Credit: mlgkhc on Flickr, under Creative Commons (CC BY-NC-SA 2.0).

(WOMENSENEWS)–Sakia’Lynn Johnson was cautiously optimistic. Last year, as one of two African American international board certified lactation consultants in Florida, she had been asked to lead an African American special interest group for the first time in the history of the International Lactation Consultants Association’s annual conference. It is the largest gathering of lactation consultants in the world.

Never mind that she was asked one month prior, when these conferences are likely planned a year in advance, and never mind that the time–7 a.m.–was not exactly primetime. But even in the small room that was assigned to the meet-up Johnson envisioned a sea of black and brown lactation consultants certified by the organization, the ones she hoped existed even though she had only met a handful in her decade-long career.

About 23 people showed up.

Only six were African American. Including Johnson herself.

The situation wasn’t what she had hoped, but it was what she’d actually been expecting.

In fact, nobody seems to know how many African American international board certified lactation consultants (IBCLCs) there are in the United States. The membership association doesn’t compile that information and the registering body (International Board of Lactation Consultant Examiners) failed to reply to multiple requests for an interview for this column.

Here’s what I do know. As I traveled the country, asking everyone if they knew of any African American IBCLCs, this story took less journalistic routes and more grapevine and Underground Railroad-like pathways. There were stories and urban legends of black IBCLCs. At one point, I wondered if I was searching for black IBCLCs or Big Foot.

Terry Jo Curtis is founder of the Indiana Black Breastfeeding Coalition. She is an IBCLC and knew of two others in her state and she is mentoring others. There are two in the state of Michigan. The Alabama Breastfeeding Coalition members knew of two in Alabama. There were rumors of another but no one could confirm that she was indeed an IBCLC as opposed to a lactation consultant. Florida has two. And in New York City there are two.

Severe Diversity Problem

This is exactly as I have observed for the past five years: The lactation consultant industry, as represented by the membership of the International Lactation Consultants Association, has a severe diversity problem–and not much is being done about it. When the association convened the last week of July for its annual convention, I, too, was cautiously optimistic that developing meaningful ways to become culturally diverse would top its agenda. But given that this year’s African American special interest group meeting was relegated to pre-conference status, I remain suspect of its priority status.

“We realize it’s a big issue. And we really don’t have much in place,” admits Cathy Carothers, outgoing president of the association and incoming chair of the U.S. Breastfeeding Committee. Carothers said this year’s board meeting agenda included talking about the association’s role to fulfill point No. 11 in the Surgeon General’s Call to Action on Breastfeeding, which specifically involves “creating opportunities to prepare and train more IBCLCs from racial and ethnic minority groups that are currently not well represented in this profession.”

But Carothers couldn’t answer why action steps weren’t created at last year’s annual meeting given that the Call to Action was released with much momentum in January of 2011 and their meeting was in July and since their lack of black and brown membership spans even longer. Did the Surgeon General really have to tell you?

Meanwhile, Johnson says she wishes she had a dollar for every time she attends an association gathering and someone assumes that she is a peer counselor for WIC (the federal nutrition program for low-income Women, Infants and Children) instead of the board certified lactation consultant that she is.

Deep Assumptions

Assumptions about who does what in the breastfeeding world run deep.

Which is deeply troubling when you consider that a lactation consultant is a mother’s best shot at breastfeeding success. And that every marketing study about African Americans shows that they prefer to be served by someone who looks like them and understands their cultural nuances.

“The proverbial ‘Sally’ cannot talk to the proverbial ‘Shaniqua,'” says Johnson.

Truth moment: I discovered something about myself when I was breastfeeding my daughter. I did not really want a white woman to see my breasts. Maybe because of my overly dark areola and large nipples (I had to get a special pump), which seemed exotic and very National Geographic in my own mind. And I certainly didn’t want to tell a white woman some of the comments of my family members, which were really at the root of my insecurities around breastfeeding but may have sounded “ignorant” to anyone else not familiar with our cultural history.

I know I am not alone.

“Black women often find it easier to speak to my black lactation consultants or nurses. They understand each other from a cultural perspective and can relate to them in a different way than they are able to relate to me,” says Sylvia Edwards, manager of lactation services at the University of Alabama Birmingham hospital and co-chair of the Alabama Breastfeeding Coalition.

Can white certified lactation consultants help bridge the racial gap in breastfeeding rates? Perhaps, with a lot of cultural training. Could more African American consultants get us there much faster? Absolutely.

Most important, do the white lactation consultants care that their colleagues are woefully undiverse? I’m not so sure.

Piece of the Puzzle

If we are to bridge the racial divide in breastfeeding rates, we need more experienced lactation professionals who can work directly with our population. The higher rates of preterm babies and other high-risk births among black women often result in situations that require the medical expertise and specialized care of a certified lactation consultant.

It is clear that they are an important piece of the puzzle. As we embark on innovative and more community-focused approaches to closing the breastfeeding gap, we need black and brown faces to lead outreach into our communities.

“You cannot send ‘Susan’ to the back-to-school jam at the church to talk about breastfeeding,” Johnson says. “It is not going to work.”

Somehow we have to do better. I’m asking the International Lactation Consultants Association to do better: Better than a handful of exam scholarships; better than a few waived registration fees (what about traveling costs?); better than “I was a single mom too” without acknowledging other avenues of advantage; better than being relegated to off hours, side rooms and pre-conference status. If the members of the International Lactation Consultants Association and its U.S. affiliates are truly committed to changing the breastfeeding landscape (not just maintaining the status quo), then they need to better mirror the real America and address the inequities in its membership so it can truly address inequities among breastfeeding mothers.

The leadership of the lactation consultants association needs to actively seek and pursue new ways to encourage diversity–perhaps recruiting peer counselors from the federal Women Infants and Children nutrition program–and find other black lactation consultants who aspire to certified status. The International Lactation Consultants Association needs to own up to its diversity challenge and take it on. Center stage.

The development of this piece was supported by a generous grant from the W.K. Kellogg Foundation.

For More Information:

Lactation Consultants Need to Diversify
to Succeed