Breastfeeding seminars

Black Women Face Unique Breastfeeding Challenges

Bre-breastfeeding is the hardest thing you will do until your child becomes a teenager,” said the host of my virtual lactation support group. My heart sank. I was two weeks postpartum and physically exhausted after recovering from an unplanned C-section, learning to care for a helpless little human being, and understanding the surprising complexities of breastfeeding.

Throughout my pregnancy, I had intended to educate myself on all things postpartum, from diapering and bathing a newborn to breastfeeding. As someone who seeks information as a path to comfort, I wanted to get ahead of the learning curve of new parenting. I signed up for webinars ready with a list of questions regarding latching, nipple pain, and pumping. I’ve read every article with breastfeeding in the title of countless baby/maternity/parenting newsletters I’ve subscribed to. I even delved into online forms and got caught up in new mom lingo as an FTM, EBF (first time mom, exclusively breastfeeding).

Despite all this preparation, I still felt like a failure in front of my hungry, hysterically crying baby, and I couldn’t help but wonder what was wrong. I was lucky in many ways: my daughter was born healthy, ready to feed just minutes after delivery. But I learned the hard way that no amount of classes and articles prepared me for how difficult breastfeeding can be.

The Unique Barriers to Breastfeeding for Black Women

I’m not the only birth parent to feel this about breastfeeding. “From anatomical challenges – such as flat, inverted, or everted nipples with stimulation – to engorgement and overproduction, mastitis and milk bubbles [blisters on the nipple]breastfeeding is not a one-size-fits-all solution,” says Itamar TurenneRN, CBC, postpartum nurse at Wow, a modern maternity center based in New York. “The media paints a beautiful picture of breastfeeding as a ‘natural’ experience with flawless latch and milk production. The reality is that it can be difficult.

In my case, I encountered some physical challenges early on that made breastfeeding difficult. I had hoped to wait a few weeks to start pumping breast milk (to establish a breastfeeding routine), but my labor and delivery pediatrician had me pump right away to increase my supply since my baby has lost weight (which is actually normal in newborns). But once I left the hospital, my breasts became massively and painfully engorged with milk as my supply began in earnest. Combine that with sore nipples from 24-hour breastfeeding as my baby’s only food source, and I was a sobbing mess.

One sleepless night, the thought crossed my mind that I couldn’t remember what my motivations were for breastfeeding. Practice seemed essential to me – and this is the recommended by all major US medical organizations for the health benefits it confers on parents and baby, but I never stopped understanding my “why”, until those turbulent times when everything seemed so difficult. (The other safe way to feed your baby, of course, is formula, but even that isn’t necessarily a reliable option anymore in the US due to the continued shortage of formula.)

When it came to postpartum care, I was a privileged black woman…yet I was still struggling to make breastfeeding work. What about the women who had the barriers that I didn’t? How would they have a fighting chance?

I would be remiss if I did not mention that I am a black woman and black infants are much less likely to be breastfed than other racial and ethnic groups. A 2015 study by Centers for Disaster Control and Prevention (CDC) on Racial Disparities in Breastfeeding found that exclusive breastfeeding rates at three months for black infants were 36% compared to 53% for white infants; at six months, only 17.2% of black infants are exclusively breastfed.

The underlying reason for these disparities goes beyond individual physical challenges like mine. “Racial disparities, institutional discrimination, trauma and stress from culturally incompetent and misinformed institutions and providers are deeply intertwined elements that affect breastfeeding outcome success rates for BIPOC. [Black, Indigenous, people of color],” says sherry jones, a birth and postpartum doula based in Los Angeles. “What affects BIPOC the most in their breastfeeding journey is access, regardless of socio-economic status or education level. The ability to know where to go, to get education and practical support before and after childbirth, and the financial ability to do so.

In the throes of my food haze, I reached out to a few mom friends who were also black women. They too had faced physical challenges similar to those I had, and all of them ended their breastfeeding journeys earlier than expected. For many, having to return to work after just six weeks (or sometimes less) has made it nearly impossible to establish a breastfeeding routine, let alone the pump to maintain their supply.

They are not alone in this situation: only 21% of American workers have access to paid family leave, and research shows that black women are more likely to have to return to work earlier than other racial and ethnic groups, with rigid work schedules that do not allow breastfeeding or pumping. Although federal law requires employers to provide break time for an employee to express her milk for a year after childbirth, women still face state-imposed limitations and discrimination.

When it came to postpartum care, I was a privileged black woman. I was able to learn about breastfeeding. I also had a supportive partner, as well as her nearby family, who were willing to help me through our rocky fourth trimester. With three months of maternity leave – which is generous by American standards – and savings in the bank to financially keep our household afloat, I was technically not at a disadvantage. Yet, I still have trouble getting breastfeeding to work. What about the women who had the barriers that I didn’t? How would they have a fighting chance?

How I made breastfeeding work for me and my daughter

The clarity I gained around my decision to breastfeed came gradually. At another virtual breastfeeding drop-in group meeting, a mother said my experience would improve and breastfeeding would improve. My mind couldn’t register that hope at the time, but she was right.

With time and practice, I gained confidence in my ability to breastfeed. But I didn’t do it myself. I had to create a community to give me the support I needed, starting with recruiting a doula and a lactation consultant to help me master breastfeeding. I also finally found my tribe and connected with those who shared my struggles in a black breastfeeding group on Facebook. My efforts were validated when our pediatrician gave me a big thumbs up for my daughter’s impressive weight gain during her two-month physical. This whole breastfeeding thing was finally working.

Today, I am proud of three months into my breastfeeding journey. I wish I could say everything was perfect, but once in a while, my baby’s occasional extreme bouts of gas or fussiness can impact our feeding session and send me into a spiral of worry. The difference is that I am now gentle with myself and have so much compassion for me and my baby who are still figuring this all out together.

Through this process, I finally realized that I had chosen to breastfeed my child, not because I thought “the breast was best,” but because I wanted that special bonding experience, the natural nutrients for my granddaughter, and to be able to say that I had given one of the hardest tasks of my life, my absolute best, no matter how long my trip was. As long as it lasts, I will do my best. I wish every black mother had the same opportunity.