Encouraging Breastfeeding

A new look at the complicated history of Black women and breastfeeding

Why Black women are less likely to breastfeed their babies

by Page Leggett

Despite the well-known benefits of breastfeeding – such as decreased incidence of asthma, diabetes, ear and upper respiratory infections, pneumonia and eczema – Black women are more likely to bottle-feed their babies than are white women.

In a study of women who gave birth in 2015, 85% of white moms said they breastfed their babies at birth compared with 69% of Black moms. The reasons are myriad, but perhaps the saddest dates back centuries.

“Enslaved Black women were forced to serve as wet nurses for their masters’ wives,” said Ty McClain, a lactation consultant at a Charlotte neonatal intensive care unit (NICU). The

term “wet nurse” describes someone who breastfed another woman’s baby, she explained.

A self-proclaimed “street warrior for breastfeeding," McClain's mission is also on display through her work at Johnson C. Smith University’s (JCSU) Metropolitan College of Professional Studies – a private, historically black university in Charlotte. McClain is program director of its Lactation Consultant Training Program (LCTP). Since 2010, its mission has been to improve maternal and child health outcomes for families of color.

Novant Health provides a clinical site for LCTP students. Practical, hands-on experience in their field of study is required to earn professional accreditation as a lactation consultant, childbirth educator or a birth doula, said Laura Corsig, a Novant Health boardcertified lactation consultant.

Students who are interested in becoming a lactation consultant often work with Corsig to earn their “IBCLC (International Board of Certified Lactation Examiners) credential, which is the gold standard” from the International Board of Lactation Consultant Examiners.

Once a consultant is board-certified, they can work in a number of places, Corsig said – a hospital, an ob-gyn office, the health department through WIC (the federal government’s nutrition program for low-income women, infants and children) or in private practice.

Four graduates of JCSU’s program work at Novant Health. And eight JCSU students graduated from the 10-month program in 2021. A similar partnership will launch in Winston-Salem when North Carolina A&T University and Novant Health Forsyth Medical Center join forces.

A painful history

The “traumatic history of Black women during and after slavery as wet nurses for white women means that for some, breastfeeding is associated with a lack of choice,” reads a 2019 American Civil Liberties Union (ACLU) blog. “This history contributes to whether Black people have the social and societal support to initiate and sustain breastfeeding.”

McClain added: “Women adapted this mindset that breast milk was only good for ‘master’s’ children and not their own. There’s a stigma that we shouldn't breastfeed.”

And there are more maddening reasons behind the reluctance.

Cultural stigma. “Society has sexualized breasts to the point that people are routinely shamed for breastfeeding,” wrote Amani Echols in the ACLU blog.

Healthcare inequity. Black women are three times more likely to die in a pregnancy-related death compared to white women. And the mortality rate for Black infants is twice that of white infants.

The introduction of formula.

Formula companies began to rise before World War II, McClain said. “Some women went to work in factories to aid the war effort,” McClain continued. “Once that happened, breastfeeding was considered a sign of wealth and privilege. You only breastfed if you had the luxury of time.”

Lack of support. McClain pointed to the number of single Black moms in the country and said: “There’s not always that father figure. When you don't have your spouse supporting you, it creates barriers to breastfeeding. You’re a single parent; you have to go back to work.

“Many Black women were still wet nurses in the 1940s,” McClain said. “I wasn’t breastfed; I grew up not seeing or hearing about it. Our moms, grandmothers and aunties didn't speak of it. And if a Black woman did come across another Black woman who breastfed, there was a feeling of ‘Oh, you think you’re better than us?’”

“In a study of women who gave birth in 2015, 85% of white moms said they breastfed their babies at birth compared with 69% of Black moms. The reasons are myriad, but perhaps the saddest dates back centuries.”

The need for support

McClain was lucky. She had support from her husband and family when she chose to breastfeed her firstborn in 2009. And she was a stay-at-home mom then, which made nursing easier.

McClain’s children, both breastfed “babies,” are now 12 and 9. She also has a 17-year-old stepdaughter. She breastfed her son until he was 2, which she said is another taboo she’s battling in the Black community. “There are still health benefits to breastfeeding past infancy,” she said.

Plus, she had a lactation consultant with both her son and daughter who helped her get the hang of it. She loved breastfeeding enough to earn a master's in health and wellness and become a lactation consultant herself.

But how to spread the word to a community that’s largely reluctant? She started at church – Friendship Missionary Baptist Church.

“Being a member, I felt I could make a connection,” she said. “A lot of Black mothers get their formula through WIC, and there's some shame around it. But I was a WIC recipient at one point in my life. I understand what it's like to be on food stamps and government assistance.” WIC actually encourages women to breastfeed, but McClain said too many Black women think of the program as “where to get free formula.”

McClain aims to change that perception. “When it comes to being a lactation consultant, it’s not just a profession,” she said. “It’s a passion. I couldn't be more humbled that God chose me for this work.”

McClain is a cofounding member of Queen City Cocoa B.E.A.N.S., a breastfeeding support service for women of color. (B.E.A.N.S. is an acronym for Breastfeeding Education, Advocacy, Normalcy and Support.) McClain’s cofounders are Lugenia Grider and Rachel Davis, who helped launch the LCTP program at JCSU.

Novant Health’s prestigious designation as a Baby-Friendly USA hospital demonstrates its commitment to supporting all families in their breastfeeding journey. Search “Nursing Mother’s Place” and Novant Health for more information.