Commentary Maternity and Birthing

To Be Young, Breastfeeding, and Black

A. Rochaun Meadows-Fernandez

Finding Black Breastfeeding Week was a relief—when I didn't find much help from white health-care providers or my friends and family.

As a young Black mother, I couldn’t help but notice that white health-care providers offered me formula instead of asking what I decided for my baby. Many seemed to assume that I was ignorant, minimally educated, and wouldn’t breastfeed. For them, “mainstream” motherhood was middle-class, older than my 23 years, and white. It looked nothing like me.

In search of cultural understanding and sympathy, I reached out to Black friends and my relatives. But I was let down again. Many Black mothers associated breastfeeding with the distant past of being forced to feed white babies and poverty, and they didn’t understand my persistence when breastfeeding didn’t come easy.

So the first time I heard about Black Breastfeeding Week (today through August 31), I was relieved. My son and I will observe it for the second time, and it will be an opportunity to commemorate overcoming breastfeeding obstacles since his birth nearly two years ago.

Black breastfeeding mothers face all the stigma and lack of support that comes with parenting in this society. But we also experience specific obstacles due to our race, gender, and economic status. We can’t take much time off work. When we do, our families can suffer. When we take pumping breaks, our co-workers whisper about our work ethic; racial stereotypes that we are lazy are hard to escape. There is pressure to take care of our babies, but there is also special racist disgust attached to our bodies.

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Black Breastfeeding Week highlights the fact that Black women are less likely to initiate breastfeeding than their Latina and white counterparts. According to an August 2016 study published in Pediatrics, 61 percent of Black women will start breastfeeding compared with English-speaking and Spanish-speaking Latinas (90 percent and 91 percent, respectively) and white women (78 percent). Black women also breastfeed for the shortest length of time, a little more than 6.4 weeks being the average. Latinas and white women who breastfeed typically do so for between 10 and 17 weeks. By the time their babies are 6 months old, only 35 percent of Black mothers are breastfeeding as compared to about 56 percent of white mothers and 51 percent of Latinas.

Why the low levels of breastfeeding, and why do they drop even more before infants’ first birthdays? My own experiences within my first six months of breastfeeding provide possible answers. Today, as my son has only intermittent nursing sessions, I’ve experienced many of the factors that limit breastfeeding use among Black mothers. But it’s critical, considering that Black infants have the highest mortality rate in the United States (along with their mothers), to think about breastfeeding’s health benefits and how it can specifically improve Black infant health.

Because my son was born with a serious kidney condition, he started his life in the neonatal intensive care unit (NICU). Like many infants who spend time in the NICU, my son was given a bottle shortly after birth. As a result, he developed “nipple confusion” and realized the automatic flow of the bottle was easier than nursing.

Even when their babies aren’t in the NICU, Black mothers are nine times more likely to be offered formula in the hospital than white mothers. Being advised to formula feed shortly after birth significantly reduces rates of breastfeeding. Although my baby was offered formula, I asked for donor milk, which made up for my lack of milk and provided the immune system-boosting benefits of human milk.

I was proactive, researched breastfeeding in online forums and books, and even attended meetings of the breastfeeding education organization La Leche League. But I didn’t realize my son might have problems latching or fastening onto the breast. So few women talk about the difficulties that may come with breastfeeding. As a result, many of us falsely believe “natural” means breastfeeding will happen easily. I soon found out that was not the case.

While I tried to figure out how to convince him to latch, I made the decision to pump exclusively. But the amount of time that I had to spend pumping to ensure my son had food was exhausting.

Expressing my struggles to my social network made me feel alone. No family members or more experienced mothers guided me, and intergenerational support is a key factor in breastfeeding success. To those around me, I was just being my stubborn and obsessed. Comments like “I didn’t breastfeed, and my child turned out just fine” and “You know you don’t have to do this” made me doubt my ability to accomplish breastfeeding at all, though they were meant to be encouraging. Speaking with lactation consultants seemed equally unhelpful because they interpreted my questions as ignorance and treated me as I had already quit breastfeeding before I’d gotten started.

Fortunately, when my son turned a month old, an absent-minded lift to the breast resulted in a latch. Unfortunately, that did not put an end to our breastfeeding difficulties.

Nothing in my breastfeeding education prepared me for the social stigma that comes with being a nursing mom. And as a Black breastfeeding mother, doing something “natural” felt so politicized, as if my presence was a challenge to all of the systems in existence.

I often had no place to breastfeed. When I was around my family, I was often encouraged to nurse in isolation or I would be scolded for indecency. Public breastfeeding was greeted with facial expressions of disgust and rude comments. If I had no cover, I was expected not to feed. I went through the all-too-common horror of nourishing my child in a smelly, germy restroom while eating out with loved ones. It was hard not to feel shame around breastfeeding when you are always encouraged to do it out of sight.

But social stigma, painful though it was, brought fewer challenges than employment policies. Once our son was 6 months old, my husband and I agreed being a one-salary family was not feasible. I sought part-time employment and discovered just how hurtful employment policies are to working mothers.

With wage gaps, wealth inequality, and the multitude of other economic stresses faced by Black mothers, it is no wonder we often have to choose employment over breastfeeding. Being a single- or no-income household is brutal even for those who are well off. As a result, many mothers are forced to return to work around six weeks or sooner postpartum. This is not enough time to effectively bond with your baby or even heal from the major event of birth, but it is also very taxing when a new mother is trying to sustain a milk supply. And many companies lack accommodations for breastfeeding mothers to pump: An acquaintance of mine was forced to use a manual single pump in her car during lunch breaks; eventually, she chose her job and a paycheck over breastfeeding.

Fortunately, my supervisor understood that my employment depended, in large part, on nursing accommodations. However, her understanding was not enough to provide me with a private place to pump.

Instead, I got the locked boardroom, a room with several windows and entrances. Colleagues with keys walked in on me pumping several times. More often than not, my frequent breaks were perceived as laziness. I could hear colleagues say, “She’s in the room again” when my supervisor asked where I was. I left that job for something more feasible.

The privilege of being married gave me the space to seek alternatives. Within a few months, I found ways to work from home that allowed me to help provide for my family and continue breastfeeding. I couldn’t help but hurt for my acquaintance who pumped in her car and many others forced to make similar choices. And it also hurts to know so many Black mothers lack the privileges I do and have limited access to breastfeeding support.

This is why Black Breastfeeding Week is so necessary. We must increase education within our community but also to illuminate the cultural, systemic, and historical struggles Black mothers experience when simply attempting to care for their children.

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