Food is a vital and necessary part of each of our daily lives. Beyond merely providing sustenance, food is frequently a provider of pleasure, a site of community, and a celebration of culture. However, food can also be a vector of inequality. To this end, Professor Andrea Freeman has pioneered the concept of “food oppression,” which occurs when facially neutral laws and policies “have a disparate impact on individuals depending on their race, class, and other intersectional identities” (114). Food oppression is often the result of formal or informal alliances struck between the government and powerful lobbies like the agrifood or pharmaceutical industries, which allows them to privilege private interests at the expense of the most marginalized communities. Thus, food oppression can be difficult to both identify and contest.
In Skimmed, Freeman uses the case of infant formula to reveal how a deceptively complex matrix of factors can contribute to food oppression, with disproportionately negative impacts on vulnerable groups. More specifically, she applies a critical race theory (CRT) perspective to examine the disparity in breastfeeding rates between Black and white mothers. Debunking the myths about lower rates of breastfeeding among Black mothers representing a lack of education or cultural or personal preferences, Freeman argues that this discrepancy instead reflects “the absence of choice created by government policies and unaccommodating social structures” (4).
As Freeman illustrates through a series of tragic examples, Black mothers in the United States have a distorted and constricted range of choices available to them in the context of children's first food. In particular, the book gives an in-depth account of the ill-fated “Fultz quads”: America's first surviving set of identical quadruplets, who were born to poor Black parents in North Carolina in 1946. Their white doctor, Dr. Klenner, exploited his position of authority in numerous ways, including by entering into negotiations with formula companies to feature the quadruplets in manipulative marketing material targeted at Black mothers. Ultimately, although the deal that Klenner struck with winning bidder Pet Milk worked to his advantage, it would have devastating consequences not only for the Fultz family, but also for Black mothers more broadly.
Interwoven with her telling of the remarkable story of the Fultz quads, Freeman elaborates on how breastfeeding practices in the United States have been shaped by a web of historic laws, policies, and practices ranging from slavery to stereotypical tropes of Black women in popular culture, and traces their enduring impacts through to the present. Her comprehensive investigation convincingly demonstrates how the obstacles that Black women face in breastfeeding are linked to the discrimination that they face “in almost every other aspect of life, including housing, employment, education, and the criminal-justice system” (135). The multifaceted nature of the issues calls for broad-ranging changes, including “in the law, the workplace, the medical profession, and the media” (174). The conclusion offers some concrete suggestions about how breastfeeding might be better promoted among Black communities.
Given the degree of nuance associated with any intersectional analysis, there are areas where the book is in danger of veering into the territory of reductive classifications or overly simplistic binaries. As such, it is important to read the book against the caveats raised in the introductory chapters. For one, Freeman openly admits to being wary of “White people telling Black people's stories” (xii). A degree of circumspection is especially warranted because the narrative that she paints of the Fultz family is based primarily on her interpretation of secondary sources. There is no firsthand account available from any of the Fultz quads, all of whom have since died.
Further, Freeman acknowledges that the book “may appear to promote the idea that breast is best” (14). Indeed, there are parts of the text that either explicitly or implicitly advance this claim. For example, in discussing misleading formula marketing campaigns from the 1930s and 1940s, Freeman writes that such campaigns “belied the medical research that breast milk … is best” (60). At another point, she remarks that “[f]ormula is a highly processed product that is essentially junk food for infants” (9). Despite these kinds of comments, Freeman maintains that the book's “advocacy and analysis come with no judgments” (14) and should not take away from the broader point that structural reforms are needed “to create genuine, universal choices about infant feeding” (14).
As is made clear in Skimmed, such reforms necessarily implicate shifts in the legal, political, cultural, and social spheres. The scope of material covered in the book means that there is some repetition and overlap both between and among chapters. Nevertheless, the primary message is undoubtedly an important one, and the book will certainly be of interest to those who are concerned about historical issues relating to race, health, and food, and the ongoing legacies that continue to bend contemporary law and policy in profoundly unjust directions.