The Problem With Breastfeeding in America & Lactation Disparities

When I decided to breastfeed my children, I had no idea how racialized breastfeeding had once been

black breastfeeding

Photo: Brianna Lisa Photography/Pexels

When I decided to breastfeed my children, I had no idea how racialized breastfeeding had once been. I didn’t know that while breastfeeding had been looked down upon in America as a whole for decades, there was even more stigma surrounding it in Black communities. I grew up in a largely Black and Puerto Rican community in an urban area where most people lived below the poverty line, and I knew that most women in that community didn’t breastfeed their children. But, I didn’t realize that there was a correlation between race and economic status, and the choice not to breastfeed.

Why would I? No one thinks much about these things until it’s their turn. Determined to successfully breastfeed my own babies — because of the health benefits, and because, well…at that time I couldn’t really afford formula — I immersed myself in every bit of information about breastfeeding that I could. I read breastfeeding books and blogs and followed accounts dedicated to breastfeeding on Instagram and Facebook. I even joined online support groups for breastfeeding moms. Still, it wasn’t until I had my second child that I noticed people were starting to draw attention to the fact that breastfeeding rates among Black moms in America are the lowest of all racial and/or ethnic groups.

Identifying as Afro-Latinx myself, this struck me in a powerful way. I knew that in my own Puerto Rican family, no one — at least going as far back as my grandmother — had breastfed their children. It made me feel even more convinced about my choice to breastfeed and to keep doing so as openly as possible. At the time though, I still didn’t know much about the history behind why breastfeeding became so much less popular in the Black community.

According to the National Library of Medicine, as recently as 2015, Black women were still 2.5 times less likely to breastfeed than white women and are 32 percent more likely to start supplementing with formula by the time their children are two days old. Keep in mind, that includes Afro-Latinx people, which in 2022 are numbered at around six million adults in the U.S., including both men and women.

There are a few things that are believed to have contributed to this, though not everyone from everywhere will agree. “At the root of what’s happening to Black women and their birth outcomes, as well as their disparities with breastfeeding, is an issue about racism and bias,” Maternal and Infant Health Strategist, Kimberly Seals Allers, writes in her book, The Big Letdown.

If we consider the fact that all over North America and the Caribbean — including Puerto Rico, the Dominican Republic, and Cuba — and perhaps even in some parts of South America, enslaved Black women and later, Black domestic workers were used to wet nurse white babies, sometimes being forced to lactate for years on end, Allers’ words couldn’t ring more true. Throughout all of history, Black women have given so much of their bodies, hearts, and minds, to white women — and men — who have proven again and again, that they don’t care about them. It shouldn’t be a surprise that consciously or subconsciously, Black women turned away from a practice that was so connected to a history of trauma.

Beyond that, in today’s America, breastfeeding successfully requires support and resources that Black women often don’t have access to. Even the Centers for Disease Control (CDC) recognizes that Black women and their babies are at a disadvantage when it comes to these things. “Increasing rates of breastfeeding initiation and supporting continuation of breastfeeding among Black women might help reduce disparities in breastfeeding duration,” a report on racial disparities and breastfeeding initiation rates published in 2019 reads: “Strategies might include improving peer and family support, access to evidence-based maternity care, and employment support.”

But, why? Well, because a hefty percentage of the Black population lived below or at the poverty line until well into the 21st century, many working minimum wage jobs without health benefits or paid time off. In fact, Black and Latinx people in the U.S., generally have less health coverage than white people. In order to breastfeed a mom needs to either be physically with her baby or have a working breast pump, which can cost hundreds of dollars without health insurance. Of course, hand expression is possible, but not so much when you’re working a full shift and have limited breaks if any.

That’s not to mention the fact that access to formula is in many cases much easier for moms on government assistance to access, since it’s covered by both the Women Infants and Children (WIC) nutrition program and Supplemental Nutrition Assistance Program (SNAP). These programs are essential and helpful for many families in need, but often disproportionately promote formula feeding over breastfeeding.

According to the USDA Economic Research Service, breastfeeding rates among mothers participating in WIC are lower than the medical recommendation. And in this case, the U.S. government again admits women need more breastfeeding support, noting that increasing the WIC breastfeeding rates would save the government millions and millions of dollars in healthcare costs. The government however, continues to do very little to help women — many of whom are Black and Afro-Latina — get that support.

We could go off on a tangent here, and argue that in some ways, the government’s lack of effort directly speaks to how it prioritizes Black women and babies. We could bring it full circle and say still and again, it’s the white majority not caring about Black bodies, and that might offend some people, but given America’s history, not much else can be deduced.

While breastfeeding initiation and continuation rates are continuing to rise in the United States, the racial disparity between Black and white breastfeeding rates remains staggering. What can we do about it? Whether breastfeeding is the norm in your family or community or not, you can be an ally for
Black and Afro-Latina moms.

  • Recognize that breastfeeding may not be as natural to some women as it is to others. Because of racial and economic disparities, many Black women — and yes, Latinas too — are completely new to even the idea of breastfeeding.
  • Support Black women who want to breastfeed. Encourage them, bring them food and water, help them find a lactation consultant.
  • Find resources to help educate yourself on the benefits of breastfeeding as well as tips and tools that can increase the likelihood of building a strong breastfeeding relationship with your baby.
  • Seek out Black healthcare providers. From pediatricians and obstetricians to lactation consultants, Black healthcare providers are more likely to care about Black patients than white healthcare providers are. The statistics prove it.
  • Advocate for women in the workplace. Moms need adequate support in the workplace if they are going to go back to work full-time and still breastfeed. Be vocally supportive and if need be, bring up the topic, whether you are a mom or not.
  • If you are a Black mom who is choosing to breastfeed, do your best to be open about it. Be an open book and do what you can to normalize breastfeeding in your family and even in your community.

We can’t change the past, but as women — as moms — we have the power to take back our bodies, to care for our babies how we see fit, and to break cycles that keep us from living life wholly, authentically, and in our best health, and breastfeeding is certainly a part of that.

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