“Why are you wasting your time?” my aunt asked me, watching as I prepared my breast pump before another grueling day of residency training. “You know we don’t do that in our family.”
Her words cut deep, not just because of the judgment, but because they came from someone I deeply loved. Here was a woman who had always been my champion, now making me feel like an outsider in my own family for making a choice — the choice to breastfeed my child — that felt so right to me. As a Black physician and new mother, I thought my medical knowledge would shield me from this kind of criticism. Instead, I found myself isolated and questioning everything.
The Weight of History
The roots of breastfeeding hesitation in Black communities run deep. During slavery, Black women were forced to serve as wet nurses for their enslavers’ children, often at the expense of nourishing their own babies. Later, aggressive formula marketing campaigns specifically targeted Black mothers, touting convenience and modernity. These campaigns featured virtually no representation of Black women breastfeeding, cementing the idea that formula was the norm for our community.
The result? Generations of Black families where breastfeeding became unfamiliar, uncomfortable, and ultimately unacceptable.
When Mental Health Meets Cultural Pressure
While other new mothers might rely on their own mothers or sisters for breastfeeding guidance and encouragement, many of us navigate this vulnerable time without that generational support system. For Black women, who research shows are already at higher risk for postpartum depression and anxiety, this cultural backdrop creates a perfect storm. We’re significantly more likely to struggle with postpartum depression, often caught between healthcare providers who dismiss our concerns and communities where admitting mental health struggles still carries stigma. The very moments when we need support most become the times we’re most isolated.
The Isolation of Going Against the Grain
Despite knowing the benefits of breastfeeding (the antibody transfer, the bonding, the financial savings that mattered during my resident salary), I struggled with overwhelming anxiety every single day.
The mental load was staggering. Where would I pump during my hospital shifts? Would my milk stay cold enough? Did I have enough supplies? These practical concerns layered onto deeper fears: Was I betraying my family’s expectations? Was my aunt right that I was wasting my time?
What made the mental health impact even more severe was the complete isolation. While many of my colleagues shared stories of supportive family members, their breastfeeding journey was different than mine. Although my husband and in-laws were supportive, my mother was appalled, and the topic became off-limits between us.
This isolation is particularly cruel for Black women, who benefit significantly from community support during the postpartum period. When that very community becomes a source of stress rather than strength, the mental health consequences can be devastating.
Returning to residency at just four weeks postpartum (while wearing a wound vac due to an infected C-section), I was already vulnerable. Adding the stress of pumping, storing milk, and defending my choices while battling postpartum depression pushed me to my breaking point. I developed shoulder and back problems from carrying my pump throughout the hospital.
I persisted with my youngest daughter for three years, even donating excess milk to help other mothers. But the mental health cost was significant.
Moving Forward
Healthcare professionals need to bring a historical approach to their conversations around breastfeeding with Black women, understanding that she might be carrying a complex history spanning generations of being told formula was superior. She is navigating cultural wounds, family expectations, and personal healing all at once.
We need to create a space where a Black mother who chooses to breastfeed isn’t seen as rejecting her culture, and where a mother who formula feeds isn’t made to feel inadequate. Healthcare providers who truly want to serve Black families must approach these discussions with genuine curiosity rather than assumptions. A mother who feels supported in her feeding choice (whether breast or bottle) is better positioned to care for her child than one who feels isolated and judged.
My breastfeeding journey was “successful” by traditional metrics, but it came at a significant mental health cost. The isolation, the constant need to defend my choices while managing postpartum depression — (these experiences shaped my early motherhood in profound ways).
For Black mothers considering their options: whatever choice you make will be yours to own, free from judgment or apology.
If you’re struggling with postpartum depression or anxiety, please reach out for help. Resources include Postpartum Support International (1-800-944-4773) and the National Suicide Prevention Lifeline (988).
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