rates. This study examined how breastfeeding experiences differed between birthing individuals who did and did not receive culturally tailored peer support.
Methods: We used an adapted, validated survey to assess perceptions of breastfeeding, and survey findings informed focus group discussions. We recruited birthing individuals who self-identified as Black and received or declined breastfeeding support within the previous year. Qualitative data were coded to identify themes and compared between groups. t tests were used to compare Likert-scale scores measuring breastfeeding beliefs and barriers between supported and unsupported groups.
Results: Twenty-one Black women (mean [SD] age, 30.1 [6.7]) participated in 3 focus groups; 13 received breastfeeding and birthing support, and 8 reported no formal support. Themes differed by support status, suggesting several benefits associated with support. Participants who received support expressed fewer concerns about pain and reported greater support from family, friends, and employers. Participants also identified opportunities to strengthen breastfeeding support, including addressing workplace barriers, enhancing family and community support, and increasing access to culturally tailored education.
Conclusions: Culturally tailored support was associated with greater breastfeeding knowledge, confidence, and perceived support among Black birthing individuals. These findings highlight the potential value of community-based, culturally tailored interventions in addressing breastfeeding disparities and improving maternal and infant health outcomes.