Black visibility and role modeling

My breastfeeding journey started 30 years before I became a mother when my mother, a Registered Nurse and lactation specialist, would tirelessly alternate breastfeeding my younger twin brothers. As a toddler, I had no idea the historical context and significance this modeling would play in my life not only as a future mother but also as a future Black woman and physician.

With that foundation, I internalized the data on poorer Black maternal and infant outcomes and their lower breastfeeding rates and set out to do something about it. But as I stepped into my own breastfeeding journey, I found that my passion and knowledge didn’t necessarily translate into compassion and understanding, and I was ultimately forced to reckon with my expectations for myself and the mothers I would care for.

Dr. Gateau is wearing the Lucille Nursing Nightgown. Click the photo to check it out!

The miseducation of Dr. Mom

Two decades after my first exposure to breastfeeding, I learned about the physiologic basis of breastfeeding in medical school. Like any type-A student doctor, I meticulously studied the physiology of pregnancy, feverishly took notes on the components of breast milk, and memorized every benefit it provided baby.

“Breast is best” was widely displayed throughout the labor and delivery ward I rotated on as a third-year medical student, establishing the hospital’s dedication to being breastfeeding friendly and the importance of mothers providing their babies with the liquid gold they need.

As a pediatric intern, I counseled mothers in my clinic about how their bodies were made to produce the nutrients their babies needed, and even if the thimbleful of colostrum seemed like too little food to nourish their baby, it was more than enough. I gave countless handouts to tearful mothers about all the benefits their breast milk provided their baby and how important it was for them to keep trying amidst the engorgement, blocked ducts, and cracked and bleeding nipples.

When the doctor becomes the patient

Fast forward yet another decade to my second night of motherhood. My beautiful baby girl woke up screaming what seemed like every 30-60 minutes. I would put her to breast, and after about 10 minutes, she’d settle, but she quickly became fussy again. I was sure she was starving, and I was sure my milk hadn’t come in -- and in that moment, I was sure I was failing her.

Through tears I begged my husband to run to the store in the middle of the night to get formula. He lovingly kissed my forehead and told me I was doing an amazing job and if I really wanted him to go to the store he would. That sleepless night eventually gave way to the morning, and my mother came in like my superhero to help me hand express and feed colostrum to my daughter and reassure me that I was indeed doing a good job.

Looking back at the student doctor and resident physician versions of myself, what did I get wrong?

Well, nothing and everything. Colostrum is supercharged and nutrient-dense; breastfeeding does have many benefits for both mother and baby. But what I missed so glaringly in those past moments of counseling breastfeeding mothers were humanism and grace. 

Breastfeeding is challenging for so many reasons. As a first-time mom, I have been privileged with excellent breastfeeding role models in my family, many resources including my own personal lactation consultant who happened to also be my mother, and the arsenal of knowledge I acquired as a medical student and resident physician.

Yet I still deeply struggled with the mechanics and emotions of breastfeeding. Throughout those first few nights and months, I often reflected on my struggle in the context of all that I had and imagined how the feelings of frustration, guilt, and inadequacy are compounded for mothers who don’t have access to the same resources. 

Dr. Gateau is wearing the Sublime® Nursing Tank. Click the photo to take a look!

Breastfeeding while Black

As a Black woman I know and deeply understand the cultural implications and significance of breastfeeding. The stigma that can exist within the community stems from a long history of lost autonomy during the enslavement of Black women who often were forced to wet nurse for their enslavers’ children. 

Fast forward to the 21^st century where numerous systemic and institutional barriers lead to lack of access to comprehensive prenatal counseling and care, lack of public and familial role models, and minimal postpartum support -- seemingly insurmountable barriers. 

So, what has my experience taught me? 

Now I look at every mother as not only a patient but also a sister-in-arms. The first thing I ask her each day is how she is and how she is feeling. I allow my patients in on my journey, the initial trials and tribulations, my struggle to adjust to a growing infant and maintain an adequate supply when I returned to work, and more. I make no judgment about how each patient chooses to nourish their child and identify any area I can support each mother in their feeding journey. 

I try to normalize breastfeeding and act as a role model for the Black mothers in my community, who often hold many anxieties and negative associations with breastfeeding. I do more listening than talking because the most important thing this experience has taught me is that this journey is unique to each woman and should be led by her and her alone.

To learn more about Black Breastfeeding Week and Black maternal health, visit here and here.