Breast, bottle, whatever: How You Feed is a shame-free series on how babies eat.
The task of feeding an infant is challenging for many mothers. Coupled with adjusting to caring for a new baby, navigating the choice of whether to breastfeed or formula feed can cause additional stress. For Black mothers, however, race adds another dimension, both in terms of the fraught history of Black women and breastfeeding and existing racial disparities.
According to the Centers for Disease Control and Prevention, “Black mothers disproportionately experience a number of barriers to breastfeeding, including lack of knowledge about breastfeeding; lack of peer, family, and social support; insufficient education and support from health care settings; and concerns about navigating breastfeeding and employment.”
Barriers to breastfeeding
The horrific history of wet nursing that exploited enslaved Black mothers has contributed to the negative connotation of breastfeeding within the Black community. While not all Black mothers may know the history of wet nursing, the oppression and disdain from years ago associated with breastfeeding has been passed down and exists to this day.
Jennifer D. Evans, a certified lactation education counselor, tells Yahoo Life that “Black women, just like our counterparts, are more likely to breastfeed if our mothers breastfed. Due to our history of not being allowed to feed our babies in the past, this has trickled down to current generations and created a disconnect in our communities. Whether or not mothers have support from their partner and immediate community plays a factor also.”
Socioeconomic factors, including retaining employment after childbirth, are also barriers to breastfeeding. Black mothers are much more likely to have to return to work sooner, given that for 55% of Black women on parental leave that leave is unpaid. Black women are also “most likely to be the primary economic support for their families, with 70.7% of Black mothers as sole breadwinners and 14.7% as co-breadwinners,” according to the ACLU, which adds to the pressure to return to work.
Factors that impact Black mothers’ decision to breastfeed
Kathey Wanliss, a college lecturer and Black mother of two, tells Yahoo Life that before having her first child, she didn't “have a stance” on breastfeeding or formula. “I just figured I would do both,” she says. “However, after the birth of my first child, the use of formula just didn't ‘feel right,’ hence the exclusive breastfeeding. By the time I had my second child, I had done more intensive research and knew all the benefits of breastfeeding.”
Dr. Kersha S. Pennicott, a pediatrician and lactation consultant, shared with Yahoo Life that “breastfeeding is the optimal nutrition for an infant. It is tailor-made to the baby and includes antibodies which provide some level of protection against certain types of infections.”
For Wanliss, exclusively breastfeeding was also less expensive than formula feeding. “I definitely saved a lot of money not having to spend on formula and bottles and all the other things that go with formula feeding,” she says. “Breastfeeding allowed me to focus on my own nutrition. Once I was eating well, then I knew that my children would also be healthy.”
But breastfeeding isn’t for everyone. As Pennicott points out, “it is important to acknowledge that breastfeeding may not be possible for all. It is critical to support parents in whatever method they use to feed their baby, whether exclusive breastfeeding, mix of breast/bottle or exclusive formula. For moms who can’t breastfeed or decide not to, formula is a safe alternative.”
Pennicott adds that the postpartum period is “a very difficult time and too many mothers feel shamed for their infant feeding choices. As a pediatrician and lactation consultant my goal is a healthy, growing infant and to support parents in nurturing their child.”
Dr. Shawn M. Smith, attending pediatrician at Lurie Children's Hospital of Chicago, agrees. “The ‘Breast is Best’ campaign initiated by the World Health Organization (WHO) in the 1990s intended to highlight the benefits and promote exclusive breastfeeding, but unfortunately, left out many families where breastfeeding or exclusive breastfeeding is not an option,” Smith tells Yahoo Life.
She adds that the campaign also “may not have taken into account historical instances where enslaved Black and Indigenous women were forced to be wet nurses for white babies of families that enslaved people against their will and the generational trauma that may be passed down in Black and Indigenous families [which] may present as disinterest, disgust or lack of support to the new parents. The more inclusive sentiment is ‘Fed is Best,’ meaning a baby with milk in their tummy is better than a baby without any milk at all.”
Latasha Brooks, a Black mother of three, has both breastfed and used formula, but primarily relies on formula "because of the convenience and my career."
“My son [Brooks’s youngest child] was the first baby I breastfed out of all of my children,” she tells Yahoo Life. “My choice to formula-feed after four weeks played a major role in the positive impact of my mental health.”
In general, formula feeding tends to be more expensive than breastfeeding, says Pennicott, “but for economic reasons Black mothers usually return to work at earlier times, making it hard to establish a successful breastfeeding relationship.”
As Pennicott points out, “Many jobs do not give protected time to pump. Often there are [fewer] hospital and community resources in predominantly Black neighborhoods to support parents. All of these examples show the complexity of why there are decreased breastfeeding rates in the African-American community.”
Implicit or unconscious bias in physicians and nurses also “inherently play a factor in our discussions on breastfeeding,” notes Smith. “We often unknowingly make assumptions about which families will choose to breastfeed and which families may choose not to breastfeed. This may influence the type of education we provide to families and the engagement of our conversations and can often lead to disparities in the amount of support, guidance and interactions with babies and families.”
Helping Black mothers make the right choice for their families
Pennicott says that the most important way to empower Black mothers is through education. “When they feel knowledgeable about their choices and how they can make their breastfeeding relationship a success, they will feel empowered and encouraged,” she says. “There is a disparity in breastfeeding rates, and I think it is important that Black mothers have even more additional support from their healthcare team, lactation consultants, family/friends and the community at large. This includes their workplace allowing for adequate breaks for pumping, community spaces protecting the rights of mothers to feed with or without a cover, and providing clean spaces to pump in public venues.”
For some mothers, however, formula feeding may be the preferred choice. “Physicians and nurses should consider that breastfeeding may be an unwanted choice,” says Smith. “Physicians and nurses should also share honestly that sometimes breastfeeding may be difficult for mothers or infants even … and should not be an untoward source of stress that interferes with parent and baby bonding.”
For Black mothers who do want to breastfeed, Evans recommends taking a breastfeeding class before giving birth and/or hiring a doula. “A doula can usually point you in the way of lactation professionals in your area and make sure that you are getting lactation support while you are in the hospital,” she says.
Finding a supportive community also helps. “We were never meant to do parenting and breastfeeding alone,” Evans says. “Inform any family who you believe will give you pushback on your plans on feeding the baby and give them ideas on how they can support you. Enlist postpartum support from those around you to take care of tasks like cooking and cleaning so that you can focus on healing and feeding your new baby. Create a meal train list at your baby shower so that those first couple of weeks you can have one less thing to worry about.”
Evans adds: “It's important that you are taken care of so that you can attune to your baby's needs.”
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