It’s no secret that, compared to their Pacific Islander, Hispanic, white, and Asian peers, black babies are at higher risk of dying during their first 12 months of life [1]. Infant mortality rates are generally trending downwards: in 2005 the rate was at a recent high, but in 2022, that rate was about 18% lower. However, at 10.9 deaths/1,000 live births, black babies still remain two times more likely to die during their first year of life compared to white babies (4.5 deaths/1,000 live births) and trois fois more likely to die than Asian babies (3.5 deaths/1,000 live births).
Fortunately, according to a 2025 US Preventive Services Task Force Recommendation Statement, these statistics are reversible, and higher rates of breastfeeding by black mothers may play a big role in the turnaround [2].
What’s killing black babies under age one?
No matter their race, the top five causes of death for babies in their first year of life, according to the CDC, are: birth defects, preterm birth and low birth weight, sudden infant death syndrome (SIDS), unintentional or accidental injuries, and maternal pregnancy complications (such as eclampsia, cardiovascular emergencies, or mental health crises).
Let’s zero in on SIDS, for one example: Rates among black babies were 244 per 100,000 live births in 2022, compared to 83.2 deaths/100,000 live births in white babies, 61.6 deaths/100,000 live births in Hispanic babies, and 31.5 deaths/100,000 live births in Asian babies.
Compounding all these issues are disparities in access to quality healthcare. For example, black babies are more likely than their white peers to be born in hospitals with higher mortality rates, and to receive care in lower-performing neonatal intensive care units (NICUs) [3][4].
Compounding all these issues are disparities in access to quality healthcare. For example, black babies are more likely than their white peers to be born in hospitals with higher mortality rates, and to receive care in lower-performing neonatal intensive care units.
At the same time, black babies are less likely to be breastfed
While correlation does not prove causation, Asian babies, who are le moins likely to die in their first year, are le plus likely to be breastfed at six months compared to other ethnic groups [1]. Conversely, while black babies have the le plus élevé infant mortality rates, they have the le plus bas rates of breastfeeding initiation (ever being breastfed), length of breastfeeding (how long baby receives any amount of breastmilk), and exclusive breastfeeding (baby receives only breastmilk or pumped breastmilk).
À noter, exclusive breastfeeding rates in the United States are unimpressive across all ethnic groups. While the U.S. Dietary Guidelines for Americans 2020-2025, le American Academy of Pediatrics et le Organisation mondiale de la santé (WHO) tous recommend exclusive breastfeeding through six months of age (and the WHO recommends breastfeeding with complementary foods through two years of age or beyond!), only 27.2% of all American babies were exclusively breastfed at six months in 2021.
What are the reasons black mothers choose not to breastfeed?
Without regard to race, the CDC identifies the top barriers to breastfeeding as “Issues with lactation and latching, concerns about infant nutrition and weight, mother’s concern about taking medications while breastfeeding, unsupportive work policies and lack of parental leave, cultural norms and lack of family support, unsupportive hospital practices and policies.”
Specific to black moms breastfeeding, according to the Task Force, “There are complex historical, structural, and economic factors that research has shown to contribute to disparities in rates of breastfeeding. Examples include lasting psychological impact and stigma of enslaved Black women being forced to act as wet nurses; the marketing tactics of formula companies; and societal messaging that emphasizes the use of breasts for sexual purposes rather than nutrition” [2].
On a practical level, black mothers are more likely to be single mothers; to return to work early; to work for businesses (especially in low-income jobs) that are unconducive to breastfeeding; and to live in zip codes with birthing facilities that don’t promote breastfeeding through specific practices like rooming in, limiting use of formula, initiating breastfeeding immediately after birth, and providing lactation support after birth [2][5][6][7].
On a practical level, black mothers are more likely to be single mothers; to return to work early; to work for businesses (especially in low-income jobs) that are unconducive to breastfeeding; and to live in zip codes with birthing facilities that don’t promote breastfeeding through specific practices like rooming in, limiting use of formula, initiating breastfeeding immediately after birth, and providing lactation support after birth.
Why is breastfeeding so important for babies of any race?
There are multiple reasons breastfeeding is key for improving infant health and decreasing infant mortality, per the CDC. Among them, breastfed babies enjoy lower rates of “[a]sthma, severe lower respiratory disease, obesity, Type 1 diabetes, acute otitis media (ear infections), sudden infant death syndrome (SIDS), gastrointestinal infections, which can cause diarrhea and vomiting, [and] necrotizing enterocolitis (NEC) (death of intestinal tissue) for preterm infants.”
How can we encourage higher breastfeeding rates, especially amongst black mothers?
