Episode 22: Why Black Breastfeeding Matters

Jacqueline Kincer  00:01

Welcome to Episode 22 of the Breastfeeding Talk podcast. I’m your host, Jacqueline Kincer IBCLC. And I have my first IBCLC guest with us today, Maxine Robinson.  Maxine is an absolute powerhouse. I cannot believe how much I learned from her in this interview, I knew it was going to be incredible. And that’s why I invited her on. But the conversation goes so deep. In fact, I really just let Maxine sort of take the wheel, and just run with it and talk and I didn’t ask her a ton of questions, because she answered, really every question I could have even thought to ask her and then some.

 

And why this episode is so important, is because Maxine is an African American woman. And she’s sharing her experience as an African American woman, and mother and health care professional, who is helping all women in her community, but especially people of color.

 

And she’s contributing to the field of lactation and breastfeeding in some very, very powerful ways. So this is an amazing episode for you to listen to, if you’re any kind of health care professional or if you’re also a lactation consultant. But even if you’re not, even if you’re just a breastfeeding mom. W

 

hat I would love for this episode to do for you is for you to walk away with a newfound understanding and compassion about the challenges that black people have, especially black women and black mothers in the health care system with breastfeeding, with formula marketing, and so many other things, really around this topic was very, very enlightening. And today I’m releasing this episode on June 10. Juneteenth, 2020. And if you don’t know what Juneteenth is, you can absolutely just, go online and read more about this or ask some friends who are maybe a little more knowledgeable than you.

 

But basically, this is the day that slavery was abolished in the United States. And I feel like today is a really, really appropriate day to release this particular episode. And no, I’m not going to edit that mistake out.

 

And so really, I want you to take this episode to heart. If you’re one of those people out there who is wanting to educate yourself more about what’s going on in the black community. Maxine is here to tell you from firsthand experience, what is actually going on, and I think she has a really incredible perspective. I feel like she’s a very, very empowering person. And, I have all of her information linked up in the show notes. If you want to work with her or get to know her more, just follow her on social media. She’s absolutely incredible. And I think she’s got some amazing things to offer the world and anyone who gets the opportunity to work with her is going to have an absolutely life-changing experience. So without further ado, here’s my interview with Maxine Robinson.

 

Maxine Robinson  04:02

So hello, my name is Maxine Robinson. I am an Internationally Board Certified Lactation Consultant based in Washington DC.

 

I have been doing breastfeeding education for about nine years now. And through that time, I’ve been able to work mother to mothers support groups and at-home visitations, hospital side of visitations but also able to create curriculum and teach young girls as well. So that’s kind of my background. I have a very long background in health education. But right now it’s lactation consultations. I’m doing virtual consultations and just making sure that the population of African American women are able to get some really vital information so that’s who I am.

 

Jacqueline Kincer  04:57

Yeah, awesome. I’m so honored just to have you because you’re doing such important work in your community. And also outside of that with the virtual consultations.

 

And one of the reasons why I invited Maxine on the podcast was not just because, she’s an IBCLC and I wanted to bring someone else on, but because she is an African American, mother, Woman, and lactation consultant, and one of the things I’ve been made aware of, and trying to get myself more education on is one, that there’s a lack of representation in the lactation consulting community of with African American women working as IBCLCs. And also just trying to provide some cultural support to them.

 

And with the whole black lives matter, protests and movements that have been so powerful in already making some pretty substantial changes, there’s still so much work left to do. And I wanted to bring a focus from that movement on to specifically Black and African American women and their breastfeeding and getting that kind of support.

 

So, that’s one of the reasons why I wanted to have you on Maxine, as you know, and so just wanna let our listeners know that and I would love to hear, maybe we could start with even just talking a little bit about the history behind why, from your perspective, why do we see African American mothers struggling so much more with not even just health issues and health outcomes, but breastfeeding, childbirth, things like that?

 

Maxine Robinson  06:35

Everything. Yeah, and I’m glad you kind of tied it all together, because, in our community, it is a wide and broader issue than just breastfeeding.

 

And breastfeeding then is a trickle-down effect of all these different systems and history and reasons why either black women aren’t getting the information, or they’re not getting the support that they need. Or it’s just myths and misconceptions about breastfeeding.

 

So I’ll give you a little bit of background about myself, because what that does is it gives an overview as to how all of this comes into part.

 

So I’m from Queens, New York. And I’m, I grew up in an environment where it was largely African American, and my mom talked to me about breastfeeding, but it kind of was muddled a little bit with your cycle and what to expect. And so, the reproductive health portion of this really intrigued me, I ended up going to North Carolina Central University in Durham, North Carolina, it’s a historically black college and university. At that time, I didn’t even know they had these things.

