Want to Improve Black Breastfeeding Rates? Fight for Equity

August 18, 2023

Mocha-skinned woman wearing glasses smiles at the camera. She has short dreadlocks framing her face and wears a forest green collared shirt.By Jasmine Pettis Marquez
California Breastfeeding Coalition

On Friday, we kick off Black Breastfeeding Week, which has been observed from Aug. 25 to 31 for the past 11 years. The theme this year, We Outside! Celebrating Connection & Our Communities, has had me thinking about my own experience with lactation and breastfeeding, both as a provider and a parent.

I entered the work of lactation long before I became a parent. I wanted to be a labor and delivery nurse but switched to public health after volunteering in an emergency room. That’s where I saw textbook cases come to life: People in life-or-death situations that could have been prevented by lifestyle interventions, health education and preventive care.

Discovering the lactation career path

My first internship as a public health student was with the California WIC Association. Raised by a single mom in the Bay Area, my sister and I knew the benefits of WIC, Section 8, and SNAP. Giving back to the program that put much-needed food on our table felt right. As an intern, I learned WIC was more than just milk, eggs and peanut butter. I learned how lactation and breastfeeding affected the overall health and wellbeing of families — especially moms and babies. Right then, I decided to become an Internationally Board Certified Lactation Consultant (IBCLC).  

As any lactation consultant will tell you, the road to IBCLC is a long one with plenty of twists and turns. But by the time I became a mom in 2018, I had already helped hundreds of families, put countless babies on the breast for the first time and supported mothers through postpartum anxiety, depression, mastitis, engorgement…You name it, I saw it.

But putting MY baby to MY breast opened my eyes to so much more. It’s one thing to support a parent with achieving that perfect latch and positioning. Being sleep deprived, in discomfort from labor and delivery and trying to latch my own newborn baby? That was a different story.

Likewise, I knew the statistics associated with Black infant and maternal mortality. I knew the disparities in breastfeeding rates, quality of care and access to resources and support. You don’t get a Master’s in Public Health without consuming vast amounts of data and learning to identify gaps and trends. But education and professional experience didn’t prepare me for the realities of being Black mother. Not the first time, nor the second.

Mocha-skinned pregnant woman wearing an orange dress holds a curly-haired toddler girl

Black, lonely and pregnant during a public health crisis

I got pregnant with my son in 2020. Living my entire life as the “lonely only” Black person in every room I entered never prepared me for the loneliness of a pandemic pregnancy.

I was raised by a single Black mother, but I was not raised in a Black community. I grew up in a predominantly Asian suburb, states away from my Black relatives in the South. And with the amount of concern surrounding the risks of COVID while pregnant, we had no visitors.  

Though I’m married, it felt like I spent my entire pregnancy battling a fractured health care system all alone with a toddler attached to my side

My husband was deemed an essential worker, which came with lots of mandatory overtime. Between work obligations and provider restrictions, he wasn’t allowed to attend a single prenatal visit with me.  My community of professional peers was stretched to capacity because while grocery store employees were considered essential, lactation providers were not — even though their work facilitates critical nourishment to infants and front-line triage of maternal mental and physical health. The nurses were reassigned to COVID wards, and everyone else was trying to transition from high-touch in-person services to supporting lactation initiation and success over phone and Zoom calls.

Quality of care disintegrated under pandemic pressure

My providers wanted me to take my own blood pressure while we met over Zoom. I was told that though I should have weekly in-person visits, they could only accommodate me once a month. I had standard symptoms of high blood pressure, and they tried to turn me away at the doctor’s office because I had no one to watch my toddler.

My entire pregnancy was a fight. No patient should ever have to tell a provider, “I am not going to die under your care,” and yet I did — more than once. I had to push aside fear of being perceived as a “loud, angry Black woman,” because sometimes, that’s how stuff gets done. I was lucky. So many women in my same situation, with my same level of education and income, fight just as hard as I did, even harder, and do not live to tell the tale.

And the ones who do live often do so in spite of the care they received, not because of it. We can’t talk about Black Breastfeeding Week without talking about Black maternal mortality in this country and how the system continues to fail Black women. 

Mocha-skinned woman in a hospital bed with long braids, holding a newborn on her chest

Improving Black maternal health outcomes, step by step

The first step in increasing lactation initiation and success is to ensure more Black women survive pregnancy and childbirth. We do this by listening to them and believing what they say.


Second, we talk to Black women about lactation early and often. We don’t wait until the third trimester or when we place their baby on their chest after birth. We do this by understanding informed decision-making takes time, so we start the conversation and the education from the moment pregnancy is confirmed.

Third, we empower Black women by connecting them with resources. It’s never too early in pregnancy to help a parent build a network of support. We do this by recognizing the importance of community and not assuming moms will figure things out on their own. They have their hands full enough.

Finally, every single one of us — regardless of our role in the continuum of care — must take a pause. Pay attention to each patient or client while completing your required checklists. Listen to them, and believe them when they describe how they are feeling and what they are experiencing. Meeting minimum expectations is not quality care.

Graphic urging you to support our mission with link to donate


Join the fight to make a better future for California

Protecting, promoting, and supporting lactation, chest, breast, and human milk feeding is a matter of public health. When we improve health outcomes for Black women and children, we are taking a crucial step towards fostering a healthier future for everyone in our state. It’s not just a mission; it’s a commitment to equity and wellness for all.

We are fortunate to receive generous financial support from the California Department of Public Health, which covers our operational costs. However, this funding cannot be allocated for our essential advocacy efforts. Advocacy is the key to dismantling and rebuilding the broken systems and structures that perpetuate disparity in our state. It’s the force that drives us closer to a California where every mother and child can thrive.

Today, I invite you to join our fight in creating a healthier, more equitable California. Your financial gift will empower us to continue our crucial advocacy work, providing us with the resources we need to be a steadfast voice for mothers and families across our state. Stand with us, and together, let’s make a lasting difference.

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Jasmine Pettis Marquez is the Executive Director of the California Breastfeeding Coalition (CBC). She is an International Board Certified Lactation Consultant (IBCLC) with years of practice in and around the Bay Area. Jasmine is also the author and illustrator of Breastfeeding All Around the Bay, a children’s book published in 2020 with the aim of adding much-needed character diversity and breastfeeding to children’s literature. She holds a bachelor’s degree in health science with an emphasis on community outreach and education from Sacramento State and a Master’s of Public Health from San Jose State.