Date of Conferral



Doctor of Nursing Practice (DNP)




Sue Bell


Breastmilk provides the optimal food for newborns and contributes to improved lifelong health. A community hospital in the Eastern United States serving non-Hispanic Black (NHB) women has a breastfeeding exclusivity rate of only 8%, which is low compared to the state’s exclusivity rate of 40%. A systematic review of the literature was conducted to identify the breastfeeding barriers for NHB mothers and to identify strategies to address them. Guided by Fishbein and Yzer’s integrative model and the SQUIRE 2.0 knowledge reporting framework, 30 articles were appraised using Melnyk and Fineout-Overholt’s hierarchy of research and the Caldwell, Henshaw, and Taylor qualitative research appraisal method. The six barriers to breastfeeding among NHB mothers identified in both qualitative (n = 17) and quantitative studies (n = 13) were (a) ineffective support, (b) cultural practices that do not include breastfeeding, (c) the need to return to school or work, (d) maternal health, (e) formula companies’ advertisements, and (f) the lack of NHB women in the field of lactation support. The Center for Disease Control and Prevention (CDC), the World Health Organization (WHO), and the Surgeon General of the United States all provided evidence-based recommendations to improve breastfeeding. The results of this systematic review can contribute to positive social change by guiding the development of a quality improvement plan to improve breastfeeding rates among NHB women served by the community hospital, which could lead to better health outcomes for newborns.

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