A Narrative Review of Culturally Informed Breastfeeding Interventions for African American Women

Purpose: The aim of this narrative review was to map the current literature on culturally informed breastfeeding interventions for African American women. Background: Breastfeeding is associated with positive health outcomes for women and infants. Nonetheless, despite interventions aimed at improving breastfeeding for African American women, they continue to have lower breastfeeding rates compared to Hispanic and Non-Hispanic White women. Therefore, there is a need for culturally informed interventions to promote exclusive breastfeeding in African American women. Methods: PubMed, EmCare, CINAHL complete, APA PsycInfo, Scopus and Web of Science were systematically searched for articles published between 2001 and 2024. Preprints were searched in medRxiv; dissertations were searched in ProQuest Dissertations & Theses and EBSCO Open Dissertations; and other gray literatures were searched in governmental/organizational websites. Hand searches of reference lists were conducted. Data were synthesized using narrative synthesis. Results: Sixteen articles that met inclusion criteria were included. Randomized controlled trial design was used in 7 studies and community-based participatory research design was used in 4 studies. Multilevel breastfeeding education and support provided mostly in-person across 4 socioecological levels (individual, interpersonal, community, and culture) was associated with increased breastfeeding knowledge, self-efficacy, intention, initiation, duration, and exclusivity in African American women. No policy-level intervention was identified. Seven different terms were used to describe the incorporation of culture into breastfeeding interventions. Conclusion: This narrative review provides evidence on the utility and essence of culturally informed breastfeeding interventions for African American women. Multilevel breastfeeding education provided across the perinatal period is effective to promote breastfeeding outcomes in African American women.