The Enormity of Injustice and How it Impacts Breastfeeding for Black Women
"Injustice anywhere is a threat to justice everywhere." - Dr. Martin Luther King, Jr.
As a cisgender heterosexual middle-class brown female, I live with a unique perspective of how race and socioeconomics playout in our country. While I can sympathize with black women, I cannot ever truly know their lived experience. And that makes writing about issues of social justice a little bit challenging.
What I do know, though, is systems in place in our culture make it harder and more dangerous for women of color and their families in all aspects of their lives. Black Breastfeeding Week attempts to address inequity in one small piece of the greater puzzle.
If we believe that breastfeeding is the normal way to feed babies, and that babies who are not breastfed suffer from more health and social issues, then we can assume that lower breastfeeding rates disadvantage some groups from birth (or perhaps even before that).
● Between 2010 and 2013, 79.2% of babies born in the US were breastfed. If you break this down by race, though, there is a huge disparity. For white infants, 81.5% were breastfed. The number for black infants, however, was 64.3% (Voelker 2017).
● In the US, Black mothers were nine times more likely to be given formula in the hospital than white mothers (McKinney et al, 2016), a known risk factor for premature weaning.
● In the US, Black mothers weaned their infants 10.3 weeks earlier than did white mothers. (McKinney et al 2016).
● Black infants in the US are twice as likely to die during their first year of life compared to white infants. (NCHS nd)
● Black mothers in the US are greater than three times as likely to die from pregnancy-related complications than their white counterparts (Creanga 2017).
The breastfeeding experiences of black women are complicated by the history of colonization, slavery and white supremacy. McGuire (2018) writes, “Within the realm of influences that contribute to the comparative low numbers for breastfeeding amongst Black Women are, slavery, racism, implicit bias, and discrimination from care/treatment providers.” Until we fully recognize and explore the interplay between these factors, we may not make an impact on breastfeeding rates in a population who deserves a level playing field.
Enslaved women in early America were often separated from their own babies - either by the fact that they worked in the house caring for the white owners and their children, or because of their long days of field work that necessitated another caretaker for their own children. These women were often forced to wet-nurse their oppressor’s children. They were abused and raped by their enslavers. They were stripped and their nakedness used as a selling asset. They were moved indiscriminately based on the whims of their subjugator, sometimes even taken far away from their own nursing baby.
The end of slavery didn’t mean a better outcome for these women. They were still often separated from their own families in order to work as domestics in white households or to move where there was work in factories. These economic factors, along with laws failing to protect or outright targeting black people, created the stereotype of the bad black mother - one who doesn’t care enough to care for her own children. In addition, formula was targeted at black mothers throughout the 20th century, while breastfeeding promotion was often only aimed at white mothers. All of these circumstances combined to not only stigmatize black women breastfeeding, but to also make black women reticent to use their own bodies to feed their babies. Choosing not to breastfeed can be viewed as an act of rebellion against white privilege and white supremacy.
The description above barely touches on the tremendous burden black women bear when it comes to being mothers. Freeman (2017) has written in depth about the topic: her article Unmothering Black Women provides an annotated background that everyone should read. Near the end of her paper, she writes,
...to be effective, breastfeeding advocates should not direct their efforts toward individual women. Instead, their goal must be structural, aimed at reforming law, policy and social inequality. They should seek to shed light on the institutionalized, systemic obstacles to breastfeeding in Black communities and the lingering stereotypes that make these obstacles falsely appear to be personal choices or failings (p 61).
The legacy of slavery poisons the experience of lactation for these women. The continued prejudice and discrimination that persists even into the 21st century compounds the fraught decisions about infant feeding, creating first food deserts. A food desert is a community that lacks access to affordable and healthy foods such as fresh fruits and vegetables, and a first food desert is one where babies lack access to breastfeeding, which affects the health of these youngest community members. These areas are disproportionately home to people of color, and the women in these communities are unfairly blamed for not breastfeeding. The problem, however, is that structural systems beyond her control - such as institutional racism, the lack of pregnancy, birth and breastfeeding support, and the economic necessity of work outside the home - make it nearly impossible to nurse.
How can we get past this predicament? How can we protect and support women of color so they can mother their children however they choose? You can learn more about Black Breastfeeding Week at http://blackbreastfeedingweek.org/ and http://www.usbreastfeeding.org/p/cm/ld/fid=839#week4. Check out journalist and author Kimberly Seals Allers’ fantastic website, Black Breastfeeding 360°. Get your hands on a February 2015 edition of the Journal of Human Lactation, a special issue about equity in breastfeeding. If you want to read about the experiences of breastfeeding while black in women’s own words, the book Free to Breastfeed: Voices of Black Mothers by Jeanine Valrie Logan and Anayah Sangodele-Ayoka is a great start. What else can you do?
● Be an ally. Educate yourself about social justice and about the experiences of those who are different from you, check your own privilege and bias, and take meaningful action to affect change. Stand beside rather than in front of those you seek to help.
● Support legislation that has the potential to lift up families of color. This doesn’t necessarily need to be specific to breastfeeding to impact breastfeeding rates. The intersectionality of race, class and gender, combined with lack of support and a healthcare system at odds with marginalized parents means that changes in one area will have a ripple effect into other areas.
● Champion baby-friendly hospitals and greater access to lactation consultants in hospitals, especially in underserved areas. Seek out and lift up the voices of black lactation consultants and reproductive justice advocates.
● Promote workplace accommodations for parents. That may mean paid parental leave or protected time during the workday for pumping or breastfeeding. Women who can take time off from work without the fear of losing their jobs (or of starvation due to lack of income) are more likely to breastfeed and to do so longer. When we make the workplace better suited to the needs of parents - both mothers and fathers - productivity is improved and families are enriched in more ways than one.
● Help to build ‘first food friendly’ communities. Fight to combat food deserts, especially when that includes first foods (breastfeeding).
My words in this blog post feel inadequate to the enormity of the injustices women of color face. But, we are ultimately one community in the end. What affects one will affect all others. Members of our greater community need help breaking down barriers to the most basic of human rights. Feminist author bell hooks writes, “To be truly visionary we have to root our imagination in our concrete reality while simultaneously imagining possibilities beyond that reality.” What possibilities can you imagine for yourself, your family, your neighbor, your community, for all women?
Creanga, A. A., Syverson, C., Seed, K., & Callaghan, W. M. (2017). Pregnancy-related mortality in the United States, 2011–2013. Obstetrics and gynecology, 130(2), 366.
Freeman, A. (2017). Unmothering Black Women: Formula Feeding as an Incident of Slavery. Hastings LJ, 69, 1545.
Hooks, bell (2000). Feminism is for everybody: passionate politics. Cambridge,MA: South End Press.
McGuire, M. (2018). Black Breastfeeding after a History of Trauma. Accessed online 08/06/2019. https://www.healthconnectone.org/black-breastfeeding-after-a-history-of-trauma
McKinney CO, Hahn-Holbrook J, Chase-Lansdale PL, et al. (2016). Racial and ethnic differences in breastfeeding. Pediatrics, 138(2), e20152388.
National Center for Health Statistics (NCHS), period linked birth/infant death data. Accessed online 08/06/2019. www.marchofdimes.org/peristats.
Pérez-Escamilla, R., & Sellen, D. (2015). Equity in breastfeeding: where do we go from here? Journal of Human Lactation, 31(1), 12–14.
Smith, P. H. (2018). Social justice at the core of breastfeeding protection, promotion and support: a conceptualization. Journal of Human Lactation, 34(2), 220-225.
Voelker, R. (2017). Racial disparities remain in breastfeeding rates. JAMA 318(8):691.