All new mothers want their babies to be well nourished, no matter how they choose to feed them.
Back in the late 1980s when I was born, my mother, who is biracial, received little to no education on the benefits of breast-feeding. There was sparse representation anywhere of women of color nursing their babies, and formula feeding was the norm among her peers. So that’s what was in my bottle.
But when I became pregnant in late 2020, there was no question about my intention to breast-feed. I learned that there were activists such as Kimberly Seals Allers, who had a mission to make sure people like me received accurate and critical information via campaigns such as Black Breastfeeding Week. My Instagram account also gave me a sense of community during a terrifying and isolating time. My goal was to breast-feed for one year or beyond, as long as I continued to have the desire and the support I needed. I recently marked 19 months of breast-feeding my son, and I feel an overwhelming sense of joy: I am breaking a generational cycle. And a cultural one, too.
The science pertaining to the health benefits of breast milk is undeniable, yet for at least 40 years Black women have breast-fed less than all other racial groups. According to federal data, Black women intend to breast-feed just as much as white women (87.2 percent versus 86.9 percent, respectively), yet have a lower rate of initiation (69.4 percent versus 85.9 percent for white women) and a shorter rate of duration (in 2019, only 17.2 percent of Black babies were exclusively breast-fed at 6 months versus a 25.6 percent national average). As it stands, Black infants experience higher rates of infant mortality, as well as ear infections, diabetes, low birth weights, and other health problems. Breast-feeding for at least six months has been shown to mitigate certain infant illnesses as well as protect the mother, lowering the risk of breast and ovarian cancers, postpartum depression, stress, diabetes, and hypertension. So, why aren’t more Black women breast-feeding?
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To find some answers, I spoke with Stephanie DeVane-Johnson, who specializes in the improvement of breast-feeding and health disparities in the Black community. She’s a Black woman, mother, certified nurse-midwife, researcher, and an associate professor at Vanderbilt University School of Nursing. “African-American women have a unique lived experience dating back to historical aspects such as slavery [and] segregation that do impact contemporary health behaviors,” DeVane-Johnson tells me. American chattel slavery set the stage for what Devane-Johnson calls the “different and unique dialogue” African-American women have regarding breast-feeding, and the generational impact that still influences feeding decisions.
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Historically, the Black body was the driver of the economy, and the Black female body even more so because of its ability to wet nurse the enslavers’ children, usually to the detriment of their own. As many as 50 percent of infants born into slavery were stillborn or died within the first year of life, often from starvation. Vitamin and mineral deficiencies and other health problems were common. “Forced wet-nursing deprived many Black infants of protective antibodies, affection, and nurturing, that are inherent benefits of breastfeeding,” DeVane Johnson explained in a Journal of Human Lactation article last year. Still, Black women breast-fed their children as much or more than white women did through the 1800s. When infant formula was invented after the Civil War, it was initially advertised to well-off white women, making it seem superior to breast milk. But then came the Fultz quadruplets.
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These Black babies became instant “celebrities” as part of a 1946 infant formula marketing scheme that unfairly targeted Black mothers to spread the message that formula was better than breast milk. Today, in-hospital providers are less likely to offer breast-feeding services to Black mothers. The result is a formula-first feeding strategy that’s nine times higher for Black women than for white women.
All of this isn’t to shame the use of formula. “We have to quit making breast-feeding seem like it’s all or nothing. There can be some compromise,” says DeVane-Johnson. “Fed is best.” Some women are on medication that prevents them from nursing their babies, she says, and there are other circumstances that can cause a person to choose not to breast-feed (including personal preference).
As a new mom, I wasn’t prepared for how all-encompassing exclusive breast-feeding is in practice, and I understand why some people have to make other choices. I’m lucky that I’ve had people around me to help me succeed: my husband, a lactation consultant, and a registered dietician. I’m also college-educated, and have health insurance, family leave, a flexible work schedule, financial stability, breast pumps, and other social privileges that make life easier.
I will admit, though, the commentary from within my own family as well as strangers on social media became irritating. Questions like: Is he getting enough nutrition from breast milk? Should you start solids a little early? Or, Wow, you’re STILL breast-feeding? More than that, it was a reminder that for Black women specifically, there are socio-cultural factors at play here.
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The intersection of race, class, and culture, coupled with systemic racism, means that the motherhood space is rife with inequity. We’re all running the same race, but we’ve begun at different starting lines. Part of my work as a full-time Black mom and activist is to help change the narrative. DeVane-Johnson’s research and activism give me hope: “I’m wanting to level the playing field and make sure that every Black birthing person who wants to breast-feed is allotted the opportunity and the support to breast-feed successfully.”
This is another reason why social media can be such a valuable tool for representation, visibility, and the shattering of stereotypes. Social media engagement is a proven driver of shifting beliefs and perceptions around breast-feeding, including a willingness to nurse beyond one year. Additionally, the number of Black women choosing to breast-feed is rising, and there has been a much bigger focus on Black maternal health in general. Personally, I’m lucky to have a group of women I can turn to for comedic relief, solidarity, and a whole lot of “Did this happen to you, too?”
As a society, we need to continue to educate ourselves and others. As DeVane Johnson says, we need to normalize breast-feeding at a young age, not wait until reproductive age. We also need to create space for Black researchers, scientists, doulas, lactation consultants, and birth workers, and pressure our policy makers to help more people become cycle breakers, too.
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Ashley Mitchell is the cofounder of The Courage Campaign nonprofit. Find her on Instagram at @blackgirlmagicmama. Send comments to magazine@globe.com.