 

So I grew up in a relatively middle-class, well, two-parent household. My father went to school but it never told me how these systems came to be. How did we have a historically black college? Why did we need that?

 

And so going to the school, I got some more history. I learned about why the school was one of the first schools for Negroes that we weren’t able to be educated alongside whites, even though at the time it was segregation, and we were getting our rights and I was slowly coming to these universities that were very integral in our community.

 

And so after being at that school, I majored in Health Education, my focus was reproductive health. I was passing out condoms on campus, I was doing different kinds of interventions and community support.

 

At that time, I had no kids, I wasn’t married. And so this was a chance that I can target a population of my peers and I was able to give them positive health education. And so from there, it kind of trickled out into all these different jobs and things that interests me based upon my experiences.

 

And so I ended up working at a Health Education Center in Raleigh, I ended up working at the American Social Health Association, answering phone calls all day long about STDs and herpes.

 

And then from there, I ended up at Planned Parenthood, which was kind of like a dream job for reproductive health educators. At this time, this was my first introduction to reproductive health and women, the vast issues that we may have and how things are solved within our community of women, regardless of race.

 

And so these things were commonalities. And so it was really, really intriguing to have a job there, but I’m still educating.

 

I’m now doing pregnancy counseling, and I’m informing women now that they’re pregnant. So now, this is a whole nother ball game. I’m still 20 something years old, not married, no children. And I’m having this discussion constantly over and over again.

 

During this time during these many many years of health education. I’ve never brought up the brass I mean, they coincide and it made sense but it was more so the discussion about reproductive health.

 

And so from Planned Parenthood and I was able to move to DC. I got married, I worked at HIV nonprofits targeting African American women, and specifically working with women, and that kind of opened my eyes to the needs that we have, we think about feeding our children and being with our children and our children are going to be with us and any programming that you have has to incorporate that. But you’re going to have to feed somebody, and they’re going to have their kids, especially if you’re working with women, that was integral and what I needed to do now that I got married, and then I started having children. And so I’ve been breastfeeding and birthing for about a decade now.

 

During that time, I was introduced to breastfeeding, and it was kind of abrupt like, whoa, you have to feed this person now that you birthed them? And I’m exhausted. And where’s this coming from? And how does this work?

 

And so it was something relatively new, I would say that with my first time I didn’t receive the best breastfeeding information. I may not have been as encouraged and really pushed to breastfeed, it kind of was in my decision. And I also think about the opportunities to receive WIC, Women and infant nutrition. And then also other supports. Those supports were heavily driven by formula. And I wanted to know what this was.

 

I tasted formula, I wanted to know what it tasted like, I had this kid and I wanted to blend things and I was intelligent about what nutrition does. And that first milk, and I started getting really, really intrigued. I then went 32 weeks pregnant with my second son, I went to Pennsylvania and got my CLC. I was the only woman of color in the whole entire class, I had a woman touch my hair in that class, it was kind of like whoa!

 

And then when I saw who was being trained, and some of the many biases that they may have had, or their own particular shelter from inequities of other races, I was concerned.

 

I was concerned because I was like, if I was to send my sister to this lactation consultant, would this lactation consultant really give her the information that she needed? Would she really empower her to let her know that she is doing the best thing? Even give her some really beneficial information that could kind of encourage and promote breastfeeding even more. And so that was my driving force.

 

From there I ended up getting a job at our local hospital here. And I was able to man their warm line. I was answering calls all day long about breastfeeding, about pumps.

 

This was a time when insurance companies weren’t covering breast pumps. And so I have lactation consultations that patients were looking to cover. So I’m talking and negotiating with insurance companies. And it really opened my eyes. Of course, I’m birthing multiple children at this time. So I’m just having babies and babies and they are just coming and coming.

 

And so they just like just coming, coming and coming. I figured out how to have a baby. And so I did pretty well. So I’m answering these calls, I’m supporting the mother support group, which grew substantially during the time that I was there. And I’m building up these hours. And I’m looking at these pathways to figure out how I can become an IBCLC.

 

During this time, I’m also sitting in the office, I’m the breastfeeding educator in the hospital and I’m sitting in an office with other lactation consultants who come to do their rounds, to come to give a report.

 

And so I’m listening to the reports, and this is every single day. And I’m like, wow! I see emphasis in encouraging breastfeeding with a certain population than I do with others. And I see hesitation and even bias when it comes to maybe young mothers or mothers that are non white, or non English speaking mothers, I see this.

