changing the faces of lactation

I always knew I wanted to breastfeed my kids growing up. I grew up in an Afrocentric culturally rich part of South West Atlanta where Rastas, Muslims, golds and grills intersected. I frequently saw Black women of various ages and backgrounds breastfeeding babies of various ages throughout my childhood so there was never a question of “if“ but “when” I would do it and I never really thought twice about it. It never crossed my mind that it doesn’t happen that way all for Black mothers.

My late older sister was the closest influence I had to a young Black woman that participated and advocated in natural parenting in every way. From midwives to natural births to baby- wearing and breastfeeding, she was and still is my muse in the lactation field. I knew I could do this.

So, when my time came to birth and feed my first son AppLe, I was anxious and honored. I was able to find a wonderful OB/GYN practice that was willing to grant my birth wishes. Although I knew I wanted to breastfeed, I didn’t receive much counseling or education about breastfeeding itself throughout my prenatal care besides being instructed to take a breastfeeding class.

That’s it. Take a class.

Statistically speaking, the National Institute of Health reports breastfeeding is discussed very briefly, 39 seconds to be exact, during 29% of initial prenatal visits. And they weren’t discussed at all if the mother never brought it up. Breastfeeding was discussed more frequently with Midwives. Most women ages 18-24 have decided to breastfeed before they have kids but for Black women that number drastically drops to 25 percent of Black babies exclusively breastfed for six months after delivery.

At 36 weeks I was diagnosed with pre-eclampsia and at 38 weeks I was admitted to labor and delivery to begin the birth of my son. After four days in the hospital, two and half pitocin bags and a heap of fluids later, I delivered AppLe by C-Section. I was extremely swollen from the fluids which made it difficult to nurse my son.

I requested a lactation consultant and was told there was only one on staff at the time and she arrived the next day.

When she arrived, she seemed distracted and overwhelmed and apologetic for the untimely response. She proceeded to show me how to latch my son but I was so swollen it made the attempt difficult. We massaged the breast to relieve some of the pressure. Hand expressed. When my son latched the pain was excruciating and each time we tried she seemed to whence in pain as if it were her nipple being torn apart.

I immediately felt overwhelmed and defeated at the first attempts. There were people in the room and it made me feel like a failure that I could not grasp the concept of breastfeeding. I also remember thinking why can’t she kick everyone out right now so I can just cry. I wasn't quite confindent enough to say it myself with a room full of people that were here to celebrate our new baby. She showed me reverse pressure softening and attempted to show me how to hand express and told me to practice on that and feed AppLe my expressed milk with a spoon for now and she would be back to assist me in a couple of hours.

I tried everything she said to do but nothing seemd to work. I remember thinking I had failed, I mean I took that cold, dark dreary hospital three hour monotone instructed class that had me more afraid to breastfeed than labor, right? That was supposed to prepare me for this. Initially, I didn’t realize how colostrum would be so little and so thick and so hard to express in the beginning stage.

I remember feeling this is it, that’s all I get to give him.

How is it possible that I can create life, carry life, birth life but now I cannot nourish life?

A few hours later after being exhausted and defeated, she arrives wheeling in a breast pump and sample bottles of formula just in time for his next feed. Black women are nine times more likely to receive formula in the hospital when breastfeeding challenges arise before discharge. We left not breastfeeding exclusively and supplementing with formula with no direction on outside support, community groups or even a follow up call.

My breastfeeding journey ended in excruciating pain after 2 months. In hindsight and my own formal training, I now know that the lactation consultant bringing me a pump helped me to create an oversupply. I was always engorged, exhausted and we both slept through night feeds because of the formula I was supplementing.

AppLe still wasn’t latching because I was still swollen and had a forceful let down. I thought he didn’t like me or my milk and I wasn’t making enough even with the above symptoms listed. I literally felt like a milk fountain. I swear if I took my nursing pads and bra off, milk would instantly begin spraying and leaking. There was milk everywhere but in my Apple, I couldn’t control it. Then I had the nerve to take Fenugreek which worked for me and created even more milk that I could not manage. I quickly gave in. I just wanted it to stop. Everywhere I went I leaked milk, mid conversations, showers, if I heard anohter baby cry I would beeline to the bathroom. You think you want that milk but trust me your body will make enough.

Fast forward nine months later I was given the chance to try breastfeeding again with my redemption baby, Jam. We like food over here.

When I delivered Jam I had the same birthing experience but this time it was complimented with a wonderful nurse. We’ll call her JoAnne, because to this day no one knows who the hell I was talking about and with the drugs given she could have been a figment in my imagination.

Jam was a very sleepy baby, in fact he still loves to sleep at 4, my favorite one, lol. JoAnne asked if I was breastfeeding and I told her about my failed attempt with my first and how I really wanted to breastfeed, but didn’t think it would work again.

JoAnne gave me this firm but gentle statement in her heavy Senegalese dialect, yes I imagined that part too, that was more encouraging than any mantra I could give myself.

“I am off in TWO days, lets get busy.”

She showed me how to correctly position myself, and guess what the cradle position is not for newbies. She showed me how to get out of the way and allow JAM to latch onto his own.

He did it.

JoAnne told me to keep latching my son even if he isn’t crying or seems full. Practice. Practice. Practice. You can never overfeed a breastfed baby. She called when she could not come and she helped me to hand express so that I could cup feed before I nursed to soothe my anxiety of how much he was getting until I was comfortable. She was adamant about hand expression over pumping and recommended me to leave it alone for at least 6 weeks until I established my supply.

Jam was latching. He was sucking. He was swallowing. He was nursing. The joy I felt. And I owed it all to JoAnn. You see when my maternal confidence was low she didn’t give up on me, she didn’t bring my baby formula, she gave me room for grace and the room to trust my instincts and my confidence in two days. I did everything right.

I was enough.

She told me to find a breastfeeding support group and a lactation consultant if problems arise. Unfortunately, my insurance during my first pregnancy didn’t cover private lactation consultants outside of the hospital after delivery, hunh? Baffling when majority of challenges arise between days 3-5, when mom is already home. My new insurance allowed me six visits after delivery. The hardest part in my search was finding a Black consultant and Black breastfeeding support groups. We talk about moms finding support but when it comes to actually locating culture specific support, where are they?

My journey with Jam lasted a little over a year. I pretty much had a breastfeeding village in tact from mom breast friends, family, lactation counselors and my breastfeeding friendly pediatrician. The difference in my two journeys was the continued support after delivery and the increase of my maternal confidence through my postpartum period.

I highly recommend any new mother that plans to breastfeed to find a pediatrician that is an IBCLC as well, a rare unicorn, but available. A breastfeeding friendly pediatrician can make or break your breastfeeding duration, believe me.

Finding a lactation consultant was super easy here in Atlanta but finding a Black one was like looking for a needle in the haystack. Fortunately, my journey with Jam went surprisingly easy compared to my first but I attest it all to reaffirming that my body and my baby were designed to do this and I needed to step out of the way, trust my baby and let him lead the way.

Not being able to find many local breastfeeding support groups for Black women nearby led my curiosity to find out more about the breastfeeding world a year later. I eventually found a local non profit breastfeeding organization called ROSE and their Community Transformer program which trains breastfeeding mothers to hold their own support groups in Black communities underrepresented. I began my own peer meet ups called Chocolate Milk + Honey T.E.A., but with limited training I could only give so much help to breastfeeding mothers to increase duration rates in Black breastfeeding, I knew I had to do more and I wanted to help.

Through a recent survey conducted by USLCA, out of 30k+ lactation consultants, less than 1% were Black. How are we to increase Black breastfeeding rates if representation is low and many white lactation consultants are culturally insensitive to the barriers that Black women face during their journey?

Beginning this journey was not as easy as I thought. The lactation field is primarily dominated by the nursing field and there is a huge misconception that you have to be a registered nurse to become a lactation consultant. This misconception alone discourages Black women from entering into the field along with huge financial expenses and a lack of mentorship opportunities to clinical training. Again the stars aligned and I found Nikki + Nikki Lactation Career Consultants, two nationally recognized Black IBCLCs, who started a lactation career consulting business for persons entering into the field fo lactation. Their consulting service breaks down training and pathway option requirements to sit for the IBCLC exam.

Feeling isolated in my studies, I founded a Facebook community group called Future IBCLCs of Color of which 900 other like minded individuals joined aspiring to become lactation professionals ranging from peer supporters, lactation counselors, educators and future licensed lactation consultants. I quickly learned there are many mothers, such as myself, who have fulfilled the educational requirements but are having difficulty finding and completing the clinical training outside of the traditional hospital setting.

If the number of private practicing IBCLCs is low, how many Black IBCLCs do you think are working in the hospital sector? Close to none. Georgia alone has less than 20 for the entire state.

Future IBCLCs of Color aims to increase the number of consultants by providing resources to lactation training, mentor ship opportunities and professional development from local community IBCLCs.

If we are to substantially increase Black breastfeeding rates we must make an intentional effort to break down barriers and open up the floodgates for interested candidates to serve their communities.

Implicit bias and racism is prevalent in the healthcare system and we have the lowest breastfeeding rates to show for it. Black women need to receive access to skilled lactation care from Black providers to increase duration rates in the Black community. I’m sorry, a white lactation consultant just can’t do it. We’ve tried it and here we are. We need to see and hear about Black women breastfeeding from Black lactation consultants assisting us with those challenges that prevent us from the recommended six months of exclusive breastfeeding.

Black women have unique barriers such as the historical trauma of slavery and wet nursing, returning to work earlier, myths and misinformation, lack of support from family, social embarrassment and socioeconomic barriers that prevent adequate health care access to lactation consultants during the postpartum period.

Black women must be the ones to teach, support and provide care to Black mothers that are breastfeeding and coach them through to success.

If you are interesting in becoming a lactation consultant of color please join our community group here.

We also welcome you to like our page here.

If you are in need of affordable virtual services please book an appointment with me here.

If you are in need of local lactation support please click here.

“We are the ones we’ve been waiting for.”

-Dr, Kimarie Bugg, R.O.S.E.