Breastfeeding While White
By: Julia Noel
Tags: Breastfeeding, Maternal Health, Motherhood, Feminism, White Supremacy

In August I learned it was National Breastfeeding Awareness month. Just a few months out from the conclusion of breastfeeding my toddler, I was still freshly awash with relief, pride and grief from the complex journey and its ending. I immediately thought about what cute photo I might upload to Instagram, and the caption I would artfully choose to go along with it (maybe “14 months of breastfeeding is the hardest and proudest thing I’ve ever done!” — insert cow emoji here). Quickly embarrassed that my mind works this way, I searched a little harder internally for a more worthy story to share. My feminist, marginalized-mom-identity narrative materialized easily — the one in which I play the role of underdog mother working her tail off to follow the edict of “Breast is Best” within a patriarchal culture, a medical system bereft of adequate resources and support for postpartum mothers, and an economy within which most mothers must return to work only very shortly after their vaginal tears or c-section scars have healed, much less having established breastfeeding fully (this can take months), bonding with their infant meaningfully (also clearly a complex process with lifelong implications for infants), or internalizing this new role and identity of becoming a mother (from personal experience and conversations with friends, this can take years).

I thought about what cute photo I might upload to Instagram, and the caption I would artfully choose to go along with it (maybe “14 months of breastfeeding is the hardest and proudest thing I’ve ever done!” — insert cow emoji here).

But as I examined this story of being a “fighter” in order to long-term breastfeed, and railing against the patriarchy (as I often, with equal parts rage and gratification, like to do), what stood out the most was my own very tight grip on this perspective. In the summer and fall of 2020, with systemic racial injustice in the United States assuming a central position in the national dialogue, I started to realize that this feminist narrative does not help me unlearn my white supremacy — in fact it probably functions to deny it. And perhaps the worst consequence of my semi-unconscious shielding of myself from having to grapple with my own privilege, is the way that act of denial consequently perpetuates the very structures of racism that pervade our culture, medical system, economy, etc. So rather than clog up the Instagram airwaves with woke feminist refrains, I decided that I needed to construct a new story for myself about my privilege, and about the resources that allowed me to successfully breastfeed my baby long-term, as a part of my own work to challenge the ways I unconsciously disavow the many systemic benefits I experience as a result of my whiteness. This will be that raw, ugly, messy and clumsy new story.

I entered into pregnancy 32 years old and healthy, and one of the many reasons for my foundation of good health is because I have never experienced the stresses or health-eroding consequences of racism. I had been hard-hit emotionally by some months of fertility struggles, which likely were so shocking and disorienting for me personally because I had never before experienced a roadblock that I could not creatively traverse, or just say “F that” and go around. The Karen in me (the “let me talk to your manager” archetypal white woman — we’ll dig more into her weaponizing of her whiteness later) did not like being told “no,” even if that opposition was coming from my own body.

The Karen in me (the “let me talk to your manager” archetypal white woman) did not like being told “no,” even if that opposition was coming from my own body.

When I did get pregnant, I took to the streets and started gathering and securing resources for myself with the goal of doing everything in my power to ensure a healthy pregnancy, positive birth experience, and thriving baby. I tend to have the perspective that receiving support from my environment will not be a given, and that I must actively demand and secure what I need from those around me. And when that environment is the mainstream medical system that overtly pathologizes the female body and “condition” of pregnancy, there are many gaps to be filled. However, I also must acknowledge how first-nature I think this kind of entitled activism is for a lot of white people like me, and how at its most toxic and destructive, it can take the form of hoarding of resources to myopically fortify oneself, one’s own family, one’s own goals, ultimately at the expense of the people in the most need. (Just look at the wealthy, and largely white, private “learning pods” right now in the time of Covid! Or my own family and our tightly controlled nanny-share arrangement, which I host from the comfort of my own home while my husband and I work remotely and our family shelters-in-place.)

To state the obvious, garnering resources can cost a lot of money. It feels impossible to trace back all the threads of my own economic privilege, but I can acknowledge that at the very least my ancestors were never enslaved, freely immigrated to this country, and quickly had access to property and education when they did. Everyone knows the rich get richer (seriously, why are billionaires even allowed to exist? — and boy do I love to shift the focus off of myself in this process of de-constructing my privilege). I used my economic advantage to pay out of pocket for private midwifery care (for which I was marginally reimbursed by our country’s broken privatized healthcare system). This would mean having an established relationship with my perinatal care providers, and a guarantee that I would know very well the provider who would deliver my baby (read: hold up my body while I am bleeding and shaking sans epidural, advocate for me based on a thorough knowledge of my health history and labor wishes, and quite literally give birth to me as a mother for the first time, and then stitch me back together afterward. WTF is this perversion that most often has women in this country go through this process with a complete stranger?). And, unlike in a traditional obstetrics practice in the United States healthcare system, my midwife would be by my side through my entire active labor and delivery — not just the pushing and heroic baby-catching parts. And whether by a doula or midwife, while we know that this continuous labor support leads to better health outcomes for women and babies, it is not generally available, even to women whose pregnancies are categorized as “high risk,” a health classification that disproportionately affects Black mothers, and is a factor in the disproportionately high maternal death rates for Black women in this country.

