The shortage of infant formula plaguing American families has precipitated calls for mothers who formula-feed to “just breastfeed.” But even as women face this pressure, Black women receive counterpressure not to breastfeed — and face obstacles to breastfeeding that White women do not.
The long-term consequence of this coercive practice — along with racist tropes and intentional economic oppression — was racial disparities in breastfeeding rates. Black women are less likely to initiate breastfeeding compared with Asian, White and Hispanic women. The prevalence of breastfeeding is close to 85 percent across the nation, but for Black women, it is around 75 percent. While many posit that this gap stems from cultural preferences, individual choice, a lack of education or lower socioeconomic status, this narrative obscures the centuries of oppressive laws, policies and behaviors that truly drive the disparity.
Before the Civil War, White female enslavers commonly found breastfeeding to be unfashionable and inconvenient. Instead, they preferred to have Black enslaved wet nurses breastfeed their babies. These wet nurses were a valuable commodity. In 1850, 20 percent of White enslavers (about 70,000) relied on them to breastfeed their children. While wet nursing was a global and ancient practice, for enslaved African women, it was dehumanizing and traumatic, stripping them of autonomy over their own breasts.
This cruel practice also had devastating effects on the health of enslaved children. Black mothers were physically separated from their own newborns to breastfeed their enslavers’ babies — sometimes, their own babies were taken from them permanently. To help justify separating enslaved babies from their mothers, White society created the racist caricature of the “mammy” — a Black enslaved woman who was devoted to mothering White children but neglected her own.
The babies of enslaved wet nurses were bottle-fed a concoction of dry milk and dirty water that was not a healthy alternative to breastfeeding. As a result, many Black babies died during slavery. Forced wet nursing also disrupted the relationship between enslaved mothers and their infants during a crucial bonding time, causing significant maternal distress.
Even enslaved Black women who were not wet nurses breastfed their babies for shorter periods than counterparts in Africa (one year compared with two or three years), because their enslavers forced them to return to labor as soon as possible.
After slavery ended, some Black women continued to serve as wet nurses for White families, exposing them to further exploitation. Black families also faced major economic barriers from centuries of exploitation and discriminatory laws, which forced Black women back to work after giving birth — often making breastfeeding impossible.
Overall, Black women breastfed less — which served White interests by freeing the women up to do more exploitative labor, including the nursing of White babies.
When infant formula based on evaporated milk became widely endorsed by both parents and physicians in the 1940s, White interests remained the priority.
Formula companies targeted Black women in their ads, leading to enormous profits for the White-run industry. The first Black children shown in infant formula advertisements were the Fultz quadruplets, Black-Cherokee sisters born in 1946 who quickly became famous as the first recorded African American identical quadruplets. A White doctor, Fred Klenner, delivered them and quickly moved to capitalize on their fame for his own benefit.
Among other things, he signed them on as poster children for the St. Louis Pet Milk company. Kenner’s exploitation resulted in a chain of events that cost the Fultz parents custody of the quadruplets, who went on to face poverty, isolation and early deaths.
While formula companies targeted Black women with ads featuring Black children, the 1950s marked a surge in the popularity of breastfeeding among privileged White women with the rise of breastfeeding organizations, such as La Leche League, founded in 1956. These White-led organizations centered their advocacy for breastfeeding on White women, largely excluding Black women.
Alongside this White-centered breastfeeding movement, popular media began to portray predominantly White women breastfeeding in humanizing images, helping to normalize White mothers breastfeeding. Images of Black women breastfeeding, by contrast, were virtually nonexistent — except for condescending images of African tribal women in National Geographic.
This difference in portrayals was built on racist ideas about mothers that dated to the idea of the “mammy.” After slavery, the “mammy” character evolved to take many forms from Aunt Jemima, a dehumanizing mascot for syrup that was recently discontinued, to the Welfare Queen, furthered by Ronald Reagan, of a promiscuous Black mother who Reagan asserted reproduced only to “game the system” by deriving more government benefits.
Popular movies and television shows also perpetuated these racist stereotypes of the “Bad Black Mother” — helping to push Black mothers away from breastfeeding, because society associated the practice with “Good White Mothers.” Some Black mothers could not help but internalize this stereotype.
In addition to media influence, several key pieces of legislation also pressured Black women to formula-feed. First, the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) launched in 1974. Black women were less likely to receive breastfeeding support from WIC compared with White women — implying that WIC staff assumed Black women would formula-feed. All the while, the program also offered free formula to low-income women, further incentivizing its adoption.
Second, the United States did not sign on to the World Health Organization’s International Code of Marketing Breast Milk Substitutes in 1981 because of concerns about the WHO becoming involved in U.S. commercial marketing. This refusal enabled formula companies to continue printing and airing unrestricted advertisements — often targeted at Black communities — despite evidence that it hurt women and babies by encouraging mothers to formula-feed (sometimes offering free samples) when they could not afford it long-term. This led to some mothers feeding their babies inadequate amounts of milk because of lack of funds.
Third, the 1996 changes to welfare — fueled by long-standing racist conceptions about welfare — forced new mothers out of the home to work at a time when workplaces largely lacked breastfeeding accommodation laws. The new law disproportionately affected Black mothers. Black female welfare recipients were less likely to receive benefits under the new law than their White counterparts and more likely to receive poor treatment from welfare agencies. An urgent need to work encouraged Black mothers to abandon breastfeeding to avoid the difficulties and work-related problems it caused.
In 1991, the WHO launched the Baby-Friendly Hospital Initiative to support hospitals in giving new mothers the necessary care and assistance to breastfeed their newborns. But medical officials prioritized hospitals in White neighborhoods for adopting Baby-Friendly practices, while largely bypassing hospitals in Black neighborhoods. Instead, they pushed Black women to breastfeed less.
Even today, Black newborns are nine times as likely to get formula in hospitals compared with White babies, and health-care providers are less likely to discuss breastfeeding with Black mothers during pregnancy. Even for Black mothers who do decide to breastfeed, lactation consultants are more likely to spend less time helping Black women with breastfeeding concerns than White women because of the racist — and false — belief that Black women do not breastfeed.
The racist legacy of coercive wet nursing during slavery has shaped every aspect of this landscape. It has fueled a combination of laws and racist stereotypes that pushed Black mothers away from breastfeeding while glorifying breastfeeding White mothers.
The racial wealth gap, which is inextricably intertwined with the economic oppression of Black Americans through laws and policies, forces new Black mothers back to work earlier, making it harder for them to breastfeed because of inadequate support from employers.
And the psychological trauma of breastfeeding for enslaved Black women endures to this day. Some Black women see breastfeeding as a way to take back the nutrients that were stolen from Black women to feed Black babies, but others refuse to breastfeed as a rejection of racist re-enslavement.
Ironically then, even as mothers come under pressure to breastfeed in the face of the formula shortages, Black mothers who desire to do so must battle pervasive racist ideas embedded in hospital policies, formula advertising, behaviors among lactation consultants and more.
Breastfeeding disparities are not the mere result of cultural preferences that education will dismantle. Instead, the racial gap in breastfeeding rates reflects white supremacy — long-standing laws, policies and oppressive behaviors created to intentionally uplift White mothers and babies while harming Black mothers and babies.
