How History and Racism Reframe the Formula Shortage for Black Families
The infant formula shortage has rattled parents across the nation, as families struggle to find the products they need to nourish their children. For Black women in particular, this crisis surfaces a deep history of systemic policy failures and racism that have impacted their abilities and available choices to feed their babies, leaving them at-risk during the current supply shortage.
Longstanding systemic barriers to breastfeeding, such as the lack of a federal paid leave and the underfunding of lactation professionals in hospitals, have led to more and more Black moms opting out of breastfeeding altogether or discontinuing after a few weeks. This has implications for both maternal and infant health. To be clear, not all women can or want to breastfeed or bodyfeed, and families must make the infant feeding decision that works for them. But the lack of policy support for all mothers, coupled with a unique historical context of racism, the systemic devaluation of Black mothers and race-targeted marketing of infant formula in our communities, has made Black mothers more vulnerable to a dependency on formula.
According to the most recent data from the US Centers for Disease Control and Prevention (CDC), 73.6 percent of Black women initiate breastfeeding compared to 84.1 percent of mothers overall. By six months the disparity increases, as just 28 percent of Black women are still breastfeeding compared to 45 percent of white women and 46 percent of Hispanic women. By 12 months of breastfeeding, which is the goal recommended by the American Academy of Pediatrics, 13 percent of Black women are still nursing compared to 24 percent of white women and 25 percent of Hispanic women.
These numbers must be put in the context of historical events that continue to impact breastfeeding in the Black community today. During enslavement, Black women were often stopped from breastfeeding their own children in order to feed the infants of the slave owner. Slave narratives show that the health of their infants suffered because of this. And since breastfeeding can delay fertility, many enslaved women were stopped from breastfeeding their own children so they could breed more children, who had economic value to the slave owner.
After the abolishment of slavery, with limited employment opportunities due to segregation, wet nursing (breastfeeding other people’s children) became work that white women with means hired Black and other women of color to perform. In addition, the racism of unfair wages meant that more Black mothers had to work, often caring for the children of white families while their own children were left in the care of others.
These historical factors that separated Black women from their children and denied them the time and space needed to breastfeed were compounded by aggressive marketing of infant formula to Black and other communities of color, which have higher birth rates. Popular marketing presented infant formula as a “lifestyle” choice and as “the substance for sophisticates”—a line of thinking that resonated with Black communities who were historically labeled as unsophisticated and uncivilized.
At times, Black infants were exploited by formula companies to advance their own commercial interests, such as with the Fultz quadruplets from Reidsville, North Carolina, the first documented set of African American quads born in the US, in 1946. Soon after their birth, the quads became national news and their white doctor began to capitalize on their fame, renaming the twins after his own family members and then selling marketing rights to the highest bidding infant formula company, Pet Milk, against the wishes of their parents. Despite their celebrity, the girls graduated high school in poverty. Pet Milk made millions.
Even as breastfeeding rates increased in the US, thanks to the rise of peer support groups like La Leche League that created valuable support networks for breastfeeding mothers, Black mothers were left behind. La Leche League spent years focused on building support groups in white suburban neighborhoods or mothers who did not work outside the home—which disproportionately excluded Black and other women of color who have always had higher labor market participation rates, regardless of whether or not they’re mothers.
As far back as 1880, 35.4 percent of married Black women and 73.3 percent of single Black women were in the labor force, compared with only 7.3 percent of married white women and 23.8 percent of single white women. “Black women’s higher participation rates extended over their lifetimes, even after marriage, while white women typically left the labor force after marriage,” according to the Economic Policy Institute.
Today, laws designed to protect breastfeeding mothers at work often don’t extend to part-time workers, to many service-related fields or to small businesses. Black women are overrepresented in the government assistance programs that distribute free infant formula. Hospitals that have been officially designated as “Baby-Friendly—meaning they embrace initiatives to support successful breastfeeding—are less likely to be in Black neighborhoods. The list goes on.
Nationally, a recent analysis based on NIS data found that the infant formula supplementation rate for infants younger than two days old was 20.9 percent for Black infants, compared to 12.7 percent for non-Hispanic white infants and a national rate of 17.2 percent. Other studies found the supplementation rate of Black women to be nine times higher than that of white women. Data from the Irth app, a nonprofit doctor and hospital rating and review platform for Black women and birthing people, shows 68 percent of Irth respondents said their baby was given infant formula in the hospital against their wishes.
Yes, it is true that not everyone can breastfeed. Even fewer are able to do so for an extended period of time when we live in a country where studies show 25 percent of US women go back to work within 10 days. It is imperative that infant formula is safe and readily available for the infants whose parents choose to use it.
But that should be a true choice, not a decision rooted in historically racist policies and practices. As a people, we know better than anyone else that we will bear the brunt of any crisis rooted in commercial interests and impacted by racism. News reports around the current formula shortage underscore that Black families are being hit hardest. We can start to educate ourselves on the racist practices that lead to less breastfeeding in our communities, push for the policy support that all parents need and ensure there is truly a level playing field for decision-making around infant feeding. Black mamas and babies deserve that .
About the expert:
Kimberly Seals Allers is an award-winning journalist, author and a leading commentator on birth and breastfeeding and the intersection of race, policy and class. She is the founding executive director of Narrative Nation, a New York City-based nonprofit that creates narrative-centered multimedia and technology to address racial disparities in maternal and infant health, including the Irth app and the Birthright podcast. She is also the cofounder of Black Breastfeeding Week and author of The Big Letdown—How Medicine, Big Business and Feminism Undermine Breastfeeding, her fifth book. Learn more at www.KimberlySealsAllers.com and follow her @iamKSealsAllers and @theIrthApp.