Experiences of Nurses Who Provide Human Milk Feeding Support to Black Parents in the Immediate Postpartum Period.

Purpose: This qualitative descriptive study examines racial disparities in human milk feeding by exploring nurses' experiences in providing support to Black parents during the immediate postpartum period.

Background: Racial disparities in human milk feeding are persistent, with Black families much less likely to breastfeed than White, non-Hispanic families. Although nurses are key providers in the immediate postpartum, their role in human milk feeding support for Black families is inadequately studied.

Methods: We conducted semi-structured interviews with 15 nurses who had 1 year or more of experience on the labor and delivery or postpartum units. Interviews followed an interview guide informed by the theory of planned behavior and critical race theory. Interviews were audio-recorded and analyzed using thematic analysis.

Results: Two main themes, each with 3 subthemes, were identified: Navigating Human Milk Feeding Support (On the Job Learning, Juggling the Workload, and Self-Doubt) and Enacting Racism (Stereotyping, Explicit Racism, and Evasive Discourse). Nurses described experiencing inadequate human milk feeding education and stressors related to understaffing, which pressured them to make decisions about how to allocate time related to lactation support.

Conclusions: Findings indicate that nurses may not offer adequate support due to their assumptions that Black parents are unlikely to engage in human milk feeding.

Implications for practice and research: Disrupting structural racism throughout nursing education, including anti-racist continuing education and changing unit and hospital policies, may help intrapartum and postpartum nurses provide equitable and optimal support.