(P18-003-23) LATCH (Lactation Advocacy To Cultivate Health) Equity Study: A Qualitative Study To Investigate Lactation Support for Black, Latinx, and Southeast Asian Birthing Parents

Objectives: To investigate (i) facilitators and barriers to exclusive breastfeeding (EBF); (ii)  experiences of in-hospital lactation support; and (iii) suggestions to improve support for Black, Latinx, and Southeast Asian birthing parents.

Methods: Eligible Black, Latinx, and Southeast Asian birthing parents were recruited during postpartum hospitalization. To date, 21 interviews have been conducted with 10 Black parents; 10 Latinx parents (7 with Spanish language preference); and 1 Southeast Asian parent. Semi-structured interviews were conducted over video or phone call. Transcripts were coded inductively using Nvivo, from which themes were extracted through team discussion.

Results: Most participants (14) intended to exclusively breastfeed at delivery, 7 of whom were EBF at the time of interview (~2 months postnatal age). At the interpersonal level, prior experiences with breastfeeding, partner and family support, and online peer support enabled successful breastfeeding. At an institutional level, most participants felt listened to by providers regarding feeding concerns; however, 8 parents reported a delay to inpatient lactation support and 2 parents reported racist care. All Spanish-speaking participants were offered an interpreter for lactation services. Gaps that emerged included need for: hospital lactation counseling sooner after birth, linguistic and racial concordance with providers, increased mental health support, and incorporation of return to work in their feeding plan. At the structural level, pregnancy leave, work environments, the national formula shortage, and programs like WIC played a critical role in influencing breastfeeding goals and outcomes.

Conclusions: Interpersonal, institutional, and structural processes all shape parents’ feeding goals and outcomes. We identified specific areas to develop lactation support in our hospital programs, including: reducing delays to lactation consultation, strengthening anti-racism interventions, increasing racial and ethnic diversity of staff, providing linguistically appropriate care, and supporting return to work, and providing mental health support.

Funding Sources: Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital