Tuesday, July 20, 2010

Guest Post: Breastfeeding Counselor Chronicles: African-American Moms

Today I am pleased to present a guest post by Saray Hill, an IBCLC who worked with low-income African-American moms as a WIC breastfeeding counselor. Here she recounts her experiences working with the moms, shedding some light on the low breastfeeding rates in this community.

Working as a breastfeeding counselor with African-American moms in California in a disadvantaged area posed many barriers. Women had to deal with the lack of food on the table, often the absence of a partner and multiple children in the household which, in some cases, were with multiple partners. There was also an overwhelming lack of breastfeeding support among family members, friends and employers. When discussing breastfeeding with them, I frequently heard the reply, “Breast is best, but I’m not going to do it.
 When I questioned them further as to their reasons, answers ranged from, “I have to go back to work”, “Breasts are for my man, if my man’s sucking on them, I don’t want a baby sucking on them”,  to “I will be leaking.
 For many of the moms, there was even the fear of having sexual thoughts or sensations while nursing. Many sexual connotations were brought up that gave my idea of breastfeeding a whole new meaning. Also, the baby’s gender was frequently a factor in whether the baby would be breastfed. If the baby was a girl, possibly. But a boy? No way. 
Every piece of information given to these moms that contradicted their breastfeeding beliefs was not enough to change them.

After a counseling session, some of these moms would come out with a new breastfeeding mentality that would lead to them pumping their breasts and bottle-feeding the breastmilk to their babies. Even though this was a huge improvement, it still wasn’t direct breastfeeding. Remember, breastfeeding is not just about nourishment, but also about nurturing and bonding. Realistically, how would a mom be able to establish a full milk supply for her newborn by exclusively pumping and with all of the barriers they were up against? That’s right. Not very easily.

I remember a case where a mom decided to pump and bottle feed her breastmilk to her baby and, in the end, became dedicated to fully breastfeeding. However, her situation was a bit different as this was her first baby, she had a family support system and there was a partner present. But, they knew nothing about breastfeeding and didn’t identify much with it.

There were also expectant moms who were very excited about breastfeeding. It made my day whenever I met one of them. I would share resources and we would have a seemingly great connection, but I would never hear from or see them again after they left the office. Their phone would be disconnected or they wouldn’t return my phone calls. Basically, they would disappear, only to reappear a few months later after they had their baby, who was now being formula fed. When I would ask what happened, the responses I received were that it hurt when they breastfed, or the baby was crying all the time, or he/she was always hungry, or the hospital gave the baby a bottle and many more. These are sad situations as the reasons given could have been explored and prevented if I would have been able to follow up throughout their pregnancy and given them the anticipatory guidance needed to avoid these situations. Where were their OBGYNs, nurses, pediatricians and lactation consultants when this happened?

There were some truly excited moms who would breastfeed. These moms were typically younger than 25, it would be their first child and they would have a mom and family support to count on. It would not matter if the partner was involved, as long as her family approved of her decision to breastfeed her baby. Usually, somebody in her family had breastfed and recommended it. In some other cases, the baby's father was involved and wanted the baby to be breastfed.

I would sporadically encounter a mom who had breastfed her first child, but didn’t want to breastfeed this child or would breastfeed him/her for a shorter length of time. Things become increasingly more difficult when there’s more than one child in the household and a lack of a solid support system.

I met a mom who said she would not breastfeed because it was very painful with her first child. After counseling with myself and other staff members, I helped her achieve a comfortable latch. She said, “You just helped me get over my past trauma about breastfeeding...thank you, but I’m still not going to do it.

I believe that some of these women who refused to breastfeed were listening when we discussed the risks of artificial infant feeding, but they didn’t want to publicly admit it as they were scared to try breastfeeding. They knew it was best for their infants, but if they decided to try, who would they turn to if and when a challenge should arise? Their families either had never done it or were unsuccessful. The pediatricians? They have no time for breastfeeding problems. The breastfeeding counselors? We just weren’t available 24/7. All these factors make artificial feeding more attractive and enticing.

I believe the best way to help African American moms embrace breastfeeding is not just by educating them, but by educating their family members as well. Building a support system with breastfeeding-friendly healthcare professionals. Connecting to community members -- real people, just like them, who care about how artificial feeding is affecting the health of their youngest and future generations. These community members need to work on creating a breastfeeding family acceptance support system to encourage and support the young mothers to breastfeed and help design a more caring and humane society, from the very beginning, through bonding and nurturing. They simply can’t do it alone; it takes a village.......

Saray Hill, BS, IBCLC, RLC is the Founder/President of Mother's Utopia , an organization focused on supporting, protecting and promoting breastfeeding. She is also the creator of the only Twitter breastfeeding support party in Espanol, El Club de Lactancia.

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