By MGH Center for Women's Mental Health | May 5, 2021

By: Shanicia Boswell | August 26, 2020

"​Raising awareness about the history of Black breastfeeding and the factors that contribute to low rates of Black mothers breastfeeding is an important way to close the gap."

"I sat on the sofa crying silently between my mother and my fiancé. Tears spilled over my cheeks as we watched a movie and I held my newborn daughter. I was three days postpartum and my breasts were painfully engorged with milk. How was this happening? I had survived a med-free labor and delivery. This was supposed to be the easy part. Looking back nearly eight years ago at my breastfeeding journey, I always remember this day. I was a first-generation breastfeeder.

​That day and many other days, I sat between people I loved the most and felt completely alone and isolated. My partner could not help me with breastfeeding because he was a man who had no experience around breastfeeding. My mother could not help me because she had not breastfed me or my brother. My friends could not help me because I was the only one in my friendship circle who had a baby. Like many Black millennial women, I was embarking on this journey alone.

​Without the proper resources, my breastfeeding journey only lasted six months. I felt defeated. In fact, the statistics show that Black women are less likely to start breastfeeding than any other race of mother and even less likely to continue breastfeeding for six months. Only 69 percent of Black women initiate breastfeeding compared to 85 percent of white women. The question that is often asked after hearing statistics is why? There are many reasons. There are unfortunate events deeply connected to our race as a people: a history of wet nursing, oversexualization, lack of economic and familial support, are a few. For me, the question became how do we raise the numbers?

This is where Black Breastfeeding Week comes in. Black Breastfeeding Week is August 25 to 31, 2020, and is a campaign that has been part of National Breastfeeding Month for the past eight years. This year, through virtual events, Black mothers, lactation experts, and public health professionals have space to discuss their breastfeeding journeys, raise awareness, and explore public policies that address the disparities in statistics around Black maternal and infant care. Black Breastfeeding Week has become even more controversial this year because we are in a time where extreme emphasis has been placed upon race and it creates a space where white mothers feel isolated. White mothers are asking why Black women are choosing to segregate themselves, even down to the topic of breastfeeding. 

As the creator of Black Moms Blog, a collaborative blogging platform for mothers of color, I am no stranger to the "why aren't we included" questions from white mothers. The truth is, weeks like this should not have to exist. Platforms like mine should not be a necessity—but they are. The needs of Black mothers as well as the specific barriers we face are left out of the overall breastfeeding conversation. The historical and cultural context as to why is important.

​The History of Black Breastfeeding

Cultural reference should always be considered when discussing breastfeeding. During slavery, Black women were used as wet nurses. A wet nurse is someone who breastfeeds another woman's child. The true definition of a wet nurse states "employed," but replace that word with "forced," and the reality becomes clear. It is generational that Black women have developed a disdain for breastfeeding due to our historical relationship with wet nursing. Because of wet nursing, many Black women were unable to breastfeed their own children. Can you imagine the psychological effect that must have had on a moment that every mother should enjoy?"

Dutch News| August 19, 2020

"What is COVID-19?
COVID-19 is a new illness that affects the lungs and breathing. It is caused by a new coronavirus. Symptoms include fever, cough, and trouble breathing. It also may cause stomach problems, such as nausea and diarrhea, and a loss of your sense of smell or taste. Symptoms may appear 2 to 14 days after you are exposed to the virus. Some people with COVID-19 may have no symptoms or only mild symptoms. 

How does COVID-19 affect pregnant women?
Researchers are still learning how COVID-19 affects pregnant women. A report released in June 2020 looked at whether pregnant women might be at increased risk of getting very sick from COVID-19. This report from the Centers for Disease Control and Prevention (CDC) notes that:

• Pregnant women with COVID-19 may be more likely than nonpregnant women with COVID-19 to need care in an intensive care unit (ICU) or need a ventilator (for breathing support).
• Pregnant women who are Black, Hispanic, or Asian may have a higher risk of severe illness or need ICU care more often than other pregnant women. This is likely caused by social and economic inequity, not biological differences.

Although the risk of needing more care in the hospital and having more severe illness may be increased, the overall risk of these outcomes is still low for pregnant women. Also, it’s important to know that the report suggests the risk of death is not higher for pregnant women with COVID-19 than for nonpregnant women with COVID-19. 

How can COVID-19 affect a fetus?
Remember that researchers are learning more about COVID-19 all the time. Some researchers are looking specifically at COVID-19 and its possible effects on a fetus. Here’s what they know now:

• Some pregnant women with COVID-19 have had preterm births, but it is not clear whether the preterm births were because of COVID-19. 
• Researchers have found a few cases of COVID-19 that may have passed to a fetus during pregnancy, but this seems to be rare.

More research is needed to understand the effects of COVID-19 before birth. After birth, a newborn can get the virus if they are exposed to it. 

