25.08.^th began Black Breastfeeding Week—a time dedicated to highlighting racial disparities in breastfeeding rates. Black Breastfeeding Week occurs at the end of August, National Breastfeeding Month. A 2023 report that examined breastfeeding initiation in 2020 and 2021 found that Black women were the least likely to initiate breastfeeding compared to other racial and ethnic groups. The racial disparities in breastfeeding rates are just one glaring example of how systemic racism is baked into American child care, beginning at the time of conception. This article examines the racial disparities in breastfeeding rates in more detail and offers strategies and solutions to address these inequities.

To understand racial disparities in breastfeeding, it’s important to look at history. During slavery in the South before the Civil War, enslaved African women were expected to be wet nurses: a nursing mother would breastfeed another woman’s child. A 2017 article by Emily West and RJ Knight states, “As a form of exploitation reserved for slave women, the forced wet nurse represented a unique aspect of the commercialization of enslaved women.” There are many psychological effects of being forced to serve as a wet nurse to the children of slave owners. These remnants of enslavement still have a profound impact on the black community in many ways, influencing black women’s desire to breastfeed.

The aggressive marketing of baby formula to blacks is also a factor contributing to racial disparities in breastfeeding rates. After the birth of the first recorded black quadruplets to a black Cherokee mother named Annie Mae Fultz in 1946, a white doctor, Fred Klenner, who delivered the girls, arranged a lucrative deal between the quadruplets and the St. Louis Pet Company to market baby formula to black women in the 20th century.^th Century. According to Andrea Freeman, author of the book Skimmed: Breastfeeding, race and injustice“Through Pet Milk’s bold marketing strategy, many black women were convinced that infant formula was as healthy or even healthier than breast milk. This reassuring belief made it easier for them to give in to a variety of external pressures not to breastfeed.” In the book, Freeman explained that the lack of positive images of black women breastfeeding also contributed to racial disparities in breastfeeding rates.

“Compared to their white counterparts, Black mothers and birthing mothers are less likely to initiate breastfeeding—and once they do start breastfeeding, they are less likely to continue long enough to pass the benefits on to their infants,” Latham shared with Thomas. Thomas is a leader in promoting Black maternal health and founder of the Mama Glow Foundation, a Brooklyn-based organization that trains and supports doulas. “Black women receive less community support after giving birth,” Thomas explained, “(are) more likely to have to return to work shortly after giving birth, and have fewer examples of successful breastfeeding across generations.”

According to a 2015 research study, factors contributing to racial disparities in breastfeeding rates include the fact that, on average, Black women return to work earlier than women of other races and also that Black women work in jobs with work hours that make breastfeeding more difficult. Barriers to exclusive breastfeeding among Black mothers include “lack of access to and knowledge of breastfeeding laws and policies, and negative cultural norms or stigma,” a 2023 qualitative study said. “My breastfeeding experience was incredibly painful, both physically and emotionally. Society often emphasizes that breastfeeding is the best option for your baby, and while that’s true, there is significant stigma associated with not being able to produce enough milk,” explained Netta Jenkins, CEO of Aerodei. More resources are needed to support Black mothers and birthing mothers who want to breastfeed but face obstacles and challenges in doing so.

Research shows that doula support can play an important role in breastfeeding initiation. One way to address racial disparities in breastfeeding may be to provide Black mothers and birthing women with greater access to doula support. Latham Thomas founded the Mama Glow Foundation and the First Foods Justice Breastfeeding Certificate Program for Doulas with this goal in mind. Thomas explained that the goals of the program are to “train and certify 100 community nurses and doulas as Community Lactation Educators, provide breastfeeding support to marginalized people, and measure outcomes and track breastfeeding successes within the program.”

Black women continue to lag behind their female counterparts in breastfeeding. The reasons for this are systemic and include a lack of flexibility in work arrangements, lack of support, and social stigma within the community. To address the disparity in breastfeeding rates among Black mothers and birthing women, more education is needed. Specific policies to support Black mothers and birthing women must continue to be created, and workplaces must do more to ensure that information about breastfeeding rights is communicated to all employees.