Black Women’s Right to Breastfeed
The Lost Causes of the Reproductive Justice Movement
By Natalie Filipowicz
This piece is a part of our Spark Series Reproductive Justice as a Human Right
Cara had been intent on breastfeeding. But at her prenatal visits, not once did her obstetrician ask her about her intended feeding practices. When her son was born, not once was a lactation consultant offered to her when she struggled to get him to latch. The only thing that ever was offered was formula, straight to her bedside minutes after giving birth. Not once did anyone consider that maybe this Black mother wanted to breastfeed.
Black infants are being breastfed at significantly lower rates than white infants. Among children born in 2019, the percentage of infants ever breastfed was only 74.1% for non-Hispanic Black infants compared to 85.3% for white infants. Of those non-Hispanic Black infants only 44.0% of them continued to be breastfed at 6 months compared to 59.9% of white infants.
These disparities are not the result of Black and African American birthing people simply choosing not to breastfeed. The complexities of breastfeeding — social support, assistance of lactation consultants, accessibility of breastfeeding friendly workplaces, affordability of pumping supplies, and time commitment — often go unrecognized. For Black and African American birthing people, these complexities are further complicated by unique historical, social, and cultural factors that prevent many from achieving their dream of breastfeeding.
Black and African American birthing people are less likely to have a strong family history of breastfeeding compared to Hispanic and white birthing people, which has been shown to positively impact breastfeeding intentions and initiation. Research also suggests that Black and African American birthing people are much more likely to be introduced to formula in-hospital after birth, which can negatively influence exclusive breastfeeding practices. The intersection of racism and socioeconomic status further impact breastfeeding rates in the Black and African American community. Black and African American mothers are more likely to be uninsured prior to pregnancy and after birth, resulting in gaps in access to care and support important for successful breastfeeding.
In fact, since the era of chattel slavery, breastfeeding practices in Black and African American communities have been heavily influenced, and even controlled by several outside factors. Enslaved women were often denied the right to breastfeed by their enslavers. They were viewed as property, and their fertility as a source of human capital. Breastfeeding, as a natural contraceptive, was seen by the enslaver as an impediment to furthering economic gain as quickly as humanly possible. It was also time consuming, time enslavers believed women should be spending out in the fields. Newborns born to enslaved women were entrusted to a designated wet nurse, an enslaved woman whose sole duty was to nurse and rear children. Many wet nurses were also ordered to nurse and give their milk to the white children of their enslaver, oftentimes starving their own. This practice was called ‘forced wet-nursing,’ and contributed to the neglect and high infant mortality rates among enslaved infants. The current-day stereotype of the ‘welfare queen’ has its roots in this forced neglect of enslaved infants, as enslaved women were subject to ridicule and blame from their enslavers and viewed as incapable of raising their own children.
Researchers hypothesize that legacies of forced wet-nursing have contributed to current day stigma associated with breastfeeding in Black and African American communities. Some may view breastfeeding as a form of oppression and a behavior that is reserved for white birthing people, while formula feeding is seen as a symbol of freedom.
In the 1900s, as the first infant formulas were being developed, formula companies capitalized on this stigma. In the 1950s, formula companies began advertising specifically to Black and African American birthing people, targeting hospitals and clinics serving predominantly Black areas. They sold the message to working-class Black and African American mothers that formula feeding was associated with success. Research suggests that this intense, targeted marketing contributed to a decline in breastfeeding rates in the Black and African American community throughout the later part of the twentieth century. In her book Skimmed, author Andrea Freeman documents how the formula company, Pet Milk, profited off the birth of the Fultz quadruplets born in 1946 and created marketing campaigns crediting the health of the Black quadruplets to its infant formula. Freeman highlights how formula companies shifted the cultural and social landscape of breastfeeding in the Black and African American community. To this day, it is argued that mainstream media rarely portrays positive images of Black and African American birthing people breastfeeding.
The stereotypes of Black motherhood born out of slavery show up in healthcare settings today. Healthcare professionals assume Black and African American birthing people will not breastfeed, which can contribute to a lack of support provided to parents for the initiation of breastfeeding. In addition to provider bias, existing structural barriers also contribute to the low rates of breastfeeding in the Black and African American community. In 1991, UNICEF and the World Health Organization launched the baby-friendly hospital initiative, a designation for hospitals that implement practices shown to facilitate breastfeeding and promote infant health. Even with the adoption of baby-friendly practices in many hospitals, there is a lack of these facilities in Black and African American communities.
Disparities in breastfeeding among Black and African American birthing people are a product of this interplay between racism, history of enslavement, and present-day social and environmental factors. Breastfeeding is integral to maternal and reproductive health; breastfeeding has been shown to lower a breastfeeding individual’s risk of ovarian and breast cancer and chronic conditions like high blood pressure. For a population that faces the highest maternal and infant mortality rates, it is imperative that we work to create environments that are supportive of every Black and African American breastfeeding individual.
With the overturning of Roe V. Wade, disparities in breastfeeding will continue to grow. However, unlike abortion and contraception, breastfeeding rarely makes it into discussions about reproductive rights. Breastfeeding shouldn’t be controversial, partisan, or political, yet it is heavily impacted by restrictions on reproductive freedom. As reproductive healthcare becomes harder to access, this will only put breastfeeding further out of reach for Black and African American birthing people. Every person deserves the right to freely exercise their choice of what, when, where and how to feed their child. It is time that breastfeeding is included in discussions of reproductive justice. As Kiddada Green, Founding Executive Director of Black Mother’s Breastfeeding Association argues, “Breastfeeding needs to be par for the course when we’re talking about maternal child health, when we’re talking about building vibrant, thriving communities for families.”
Natalie Filipowicz is an early career public health professional. She received her MPH from the University of Michigan School of Public Health in April 2022.
