Matriarchal Influence on Black Women's Decisions to Provide Mother's Own Milk for Preterm Infants

Background: Black preterm infants cared for in the neonatal intensive care unit (NICU) are less likely to receive mothers' own milk (MOM) at NICU discharge than non-Black preterm infants. This disparity increases the risk of health and neurodevelopmental problems and their associated costs throughout the lifespan. One modifiable barrier to receipt of MOM at NICU discharge may lie within the role of Black maternal matriarchs; however, this role is not well characterized. Purpose: To describe and synthesize evidence related to the Black matriarch's influence on a mother's decision to provide MOM for a preterm infant hospitalized in a NICU. Data Sources: We searched the Cochrane Database of Systematic Reviews, CENTRAL, PubMed, CINAHL, and Web of Science databases and reviewed reference lists of included articles. Study Selection: A total of 139 articles were retrieved (n = 99 after deduplication), of which 2 met a priori criteria for inclusion. Data Extraction: We conducted an integrative review, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Results: One key theme emerged: the Black matriarch serves as a barrier to continued MOM provision among mothers of preterm infants in the NICU, despite mothers perceiving the Black matriarch as supportive or helpful. Implications for Practice and Research: Matriarchal influence over Black women's decision to provide MOM to their preterm infant hospitalized in the NICU likely serves as a barrier to continued MOM provision. Research priorities include developing culturally sensitive instruments to measure Black matriarchal support for MOM provision and conducting intergenerational studies.