I made sure I would know the provider who would deliver my baby (read: hold up my body while I am bleeding and shaking sans epidural, advocate for me based on a thorough knowledge of my health history and labor wishes, and quite literally give birth to me as a mother for the first time, and then stitch me back together afterward. WTF is this perversion that has women in this country go through this process with a complete stranger?)

Now this is where my story, and my de- and re-construction of it, gets more confusing and muddy for me: my pregnancy was considered a “high risk” pregnancy. Because of the combination of my semi-decent health insurance (thank you Obamacare, even though it has gotten much more expensive for me as a self-employed person since Trump gutted the ACA), plus the thoughtful prenatal care through my midwife group, plus my white skin, this risk category meant that I got blanketed in care and monitoring. In contrast, for a young, low income, Black woman in New Orleans named Simone Landrum, this risk category translated to very little in the way of additional care, and in fact she felt she got nothing short of “thrown away” by her provider, and ultimately lost her baby daughter and almost died, due to what many would see as medical negligence. Our experiences as “high risk” pregnant mothers-to-be could not have been more different.

Our experiences as “high risk” pregnant mothers-to-be could not have been more different.

I have genetic mutations on two genes that are involved with blood clotting (factor V and factor II), and carry an increased risk for blood clots, compounded during pregnancy. My primary prenatal care was with my midwife, but because of my risk factors, I was also sent to a perinatology clinic associated with a major medical hospital for regular monitoring and management of my medication (a lovely, daily, self-administered injection of blood-thinning medication into my tummy or butt fat for the entire pregnancy, plus three months postpartum). Perinatology is a highly specialized field, and the care from perinatologists undoubtedly saves the lives of many mothers and babies in high risk pregnancies of all kinds. But the contrast between midwifery and more “mainstream” medical care (the UCSF Maternal-Fetal high risk medicine clinic) was stunning. With my midwives, the underlying assumption was always that I was progressing on the normal and natural process that is pregnancy — there was great trust and respect in me and my body. The perinatologists almost always hooked me up immediately to a machine and spoke to me about statistics (my greater likelihoods of pregnancy loss or stillbirth, for example) as the machines buzzed and chirped away.

What does a pregnant person do with this information? Freak out. And develop an anxiety disorder during pregnancy.

What does a pregnant person do with this information? Freak out. And develop an anxiety disorder during pregnancy. What does a perinatologist do with this information? More appointments, testing and monitoring. I can absolutely appreciate the reality that if there had been something wrong, these providers would have caught it. However, my experience of mainstream medicine and risk management was not particularly person/patient-centered in its frequent talk of following “best practices,” which felt to me like thinly veiled butt-covering of their own liability. I grew wary of (and weary from) the extra measures, tests, pokes and prods, and began to resent the high risk perinatology care.

Side by side with Simone Landrum’s story, that kind of statement smacks of privilege, and feels shameful and confusing for me to sit with. Most white women want to distance themselves from the “Karen” meme and archetype; disavow it as “not me.” And while many may not actively weaponize their whiteness against marginalized people as “Karen” became infamous for doing, they have internalized some level of unconscious self-importance and superiority. And when I was 32 weeks pregnant, coming into the hospital twice a week for Non-Stress Testing in the middle of my workday (don’t let the name fool you — these screening tests for high risk pregnancies are incredibly stressful), and flunking the majority of them, my internal Karen bust through. My Karen looks a little weepier and more self-pitying than the classic Karen, like when I would call my husband crying from the hospital triage bed exclaiming that “they” (the perinatologists, my provider team) were keeping me there again for hours of fetal monitoring and IV fluids, and I was starving but not being allowed to eat. Or, in a more aggro moment, my Karen would look like an eye roll or exasperated tone with the nurses who could not release me until the perinatologist on-call gave the ‘OK’ — you know, shooting the messenger in order to feel a little less vulnerable in my swollen, medically unstable state that defied explanation.

