Birthmark Doula Collective, the New Orleans-based group that I’m the director of, has celebrated Black Breastfeeding Week annually since 2013. Each year, we host celebratory gatherings with our local Black breastfeeding support group, Café au Lait. Before the pandemic, we would gather together, take photos with certificates of achievement celebrating the number of months each mom has breastfed, share tales of triumph, and have cupcakes for all. (Well, we actually had to stop doing cupcakes because toddlers with frosting hands are a nightmare.)
Every year, we also post inspirational quotes: “We’re in this together!” “We’ve come so far!” We share gorgeous Black breastfeeding selfies: Picture 12 Amazonian figures, skin in every shade of chocolate, breastfeeding their nurslings while posing against a canvas of natural beauty—canyons, forests, prairies.
And every year, we explain, yet again, why we need this week.
During my own first week of breastfeeding in December 2015, I did feel celebratory. A lactation nerd to my core, I narrated aloud to my care team while my newborn completed each of the nine stages of the first “golden hour” after birth, while lying naked on my chest. After an hour of licking, nuzzling, massaging, and dozing, she finally gaped her mouth wide, lifted her head, and dropped onto my breast. I called out to the room: “She latched on unassisted at the one-hour mark, just like the textbook!”
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In the subsequent week, we nursed and slept, slept and nursed, and I gorged myself on delicious postpartum meals, like a mother bear emerging from hibernation. Blurry-eyed rounds of repeat nighttime feeding left my nipples raw and scabbed. When I caught myself wincing while I hesitantly held my breast over my baby’s awaiting mouth, I knew it was time to call in the lactation consultant. My colleague Nikki came that night and gave me the tips and assurances I needed to latch better, care for my nipples, and persevere.
But sore, scabbing nipples would be the least painful of my breastfeeding difficulties. Within two weeks, my baby and I settled into a comfortable nursing rhythm, and my attention started to drift to other aspects of parenting.
I had begun to notice a nagging sensation that would pop up unannounced at seemingly random moments in my day. I might be changing a diaper, breastfeeding, or dressing my baby, and there it would be. The sensation was hard to describe—I couldn’t even tell if it was physical or mental. It was like a grating sensation in my brain, sometimes on my skin too, and though it lasted for only a few moments each time, it always left me feeling very irritable. I would be in the middle of bathing the baby and suddenly have this feeling, and then I’d have the urge to just stand up, throw down the washcloth, and storm away. If my daughter was in my arms at the time, I’d want desperately to push her off me.
Slowly, I began to notice a pattern and realized it was not as random as I had first thought. I would only get the grating feeling when one or both of us was undressed, and if touch was involved. The moment I realized this, I was flooded with shame. “Not this,” I thought. “Do not let this in.”
During my pregnancy, I had started to experience visceral and visual flashbacks from a history of childhood and sexual abuse. I had worked very closely with a therapist who introduced me to the concept of complex post-traumatic stress disorder (CPTSD). I learned that CPTSD could cause stressful symptoms similar to the PTSD of war vets and accident victims that I had often heard of, but CPTSD results from chronic exposure to trauma over months or years of someone’s life.
Over the first year of my baby’s life, I began to have more of these flashes of negative feeling. Sometimes they were short, vague, and passing. Other times, they developed into full-on intrusive thoughts. The most difficult instances were usually while breastfeeding. I would start to feel like my nipples were being torn off, or I would have a desperate urge to escape the weight on top of me. I felt like I was running from someone who was chasing me inside my own skull.
For months, I could not bring myself to share any of these experiences with anyone. Shame had convinced me that no one—not the support group members, my colleagues, my husband, or my therapist—would ever love or respect me again if they knew what I was really feeling.
Finally, after a very rough night when breastfeeding had made me so physically nauseous I thought I may throw up, I started to challenge my shame. I became brave enough to research the phenomena I was experiencing. Reading about sexual trauma and breastfeeding eventually led me to a place of acceptance and compassion for myself. Writing about my struggles led me to identify which coping mechanisms I found helpful. The more I wrote and talked about my experience, the more manageable it became.
As I shifted my focus from my own day-to-day parenting to my professional community, I began to feel angry. In my training as a nurse and lactation consultant, I had not been prepared to care for someone like me. I had read a few mentions of how the historical trauma of the trans-Atlantic slave trade impacted Black American breastfeeding practices. I had also learned that some mothers may decide not to breastfeed, or to pump only, because of a personal history of sexual assault. But the bulk of the breastfeeding advocacy and education that I had both received and contributed to was overly simplistic. Where were the parents like me? The parents that were both celebrating and suffering, persisting and in pain?
Black Breastfeeding Week, among many other BIPOC initiatives, has actively challenged the racial whitewash of breastfeeding imagery and narratives that dominated our field until recently. But as I now see, the louder we are forced to yell, the fewer things we can actually say.
Every year, we explain why we need this week. I am tired of saying, reading, and posting things like:
- Black families need this week because we have some of the lowest breastfeeding rates in the country.
- We need it because our babies die at least twice as often as white babies, and breastfeeding can prevent some of their deaths.
- We need it because we return to work earlier postpartum and work more than other parents.
- We need it because we have fewer Baby-Friendly hospitals in our communities.
- We need it because our communities are in lactation-support deserts.
Black breastfeeding advocates have been cornered into a defensive stance, constantly advocating for resources, training, and space in the narrative. We join our cries in a chorus so we may be heard, leaving our voices bereft of complexity. As a director of a breastfeeding program, I have recommitted to giving voice to complicated and common parenting experiences like mine.
Black (and Native) women experience sexual violence more often than their white counterparts, with somewhere between 30 to 60 percent of Black women and girls being assaulted in their lifetime. In North America, a shocking 50 percent of women survivors of sexual violence may experience PTSD symptoms.
This means that post-traumatic symptoms may be as common a part of the Black breastfeeding experience as sore nipples. So where are the stories, tips, and articles on this topic? A quick search on the well-known and respected La Leche League website demonstrates this disparity. My search for “sore nipples” yields 36 articles and resources. Yet searches for “violence,” “sexual assault,” and “trauma” each yield less than three results.
Black women experience sexual violence at the intersection of racialized and gender-based violence. We experience breastfeeding inequities along that very same nexus. The intersecting impacts of racial and sexual oppression limit our access to the supports that would enable our breastfeeding success. In the context of these obstacles, it is unsurprising that Black women stop breastfeeding earlier than any other group.
The choice to stop, pause, or continue breastfeeding belongs to the breastfeeding parent alone, and we face that choice at each and every feeding. Personally, I just kept telling myself to “try one more feeding.” Sometimes it was terrible and I would say it was the last. But those “one more feedings” lasted until my first daughter turned 3 years old, and they keep me going now as I nurse my 14-month-old.
Although my psychological and physiological symptoms have caused me great suffering, breastfeeding is also joyful for me. I will treasure forever my memories of looking into my daughter’s eyes throughout a feeding, of her giggles and silly nursing faces, and of feeling her little clammy fingers tickling my ribs under my shirt. I feel pride to know that my body provides 100 percent of my baby’s nutrition and hydration.
When my daughter was 1, I developed a trauma-informed parenting workshop. I remind parents that it is all too common to parent with trauma. I teach strategies like having a set routine for potentially triggering infant care activities, such as baths, diaper changes, and nursing. I recommend talking or singing aloud during these activities to stay grounded in the present and be able to continue through moments of dissociation, flashbacks, or intrusive thoughts. And I tell them that breastfeeding is not all or nothing; we can take breaks and try again another day.
We need a dialogue about breastfeeding that is as nuanced and complex as is breastfeeding while Black. There are so many parents out there like me, who just need someone to talk to. We need to know that breastfeeding with trauma is not shameful—it is heroic.