In the field of maternal health research, it has been observed that Black women have historically had lower breastfeeding rates compared to other new mothers. Among those who initiate breastfeeding, Black mothers tend to breastfeed for a shorter duration. For instance, only 44% of Black mothers breastfeed at 6 months, compared to 62% of white mothers. Several historical factors contribute to these disparities. During slavery, Black women were often forced to act as wet nurses for white families. In the 1950s, formula feeding was promoted to minority women as a superior alternative, and formula companies like Nestlé targeted impoverished communities with aggressive marketing, disparaging breastfeeding. Today, with more Black women participating in the workforce, many face work environments that do not support breastfeeding or pumping. 

Research has highlighted numerous benefits of breastfeeding for both mother and infant, including enhanced bonding due to the release of oxytocin. Studies also suggest that breastfeeding may be associated with lower rates of postpartum depression, which affects bonding and the ability to breastfeed adequately. With the Preschool to Prenatal (P2P) study occurring during the COVID-19 pandemic, the uncertainties about the infection may have also been associated with breastfeeding.  

This study investigated the associations among race, socioeconomic status, COVID-19 concerns, postpartum depression, and breastfeeding practices. The study sample contained 197 women, with 94 identifying as Black and 103 as white. Participants answered questions about their experiences from childbirth to postpartum. Demographic data were collected from the University of Pennsylvania’s Electronic Health Record system, while other data were obtained from the COVID-19 General Worries Scale, the Postpartum Bonding Scale, questions about breastfeeding practices in our postpartum and 12-month surveys, and the Edinburgh Postnatal Depression Scale. 

Our findings revealed significant differences in breastfeeding practices between Black and white mothers, with Black mothers reported higher rates of not breastfeeding and lower rates of exclusively breastfeeding. Additionally, more Black women reported lowed education and income levels, which may impact their ability to breastfeed as they might need to return to work sooner to support their families. We observed a positive association between impaired bonding and postpartum depression for white mothers, but no significant differences were seen regarding the impact of breastfeeding worries or COVID-19 concerns on bonding scores. In the 12-month survey, mothers had the option to provide reasons for stopping breastfeeding. Common reasons included insufficient milk supply, difficulty with getting the baby to latching, medical issues, and work-related challenges.  

Our study’s limitations included a small sample size, lack of inquiry into specific reasons for not breastfeeding, and variability in the timing of postpartum surveys (ranging from 8 to 35 weeks). Black women in our study had a lower rate of breastfeeding. On a larger scale, a lower rate of Black mothers breastfeeding means a higher rate of infants deprived of nutritional and immunological benefits heightens risk and weakens the health of the children in the community. Future research could address this by developing educational programs about the importance of breastfeeding, and workplaces must create supportive workplace environments for breastfeeding mothers.