Throughout all of this screening, poking and prodding, there were never any answers for me about why I kept “failing” these tests (why my contractions were so frequent and strong so early, or why baby’s oxygen levels dropped to borderline unsafe levels during those contractions); just many threats of early induction should my status become even less stable. I wouldn’t get that closure until my daughter was born with a perfect little knot in her cord (a “true knot,” it is called) — a rare and completely random occurrence having nothing to do with my “high risk” designation due to my blood clotting factors, the actual reason I was followed by perinatology and constantly screened, poked and prodded to begin with. And nothing that their screening, poking or prodding would have ever been able to reveal with our current technology. In any case, I do not remember ever feeling particularly grateful for the higher level of medical care I received. Yet from my (very lay) perspective, if Simone Landrum had even been offered a few of these Non-Stress Tests in her last trimester of pregnancy (of which I can count having had around 15), the screenings may have triggered more attention to her pre-eclampsia, she may have been induced early, and her daughter maybe, just maybe, would be alive today. And it is precisely this contrast — that before I knew my own ultimately healthy birth outcome, I essentially rebuffed potentially life-saving medical care because it felt intrusive, anxiety-provoking and fruitless for me, while there are women in need of care who get overlooked — that is so incredibly disquieting.

So my daughter arrived safely and finally we get to breastfeeding! No one ever asked me if I planned to breastfeed — it seems like doctors, labor and delivery nurses, other mothers just assumed I would. I’m not sure what to make of this, or what pressures or assumptions non-white or less advantaged mothers receive. But I do know that I think the whole “Breast is Best” campaign is a persecutory and bootstrap-y concept. Persecutory because for any mother who cannot breastfeed, chooses not to breastfeed, or tries to breastfeed but does not have a lot of success — have they now suddenly not done “Best” by their baby? Bootstrap-y because how the hell are women in this country supposed to complete a year of breastfeeding their babies when there is virtually no infrastructure in place to support them in doing it? In the United States there is no national paid minimum maternity leave (we are the lowest on a list of 41 other countries, despite being among the very most wealthy) to support a mother’s recovery from childbirth, early parent-infant bonding, and the establishment of breastfeeding — but lest you forget, “Breast is Best.” California offers mothers four weeks of disability leave leading up to their due date, four weeks when they give birth, and another six weeks of family leave that can be used for “baby bonding” (all paid out at a proportion of a mother’s typical full earnings). I did not personally qualify for any of these state benefits because I am self-employed, so I would elect to go back to work when my daughter was 3.5 months old, barely out of newborn phase, milk still occasionally leaking from my still-regulating breasts. This personal pressure I felt is much more systemic for low income parents and mothers of color. Black women, for example, participate in the workforce at significantly higher rates than any other groups of women, and are more likely to be the primary or sole breadwinners for their families. I’m pretty sure nursing through the night and pumping through the workday would have sounded like an absurd joke to me with that level of economic pressure on my shoulders. What’s more, to breastfeed for one year, the ideal minimum that is drilled into new mothers, I would have to pump breastmilk two to three times a day while at work, and yet my health insurance didn’t even cover the full cost of a breast pump. (Yes, this is real life in the good ol’ US of A).

“Breast is Best”! …Yes, this is real life in the good ol’ US of A.

My self-employment was both a blessing and a curse as a new mother. And my economic advantages, as I cannot emphasize enough, allowed me much flexibility, creativity and leverage in trying to make “Breast is Best” work. In a sense, my own “bootstraps” were big and strong, and I started pulling myself up with them from a few solid levels above many other new mothers. The impossibility and sacrifice of exclusively breastfeeding for a year felt very real to me in the moment, and I felt on fire at times with rage in my marginalized-mom identity (which I am now working to de-construct), as though backed into a very tight corner. But the other truth is, I had choices and options that many do not. Hours spent pumping during my workday as a private practice psychologist meant spacing out patients with several large breaks throughout the day, and ultimately seeing about five fewer patients a week than what I ordinarily considered as “full.” The economics of structuring my schedule this way translated to nothing short of thousands of dollars of lost income each month, not to mention privately paying a childcare provider to look after my baby at home while I sat in my office half-naked, pumping, feeling more identified with a dairy cow than a human mother, and wondering in these moments why I wasn’t just at home breastfeeding my baby directly. Many women feel a sense of great freedom that comes with being able to go back to work, and to use a breast pump as a tool to set someone else up to feed the baby; but ultimately, until our country and culture invests more into women and families (through both money and parental leave benefits, as well as inherent respect and valuation of the work women do both in the workforce and at home), women will continue to feel damned if they do and damned if they don’t. Or as my mother-in-law once described feeling when she went back to work, “Like I was half good at two things now,” which must have been wholly unsatisfying.