 

So I’m gaining all this information. And then finally, one of our breastfeeding coalition’s here in DC, they sent me to Ohio to work under Linda Smith. And Linda Smith is one of this founding, heads of the breastfeeding world.

 

And so she wrote a lot of the lactation books, reviews, all those things. And the prep for the test. And so she really understood where I was coming from because she wanted to make sure of some of these biases and some of these systematic setups that prevent women from breastfeeding, that encourage women to formula feed which may not breastfeed as long. They exist and they’re there and she was really intrigued by my cause.

 

And so I ended up taking her class. Getting my ninety hours and also getting 1000s of hours doing all these support groups and warm lines and peer-to-peer support that I became an IBCLC. And from there I have the opportunity to now continue to work with the community and talk to all these women and dads and support people to make sure that breastfeeding was ensured. I had a bright idea because a lot of my teaching before I even got to be a lactation consultant was on puberty information, puberty education, pregnancy prevention, HIV prevention.

 

I had the brilliant idea of going, okay, you know, what we’re talking to moms too late. We should not be telling the mother at the time of birth, that you’re going to feed the baby from your breast. So that’s pretty jarring after the baby just came out of our vaginas or we were cut in some way. So we needed to start earlier.

 

And I went back to the high schools, I went back to the teenagers. And it kind of was like, Look, girls, this is the stuff your breasts, but kind of connected to your uterus, and everything goes hand in hand. You can look cute while breastfeeding.

 

And also, I had to learn the history of our culture within this country when it comes to breastfeeding, because there’s a lot that goes into it.

 

And so it’s making sure that it was specific and culturally appropriate, but also empowering, because there are quite a few inequities when it comes to black women and breastfeeding and why that happens.  Now, I had to do research, Jackie, and I was just like, let me make sure that the understanding of why there are inequities is because it really does start from the beginning.

I went to the CDC and they had their breastfeeding report card, you probably saw it.

 

Jacqueline Kincer  16:39

Oh, yeah!

 

There were some statements that stood out to me. And this is something that’s known within the community, that fewer non Hispanic black infants about 74% Are never, ever breastfed compared to non Hispanic whites, which is about 86% and even Hispanic infants 82%. So the initiation of breastfeeding is not there.

 

But listen to this, even infants that are eligible for EBT, snap, or WIC are less likely to ever breastfeed.  So about 75% of infants that are eligible for these governmental services, they never breastfeed, and then infants who are eligible, but maybe don’t get WIC, it goes up to 89%. And then infants that don’t even, can’t even get any of those things. It’s about 92%.

 

And so my introduction into the WIC world and into supplemental feeding, and even going higher, and looking at the formula companies and who owns them, and how they’re distributed to the hospital, Baby Friendly hospitals. That was really intriguing because it’s systematically set up that way. And as a mom who birthed these children, I experienced that. I’ve had nurses just set up a two ounce bottle of formula in my room, Or just make a suggestion of supplementation, not really taking into consideration that I would like to 100%, exclusively breastfeed.

 

And so knowing those things, it helps you to deliver a different type of message to the women, you’re trying to empower and encourage who are already in low or marginalized from the get go of starting their pregnancies and starting their female care and then getting to postpartum. And then the after effects of that as well. So there’s all these different factors as to why they stop.

 

And it’s kind of racial biases, we lack support from our workplace. And then community support. We”re not taught our history. And so we don’t even know the power that we have to know we can give life to our own, plus other children, and continue to do this and how beneficial that is, in the long run for other cancers and different diseases, even for my children to our own self. So, I’m not sure if that answers your question.?

 

Jacqueline Kincer  18:59

Oh my! Yeah, it does. This is awesome. I was hoping that I could just bring you on and learn so much, and I already am.  And some of the things you said, that is systematic, right? And, I was just thinking about that, as you’re talking about going and studying with Linda, which is amazing, and the exam and things.

 

And I was thinking, you know, when I sat for my boards, and the whole second half of the test is a lot of like case study questions and photographs and things. I don’t think I ever saw an African American woman’s breast in any of those photos on my exam.

 

And then I think about my textbooks. And, I’m not here necessarily to throw authors under the bus, but I think all the breasts of the books are white breasts.

 

And if you’re taught, okay, well, this is what mastitis looks like or thrush or whatever, or an inverted nipple or whatever. That’s great to know what it looks like on a white woman. But maybe I’m not only gonna be working with white women.

 

And so I was just thinking about that, like, wow, even my own education, you just made me realize, I was not shown women of color.

