Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Dec 17;17(1):86.
doi: 10.1186/s13006-022-00527-z.

A systematic literature review of breastfeeding interventions among Black populations using the RE-AIM framework

Emiliane Lemos Pereira  1 , Paul A Estabrooks  2 , Alejandro Arjona  3 , Wyconda Cotton-Curtis  4 , Judith C P Lin  5 , Carrie L Saetermoe  5 , Kacie C A Blackman  6   7
Affiliations

A systematic literature review of breastfeeding interventions among Black populations using the RE-AIM framework

Emiliane Lemos Pereira et al. Int Breastfeed J. .

Abstract

Background: Lactation support resources are less likely to be located in close proximity to where Black families live and there is a systemic racist health care belief that Black women prefer bottle feeding (with infant formula) over breastfeeding. Together, these lead to lower reported breastfeeding rates of Black babies compared to other racial / ethnic groups. It is imperative to have a deeper understanding of the cultural aspects as well as the underlying limitations that prevent Black women / persons from being supported to breastfeed. There is a need to know how effective breastfeeding interventions are in reaching the intended population; how well they work in promoting breastfeeding initiation and continuation; and how successful they are when implemented at the setting and staff level. The purpose of this investigation was to establish the level of internal and external validity that was reported by breastfeeding intervention studies among Black communities.

Methods: Studies on breastfeeding interventions on Black people that were published between the years 1990 and 2019 were carefully examined through PubMed, EBSCOhost, Web of Science, and OneSearch. A total of 31 studies fulfilled the requirements to be included for this evaluation. In order to extract the information from the articles, the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework extraction tool was utilized.

Results: On average, the proportion of studies that reported across reach, effectiveness, adoption, implementation, and maintenance indicators was 54, 35, 19, 48, and 9%, respectively. Across core RE-AIM indicators only sample size (100%) and breastfeeding outcomes (90%) were reported consistently. External validity indicators related to representativeness of participants (16%) and sites (3%) were rarely reported. Similarly, adherence to intervention protocol, and indicator of internal validity, was reported in a small proportion of articles (19%).

Conclusion: This body of literature under-reported on aspects associated to both internal and external validity across all RE-AIM domains. The reporting of the individual level of representativeness; the setting level of representativeness; the intervention's adherence to the protocol; the expenses; and the factors of sustainability would benefit from improvement in future research.

Keywords: African Americans / Black; Breastfeeding continuation; Breastfeeding duration; Breastfeeding initiation.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA Flow Diagram
See this image and copyright information in PMC

References

    1. Eidelman AI, Schanler RJ. Breastfeeding and the use of human milk. Pediatrics. 2012;129(3):e827–e841. doi: 10.1542/peds.2011-3552. - DOI - PubMed
    1. Breastfeeding report card: United States, 2020. Centers for Disease Control and Prevention. https://www.cdc.gov/breastfeeding/data/reportcard.htm. Accessed 15 July 2022.
    1. Beauregard JL, Hamner HC, Chen J, Avila-Rodriguez W, Elam-Evans LD, Perrine CG. Racial disparities in breastfeeding initiation and duration among U.S. infants born in 2015. Morb Mortal Wkly Rep. 2019;68(34):745–748. doi: 10.15585/MMWR.MM6834A3. - DOI - PMC - PubMed
    1. McCardel RE, Padilla HM. Assessing workplace breastfeeding support among working mothers in the United States. Workplace Health Saf. 2020;68(4):182–189. doi: 10.1177/2165079919890358. - DOI - PubMed
    1. Freeman A. Skimmed: breastfeeding, race, and injustice. Stanford: Stanford University Press; 2019.

Publication types