ROBERT SIEGEL, host:
From NPR News, this is ALL THINGS CONSIDERED. I'm Robert Siegel.
MICHELE NORRIS, host:
And I'm Michele Norris.
Among mothers in the U.S., African-Americans have the lowest rate of breast-feeding. By some measures, they're half as likely to nurse as whites or Latinos. This is frustrating for the medical community. Doctors are looking for ways to bring down high rates of infant mortality and chronic diseases among African-Americans.
As NPR's by Jennifer Ludden reports, why black women are less likely to breast-feed remains a mystery.
JENNIFER LUDDEN: Diabetes, obesity, ear infections, respiratory illness, studies show exclusive breast-feeding lowers the baby's chances of developing all these things, and yet nursing has been a hard sell for African-Americans.
Ms. DIJONNA HUNTER(ph): People tell me it hurt.
LUDDEN: Dijonna Hunter is due with her first baby in February.
Ms. HUNTER: My mother tried it and she was like it hurts so she ain't do it.
LUDDEN: Breast-feeding advocate Angela Ewing-Boyd says other women tell her the idea of nursing is disgusting.
Ms. ANGELA EWING-BOYD (Program Manager, The Developing Families Center): Saying I just, you know, I can't imagine doing that to my child, and that's just nasty. It's like the primary function of the breast is one-dimensional.
LUDDEN: So, the Developing Families Center in Washington, D.C., where Ewing-Boyd works, has set out to change attitudes. I dropped in on a counseling session.
Ms. JOAN BRICKHOUSE (Counselor, The Developing Families Center): I have a car. What does this have to do with breast-feeding? Okay?
(Soundbite of whoosh)
Ms. BRICKHOUSE: Oh, my God.
LUDDEN: After a few guesses, counselor Joan Brickhouse tells the group the answer.
Ms. BRICKHOUSE: You can take your breasts with you anywhere. On a airplane, you know, you can just whip it out, there you go. You know what I'm saying?
LUDDEN: Brickhouse then passes out a stack of fake greenbacks. They represent all the money moms can save since breast milk is free while baby formula can easily run $150 a month - yet another reason is baffling why the young and less well off of all races are more likely to choose formula. But the disparity for African-Americans is so great, it transcends socio-economics. Even an older, more-educated black mother is less likely to nurse than her white counterpart, which leaves experts and others trying to answer the question: Why?
Ms. KATHI BARBER (Author, "The Black Woman's Guide to Breastfeeding") We don't have any role models.
LUDDEN: Kathi Barber is the author of "The Black Woman's Guide to Breastfeeding." When she gave birth in the late '90s she was the first in her family to nurse and had no idea where to turn for help.
Ms. BARBER: Because our aunts didn't breast-feed, because our mothers didn't, maybe our grandmother did. But she doesn't really talk about it much. We don't have that imagery.
LUDDEN: Barber longs for Oprah to take up the cause or for some big music star to nurse her baby. Instead she says, new black moms are more likely to think National Geographic.
Ms. BARBER: Tribal women with elongated breasts, earrings and tribal jewelry and things like that. And let's say we're trying to promote that to a 25-year-old. Hmm, I don't think that's going to do the trick for us.
(Soundbite of laughter)
LUDDEN: So, what happened? Barber says one big barrier to breast-feeding is work. Black moms have had to earn money since long before women's lib. In fact, she thinks you can trace the problem all the way back to the breakup of families under slavery and the enduring, negative image of so-called mammies -those were slaves made to serve as wet nurses for their master's white children. In the 20th century, it was white, wealthy women who led the march to formula feeding, and minorities followed. But when white elites backtracked and made breast-feeding hip African-Americans didn't buy it.
Ms. BARBER: Infant formula became a thing of prestige. Breast-feeding was thought to be something that lower-class women did. So, breast-feeding - if you can think of it as a political issue, it really is.
(Soundbite of door knocking)
Ms. TINA PANGELINAN (Counselor, The Developing Families Center): Hi, how are you?
LUDDEN: Kala Blue(ph) gave birth five days ago and is having trouble getting daughter Kamiya(ph) to latch on. The Developing Families Center in Washington had sent Tina Pangelinan on an urgent house call.
Ms. PANGELINAN: So, have you tried at all today? I know that you were not able to try yesterday.
Ms. KALA BLUE: No I didn't.
(Soundbite of laughter)
Ms. PANGELINAN: Okay.
Ms. BLUE: I've just been feeding her the formula that they gave me at the hospital.
Ms. PANGELINAN: Mm-hmm.
LUDDEN: And here is another obstacle: aggressive marketing by the multibillion dollar baby-formula industry. It's convinced hospitals to hand out its products for free. Barbara Philipp of Boston Medical Center says the impact is huge.
Dr. BARBARA PHILIPP (Pediatrician, Boston Medical Center): When I, as a physician in a white coat, or when a staff nurse with her hospital badge on, when we hand out that diaper bag that we get for free from the formula company, that mom and baby will go on to exclusively breast-feed for a shorter period of time.
LUDDEN: A decade ago, Boston Medical Center stopped giving out formula. Philipp says it caused a ruckus. But since then the number of mothers at the center who start out nursing has shot up to 90 percent - well above the national average for black mothers.
(Soundbite of child crying)
LUDDEN: Back in Washington Kala Blue is working hard to get baby Kamiya to nurse as counselor Pangelinan offers tips and encouragement.
Ms. PANGELINAN: Almost, Mommy. You're hungry. We know.
LUDDEN: After 20 frustrating minutes, bingo. Pangelinan says, she'll be back tomorrow, whatever it takes to keep one more African-American baby getting mother's milk.
Jennifer Ludden, NPR News, Washington.