 

And I’m in Arizona, so I wouldn’t say we have a huge African American population, we have a huge Hispanic population, and they have their own cultural things that I’ve had to learn about in order to support them. And it was kind of learning on the job, you know, I didn’t really have any specific education on that, even though I’m supposed to have these cultural competencies as an IBCLC just like you are. So you’re teaching me a lot.

 

And I think what you said about just for the part that you ended with, and how breastfeeding has all these amazing benefits, like anti cancer and things like that. And I kind of mentioned it with my question where we know the African American community, even with something as current as COVID, that they’re having a harder time.

 

There’s worse health outcomes. And overall, if we know that breastfeeding is so good for health, why are we not investing more in education for the African American community on what breastfeeding can do for them to transform and change their health outcomes? If as much as 90 some percent of black mothers are never even initiating breastfeeding? That’s a scary number. I’m worried about that, really worried.

 

Maxine Robinson  21:25

I think that something I was looking at that really stood out to me was that I’m looking at Arizona and I looked up some of their information because there’s a higher Hispanic population.

 

And so a lot of times, when it comes to breastfeeding, it is that peer support. And so having someone who is from the community, who still understands that, or if you look at the journey of a non white mother going through the health system, and even to breastfeeding, more than likely she’s experienced, white doctors, white nurses, nurses that may write off what they’re saying, or even concerns that they may have.

 

And so just to tie that back around, when they get to breastfeeding, we don’t have representation of African American lactation consultants, or Hispanic lactation consultants who can relate on the level of the cultural things that connect them, then it’s really hard to get that information to them.

 

And then also making sure that they understand it, sometimes we gotta check. Sometimes we need to check our egos. And we need to make sure that we check our own biases, because, that’s very interesting, Jackie, because, have you ever touched a black breast? Have you ever felt or really seen what it looks like?

 

Because mastitis may look completely different in a very dark breast or in a breast that is different parts of it or different colors. And so it’s definitely different.

 

And, you know, this, the lactation consultant tends to be the first person mom sees after she has a baby postpartum.

 

And so there’s a lot of things we’re looking for, even knowing some of these cultural factors and outcomes of postpartum and maternal health.

 

African Americans suffer from preeclampsia, much more at a higher rate. And so when I would go into home visits and go to see moms. That’s something I’m looking for. I’m making sure that not only the breastfeeding information, I’m making sure that it’s comprehensive as well. And that I’m looking for things that might be signals or concerns when it comes to something that I know specifically affects this culture and this race, or this group or statistic of people. And so I think it’s important that it’s kind of tied in as a conversation and even acknowledging it as well.

 

One of my last job was at this awesome organization called mama todos military in DC. And what they do is they work with actress moms, they do home visitation, and lactation consultants come, doulas come. They come and assess the mom.

 

And I was working with a Muslim community. And she was training her child on how to breastfeed underneath her covering. And she was training very, very early. And this was new to me. And she said, I had a child already, a very young mom, and I know to put coverings over the baby so that when I cover and I breastfeed, it’s something that the baby knows and learns. I’m like wow! That was amazing. Very good.

 

That’s a wisdom that we don’t have and that we can incorporate and our teachers with this different population. That’s wonderful. I’m so glad you shared that with me. You know what, that was so good. And it’s empowering to her like, you know what, that is something you need to share with a group of young women that you come in contact with on a regular basis.

 

And if that’s the information that you got from some other wise woman or someone else sheare it continuously, because that could be a barrier as to why Muslim women, African American women may not breastfeed, because they don’t know, the baby’s ripping off the cover, they’re not able to really get comfortable, but look what you’ve done.

 

And so my other goal is then to inspire. I think I’m gonna get to the transition of womanhood, where it’s like menopause and stuff, but to inspire other lactation consultants to come in and to actually really bring what they have to this. Like our cycle, this is one of those things, we’re just gonna keep on doing. So.

 

Jacqueline Kincer  25:36

Yeah! I would, I would love to hear like such a great example, like you said, about breastfeeding under the coverings.

 

And how important it would be to just start teaching that right off the bat for that particular mom.  So what are some things that you find for African American moms? What are some things that you really wish that every lactation consultant knew when it comes to helping out their clients?

 

Maxine Robinson  25:59

Yeah! and I wanted to say it’s mainly about three things that really take part in the racial disparities when it comes to breastfeeding.

