Parents are panicking in the face of an infant formula recall and ongoing supply chain issues that have created a formula shortage. Families who can afford to are hoarding cans, and those who can’t are pleading for help. Infants with special needs are in danger of dying or falling extremely ill. But what is missing from the story is that this shortage is a racial justice issue. Black families use formula at much higher rates than any other families. That is not because Black moms prefer formula. In most cases, they have no choice.

Even before their babies are born, Black mothers are inundated with ads and popular culture saying breastfeeding is for white moms, formula is for Black moms. In the hospital, staff often assume that Black parents will not breastfeed and give their babies formula right away. Hospitals in Black neighborhoods have fewer “baby-friendly” practices that encourage breastfeeding. They send moms home with generous packages of free formula. These gifts are a form of formula marketing disguised as a medical recommendation. This marketing continues in the pediatrician’s office. Black moms often live in neighborhoods without lactation clinics that offer support for nursing mothers.

WIC, the government program that supports women, children and infants in need, gives out formula for free for six months. Women who get WIC use formula much more than women who don’t participate in the program. The USDA, the department that administers WIC, gets almost full rebates from the formula companies that finance the WIC program. The formula companies make so much money from using WIC as a marketing scheme that they can afford to give it away practically for free. Black women disproportionately receive WIC.

Moms who rely on welfare benefits also face huge barriers to breastfeeding. In some states, the welfare program requires moms to go back to work immediately after giving birth or a few weeks later. Black women disproportionately receive welfare. There is no federal parental leave to give new parents time at home with their babies to breastfeed. Black women are the most likely of all women to be the breadwinner of their families. Black women disproportionately work at jobs without accommodations for breastfeeding parents or leverage to negotiate some.

The U.S. government makes no secret of its willingness to follow the formula industry’s lead. At the 2018 World Health Assembly, when Ecuador proposed a breastfeeding promotion resolution, the U.S. threatened aid and trade sanctions until it withdrew it.

In my book, “Skimmed: Breastfeeding, Race, and Justice,” I tell the story of the Fultz sisters, the first recorded Black quadruplets — adorable babies who, in the 1940s, became the first Black poster girls for formula. Their white doctor, Fred Klenner, launched a bidding war between formula companies to become their corporate godfather. Pet Milk won, launching the first ad campaign to target Black families to buy anything but alcohol, cigarettes or beauty products. Although the sisters lived in poverty all their lives, Pet Milk’s profits skyrocketed.

The laws, policies and marketing schemes that make Black women use formula at the highest rates come with a heavy cost. Black infants experience the illnesses and conditions linked to formula use at higher rates than other infants.

Now, the formula shortage is making this cost even higher. Formula companies and the government have profited from Black families’ high use of formula. Now that formula is not widely available, how will they ensure that these families can keep their babies thriving?

Along with immediate action, we need a long-term strategy for making infant feeding a matter of genuine choice for all families. We need to separate corporate profits from health programs and policy. We need to eliminate the racial disparities in infant illnesses and deaths. And we need to start by recognizing that the formula shortage is a life-or-death racial justice issue.

Andrea Freeman is a law professor at the University of Hawaii-Manoa’s William S. Richardson School of Law, and a Fulbright research scholar.