“Breastmilk is cheaper than formula!” YES and NO.

But “breastmilk is cheaper than formula!” Yes and no. We should be reciting this line to our legislators and leaders, not to our mothers (who hear it the most). The cost to women and mothers of breastfeeding can be great — whether working for minimum wage or in a corporate setting, adding the job of breastfeeding and pumping on top of the job they are hired to do, almost inevitably results in some form of lost career opportunity, growth, or income potential for working mothers. (One white mother, @thejennytamas, calculated that she spent 1,825 hours breastfeeding her daughter in the first year; a full time job with three weeks of vacation amounts to 1,960 hours per calendar year.) I would truly love to hear stories from women who did not feel this was their reality, and work to understand the conditions that applied. And I will state what should be the obvious again here, that lower income mothers, disproportionately women of color, stand to lose the most in this system when their economic footing is already precarious.

One white mother, @thejennytamas, calculated that she spent 1,825 hours breastfeeding her daughter in the first year; a full time job with three weeks of vacation amounts to 1,960 hours per calendar year.

Where this cost calculation is true — where breastfeeding truly is more economical than formula-feeding — is on a macro level in our country. The “return on investment,” to put it crudely, of supporting breastfeeding would be huge from a medical value standpoint alone. The United States could likely save upward of $13 billion a year in pediatric health costs alone if we were able to about triple our rates of breastfeeding in this country. This type of breastfeeding support would not be a superficial marketing campaign like “Breast is Best,” but a legitimate upfront investment in women and families, beginning with offering considerable paid parental leave to all workers in the United States. It would mean pouring the most breastfeeding resources and infrastructure (I’m no expert, but maybe healthcare that offers lactation consultation visits, or that covers the cost of a decent breast pump, for starters?) into communities with the most health disparities now. And if I haven’t made this clear enough already, I will gladly woman-splain this equation some more: these investments would almost certainly cost us less as a country in the long run than the consequences of our current deficient breastfeeding status quo.

One thing much harder to quantify than the economic cost of breastfeeding, or my personal financial advantages as a new nursing mother, is the way in which our society views white people as inherently “good.” Nowhere is this illustrated better than in the extreme, where white men (domestic terrorists) commit shocking acts of mass violence, and over and over the media coverage they receive is sympathetic, carefully noting their struggles with “mental illness,” and taking time to paint a picture of their lonely, friendless, abused childhoods. When a Black person commits a crime, he is swiftly dehumanized and called a “thug.” Cell phone videos show footage of armed and actively violent white men being disregarded by police, while Black women are killed by police in their own homes while sleeping (Breonna Taylor — say her name). White people are given so many damn chances.

Cell phone videos show footage of armed and actively violent white men being disregarded by police, while Black women are killed by police in their own homes while sleeping (Breonna Taylor — say her name).

I do not like to see myself as “bad.” Who does? But even further, I struggle with accepting the parts of myself that are competitive, greedy, selfish, ignorant (to name a few). When I am feeling especially vulnerable, or stress is high, I disavow my loathed parts the most violently, projecting them out into the world, the “others” (my sometimes oblivious husband who I infinitely depend on, the evil patriarchy, our annoying dog, the Exxon’s responsible for climate change and never me and my daily diet of Amazon deliveries, etc. etc.), a mechanism of ego-preservation that everyone uses to some degree. And I unconsciously search for reinforcement and reflection of my “goodness.” That positive reinforcement has been much easier to find as a white woman in our society, than it is for someone with black or brown skin. And I don’t think that there was a time in my life when I so desperately needed to be seen as good, worthy or lovable, than when I was a new mother, back at work, trying my hardest to breastfeed, run a household, and care for my daughter, but found myself living in the almost-constant state of being “half good at two things.” At my lowest points, I felt no good at any of the things.

At my lowest points, I felt no good at any of the things.

That is why when breastfeeding started to veer far off-course when my daughter was around nine months old, I did not hesitate to seek consultation from professional lactation experts. I had been through every nursing challenge already (or so it seemed): troubleshooting a painful latch, multiple clogged ducts and one case of full-blown mastitis, a biting phase that resulted in blood loss from my right nipple. I was a breastfeeding OG! What kind of answers could a professional really offer me about my daughter’s new pattern of “reverse cycling” (being too busy proto-walking by catapulting herself from coffee table to ottoman to sofa around our living room, that she defied being slowed down to breastfeed during the day, and instead, started to wake up 3+ times each night to nurse and make up missed calories from the frenetic previous day). I had Dr. Google at my fingertips, after all, and it told me that, like so many things in raising a small child, “this is just a phase,” and here are a few tidy tips to try in the meantime:

1. Pump more often and offer bottles of breastmilk. (When your daughter is a wild animal like mine, the only time you can strap yourself into an electric breast pump for a 20 minute sitting is when she’s sleeping, so this would mean not a moment to oneself during the day. Or putting her in a playpen and tossing snacks her way while she relentlessly shakes at the gate. I tried both.)