The 2025 Task Force statement recommended early and frequent promotion of breastfeeding starting while women are still pregnant, during prenatal care visits. In-office education should include “general breastfeeding knowledge and… the benefits of breastfeeding, practical breastfeeding skills (e.g., latching), and the management of common breastfeeding complications.” Additionally, women should be encouraged to attend breastfeeding classes. Of course, timing is crucial as far as initiating latching in the “golden hour” after birth. As far as maintaining breastfeeding, the most important factor is undoubtedly ensuring support after discharge from the hospital. Of note, while in-person consultations are arguably most helpful, even virtual visits with lactation consultants or other supportive healthcare personnel may have some value for troubleshooting common breastfeeding issues.
Doulas, whose praises we’ve sung repeatedly at Natural Womanhood, may be key to ensuring successful initiation (and continuation) of breastfeeding. One Étude de 2014 of black mothers on Medicaid and with doula support found that fully 92.7% initiated breastfeeding [8]. Similarly, an earlier 2008 study found that low-income mothers with doulas of the same race had higher rates of breastfeeding initiation than mothers who did not [9].
One 2014 study of black mothers on Medicaid and with doula support found that fully 92.7% initiated breastfeeding [8]. Similarly, an earlier 2008 study found that low-income mothers with doulas of the same race had higher rates of breastfeeding initiation than mothers who did not.
Culturally competent care can help boost breastfeeding rates amongst black mothers
When it comes to turning the tide on low breastfeeding rates amongst black mothers, black women are leading the way. Le Black Breastfeeding Mothers Organization is one prominent advocacy organization. Black Breastfeeding Week, which occurs during National Breastfeeding Month in August, increases visibility to normalize black mothers breastfeeding. Other groups around the country, such as Black Mothers ATX in Texas and Abide Women’s Services, also in Texas, are providing lactation support to local communities. And, since there are relatively more black doulas than black lactation consultants, Mama Glow founder Latham Thomas rolled out a First Foods Justice Breastfeeding Certification Program for doulas in 2024.
Thomas told ESSENCE in an interview, “As a Black mother who breastfed my son for 3 years, I’m deeply proud of the work we did to develop [First Foods] for the community. I was blessed to have a mother who was a powerful teaching example of Black breastfeeding, who helped me in the first week postpartum in learning how to feed my newborn. My son and I developed a rhythm and over time, breastfeeding would become second nature to me. This is not the case for all of us.”
The bottom line on black moms breastfeeding
All mothers and babies benefit from breastfeeding, regardless of their race. But because of the disproportionately high mortality risks for black babies in the United States, black babies stand the most to gain from increased breastfeeding rates within the black community. A society-wide push for the conditions that make breastfeeding possible for more mothers is long overdue.
Références :
[1] Chen Y, Shiels MS, Uribe-Leitz T, et al. Pregnancy-Related Deaths in the US, 2018-2022. JAMA Netw Open. 2025;8(4):e254325. doi:10.1001/jamanetworkopen.2025.4325[2] US Preventive Services Task Force. Primary Care Behavioral Counseling Interventions to Support Breastfeeding: US Preventive Services Task Force Recommendation Statement. JAMA. 2025;333(17):1520–1526. doi:10.1001/jama.2025.3650 [3] Howell EA, Janevic T, Hebert PL, et al. Differences in Morbidity and Mortality Rates in Black, White, and Hispanic Very Preterm Infants Among New York City Hospitals. JAMA Pediatr. 2018 Mar 1;172(3):269-277. doi: 10.1001/jamapediatrics.2017.4402. PMID: 29297054; PMCID: PMC5796743. [4] Horbar JD, Edwards EM, Greenberg LT, et al. Racial Segregation and Inequality in the Neonatal Intensive Care Unit for Very Low-Birth-Weight and Very Preterm Infants. JAMA Pediatr. 2019 May 1;173(5):455-461. doi: 10.1001/jamapediatrics.2019.0241. PMID: 30907924; PMCID: PMC6503514.
[5] Safon CB, Heeren TC, Kerr SM, Clermont D, Corwin MJ, Colson ER, Moon RY, Kellams AL, Hauck FR, Parker MG. Disparities in Breastfeeding Among U.S. Black Mothers: Identification of Mechanisms. Breastfeed Med. 2021 Feb;16(2):140-149. doi: 10.1089/bfm.2020.0310. Epub 2021 Feb 4. PMID: 33539248; PMCID: PMC7891211.
[6] Jou J, Kozhimannil KB, Abraham JM, Blewett LA, McGovern PM. Paid Maternity Leave in the United States: Associations with Maternal and Infant Health. Matern Child Health J. 2018 Feb;22(2):216-225. doi: 10.1007/s10995-017-2393-x. PMID: 29098488. [7] Johnson AM, Kirk R, Muzik M. Overcoming Workplace Barriers: A Focus Group Study Exploring African American Mothers’ Needs for Workplace Breastfeeding Support. J Hum Lact. 2015 Aug;31(3):425-33. doi: 10.1177/0890334415573001. Epub 2015 Feb 24. PMID: 25714345; PMCID: PMC4506723.
