2021 Breastfeeding Disparities Qualitative Research Study

Breastfeeding Disparities

Although current breastfeeding rates are promising, and there have been recent increases in breastfeeding rates for all racial and ethnic groups, breastfeeding disparities are apparent, especially between non-Hispanic White and non-Hispanic Black infants.1 In New York, the breastfeeding disparity gap, especially for breastfeeding initiation, is smaller than when compared to the U.S. rates; however, disparities still exist.2

According to the literature, the causes of breastfeeding disparities vary, and there is no one, clear solution to address them. Systemic barriers and cultural factors must be taken into consideration, including historical traumas and healthcare access barriers faced by many groups who are also most likely to experience breastfeeding barriers and disparities.3,4  The local context must also be examined to determine the impact of specific environmental factors and settings that may be contributing to breastfeeding disparities.5


  1. Li R, Perrine CG, Anstey EH, Chen J, MacGowan CA, Elam-Evans LD. Breastfeeding trends by race/ethnicity among US children born from 2009 to 2015. JAMA Pediatr. 2019;173(12):e193319.  doi:10.1001/jamapediatrics.2019.3319. 
  2. Chiang KV, Li R, Anstey EH, Perrine CG. Racial and ethnic disparities in breastfeeding initiation ─ United States, 2019. MMWR Morb Mortal Wkly Rep. 2021;70(21):769-774. doi:10.15585/mmwr.mm7021a1 
  3. Brown HL, Small MJ, Clare CA, Hill WC. (2021). Black women health inequity: The origin of perinatal health disparity. J Natl Med Assoc. 2021; 113(1):105-113. 
  4. Center for Social Inclusion. Removing barriers to breastfeeding: A structural race analysis of first food. 2015. Accessed March 7, 2022.
  5. U.S. Department of Health and Human Services. Office of the Surgeon General. The Surgeon General’s Call to Action to Support Breastfeeding. 2011. Accessed March 20, 2022.


Inclusive Language Statement

Lactation professionals, experts and advocates are actively discussing ways to promote diversity, inclusion, and equity in promoting and supporting infant human milk feeding. There is no consensus on the best way to change language or terminology. The appropriate use of gender- or sex-based language differs by the purpose, context, or audience, and whether one is discussing research findings, making recommendations about a population, or providing one-on-one counseling with a patient or client.

At the time of this study, the term "breastfeeding" was used. However, when reviewing materials on this webpage, this term should be viewed as encompassing all forms of lactation, including chestfeeding, to recognize diversity in gender and gender identity and recent changes in language to support diversity and inclusion.

Goal & Purpose of Study

The goal of this study was to better understand breastfeeding disparities in New York and how to address them.

The purpose of this study was to understand breastfeeding disparities by conducting a qualitative study using virtual key informant interviews (45 respondents) and an online survey (253 respondents) of New York breastfeeding experts from all 5 regions of the state who directly work with the communities most at risk of experiencing breastfeeding disparities and to capture expertise and recommendations from national breastfeeding experts.

Research Study Background

This study was conducted in 2021 by the University at Albany School of Public Health in collaboration with the New York State Department of Health’s (NYSDOH) Bureau of Community Chronic Disease Prevention and Division of Chronic Disease Prevention. These findings will inform the NYSDOH in developing a larger report to identify barriers to breastfeeding and strategies to increase breastfeeding rates and reduce disparities. 

The study's purpose was to identify: 

  1. barriers to successful breastfeeding
  2. strategies to reduce barriers
  3. strategies to improve access to prenatal and postpartum health care services; and
  4. strategies to increase breastfeeding rates and reduce racial and ethnic disparities in NYS.

The study was approved by the University at Albany’s Institutional Review Board (IRB Protocol: 21X130). A final report detailing findings from the research study was submitted to the NYSDOH on March 31, 2022.


Research Team

Christine T. Bozlak, PhD, MPH
Associate Professor
Health Policy, Management, and Behavior
Co-director, Maternal and Child Health Program
[email protected]

Lindsay Ruland, MPH, MBA, CHES®
Associate Director
Center for Public Health Continuing Education
[email protected]

Britnee Eskew, MPH, CHES®  
Professional Development Coordinator
Center for Public Health Continuing Education


The research team would like to acknowledge the research participants and the New York State Department of Health who made this study possible.