2. Keep waking up to feed at night, and then “sleep when the baby sleeps” during the day. (This is a trite and unfair fiction no better than “Breast is Best,” even when still on maternity leave, unless a mother is trying to starve off her baby weight and to live in squalor for months on end.)

3. Ask for help. (For me, this is where the professional lactation consultants came in.)

What was I truly looking for? I can see now that I was looking to be told, in this low moment, that I was inherently “good.” That this challenge (which felt to me like failure!) did not mean I was intrinsically ineffective, unfit, or unworthy as a mother or person, even though I had wrapped up my own value into it so fully. And that is precisely what I found, both directly and indirectly, in these private lactation home visits at $200 bucks a pop. (I do want to take a moment to acknowledge here that this type of service is critical for the many issues nursing mothers contend with on their journeys — babies with tongue ties or latch problems, breast mastitis, milk supply issues, and general emotional support in this incredibly new bodily process, to name a few — but the hidden function that it served for me went far beyond these mechanics.) And the good-mother pat-on-the-back is what I found, in no uncertain terms. I’d barely murmured a word of my breastfeeding saga and woes before I was answered with praise for my valiant efforts and commitment to my daughter: “Well done, mama,” “Baby looks great,” “It will get easier again, hang in there but be kind to yourself.” What a salve for my uncertainty and mercilessly high self-expectations.

Most new moms have no idea what the f*ck is going on in that first year, and if you meet someone who acts otherwise, run fast in the direction of more honest mom friends.

In retrospect, I’m sure I was doing about a million things “wrong” (most new moms have no idea what the f*ck is going on in that first year, and if you meet someone who acts otherwise, run fast in the direction of more honest mom friends). Or there was more I could have done or sacrificed. But that is never what was reflected back to me by the pediatricians and lactation consultants. Tormenting internalizations from the “Breast is Best” standard didn’t fade away, but what I was reflected back by my surround was applause for my efforts, not a questioning or critique of my shortcomings. My experience was qualitatively different from that of many Black mothers; women of color and Black mothers have told me as much about their interactions with our medical system. White people learn to expect and enjoy the benefits of the default position that white folks can do no wrong (at least until I kick my baby or feed him lead paint, at which point I’d probably get my wrist slapped and be given a few more chances), while Black people learn to navigate a world of violent projections of other peoples’ disavowed “badness.” This must be a huge factor in why we see Black and white mothers having such wildly diverging experiences interacting with systems like medical institutions, child protective services, or educational organizations.

White people learn to expect and enjoy the benefits of the default position that white folks can do no wrong (at least until I kick my baby or feed him lead paint, at which point I’d probably get my wrist slapped and be given a few more chances).

Is it possible for me to be both a scrappy fighter and a person who benefits from considerable white privilege? To feel marginalized in some ways as a mother in our society, and yet also know that so many systems in our society (medical, legal, law enforcement, education) were created to protect white people like me, and largely still function exclusively for our benefit? It’s my job, and the job of many white people, to get to know this latter, less becoming or sympathetic side of the story — to really feel our way into it, let it become familiar, and then consciously live inside of it more continuously. But when the underdog fighter narrative takes up too much space, there is no room for anything new, or a coexisting reality — the both/and/also stories. And there is absolutely no room when the purpose of the first story (the story of fighting, of victimhood, or of not having) is to make it impossible for anything uglier to penetrate. This was the easy, cozy, comfortable kind of home that my white feminist narrative afforded me. And when white people, myself included, have been so consistently reflected our supposed “goodness,” and automatically find ways to reinforce the projections and reflections that suit us most (being loving, hardworking, valuable, generous and strong), it gets even harder for us to tolerate anything else (being competitive, complicit, greedy, bad). But the truth is, we are all mixed up vessels of a lot of contradictory parts. And white people need to give up our sham monopoly on total virtuousness, and the systems that keep that myth alive.

White people need to give up our sham monopoly on total virtuousness, and the systems that keep that myth alive.

I still want to smash the patriarchy, I just need to stare down my own whiteness a little more while I kick and punch.