Drawing beautifully on a well-established set of literatures regarding Black motherhood, law, and policy in the United States, Andrea Freeman's Skimmed brings that work into conversation with scholarship on food justice and environmental justice in an innovative and important book.
Freeman's exemplary historical detective work into the tragic lives of the Fultz quadruplets becomes a narrative through-line in a text that examines the racial disparities in breastfeeding rates in the United States and the ways that those disparities impact public health, and—importantly restrict maternal autonomy and decision-making. Ending with a resounding call for “First Food Freedom,” Freeman's book is a piece of advocacy, grounded in rigorous analysis, and an example of the way that law and society scholarship can inform public discourse and policy.
Central to Freeman's analysis is the story of the Fultz Quadruplets: Ann, Louise, Alice, and Catherine, who were born to Annie Mae and Pete Fultz in North Carolina in 1946. Annie Mae was, according to Freeman, “a tall, beautiful, Black-Cherokee mother of six children”—ten, with the quads. She had “lost her ability to speak and hear during a childhood illness” (2). Her husband, Pete, was a tenant farmer who “had never made more than five hundred dollars a year in his life, and he now had ten children, a wife, himself, and his mother to feed” (17). The harsh economic realities into which the quadruplets were born, combined with the racialized power disparities of North Carolina in the 1940s, were exacerbated with the bad luck of having Dr. Klenner, a Nazi-sympathizing John Birch Society and Citizen's Council member deliver the quads in the segregated basement of the local hospital.
Working without the consent of the Fultz family, Klenner sought contracts with several emerging formula companies, to sponsor the quadruplets and use them in marketing. Pet Milk, then an evaporated milk company, won the right to capitalize on the infants' celebrity; through the contract with the corporation, Klenner and his family received on-going access to the sisters, as well as material perks that enriched them for generations. The terms of the contract were not favorable to Annie Mae and Pete, and the sponsorship exploited the instant celebrity of the sisters. At Klenner's instruction, and with Pet Milk's money, a glass wall was installed in the infant's nursery, so that curiosity seekers could drive out to the farm and observe the quadruplets as they slept or played. Ebony magazine followed the girls' upbringing breathlessly, and worked hard to keep them in the public eye. There are photos of the quads with President Truman, when they were nearly four years old, and with President Kennedy, when they were in their teens. For the entirety of their lives, the girls were expected to perform—and they were devoid of a family to ground and support them.
Indeed, as a direct result of Klenner's machinations, Annie Mae and Pete soon lost all rights to their children. In their first days, Annie Mae lost the right to even name them. Klenner named them all after his wife, Mary; the girls went by their middle names, also chosen by the doctor. Soon, Annie Mae and Pete lost to the right to raise the girls—by the age of six Klenner had convinced a court that nurse Elma Saylor was a better parent, and with her husband Charles, she became legal guardian of the sisters. Pet Milk contracted to pay Elma's salary, and the girls moved from their farm to a “modest brick house” thirty miles away—a distance much too far, in those days and with their limited resources, for Annie Mae and Pete to maintain a familiar relationship with their daughters.
This story—which unfolds in the first 35 pages of Freeman's book—is heartbreaking. It is also, in Freeman's skilled hands, a story through which we can understand the persistence of racial disparities in breastfeeding and the paucity of first food freedom and maternal autonomy, in the United States.
After establishing that racial disparities in infant feeding exist, and that they have negative impacts on maternal and infant health, Freeman shows, clearly, that these disparities are not accidental, nor are they the result of the unconstrained choices of mothers. Using the example of Pet Milk's interference in the quads lives, and continually returning to them as a touchstone for her analysis, Freeman turns next to an examination of the ways that formula companies have benefited materially from the interaction of cultural scripts of Black motherhood combined with historical indignities of wet nursing during slavery, to influence contemporary feeding choices of black mothers.
Freeman convincingly shows how popular culture artifacts of white motherhood valorize breastfeeding, and traces the cultural scripts and history that make “wealthy White women's opportunities to breastfeed looked like reflections of good choices, not good fortune” (47). In her examination of a contemporary media, in particular a biting analysis of a recent Chicago Hope episode, Freeman demonstrates ways that formula companies influence popular culture scripts that exploit “existing racial inequalities” (57), while profiting off of Black motherhood in the news—frequently sensationalized and racialized accounts of tragic circumstances related to infant death. Arguing that formula marketing strategies set up “an expectation of breastfeeding failure” (74), Freeman shows how those failures are articulated in racialized ways, and are stunningly successful in depressing rates of breastfeeding in Black communities.
Crucially, though, Freeman notes that “dehumanizing stereotypes about Black mothers have always accompanied laws and policies that disproportionately harm them” (123). Her analysis of these laws and policies makes the book a unique intervention—the analysis clearly shows that the cultural scripts influence policy and law, and indeed that culture, policy, and law are constitutive with each other in the creation of racial disparities. Freeman is clear: hospital practices, marketing strategies, and laws at the national and state levels, all combine to “promot[e] formula to Black women while simultaneously restricting resources for Black mothers who want to breastfeed,” which results “in large profits for the formula industry at the expense of the health of Black mothers and babies” (36).
Freeman shows how persistent the industry has been in rolling back international, national, and state-level policies meant to facilitate breastfeeding. For example, under industry pressure, the United States has consistently refused to sign on to key international documents that would support breastfeeding, like the WHO's International Code of Marketing of Breast-Milk Substitutes. Federal policies regarding family leave and workplace accommodation for employed women (which are, as we know, insufficient), as well as Temporary Assistance for Needy Families (TANF) and other welfare “reform” measures, all make formula seem like a better option, especially for women who must return to low wage labor in order to maintain benefits. Even state and local laws banning hospitals from handing out free formula to new parents are subject to industry lobbying. States with pharmaceutical plants and formula makers' headquarters, Freeman notes, have been much slower to adopt policies that would facilitate breastfeeding.
In combining self-reflection and narrative with historical, doctrinal, and policy analysis, Freeman offers a terrific example of work at the intersections of feminist, legal, critical race, and food justice perspectives. She also produces, ultimately, a compelling and respectful piece of advocacy, the goal of which is, in her words, “to create true choice for every parent. This includes making formula or breast milk available to and affordable for parents who want or need it,” with the realization that “societal structures must change. We must work to dismantle the institutionalized, systemic obstacles—erected by law, politics, and corporate greed—to breastfeeding in black communities” (174).