 What should pregnant women do to avoid the coronavirus?
Pregnant women should take steps to stay healthy, including:

• keeping your prenatal care visits 
• limiting contact with other people as much as possible
• staying home as much as possible
• staying at least 6 feet away from other people if you need to go out 
• wearing a mask or cloth face covering in public and any other needed protection while at work 
• washing hands often with soap and water for at least 20 seconds
• cleaning hands with a hand sanitizer that contains at least 60 percent alcohol if you can’t wash them (rub until your hands feel dry)
• avoiding touching your eyes, nose, and mouth 
• having a good stock of essential supplies, including at least 30 days of any medications (so you don’t have to go out as often)

Should pregnant women wear a mask or face covering?
As of April 3, the CDC says all people, including pregnant women, can wear a cloth face covering when they are in public to slow the spread of COVID-19. Face coverings are recommended because studies have shown that people can spread the virus before showing any symptoms. See the CDC’s tips on making and wearing a face covering.

Wearing a cloth face covering is most important in places where you may not be able to stay 6 feet away from other people, like a grocery store or pharmacy. It also is important in parts of the country where COVID-19 is spreading quickly. But you should still try to stay at least 6 feet away from others whenever you leave home.

If you have COVID-19 or think you may have it, you should wear a mask while you are around other people. You also should wear a mask if you are taking care of someone who has COVID-19 or has symptoms. You do not need to wear a surgical mask or medical-grade mask (N95 mask). 

How will COVID-19 affect prenatal and postpartum care visits?
It is important to keep your prenatal and postpartum care visits. Call your obstetrician–gynecologist (ob-gyn) or other health care professional to ask how your visits may be changed. Some women may have fewer or more spaced out in-person visits. You also may talk more with your health care team over the phone or through an online video call. This is called telemedicine or telehealth. It is a good way for you to get the care you need while preventing the spread of disease. 
If you have a visit scheduled, your care team’s office may call you ahead of time. They may tell you about telemedicine or make sure you do not have symptoms of COVID-19 if you are going in to the office. You also can call them before your visits if you do not hear from them."

By Cassie Shortsleeve| June 08, 2020

"Last month, one random morning while breastfeeding my 11-month-old daughter Sunday, she bit down (and laughed) then tried to latch back on. It was an unexpected snag in an otherwise smooth breastfeeding journey, but after some bleeding (ugh), a prescription antibiotic ointment, and shedding some tears, I decided it was also the end.

Not only did I beat myself up—I didn't make it to the (albeit self-imposed) one-year marker that I had set—but within days, those teary, dark moments that had been with me in the early postpartum period crept back up. I could almost feel my hormones changing.

If you just had a baby (or have new mom friends), you're likely aware of some of the mood changes that can accompany new parenthood, namely the "baby blues" (which impact some 80 percent of women in the weeks following delivery) and perinatal mood and anxiety disorders (PMADs), which impact some 1 in 7, according to Postpartum Support International. But mood issues related to weaning—or transitioning your baby from breastfeeding to formula or food—are less talked about.

In part, that's because they're less common than PMADs, such as postpartum depression. And not everyone experiences them. "All transitions in parenthood can be bittersweet and there is a wide array of experiences associated with weaning," explains Samantha Meltzer-Brody, M.D., M.P.H., director of the UNC Center for Women's Mood Disorders and a principal investigator in the Mom Genes Fight PPD research study on postpartum depression. "Some women find breastfeeding very satisfying and do experience emotional difficulty at the time of weaning," she says. "Other women do not experience emotional difficulty or they find weaning to be a relief." (See also: Serena Williams Opens Up About Her Difficult Decision to Stop Breastfeeding)

But mood changes related to weaning (and *everything* breastfeeding, TBH) make sense. After all, there are hormonal, social, physical, and psychological changes that take place when you stop nursing. If symptoms crop up, they can also be surprising, confusing, and occur at a time when you may have *just* thought that you were out of the woods with any postpartum woes.

Here, what's going on in your body and how to ease the transition for you.

The Physiological Effects of Breastfeeding
​
"There are basically three stages of hormonal and physiological changes that allow women to produce breastmilk," explains Lauren M. Osborne, M.D., assistant director of the Women's Mood Disorders Center at The Johns Hopkins University School of Medicine. 

The first stage happens in the second half of pregnancy when the mammary glands in your breasts (which are responsible for lactation) begin to produce small amounts of milk. While you're pregnant, super high levels of a hormone called progesterone produced by the placenta inhibit the secretion of said milk. After delivery, when the placenta is removed, progesterone levels plummet and levels of three other hormones—prolactin, cortisol, and insulin—rise, stimulating milk secretion, she says. Then, as your baby eats, the stimulation on your nipples triggers the release of the hormones prolactin and oxytocin, explains Dr. Osborne.

"Prolactin brings a feeling of relaxation and calmness to mom and baby and oxytocin—known as 'the love hormone'—helps with attachment and connection," adds Robyn Alagona Cutler, a licensed marriage, and family therapist who specializes in perinatal mental health.

Of course, the feel-good effects of breastfeeding are not just physical. Nursing is an extremely emotional act in which attachment, connection, and bonding can be cultivated, says Alagona Cutler. It's an intimate act where you're likely snuggled up, skin-to-skin, making eye contact."