Lactation certificate program student Sierra Bizzell, left, demonstrates a technique with a breast model for program director Janiya Mitnaul Williams March 17. The Cone Health Women’s MedCenter clinic serves women from all backgrounds in East Greensboro. (Photo by James Parker/NC A&T University) More support for new mothers.
Lactation certificate program student Sierra Bizzell, left, demonstrates a technique with a breast model for program director Janiya Mitnaul Williams March 17. The Cone Health Women’s MedCenter clinic serves women from all backgrounds in East Greensboro. (Photo by James Parker/NC A&T University)

NC A&T is leading the effort to swell the ranks of Black lactation consultants, yielding better health outcomes for Black mothers and their kids.

GREENSBORO —   Janiya Mitnaul Williams was getting recognized in the field before she ever became a lactation consultant – literally. For years, other Black and brown women would stop her in stores and on the street with questions about how to breastfeed their babies.

Though not certified, she was featured recounting her experiences  as a mother in breastfeeding educational materials that Cone Hospital shared with new and soon-to-be parents.  It earned her a modicum of fame in an arena where less than 2% of those certified by the International Board-Certified Lactation Consultants are Black. 

“I’d be shopping and people would ask me, ‘Can I ask you a breastfeeding question? I saw you, you’re the breastfeeding lady,’” she said in a recent interview with Cardinal & Pine. “It was other people who were Black and brown who would ask me these questions.”

Seeing the need, Williams set out to become a lactation consultant, but she didn’t stop there. She forged ahead to bring the highly-regarded Human Lactation Pathways 2 program to NC A&T, her alma mater and the largest public HBCU in the nation. Her goal? To train more Black lactation consultants.

A&T is now one of only two lactation consultation programs housed at an HBCU, with the other at Charlotte’s Johnson C. Smith University.  Williams is also working with other HBCUs to set up more lactation consulting programs. It’s a critical need, given that research has shown persistent gaps in Black maternal healthcare, and that outcomes for people of color tend to improve with medical providers from similar backgrounds.

Increasing breastfeeding rates, especially in the first few weeks of a baby’s life, could improve health outcomes for both children and their parents because of the multiple health benefits of human milk, public health researchers believe. But Black mothers are also much less likely to breastfeed than white, Latina and Asian women for a number of complex reasons.

“If we’re there supporting these families and making sure that they have that foundational information, we can definitely see breastfeeding rates skyrocket,” Williams said. Then comes “all the health benefits that encompass breastfeeding for the family, for the baby, for the lactating person.”

Better Health for Moms and Babies

Increasing the rates of breastfeeding among Black families could go a long way in bettering outcomes for babies in North Carolina, where a Black baby is more than 2.5 times more likely to die in its first year than a white baby. It’s the worst the disparity has ever been. 

One national study predicted 911 more people, largely infants, would survive each year if 90% of them received human milk in the first few days of their lives. The current rate is 84%, with Black children experiencing the lowest rates of initial breastfeeding at 76%, according to 2018 data from the Centers for Disease Control and Prevention.  

Women in North Carolina’s small towns face even more challenges.

“We know that in rural communities, there’s a lack of access that’s even greater,” Williams said. “And when we’re talking about health disparities, that shines even more so for people who are Black and brown.”

Increasing breast feeding rates will also help women years from now, given how breastfeeding has been shown to lower the risk of developing breast cancer and other serious conditions later in life, said Karida Giddings of the NC Black Alliance. The group received a grant from Blue Cross Blue Shield of North Carolina to increase the access women in Eastern North Carolina have to lactation services.  

“We need to improve the longer-term health outcomes for Black women,” Giddings said.

The Power of Human Milk 

The benefits of breastfeeding are well-documented and significant. Breastfeeding, especially in the first days of life, has been shown to have enormous benefits for babies, with lower rates of SIDS (sudden infant death syndrome), asthma, ear infections and stomach bugs, according to the CDC. 

Colostrum, the thick milk made right after delivery, is especially rich in nutrients and antibodies and considered the ideal nourishment for a newborn. The American Academy of Pediatrics recommends all babies be exclusively breastfed for their first six months and that it continue at least until a child reaches a year old.

Women who breastfeed are shown to recover from labor and delivery faster, and go on later in life to experience lower rates of ovarian and breast cancers, Type 2 diabetes, and high blood pressure.

But breastfeeding isn’t easy for everyone to start or to incorporate into their lives without support from families, hospitals, and workplaces. And the reasons for lower rates among Black women are complex and systematic.

There is this nation’s history of using enslaved women to serve as wet nurses for white babies, which reduced the availability of milk and cultural practice for Black babies. And from the 1950s forward, companies heavily marketed baby formula toward Black mothers, many of whom were forced by economic pressures to work outside of the home. Breastfeeding was less viable than leaving an older child or sitter with a bottle.

Today, false assumptions in the medical community persist that Black families aren’t interested in breastfeeding. The same type of bias that discounts the concerns and desires of Black women in the birthing process also prompts hospital workers to be more likely to offer formula to a Black mother instead of the support that lactation consultants can offer.

“Black [families] have been labeled as non-breastfeeding families, so  they’re offered formula as opposed to help,” Williams said. “And so that’s another reason why this program is so beneficial, because then we’ll get more IBCLCs [licensed lactation consultants] in the hospital.”

The challenges go beyond what is happening in medical settings, of course. Black women are also more likely to be working in lower-paying service industry jobs, jobs that may not offer paid time off to care for a new baby and establish breast-feeding routines.   

‘People Helping People’

Less than two years since the program started, the effects are already being seen, Williams said.  Participation from Black and Latino parents in lactation workshops were higher at Cone Health since A&T students began conducting their clinical hours there. And A&T’s first 11 graduates sat for their certification exams this year, and are now working in hospital and private settings.  

William’s hope is that increasing the number of Black lactation consultants will set off a ripple effect, building more networks of support for people to turn to in North Carolina. 

Now a mother of five, with a four-month-old daughter, she emphasized that most of what people need to breastfeed successfully is support. The work follows in the footsteps of Black birth workers of the past, she said, who were there to guide and support women.

“It was women helping other women,” Williams said about birthwork in generations past. “And so now it’s just fancy, because we have credentials and titles and things behind it, and education, which is great. But when we peel back all of those layers, we’re just people helping people.” 

Editor’s note: This article has changed from the original to reflect Janiya Williams is a mother of five and clarify the role of NC Black Alliance. We regret the errors.