To explain the persistence of lower rates of breastfeeding among black mothers, we should look to systemic and historic factors rather than individual choice. That's the argument of Skimmed: Breastfeeding, Race, and Injustice (Stanford University Press) by law professor Andrea Freeman, which provides in-depth historical, socioeconomic and legal context that sheds new light on black motherhood.

Skimmed tells the poignant story of the Fultz quadruplets from Reidsville, N.C., the first documented set of African American quads born in the U.S. Their birth in 1946 became national news turning them into celebs and the face of baby formula company Pet Milk. Despite their celebrity, the girls were exploited financially and graduated high school in poverty.

To stunning effect, Freeman uses their story as a starting point for providing a history of black motherhood from enslavement to the present. The Fultz quads—Mary Alice, Mary Ann, Mary Catherine and Mary Louise— also help illustrate how companies selling baby formula and pediatricians of that era pushed black mothers away from breastfeeding.

Only about 66% of black infants are breastfed compared to more than 82% of white and Latinx moms, according to data from 2012.

Freeman spoke to NPR about the history of breastfeeding, why Beyoncé being a black mom matters, and the importance of telling new stories about black motherhood.

This interview has been edited for length and clarity.

In the past few years the black maternal healthcare crisis has come to the forefront. Is breastfeeding part of that crisis? How do you put it in context?

I absolutely see these things as different aspects of the same problems. Doctors and nurses not listening to black women, not paying attention to their symptoms and circumstances in the same way, approaching them with assumptions that disallow the possibility of just noticing and seeing where there's a need. With breastfeeding specifically, there's an assumption when [black] women give birth that they're not going to breastfeed, and they're not offered the same kind of assistance. They're offered formula right away. There is no attention paid to potential health risks.

In your book you write that "promoting breastfeeding for black women is an act designed to further racial justice." Break that down for us.

The fact that many black women do not have a choice about how they feed their infants leads to racial health disparities that can be long lasting for the children and for the mothers. I work in what I call food oppression, which is cooperation between the government and food industries that has racially disproportionate impact on communities of color. And this story, and the general story of black women and breastfeeding, is a perfect example of how that works in practice.

But it is so hidden by the fact that we think of breastfeeding as a very intimate and personal choice, when in fact, for many people, there is no choice at all. And that is due directly to the acts of the government through law through policy, through partnership with the formula industry. So I think racial justice needs to incorporate these hidden oppressions that pretend that we're just making choices based on personal preferences, when in fact, we're all just responding to our circumstances that are set by forces greater than us.

You write in Skimmed, "ironically, the most non-stereotypical images of black women breastfeeding are in formula advertisements." Tell us about that.

It has always been true and is still true today that it is almost impossible to find a positive image of a black woman breastfeeding, in a magazine, on television, on social media or any source of imagery that tells you who is a good mother. But the formula companies when they do their race-targeted marketing, they do provide images of black women breastfeeding that are very positive. Of course, they're using these images to try to stop black women from breastfeeding and use formula instead.

You tell a harrowing story about a mother named Tabitha Walrond whose infant died from malnutrition. Why is her story important?

Tabitha Walrond was a single mother who had problems getting a Medicaid card because there was a computer error, and she wasn't able to get one before her son Tyler was born. And when she was sent home from the hospital, the doctors never told her that she might have trouble breastfeeding because she had a lot of problems with the birth and she had a previous surgery. [When] she tried to take Tyler to a postnatal appointment, nobody would see her because she didn't have her card yet. And she was breastfeeding exclusively. And being so close to the baby, she didn't realize that he wasn't really growing.

So very sadly, he died a few weeks after his birth, in a taxi on the way to the emergency room. She was charged with homicide. She then had to endure a trial where the New York papers demonized her. It's a terrible story because it contrasts so starkly with the way that white mothers who experienced almost identical circumstances were treated.

You write about pop culture figures, like Rainbow in Blackish and Claire Huxtable and Beyoncé. What's their role in shifting narratives about black motherhood?

I think popular culture is hugely important and influential on how people think and will accept because if every black female character on TV and movies is a horrible mother or doesn't breastfeed, then you start to think that's just how it is. Also, when I say 'tell a different story about black motherhood,' I'm actually asking popular culture to do that. It's not just grassroots organizing. It needs to come from everywhere.

What impact would you say Beyoncé in particular has had on black motherhood?

She has been so fabulous in promoting motherhood. And in having the most liked tweet ever announcing the birth of her twins. She is a glorious mother. And she embodies motherhood. She doesn't try to divorce it from her celebrity or who she is. She is everything she is, including a mother. And I think that's really important. There were these rumors that she was breastfeeding Blue Ivy outside a restaurant in New York. So many mothers have felt shame and discomfort or experienced harassment when they've tried just to feed their children when they need to. And the fact that she could do that and say, 'hey, this is okay' was extremely meaningful.

You open the book with your personal story of being a mother of twins. Why did you feel is important to start the book this way?

I wanted to share my personal connection to the story. It would be important to let people know that this is something very personal and very real to me. And also that I recognize that as a white woman there's many things I can only imagine and I try not to impose my own perspectives in a lot of the storytelling.

You conclude the book by saying "it's time to tell a new story about black motherhood." Why?

The first stereotype or myth about the bad black mother arose in slavery. And it was intended to justify the brutal separation of black mothers from black children that slave owners did for their own profit and purposes. So we see then the development of stereotypes, like "mammy," who is a wonderful caretaker of white children, but completely indifferent to her own and other stereotypes that evolved into the welfare queen, who is a black single mother who also doesn't care about her kids. The only reason she has them is to collect government checks.

So we have a through-line throughout history of demonizing black mothers in a way that allows corporations to profit. And these stories are myths and they are political, so I'm saying we need reality. We need to show that black mothers are no different from white mothers and every other mother there is. Black mothers are amazing, resilient, they are heroes. The stories that we tell have a direct impact on laws and policies.

Beandrea July (@beandreadotcom) is a writer and independent audio producer in Los Angeles. Her work has appeared in The New York Times, Time, The Hollywood Reporter, and several other publications. She has also been a guest on the NPR shows 1A and The Takeway as well as KPCC's The Frame.

Copyright 2020 NPR. To see more, visit https://www.npr.org.

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