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Health Equity/Community Health

Poster Session 2

(386) Breastfeeding rates among Black participants in a remote hypertension monitoring/community-based doula partnership study

Tuesday, February 13, 2024
3:30 PM – 5:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: Black patients both nationwide and within our state are known to have higher rates of hypertensive disorder of pregnancy (HDP) and worse pregnancy outcomes compared to White patients. Breastfeeding has been shown to decrease long-term cardiovascular risks in patients with preeclampsia; however, pre-study and pre-COVID local data suggests lower rates of breastfeeding initiation and exclusivity at hospital discharge among the Black patients compared to White (81 vs 93%) and (70 vs 88%). The objective of this project was to adapt our preexisting remote monitoring based postpartum hypertension program to include community-based doula support with lactation counseling to increase breastfeeding rates in a Black urban community in Wisconsin.

Study Design: This was a prospective feasibility study at a single academic center from 1/2021-12/2022. Postpartum patients were eligible if they had a diagnosis of HDP, self-identified as Black and were enrolled in remote blood pressure monitoring. Community doulas were paired with patients to offer postpartum care, lactation, social and mental support for 6 weeks postpartum.

Results: Forty-nine self-identified Black postpartum patients with a HDP were enrolled. Unexpectedly, this study was conducted during the COVID epidemic and at time of discharge, 80% of patients were breastfeeding in some capacity with only 39% exclusively breastfeeding. At the conclusion of the 6 week postpartum intervention, exclusive breastfeeding rates increased to 63%, with 79% of patients continuing to breastfeed at some level. Everyone who initiated breastfeeding was still breastfeeding at 6-weeks postpartum. Furthermore, no patients were utilizing donor milk at discharge, but two patients were transitioned to donor milk from formula during the 6 week postpartum period.

Conclusion:

These data suggest that community doula support can not only support breastfeeding efforts established in the hospital, but actually increase exclusive breastfeeding rates after hospital discharge among a patient population with historically low rates of breastfeeding.