From Sand to Stone: Building a New Foundation for Black Breastfeeding

Plato said, “The beginning is the most important part of the work.” How something starts often impacts if and how it thrives or falters.  This is certainly true of the Black breastfeeding experience. Ever since we arrived in this country as enslaved people, our breastfeeding journey has been systematically undermined. Our milk was often not for our own children, but we were forced to feed the children of our oppressors. And since breastfeeding impacts fertility, many enslaved women were stopped from breastfeeding their own children so they could breed more children, who had economic value to the slave owner. Either way, the normal motherhood bond and act of infant feeding—a mother’s first job—was disrupted and corrupted by slavery.  Our bodies were not ours and our milk was not ours. These were the foundational experiences of breastfeeding while Black in this country. Later, when few economic opportunities existed for Black and other women of color, wet nursing was a form of labor white women of means paid these women to do. Our bodies were not ours and our milk was not ours.

Therefore, our foundation in breast and body feeding was shaky, unfortified—like shifting sand beneath our feet. It is no wonder then, that for over 40 years or for as long as breastfeeding data has been collected, there have been deep racial disparities in breastfeeding rates. According to the most recent CDC data, 73.6% of Black women initiate breastfeeding compared to 84.1% of women overall. That means 25% of Black infants never receive any of the unparalleled nutritional benefits of breast milk. By six months the disparity increases—as only 28% of Black women are still breastfeeding compared to 45% of white women and 46% of Hispanic women. By 12 months of breastfeeding, which is considered the gold standard of infant nutrition, only 13% of Black women are still nursing compared to 24% of white women.

Much of it through no fault of our own. Racist ideas about who is a “good mother” lead doctors and other health care professionals to not provide the same level of breastfeeding education to Black parents. For decades, breastfeeding support groups focused on white suburbs and avoided Black and brown communities. Baby-Friendly Hospitals, an important national initiative to reduce unnecessary infant formula distribution in hospital settings, are less likely to be in Black neighborhoods. The lack of policy support for all mothers, coupled with a unique historical context of racism, the systemic devaluation of Black mothers, and race-targeted marketing of infant formula in our communities, have left our communities less likely to have the support to breastfeed and Black parents more vulnerable to a dependency on formula.

Data from the Irth app, the non-profit doctor and hospital rating and review platform for Black women and birthing people that I founded, shows 68% of Irth review respondents said their baby was given infant formula in the hospital against their wishes. A recent analysis, based on NIS data, found that the infant formula supplementation rate for infants younger than 2 days was 20.9% for Black infants, compared to 12.7% to non-Hispanic white infants and a national rate of 17.2%. Other studies found the supplementation rate of Black women to be nine times higher than that of white women—early supplementation is directly related to reduced breastfeeding. Another start that leads to faltering outcomes.

Ten years ago, I joined arms with two amazing community advocates for infant feeding and maternal health and we created Black Breastfeeding Week, as the only national awareness campaign dedicated to optimal infant feeding in the Black community. BBW was always about reclaiming a tradition—on our terms and in our way—as a restorative step toward the culture of breastfeeding that was stolen from us in enslavement, the motherhood we had before our babies were stripped from us, before we were ignored in support models, and before being excluded in nearly every breastfeeding research study that has shaped national policies.

Since then, even more committed groups of Black organizations, advocates, and allies have been working to build a new foundation for breastfeeding. That includes creating new Black-centered lactation training modules and increasing the number of Black lactation professionals. That meant uncomfortable, yet critical, conversations about racism and breastfeeding as a white female dominated movement, and how that has caused harm.  That means examining state policies that create barriers to more Black women receiving broad-based professional lactation support. And it meant honoring our community knowledge and culture versus always deferring to academic research or medical models as the “experts.”

Support groups like CinnaMoms in Los Angeles, the Chocolate Milk Cafes in NYC, New Orleans and various other cities, the Black-led Midnight Milk Club on Facebook, and more, have emerged with pro-Black, culturally relevant breastfeeding support for families. In addition to its nationally-recognized breastfeeding “club” model, the Detroit-based, Black Mothers Breastfeeding Association (BMBFA) recently launched the Birth and Breastfeeding Leadership Institute, a virtual leadership development program designed to advance community-level leadership for racial justice and equity in maternal child health. Their new app, BMBFA B’Right Hub, helps parents find a breastfeeding class or support group in their area.

Organizations such as The Black Breastfeeding Coalition (BBC) and Reaching Our Sisters Everywhere (R.O.S.E) are leading work on the state and national policy level including the push for federal paid leave.

The new foundation for Black breastfeeding is for us and by us. Community-centered. Culturally rooted. Strong like granite. (WHAT IS THE STRONGEST ROCK?) And all about self-determination.

Our ancestors did not have such footing. And Black mom and babies paid the price.

Our first foods are the earliest opportunity for a healthy start in life and the unparalleled benefits of breastmilk are needed in the Black community. Breastfeeding reduces the risk of ear infections, type 2 diabetes and been linked to decreased incidences of childhood obesity.

Studies show that women who breastfeed exclusively are more likely to lose weight postpartum than women who breastfeed non-exclusively and formula-feed. Longer breastfeeding duration has also been associated with reduced incidence of type 2 diabetes in the mother. Research suggests that breastfeeding may reduce a mother’s risk of hypertension, hyperlipidemia, and cardiovascular disease.

Breastfeeding is also integral to reducing our high Black infant mortality rate. Black babies experience nearly four times as many deaths related to being pre-term or low birthweight. For those babies, breastmilk can be lifesaving for underdeveloped guts and compromised immune systems. Black preterm infants, compared with white infants are three times more likely to suffer from necrotizing entercolitis (NEC) and twice as likely to die from it. And years of research proves that breastmilk significantly reduces the risk of NEC. These are critical public health issues.

But like any good foundation—it takes time, persistence, and the dedication of committed people, working together to build something special. Brick by brick. Layer by layer. That foundation needs a super adhesive—our shared vision for birth and breastfeeding equity and justice.

This year, the co-founders of BBW are marking the 10-year milestone with a fundraiser reception and awards dinner in Brooklyn, New York on August 30th. The celebration, hosted by Angela Lewis, star of SnowFall on F/X honors the great work of the past 10 years and beyond. The funds will be used to support and sustain community grants to local Black-led breastfeeding support groups and scholarships for aspiring lactation professionals, and donations are needed. We are building for the future of Black breastfeeding.

A new foundation that is framed by Black-led support, girded with resilience, and sustained by joy.

Kimberly Seals Allers is an award-winning journalist, author, and a leading commentator on birth and breastfeeding and the intersection of race, policy, and class. She is the founding executive director of Narrative Nation, a NYC-based non-profit that creates narrative centered, multi-media and technology to address racial disparities in maternal and infant health, including the Irth app and the Birthright podcast. Her fifth book, The Big Letdown—How Medicine, Big Business and Feminism Undermine Breastfeeding, published by St. Martin’s Press in 2017. Learn more at and follow her @iamKSealsAllers and @theIrthApp.

August 15, 2022
September 1, 2022