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[quote=Anonymous][quote=Anonymous]Yes and that's why the AAP recommends TARGETED interventions.  Also there is nothing in the policy statement that says that racial equity is a key justification for these updated guidelines. If it were, I'm sure they would spend more than 2 paragraphs on it.  If they failed to note disparities that would have been so tone deaf and disturbing that they would have been rightly blasted for it.   I don't think they are using racial equity as a rationale for their guidelines,  I think they are giving a token amount of attention to racial disparities which is their greater failure not using racism to promote breastfeeding.

I agree that the equity analysis seems lazy - particularly since it fails to mention the contribution of racism and bias in health care to these disparities.  Since AAP guidance is aimed at health care providers that is a key failing since it is actually something health care providers can do something about.  (Vague allusions to structural racism are much less actionable.)   Where is the discussion of that black women are more likely to be given formula or assumed to be uninterested in breastfeeding?   Racism in health care was identified as an important factor in this study (very qualitative) on barriers to breastfeeding in African American women: 
 
[quote]In this study, SMEs significantly stressed the importance of addressing fundamental issues related to disparities in breastfeeding. Provider stereotyping, judgment, racism, and equity concerns were salient throughout the findings. Key informants highlighted the realities of racism within healthcare organizations,
among providers, and within communities concerning breastfeeding initiation among African American mothers. Despite the “call to action” to support breastfeeding
initiation in African American women, accounts from key informants provided evidence regarding the continued presence of stereotyping, disparities in approaches
to care based on culture, and lack of access/resources in specific communities and locations.9

https://journals.lww.com/jpnnjournal/Abstract/2021/04000/Subject_Matter_Experts_Identify_Health_Equity.13.aspx [/quote]

[/quote]

I agree with most of this, and certainly about addressing racism and bias in health care, but that should be part of a much larger effort because these same providers are not just discriminating with regards to breastfeeding, they are discriminating in other ways which are much more directly tied to maternal and infant mortality. I do not agree with targeted interventions to address bias and racism that solely address breastfeeding, I do not even think that breastfeeding should be the focus of those interventions.[/quote]

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