African-American women face unique challenges in breastfeeding

B.going back to breastfeeding is the hardest thing you will ever do until your child becomes a teenager,” said the host of my virtual breastfeeding support group. My heart sank. I was two weeks postpartum and physically exhausted from recovering from an unplanned C-section, learning how to care for a helpless little human being, and discovering the amazing intricacies of breastfeeding.

Throughout my pregnancy, I had wanted to educate myself on everything postpartum, from changing diapers and bathing a newborn to breastfeeding. As someone who seeks information as a path to comfort, I wanted to get ahead of whatever learning curve there was for new parenting. I signed up for webinars, ready with a list of questions related to latching, sore nipples, and pumping. I read every article with breastfeeding in the title of the countless baby/maternity/parenting newsletters I subscribed to. I even dove into online forms and picked up on new mom jargon like FTM, EBF (new mom, exclusive breastfeeding).

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

The Unique Barriers to Breastfeeding for Black Women

I am not the only birth mother who has felt this way about breastfeeding. “From anatomical challenges, such as flat, inverted or everted nipples with stimulation, to engorgement and overproduction, mastitis and milk blisters. [blisters on the nipple], breastfeeding is not the same for everyone,” says Ithamar Turenne, RN, CBC, a postpartum nurse at Oula, a state-of-the-art birthing center based in New York. “The media paints a beautiful picture of breastfeeding as a ‘natural’ experience with continuous latching and milk supply. The reality is that it can be a challenge.”

In my case, I experienced some physical challenges early on that made breastfeeding difficult. I was hoping to wait a few weeks to start pumping (to establish a breastfeeding routine), but my labor and delivery pediatrician had me pump right away to increase my supply since my baby lost some weight (which is actually normal in newborns). But once I got out of the hospital, my breasts were massively and painfully engorged as my supply started in earnest. Combine that with sore nipples from nursing 24 hours a day as my baby’s only food source, and I was crying like a mess.

One sleepless night, the thought crossed my mind that I couldn’t remember my reasons for breastfeeding. The practice seemed essential to me, and is recommended by every major American medical organization for the health benefits it confers to parents and baby, but I never stopped to understand my “why” until those restless moments when that everything felt so hard. (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 ongoing formula shortages.)

When it came to postpartum care, I was a black woman with privilege… Yet I still struggled to make breastfeeding work. What about the women who had the obstacles that I didn’t? How would they have a fighting chance?

I would be remiss if I didn’t mention that I am a black woman and that black babies are far less likely to be breastfed compared to other racial and ethnic groups. A 2015 Centers for Disease Control and Prevention (CDC) study on racial disparities in breastfeeding found exclusive breastfeeding rates at three months for black babies was 36% compared to white. 53% among white babies; at six months, only 17.2 percent of black babies are exclusively breastfed.

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

In the midst of my feeding haze, I reached out to some mommy friends who were also black women. They, too, had faced physical challenges similar to mine, and they all finished their nursing journey earlier than planned. For many, having to return to work after just six weeks (or sometimes less) made it almost impossible to establish a breastfeeding routine, let alone express milk to maintain their supply.

They are not alone in this situation: only 21 percent of US workers have access to paid family leave, and research shows that black women are more likely to have to return to work sooner than other racial groups and ethnic, with inflexible work schedules that are not compatible with the ability to breastfeed or pump. While federal law requires employers to provide time off for an employee to express breast milk for a year after the child’s birth, women still face state limitations and discrimination.

When it came to postpartum care, I was a black woman with privilege. I had access to educate myself on breastfeeding. I also had a supportive partner, along with her family nearby who were willing to help out during our chaotic fourth quarter. Complete with a three-month maternity leave, which is generous by US standards, and savings in the bank to keep our household financially afloat, I wasn’t technically disadvantaged. However, she still struggled to make breastfeeding work. What about the women who had the obstacles that I didn’t? How would they have a fighting chance?

How I was able to make breastfeeding work for me and my daughter

The clarity I gained about my decision to breastfeed came gradually. At another virtual breastfeeding group meeting, a mom said my experience would get better and breastfeeding would get better. 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 alone. I had to create a community to give me the support I needed, starting with hiring a doula and lactation consultant to help me learn how to breastfeed. I also finally found my tribe and built connections with those who shared my struggles in a black breastfeeding group on Facebook. My efforts were validated when our pediatrician gave me a high five for my daughter’s impressive weight gain at her two-month checkup. This whole breastfeeding thing was finally working.

Today, I am proudly three months into my breastfeeding adventure. I wish I could say everything was perfect, but every once in a while, my baby’s occasional extreme bout of gas or fussiness can affect our feeding session and send me into a spiral of worry. The difference is that now I am kind to myself and I have a lot of compassion for myself and my baby, that we are still working through all of this together.

Through this process, I finally realized that I chose to breastfeed my daughter, not because I thought “breasts were the best,” but because I wanted that particular bonding experience, the natural nutrients for my little girl, and to be able to say I had Given one of the most difficult tasks of my life, I did my best, no matter how long my journey took. While it lasts, I will give my best effort. I wish all black mothers had the same opportunity.

Leave a Reply

Your email address will not be published.