Race or ethnicity is not a barrier to breastfeeding but implicit bias within the medical system and lack of community support can play a role
August 3, 2026 - ITASCA, IL - Breastfeeding offers important health benefits for both babies and mothers, but not all families have the same opportunity to succeed.
The American Academy of Pediatrics observes in a new policy statement that, despite overall improvements in breastfeeding rates, significant disparities remain, with some of the lowest rates seen among Non-Hispanic Black and American Indian/Alaska Native families.
The statement, “Opportunities for Pediatricians to Address Racism and Bias to Reduce Racial Disparities in Breastfeeding and the Use of Human Milk,” is published in the September 2026 Pediatrics. The statement is published in Pediatrics online Aug. 3 in conjunction with World Breastfeeding Week Aug. 1-7.
“The good news is that more Black mothers are starting to breastfeed than in the past, and some of the gap in breastfeeding initiation is narrowing,” said Lori Feldman-Winter, MD, MPH, FAAP, FABM, NABBLM-C, co-lead author of the statement. “Yet we also know that Black mothers are still less likely to be breastfeeding at six months, and disparities in exclusive breastfeeding have grown.”
The AAP calls for consistent, evidence-based care and ensuring that all families have access to the same opportunities for success. The policy statement unpacks the reasons behind disparity gaps, observing that there are ways that different care practices and implicit bias can affect the breastfeeding education, encouragement, and support families receive.
Policy statements created by AAP are written by medical experts, reflect the latest evidence in the field, and go through several rounds of peer review before being approved by the AAP Board of Directors and published in Pediatrics.
This policy was written by the AAP Section on Breastfeeding, Committee on Fetus and Newborn, and Council on Health Equity.
Research cited finds that racial and ethnic disparities differ in terms of degree and group(s) affected depending on US geographic region, with disparities ranging from 6.6% to 37%.
“While we have seen a lot of progress in healthcare, non-white newborns are still more likely to receive formula in the hospital when there is no medical reason,” said co-lead author Sahira Long, MD, IBCLC, FAAP, FABM. “"This practice, rooted in implicit bias, can make it harder to continue breastfeeding and exclusively breastfeed over time.”
Recommendations include:
- Expanding paid family leave;
- Improving workplace pumping accommodations;
- Increasing payment for lactation services and breast pumps;
- Supporting community breastfeeding programs;
- Discouraging targeted formula marketing in communities with lower breastfeeding rates.
- Engaging in quality improvement efforts to support breastfeeding and the use of human milk and track outcomes by race/ethnicity.
The AAP recognizes that breastfeeding outcomes are shaped by more than health care alone. Factors such as language, income, geography, workplace conditions, and access to community support can all influence a family's ability to meet its breastfeeding goals.
“Pediatricians play an important role in closing these gaps by providing culturally responsive care, partnering with trusted community organizations, and connecting families with lactation support services,” Dr. Feldman Winter said.
“Ultimately, the goal is not simply to raise breastfeeding rates, but to ensure that every family has equitable access to the support and resources needed.”
More resources are available in HealthyChildren.org: Why Breastfeed: Benefits for You & Your Baby - HealthyChildren.org
The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.
Source: American Academy of Pediatrics
