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Written by: Bentley Porterfield-Finn, Doula
Social support, education, and resources. These are all vital components of a successful chest/breastfeeding experience. However, these things are not easily accessible to all birthing persons, as maternal and infant healthcare is not always equitable. Breastfeeding can be challenging, and things can be done do facilitate a better nursing experiences for all mothers. However, Black infants are less likely than White infants to initiate and continue breastfeeding, and it is crucial to consider social, systemic, and historic factors when investigating these racial disparities. Encouragingly, Black chest/breastfeeding rates have been increasing in recent years, but there is a need for more systemic support and cultural empowerment for Black pregnant and birthing persons before and after their babies are born.
The many benefits of breastfeeding are well-established. Breastfed babies have increased immune function, reduced risk for various infections, and are less likely to develop asthma, obesity, and diabetes. Parents who breastfeed are at reduced risk for breast and ovarian cancer, and a lower risk for developing hypertension, and diabetes. However, this journey is not guaranteed to come easily, especially for Black birthing persons. A 2015 study by the Centers for Disease Control and Prevention (CDC) found that overall, Black infants are less likely than White infants to be breastfed. In this study, about 69% percent of Black infants initiated breastfeeding, compared to approximately 85% of White infants. We do know that breastfeeding rates are increasing for all populations—in 2012, 66% of black infants were breastfed while 82% of White and Latinx mothers breastfed, a lower number than 2015. This overall increase is positive, and we need to continue to do what we can to support all birthing persons. Nevertheless, it’s vital that we consider the additional barriers faced by Black parents in this breastfeeding journey.
Many birthing persons of all racial backgrounds experience barriers to breastfeeding initiation and continuation. Our culture in the United States has not quite reached a point of encouraging and normalizing breastfeeding as much as other economically developed nations have. However, we do know that rates of breastfeeding are rising.
We can do this by:
These are just a few things that can be done to support chest/breastfeeding initiation and work to diminish the racial disparities in the initiation and continuation of breastfeeding in the United States.
Breastfeeding disparities, similar to those in maternal and infant mortality, are influenced by historic and systemic factors. Most notably, the history of wet nursing in the United States must be considered when exploring these disparities. In the antebellum slave era, Black women were tasked with breastfeeding White babies, oftentimes instead of their own. This was a unique form of exploitation and evidence of an established unequal power relationship. As Emily Knight and R.J. West explain their article Mothers’ Milk: Slavery, Wet-Nursing, and Black and White Women in the Antebellum South, “Feeding another woman’s child with one’s own milk constituted a form of labor, but it was work that could only be undertaken by lactating women who had borne their own children.” This deep historical exploitation is not erased or made inconsequential with the progression of time and the abolition of antebellum-era enslavement. Black women grapple with generational trauma, as they continue to exist within a system that was not built with their unique experiences in mind.
In addition to this generational trauma, Black mothers experience various barriers to breastfeeding. This includes, lack of support, less flexible employers, challenges accessing education about breastfeeding, and insufficient support from healthcare settings. Additionally, maternity care facilities in neighborhoods with largely Black populations have not received as many resources to promote the implementation of evidence-based maternity care as those that serve largely White populations. An increase in affordable, culturally competent support prenatally for breastfeeding initiation and postpartum for continuation might alleviate some of these disparities. Specifically, Black mothers should be connected with Black lactation educators and lactation counselors, and this type of support should be made more easily accessible.
Overall, all pregnant and birthing persons deserve support and education pertaining to chest/breastfeeding. With the support of employees, loved ones, social networks, and partners, mothers can get the extra boost of confidence needed to have an empowering and successful breastfeeding journey. It’s also important to keep in mind the nuances behind why Black breastfeeding rates are lower, and the systemic and historic factors that contribute to this disparity.
Skimmed: Breastfeeding, Race, and Injustice
Bentley (she/her) is a birth, postpartum, and bereavement doula in Northern Colorado. She is passionate about providing intentional support to birthing persons through all stages of the birthing process, and witnessing birthing persons discover the power and wisdom of their bodies. Bentley is a member of the Inclusive Birth Collective, providing doula support to underrepresented community members in Northern Colorado. In addition to her doula work, Bentley is a graduate student in the Department of Communication Studies at Colorado State University, where she studies health communication, social support, and identity. Find more information about Bentley and her services on Instagram (@bentleypojo.doula) or on her website (www.bentleypojo.com).
 Jennifer L. Beauregard et al. “Racial Disparities in Breastfeeding Initiation and Duration Among U.S. Infants Born in 2015.” Centers for Disease Control and Prevention. August 30, 2019 / 68(34);745–748. https://www.cdc.gov/mmwr/volumes/68/wr/mm6834a3.htm#:~:text=Rates%20for%20exclusive%20breastfeeding%20at,0.05
 Donya Currie. “Breastfeeding rates for black US women increase, but lag overall: Continuing disparity raises concerns.” American Public Health Association. The Nation's Health April 2013, 43 (3) 1-20.
 Emily West & R.J. Knight. Mothers’ Milk: Slavery, Wet-Nursing, and Black and White Women in the Antebellum South. Journal of Southern Slavery. 2017
 Kimberly Seals Allers. The Big Letdown: How Medicine, Big Business, and Feminism Undermine Breastfeeding. 2017