By Lisa Rapaport

(Reuters Health) – Even as more U.S. mothers are breastfeeding their babies, a new study suggests the gap in breastfeeding between black and white infants is widening.

Researchers examined data 167,842 infants born from 2009 to 2015. Overall, the proportion of mothers who initiated breastfeeding increased by 7.1 percentage points, and the proportion of women exclusively breastfeeding climbed by 9.2 percentage points.

But disparities between exclusive breastfeeding at six months of age became more pronounced between black and white babies, the study also found. At the start of the study, the proportion of black infants being exclusively breast fed was just 0.5 percentage points behind white babies, but by the end this gap widened to 4.5 percentage points.

While the study didn’t look at why racial disparities in breastfeeding rates might develop, a variety of factors could play a role, said Dr. Ruowei Li, lead author of the study and a researcher at the U.S. Centers for Disease Control and Prevention in Atlanta.

“In the United States, implementation of practices that support breastfeeding is lower among maternity care facilities in neighborhoods with larger black populations, suggesting disparities in access to hospital support for breastfeeding,” Li said by email.

“Black women, especially those who are low-income, return to work earlier than do other racial/ethnic groups and are more likely to experience challenges to breastfeeding or expressing milk, including inflexible work hours,” Li added. “Additionally, black women may lack breastfeeding role models in their social networks and be more likely to face negative perceptions of breastfeeding among their peers and communities.”

Pediatricians recommend that mothers exclusively breastfeed infants until they’re at least 6 months old because it can bolster babies’ immune systems and reduce their risk of ear and respiratory infections, sudden infant death syndrome, allergies, obesity and diabetes. For mothers, breastfeeding for at least one year has been linked to a lower risk of depression, obesity, and certain cancers.

At the start of the study, 15.7% of mothers exclusively breastfed their babies for at least six months, researchers report in JAMA Pediatrics. This reached 24.9% by the end of the study.

By 2015, exclusive breastfeeding rates ranged from as low as 17.2% for black babies to as high as 29.5% for white infants and 30.1% for Asian babies,

That year, the proportion of mothers still breastfeeding at 12 months ranged from as low as 24% for black babies to as high as 50.3% for Asian infants and 39.8% for white babies.

The results suggest that many women may need more support for breastfeeding than they currently receive, said Melanie Lutenbacher, an associate professor in the School of Nursing at Vanderbilt University in Nashville, Tennessee.

“Most women can successfully breastfeed but often it is a learned skill,” Lutenbacher, who wasn’t involved in the study, said by email.

“Most black women know the benefits of breastfeeding but may be caught in a personal tug of war between wanting to breastfeed their baby and beliefs or traditions in their family and social networks,” Lutenbacher said. “Receiving mixed messages and inconsistent support across critical points in time – late pregnancy, early postpartum and returning to work or school – creates huge roadblocks for women and their nursing infants.”

SOURCE: JAMA Pediatrics, online October 14, 2019.