Breastfeeding my son was one of the hardest things I have ever done. It tried my patience, my body, and my will. Despite all of that, it is also my proudest and most empowering accomplishment. After experiencing the difficulties of breastfeeding for myself, I started to understand why breastfeeding rates were so low in this country. Being a new mom is hard, breastfeeding is hard, and there is not enough support. However, what struck me the most, was the huge racial disparity in breastfeeding. While 79% of white women initiate breastfeeding, and 52% are still breastfeeding at 6 months, only 62% of Black women initiate breastfeeding, and only 36% are still breastfeeding at 6 months. If breastfeeding is hard, which it sometimes can be, shouldn’t it be equally hard for all of us? Like most things when it comes to equity, the answer is no, it is not equal, and there are many reasons why.
I want to briefly discuss some of the reasons why we should even care about breastfeeding. But, before I do, I want to address the big bottle in the room, formula feeding. It is important to state that breastfeeding is not a shame game. If you are reading this and you are formula feeding, or were formula fed, I honor you and the tough decisions we make every day as mothers. There are about a million factors that go into breastfeeding being the right choice for a family, and no one else can make that choice for you. The following facts are not to tell any mother, yes, your child will get this illness if you don’t breastfeed, or, no you can’t be a good mother if you don’t breastfeed. Instead, these facts are useful in coming to a decision for yourself. If not for yourself, I hope this information can arm you with the knowledge you need to support your friend/family member in the future.
Lowers the risk of ear infections, respiratory infections, diarrhea, and asthma in children.
Reduces the baby’s chance of developing diabetes, high cholesterol, and high blood pressure later in life.
Reduces the mothers chance of developing post-partum depression, diabetes, breast, uterine, and ovarian cancer.
Increases intelligence test performance later in life.
Helps mother and baby bond early on.
Despite these benefits, Black woman still breastfeed at an alarmingly low rate. Why? Why aren’t we breastfeeding? The answer as you can imagine is complex. We cannot point to a single influence that lowers our breastfeeding rates, instead it is a huge intersection of issues. Here are some key points to why Black women may not be breastfeeding.
Barriers to Breastfeeding:
Misinformation: One explanation to the disparity is simply that we don’t know all those breastfeeding facts listed above. We don’t know how healthy and fulfilling breastfeeding can be. We either aren’t told or are told wrong information from our providers, our friends, our family, and our TVs.
Discrimination: Systemic racism. It is making Black people sick. We know this, we live with this, we fight against this. What we may not know is its role in breastfeeding. The way our health care providers treat us matters. Many providers assume Black women won’t breastfeed. Black mothers are nine times as likely to be given formula for their babies than white mothers. This discourages Black mothers early on through sending a message that they will not be able to breastfeed their baby. This discrimination has physical and psychological effects on Black women, and can greatly deter them from breastfeeding.
Stigma: When looking at Black history, breastfeeding gets complicated. From slavery, to wet nursing, to being targets of formula company’s marketing, Black women and breastfeeding have a spotty history. In the here and now many of the feelings of breastfeeding equaling oppression and formula feeding equaling freedom and privilege have carried through. This both lowers the rate of breastfeeding among Black mothers and lowers the visibility of Black women breastfeeding. If Black women feel that they are going against their communities then that makes it more and more difficult to breastfeed. Breastfeeding should not be reduced to bathroom stalls and back bedrooms. When we limit where a mother can breastfeed, and make derogatory comments, we are sending her a message that breastfeeding is a thing to feel ashamed of. We must reframe breastfeeding as an act of resistance.
Accessibility: We work. Black women work a lot. In whatever way, you want to categorize work, I know Black women do a lot of it. Working puts a strain on a breastfeeding mom. Not all jobs create opportunities to take breaks to pump, or places to store milk, or co-workers who are supportive. Not all mothers can afford to take time off work, especially without systems put in place such as paid maternity leave.
There are steps we can take to reduce some of these barriers. Here are some ways to make this possible:
Tips for Black Women Breastfeeding:
Build a network of other Black women who are breastfeeding too. Having the peer to peer support is invaluable for a newly breastfeeding mother. If you don’t have friends or family who are breastfeeding take to the internet. There is a great support group entitled “Breastfeeding Support Group for Black Moms.” There are over 20,000 members and the group is moderated by certified lactation consultants and counselors.
Fight back against the stigma by making breastfeeding more visible. Some resources to folks who are doing this work already include, Normalize Breastfeeding, Black Women Do Breastfeed, Black Breastfeeding Week, and Black Mothers’ Breastfeeding Association.
Seek out help. Our healthcare system is far from perfect, especially when it comes to providing culturally sensitive care, however, there are providers out there who want to and can support you. When picking a pediatrician ask about their experience with breastfeeding moms. When pregnant and going to the OBGYN, ask about how they support breastfeeding moms both prenatally and during the postpartum period. Seek out groups like La Leche League, and folks who specialize in helping women breastfeed like Certified Lactation Counselors (CLC), and International Board Certified Lactation Consultants (IBCLC).
The infant mortality rate among Black babies is twice as high as white babies, we must all act together to change this. One of the many ways to do this is through giving our babies the healthiest thing for their bodies, breastmilk. Black women are strong, and resilient, and beautiful, and we deserve every opportunity to give our children the best. We can do this, together.
About Tesiah Coleman
I am a Nurse Practitioner student at MGH Institute of Health Professions. As a Lactation Counselor and a mother, I am passionate about breastfeeding support, especially in the Black community. After school, I hope to address other health inequities affecting Black women, such as high infant and maternal mortality rates. I believe deeply in building community with other Black women, and I am excited to begin collaborating with, and learning from, Community Conversations: Sister to Sister.