 

One is race. So it is racial bias in our system, in the medical system. I recently just spoke with a nurse friend who had an interaction with another nurse who said, you know, a black woman, they don’t feel pain as much as their skin is thicker than white women. And my nurse friend was like, No, that is incorrect. We all have the same thickness, and we all feel pain. So there’s no way that one race feels more than the other. And that nurse was very adamant to say this was in my books, just like what you said, this was in my books. This is what the book said that black women they don’t feel as much pain as white women. And sadly they call it white fragility. I would be insulted. Like, how dare you? We all feel that. And so still in that system there’s nurses who feel this way. There’s doctors who feel this way.

 

Jacqueline Kincer  27:03

And this is recent. This isn’t like something from 1950s. This is recent.

 

Maxine Robinson  27:07

This is recent.

 

Jacqueline Kincer  27:08

Wow!

 

Maxine Robinson  27:09

So, changing that mindset, and this why I always relate it to our menstrual cycle, because for some reason, when you talk to women about menstrual cycles, they kind of get it. It’s like, oh, you know, It does not matter what color we are, we all kind of do that! Yeah, this is kind of the same thing.

 

And so I think it’s important that we have to recognize, like, okay, there’s bias in the medical community, it’s an understanding, from my experience. Lactation consultants and young women who may be non white, non black and they just automatically think she’s not going to understand the information I’m giving her.

 

There’s even an understanding that they may be lazy, that they don’t want to breastfeed, or that it takes work and that they’re not really committed to doing this. And so when given the opportunity and the support that they need in the medical sense, for example, I have examples all the time.

 

For example, I had a young mom, twenty. Who was on her second baby and delivered this baby at 22 weeks. And I was coming to speak with her. And I kind of let her know like, look, I’m he’s early. But we could do this, what this is, is we’re going to be pumping a lot, you’re going to be coming to the hospital, often every chance to get, you’re going to hold him, you’re going to keep him skin to skin and we’re going to grow this baby.

 

Also at this hospital, they offer donor milk. And you can even offer that to baby in addition to what you already want to provide. And I really sat down with her and told her the honest truth. This is what this is. This is what’s in the milk. The milk is that good. And so what our goal is to just fatten the baby up and get them engaged and everything.

 

This 20 year old girl went to that hospital every single day. She pumped every single day, multiple times a day, she literally grew that child, kangaroo every day and she was there.

 

And maybe she was the typical, young African American girl. Long eyelashes, long nails. When I saw her the first time I said, Oh, honey, you know, he’s little and fragile, you might have to cut those nails, she cut the nails off. And so this is the goal for this amount of time. And it’s like, you and I are going to be in a relationship for this amount of time and I got you.

 

So if you could do this, we could do it. Somedays gonna be better than others. She did it! And she grew him and got him out. And he’s exclusively breastfed and he’s at home and the complications of the baby’s there, but they’re not as severe. And so we know that benefit. It was a matter of really investing in this particular girl. Now I have someone who is an advocate for breastfeeding, they understand the value of it. And this is now going to be passed on hopefully as she goes along in her breastfeeding journey.

 

But we got to recognize that she wasn’t getting that kind of one on one care. She wasn’t getting that person that was going to be right there with her. Regardless if it was her mother, her aunt, or anyone, it was like no one was investing that on for this child. And so there’s medical bias, and there’s bias in the medical.

 

And then after that is our employer, so African American women, low income, non white women, they tend to work jobs, where they are not all that supportive of breastfeeding.

 

Let’s say for example, Uber. I had a mom who delivered an early baby. That’s another issue that we have in our community, a lot of the women deliver very, very early, their babies already at risk, and then they introduce formula, which then is not going to produce outcomes.

 

And so this particular mom delivered very early, her baby, unfortunately, did not make it. But during the initiation of breastfeeding and talking to this mom, her concern was going back to work, she worked for Uber, and her car was on loan, and she needed to return back to work. And so in two weeks, she got back in that car and drove, she was trying to drive the next day.

 

And so if we really, really, truly think about it, if I go to all these places and I talk to the cashier, and she says, I just had a baby, and I’m like, Oh, wow, congratulations, are you breastfeeding? How’s breastfeeding going? I’m a lactation, how’s it going? Oh, he’s two weeks, he’s doing good! Two weeks? Oh, no, that’s really early, there’s no option for no six months of paid leave. And there’s no option for taking time off, the employer doesn’t really care that you just had a baby.

 

And we’re telling mom to rest and to breastfeed and skin to skin, on demand, feed early. The likelihood of those things really taking place for that particular mom are very slim to none, even let’s say the mom is a police officer, and she does get time off. Now she wants to go back to work after maternity leave, and there’s nowhere to pump. There’s no where for her to do what she needs to do.

