School of Nursing, University of Connecticut, Storrs, Connecticut, USA.
Breastfeed Med. 2021 Feb;16(2):103-111. doi: 10.1089/bfm.2020.0312.
Disparities in breastfeeding (BF) continue to be a public health challenge, as currently only 42% of infants in the world and 25.6% of infants in the United States are exclusively breastfed for the first 6 months of life. In 2019, the infants least likely to be exclusively breastfed at 6 months are African Americans (AA) (17.2%). A scoping review of the literature was undertaken by using Arksey and O'Malley's six-stage framework to determine key themes of AA women's experience BF through an equity lens. Electronic databases of CINAHL and PubMed were searched for peer-reviewed, full-text articles written in the English language within the past 5 years by using the terms BF, AA, Black, sociological, cultural, equity, health, attitude, exposure, initiation, continuation, barriers, and facilitators. Initially, 497 articles were identified, and 26 peer-reviewed articles met the eligibility criteria. Through an equity lens, three main themes emerged, which summarized AA women's BF experience: cultural (family, peers and community support; misconceptions; personal factors), sociological (prejudices, racism, home environment; financial status; sexuality issues; BF role models; employment policies), and health dimensions (family involvement; timely and honest information from staff; baby-friendly hospital initiatives; postnatal follow-up; special supplemental nutrition program for women, infants, and children). For AA women, exclusively BF is beset with diverse cultural, health, and sociological challenges. Multifaceted approaches are needed for successful resolution of BF challenges to bridge the racial gap in BF in the United States. Future studies may explore interventions targeted to modifiable barriers to improve BF outcomes.
母乳喂养(BF)的差异仍然是一个公共卫生挑战,因为目前全世界只有 42%的婴儿和美国只有 25.6%的婴儿在生命的头 6 个月内完全母乳喂养。2019 年,完全母乳喂养的婴儿中,最不可能在 6 个月时进行母乳喂养的是非裔美国人(AA)(17.2%)。通过使用 Arksey 和 O'Malley 的六阶段框架,对文献进行了范围审查,以确定通过公平视角观察 AA 女性母乳喂养经验的关键主题。使用 BF、AA、Black、社会学、文化、公平、健康、态度、暴露、开始、持续、障碍和促进因素等术语,在 CINAHL 和 PubMed 电子数据库中搜索过去 5 年内以英文撰写的同行评审全文文章。最初确定了 497 篇文章,有 26 篇同行评审文章符合资格标准。通过公平视角,出现了三个主要主题,概括了 AA 女性的 BF 经验:文化(家庭、同伴和社区支持;误解;个人因素)、社会学(偏见、种族主义、家庭环境;财务状况;性问题;BF 榜样;就业政策)和健康维度(家庭参与;员工及时和诚实的信息;爱婴医院倡议;产后随访;妇女、婴儿和儿童特别补充营养计划)。对于 AA 女性来说,完全母乳喂养面临着各种文化、健康和社会学挑战。需要采取多方面的方法来成功解决 BF 挑战,以弥合美国 BF 中的种族差距。未来的研究可能会探索针对可改变的障碍的干预措施,以改善 BF 结果。