# Race, Breastfeeding Support, and the U.S. Infant Formula Shortage: An Exploratory Cross-Sectional Study

## TL;DR

This study explores how the 2022 U.S. infant formula shortage affected breastfeeding support among African American and White residents in Mississippi, finding stronger support increases among African Americans.

## Contribution

The study is the first to examine racial differences in how the infant formula shortage influenced breastfeeding support in the Gulf Coast region.

## Key findings

- African American respondents were five times more likely than White respondents to report increased breastfeeding support due to the formula shortage.
- The formula shortage prompted stronger shifts in breastfeeding support among African Americans compared to White respondents.
- Baseline models showed a statistically significant association between race and changes in breastfeeding support.

## Abstract

Background/Objectives: African American women are less likely to breastfeed in general and to breastfeed exclusively for the first six months of infancy. Racial and ethnic breastfeeding disparities are especially pronounced in the South, particularly in rural communities. These differences are attributed largely to structural lactation impediments that include less breastfeeding support in healthcare settings, workplaces, and communities. While a great deal of research has explored racial differences in breastfeeding, minimal attention has been paid to the social correlates and racial disparities associated with the 2022 U.S. infant formula shortage. Our study explores racial distinctions in the formula shortage’s effect on breastfeeding support among Gulf Coast Mississippians. Methods: We use data from the second wave of the Mississippi REACH (Racial and Ethnic Approaches to Community Health) Social Climate Survey to determine if racial differences are evident in the formula shortage’s influence on breastfeeding support. We predict that the infant formula shortage will have prompted African American respondents to become much more supportive of breastfeeding than their White counterparts, net of sociodemographic controls. This hypothesis is based on the lower prevalence of exclusive breastfeeding among African Americans, thereby indicating a greater reliance on formula. The study uses a general population (random digit dial) sample and purposive (exclusively African American) oversample to analyze validated data from a cross-sectional survey. Sampling took place between September and December 2023, with a sample population of adult male and female Mississippians. A series of binary logistic regression models were employed to measure the association of race with breastfeeding support changes resulting from the infant formula shortage. Results: The study results support the hypothesis, as seen by a positive association between African Americans and increased breastfeeding support directly related to the infant formula shortage. Further, the baseline statistical model reveals African American respondents to be five times more likely than White respondents (p < 0.001) to report that the formula shortage increased their support of breastfeeding. Conclusions: We conclude by discussing this study’s implications and promising directions for future research.