 

And so we really need to take into consideration the demands from the employers and not making the adequate accommodations, and really being vested in women, because birth could happen. So it’s like, makes you think twice, it’s like I get in an Uber, this girl tells me she just had a baby. And it’s like, wow, you know, I would have taken three months off for my lease. And unfortunately, she’s back to work in three weeks, still healing. So the employers do a big portion of this.

 

And then also community support. Community support is vital. Because a lot of the times when it comes to influencing change, or integrating new information to a community, you’re going to have to break a lot of these myths, and you’re gonna have to break a lot of the things that are happening.

 

One, with our community, like, for example, where I live in DC, I can count on one hand, how many grocery stores are available on this side of DC,  there’s no hospital to have a baby.

 

And so these things are important to really kind of recognize because if you’re saying no, like, you know, just go to this particular place to get your breastfeeding support, how are they going to get there? And all these things are really important when it comes to breastfeeding.

 

The other thing, I read the rates on getting food stamps, or EBT, or WIC. So my experience with those is they push formula. And they may have breastfeeding classes and support. But a lot of the time because we are kind of lacking on, you can kind of breastfeed if you want to. The option there is like, well, I better go ahead and get this formula, or I better go ahead and get this free stuff. Because what if breastfeeding doesn’t work?

 

But you brought up COVID Right now, and the conversations that I have now with African American moms, is like you decide to breastfeed. I don’t care how you get that milk in there. But right now, because of what’s going on, I need that milk in that baby!

 

I don’t care how you did it. Pump, hand express, haaka, whatever. I know now, what I know is to get that milk in there, because it’s that important, and it’s needed now.

 

And so I question just having the availability within the community of WIC, and that by supplementing with the formulas, there are families who desperately need it, but how do we properly do that? Are we teaching how to properly administer formula? And then also paced feeding. I teach all my mommies paced feeding.

 

I try to give them options to understand that breastfeeding is so much more than just that milk. And so it’s so important to focus on that to let them know the options because it could really put them in a position where it’s like, well, I’m not producing all that I need to produce. And so just forget it. All or nothing, it’s all over.

 

So you know you could do this. So what is the barrier?  I can breastfeed cutely! I don’t know! But how are we going to do this? Because it’s like you gotta keep coming and knowing that there’s going to be these barriers that are gonna prevent this.

 

Unlike, maybe white women, or maybe women who may have more money or more access, where they can actually have rest, and they can focus on breastfeeding all day. And they don’t have to worry about any other children or however they can, the support that they need.

 

So, I’m hoping that other lactation consultants that will be listening, will really look at the lens from all these different angles when approaching an African American woman or even a woman that’s non Hispanic, non white.

 

Jacqueline Kincer  35:45

Yeah! I mean, this is just a wealth of information. And I know, I do have a lot of lactation consultants or other health care providers, who are interested in supporting breastfeeding moms that listen to this podcast.

 

So I hope that for those of you that fall into those categories that are listening, really take what Maxine saying to heart, I know I am. And, I just think a big message that I hear you saying is, really, the biggest thing that we can do is just not make assumptions.

 

There’s some assumptions made about African American women, that they’re lazy, or that they don’t want to, or, these other things, but what you’re saying is no, it has nothing to do with that.

 

The assumption is also part of the problem. But then if they have to go back to work in two weeks, like you just gave that example, I even had a client who had to go back in six days.

 

Maxine Robinson  36:35

I believe you!

 

Jacqueline Kincer  36:36

Six days. And I was like, how? Just physically, like, let’s put breastfeeding aside. But physically, you just had a baby,

 

Maxine Robinson  36:46

That’s concerning.

 

Jacqueline Kincer  36:48

It’s very concerning. Like you said, those risk factors, that we are supposed to screen for, maybe we can’t treat preeclampsia or some of these other things, but we kind of need to be on the lookout for retained placenta, whatever it is. Postpartum depression, anxiety, there’s so many things that we need to be looking for just in the mom, let alone the baby. We’re this unique profession that has two patients, not just one. And if we’re not catching those things, they may not be seeing another health care provider for a while which is scary.

 

Maxine Robinson  37:18

Very true. I think those are why a lot of the reasons why women end up stopping or a lot of women may not receive anticipatory guidance or guidance in the beginning, as to how am I going to nutritionally feed this baby?

 

And, I’ve talked to so many women just in our field, sometimes the thought of breastfeeding, and you know, the lactation consultants run the gamut as to how it’s like no formula ever in the house, don’t you have a drop of it.

