Feature Stories

Research that Matters grant recipient Dr. Elizabeth Miller studies breastfeeding support among African-American new moms

Mothers, practitioners, researchers, doctors, and doulas extol the virtues of breastfeeding. It is considered the "perfect" food for a newborn with its own moniker "breast if best." Yet baby formula is an over $10 billion dollar a year industry, and there are many obstacles to breastfeeding, including moms heading back to work and social pressures to keep this natural form of nurturing newborns hidden behind closed doors.
Dr. Elizabeth Miller, a 2015 Research that Matters grant recipient
Dr. Elizabeth Miller, who received a Research that Matters grant from the Office of Community Engagement and Partnerships to do a study of barriers to breastfeeding among African-American mothers of newborns, said "We have done a great job of destroying the breastfeeding culture" in the United States.

Miller said, "Medical anthropology is a new step for me. The field emerged from cultural anthropology as a critique of the culture of medical systems globally." She continued, "Breastfeeding, within the system of medical childbirth, is an issue which has long been ignored."

"Often you hear women say they became interested in breastfeeding because they have children," said Miller, "Well, I don't have any children and have not breastfed! When I was in graduate school, I became interested in research, which suggested strong links between immune processes in the gut and general immune functioning. At the time, most research on these questions happened in US populations. As an anthropologist, I wanted to expand our knowledge of immune system development to populations outside of the United States, who experience a much different hygienic and disease environment. So, I did research on breast milk in rural Kenya."

Miller said she joined the Hillsborough County Breastfeeding Taskforce about two and a half years ago when she began working at USF, because the department strongly encourages community engaged research. In fact, all four recipients of OCEP's 2015 Research that Matters grants were USF anthropologists.


Ivonne Hernandez, Miller, and Dr. Adetola Louis-Jacques at Tampa General Hospital.

Louis-Jacques stated, "Ethnic disparity for breastfeeding is really present in our midst, and we wanted to address that." In fact, after examining a CDC report in August of 2014, which discussed the ethnic disparity in lactation, Louis-Jacques and Hernandez compared numbers among the populations at Tampa General, at Genesis, and then more specifically among African American women at Genesis. During that month, at Tampa General, 84% of mothers initiated breastfeeding and 46% were exclusively breastfeeding upon discharge from the hospital; among mothers at Genesis 75% initiated breastfeeding and 20% were breastfeeding exclusively at discharge and finally, and as Louis-Jacques said among African American mothers, 69% initiated breastfeeding and only 7% breastfed exclusively at discharge.
Louis-Jacques, a fellow in Maternal Health, supports the mother and baby bonding at Tampa General

Miller attributes many of the difficulties mothers face in trying to breastfeed to the "culture of pregnancy, birth, and lactation that got taken over by doctors, indeed, taken over by people who prefer interventions, which are sometimes done without being empirically tested."

Miller continued, "As much as I am an advocate for breastfeeding, women are under real constraints in this society that make breastfeeding more difficult," and the team wanted to look more closely at these barriers to determine how to alleviate them.

"African-American women have been hit particularly hard by the destruction of the breastfeeding culture," said Miller.

"There is a socio-economic aspect of this, because women have to go back to work" in the United States (one of only three countries that provides no financial support to new mothers); and this impacts mothers' ability to breastfeed.

Miller tells mothers participating in her study, "I'm not a physician so you can tell me about it." Her quiet and kind demeanor allows mothers to feel comfortable sharing some of the most intimate details of their lives with her – their birth experiences and their subsequent efforts to breastfeed their babies.

Although she has not analyzed the data yet, Miller has been very encouraged by the interviews she has conducted. She believes that with the help of the mothers she interviewed, the team will be able to "better support moms in the way moms find appropriate," she said.

Deubel stated, "It is critical to understand how women are receiving information and making choices about feeding their babies in order to provide better services and increase awareness about the numerous health benefits of breastfeeding for mothers and babies. Working with an interdisciplinary team bridging anthropology and health sciences, Miller is helping to bring key community partners together to improve breastfeeding education and support for women throughout the area."

She continued, "Miller's expertise is a great asset to the Tampa community in promoting the health and nutritional status of infants, children, and mothers."

The team will share their findings at a local conference called "The Culture of Breastfeeding." Among the recommendations is sure to be that mothers need time in the first few months to rest and bond with their babies. Miller said that for moms in Kenya, the first few months are considered sacred time, and they are required not to work while caring for their newborns.

Dr. David Himmelgreen, the Chair of the Department of Anthropology, also a recipient of an OCEP Research that Matters grant, said, "Elizabeth Miller is a rising star in biological anthropology, and we are fortunate to have her here at USF. Her research represents the best of what anthropology has to offer in addressing issues related to infant feeding and maternal and child health."

When asked if she found the Research that Matters funding useful, Miller declared "Absolutely! I couldn't have done this study without it." Louis-Jacques concurred, "I really appreciate the grant. We were so excited. It's helping us start this crucial work.

Funding such as the OCEP Research that Matters grants can be vital in getting university-community partnership research studies off the ground; and OCEP is proud to help nurture these partnerships that strengthen our communities.