 

And there’s others who are like, yeah, you could do both. And then, you know, breastfeeding is here and there. And so sometimes, just getting that information at that time, could be a lot and overwhelming. So, like to make sure that I’m hearing the concerns of the mom, and I’ve worked with so many different moms that, let’s say smoking.

 

Smoking is something that moms do. And when we’re talking about breastfeeding, and mom is focused on smoking, it’s like, I have to give her the information. But let me educate you about what breast milk is.

 

Even in our community, we know regardless if there’s no disease and which one is better? Breastfeeding, like the exam. If there’s an option for anything else, generally, breastfeeding is going to be the answer.

 

Formula will not be the answer. And just making sure that we’re looking at it from a lens of positive, like, how am I going to get them to reach this small goal in three days? All right now, three weeks?

 

And making sure that we’re investing in that community, because we know from the beginning that breastfeeding is the best start, and that breastfeeding and breast milk and exclusive breastfeeding is giving that beginning process of really, this human getting to the highest potential that they can be.

 

And so, naturally I would just think like, if I saw a formula being pushed on African American mom, a Hispanic mom, that I would be kind of upset as a lactation consultant.

 

Take away the fact that I’m black, Whoa, like, wait a minute, don’t be pushing that for her. Let’s see if we could get anything out of these boobs first. And making sure that I’m valuing the sainthood of breast milk, regardless of whoever it is.

 

Jacqueline Kincer  39:43

Yes.

 

Maxine Robinson  39:43

And then calling out those nurses and calling up those companies and letting them know.

 

Just telling a black mom about the size of the baby’s belly is enough for them to understand like, wow, this baby’s not suppossed to eat a two ounce bottle at one day old.

 

Maxine Robinson  40:00

Let them know that small information is like, Oh, no wonder she stops at five mls! It’s like, well, that was an easy bit of info, but everyone doesn’t know. And so it makes the mind go Oh! You could take that information forever. So just small things like that. And really incorporating those types of things.

 

I think other lactation consultants that are listening, they can really be influential in that sense of like, she may not hear nothing else I’m saying. She only keeps asking me about the formula. Let me tell her how big the belly is. Let me show her how to pace feed. At least she can feed the baby slowly. You know, it’s options. And if I’m gonna look at this.

 

Jacqueline Kincer  40:41

I think that’s so incredibly helpful. And yes, there are little things like that, that can make such a huge impact and that are easy to remember and to pass on. So I absolutely love that you brought up the example of the of the belly size.

 

And I think kind of one of the things that you’ve touched on a lot is just really, women are having a harder time in the healthcare system than men already.

 

And then to throw on top of that, being a black woman, and going through probably already a culturally biased pregnancy and birth experience. And now you’re entering into breastfeeding.

 

Maxine Robinson  41:16

For any of the black mothers that may be listening to this episode, I would love for you to share what are the things that you would want to impart to them? Either knowledge, or what are the best resources for them? I know, you mentioned community and in several things already, but if you could summarize it for even just women of color in general, like what would you recommend for them to empower themselves and to really get the support through breastfeeding and giving breast milk to their babies that they need?

 

I think that if black moms are listening, and they’re really wanting to breastfeed or wondering how this is achievable, or something that they can do. The first thing I always come from is that we’ve been doing this. Women, we’ve been breastfeeding, from day one. Birthing, breastfeeding, nurturing, that’s what we do.

 

And so there’s a great power in that. And I know that in a situation where we just come off of months of lockdown and being isolated that in the terms of accessibility, that women are now turning to this is what I have to do, I need to breastfeed, and this is how I’m going to do it.

 

And and I think there’s power in that. Because what that means now is that ideally there was a world crisis like we were in, we can sustain a person and the thing that you need within it. The other part I think I would tell black moms is really learn about what’s in breast milk.

 

And it’s sad that we have to learn this, I don’t see cows really encouraging calves to take the milk. But breast milk has everything that’s amazing in it. Stem cells, anti-body cells, human growth hormone, there’s actually $1 value to breast milk, and there are women who sell breast milk.

 

And there’s a value, a dollar value to that. What does that mean? That means that one these are things that formula cannot recreate. And then two is that something that we’ve produced for free, is something that will grow and nurture and monetary wise, have a value within that child.

 

And so I always like to make sure I let moms know this, because there’s a reason why I’m excited and passionate about it is because it’s like that. There are studies that are happening in New York.

 

One of the first month that I did my virtual consultations with she was positive for COVID. And she ended up being a part of the study, and they’re studying her breast milk and looking at the IgG and IgM antibodies, like, that’s amazing, that puts even more value to it.

 

So one, we have it in us, it’s valuable, and it’s necessary. And then two, it is something that could be sustained with support. And the support that you’re looking for is someone who was going to support you, regardless of what your situation may be. So if that means you have to go back to work, support is not judging you like I thought you were going to breastfeed how you’re going to do that now?

 

Instead of trying to really incorporate, maybe you need a breast pump that plugs into the cigarette lighter in the car. I don’t even know if they make cigarette lighters for the care anymore? I think just for charging purposes. A lot of people don’t even know what that is anyway.

 

So, maybe you need that or just sitting down and having an opportunity to map out the pumping process for going back to work. Or maybe I need to pull the laws for going back to work. Maybe I need to pull the laws for the state and I need to educate the employer.

 

You need some sort of like information because you know, you want to go back to work, I need to support my family. But I do want to breastfeed, and I do want to provide the right milk, and I may not be able to have baby suckle directly from the breast, but I could pump and I do get a pump for my insurance company.

 

So it’s like an opportunity now, to kind of map this out and see how we’re going to make this play out. But that’s really important, you’re going to end up having a relationship with the lactation consultant, because your breasts are gonna continue to do this.

 

And then just being mindful of the specific barriers that come to what you’re going to be doing as a black breastfeeding mom. Covering up, and unfortunately, because of our color of our skin, we tend to be targets.

 

And so we could be breastfeeding at a park and someone could come up and say something about indecent exposure. And so barely there you go with the laws again. So now we have to pull the law. Or the company you work for has you pumping in the electrical room. So that’s not safe. What are the laws that come with that?

 

So just being mindful of those barriers. Here’s the other thing. Companies that are sending samples in the mail, when you go to your WIC appointment, they ask you, are you still breastfeeding, do you need formula?

 

Even making sure that within the hospital that you’re making a decision about where you birth. Well, if you go to birth somewhere, and you’re saying I would like the golden hour with my baby, that one is the terminology where it’s like, oh, she knows, and two what is the hospital policy?

 

Does it say skin to skin? Which it should. There’s always, number one, and that’s what we’re going to do. Or it’s like, in order for us to do our assessments, we have to take the baby from the mom to the nursery, if that’s not what you’re in line with, then that’s not the place you go to birth at.

 

Making sure that you’re aware of what your rights and the things that are happening within this place beforehand, really does empower you to make these decisions that I’ve been saying over and over, I’d like to breastfeed, I’d like to breastfeed.

 

If it’s not going the way it needs to go then what are the other options? Just being prepared for those things, and making sure that you have adequate educated people that are going to be able to support them and their decision making, regardless of whatever that is.

 

And then as a lactation consultant, you gotta have some tricks in your bag. If you haven’t touched black boobies, I’m glad you said that about the pictures. I had my last baby. And there aren’t any African American breastfeeding pictures. And I got a photographer to come and take pictures of me breastfeeding my son. And it was really great, because one, he never did it. And it was wonderful, because I had another lactation consultant who was working with me, and she’s not black. And she was just really intrigued by all of the things that we were discussing. And so I’m normalizing this within our community, as if  this is something that we just do. And so yeah, I think that’s some good stuff I can leave with.

 

Jacqueline Kincer  48:06

Oh, that’s, that’s amazing. And I have to say, yes, definitely, for you lactation consultants out there, doctors, whoever is listening, yes, like touch some black boobies, they’re different. I do see generally that at least in the clients that I’ve had, that have been African American, their nipples are generally a lot larger than the white women that I work with.

 

And if you are used to always latching a baby, with a mom with small nipples, you got to kind of branch out and do it with a mom with larger nipples. And so there’s definitely things out there and knowing how to recognize symptoms of mastitis and all those things. It’s so important. And we need to share that as a community. And I’m so glad you’re bringing light to this because I know there’s always more to learn, and especially about cultures that are different from my own. And I feel like I learned so much.

 

And I have to say, your passion, your knowledge, anyone who gets to work with you, as their lactation consultant, or gets education from you, or whatever other capacity you’re doing is really, really lucky.

 

What you shared on this episode, I really want people to know. This is what an amazing lactation consultant looks like Maxine, and she can do virtual visits. And I would encourage you guys to reach out to her. I’ll link up all her stuff in the show notes.

 

But Maxine, you are just a wealth of information. I feel like you just have such an appreciation for breastfeeding and breast milk and what it can do for the moms and babies out there in the world.

 

And just your cultural perspective has brought so much to this conversation. And I just thank you so much today for sharing everything you shared.

 

I feel like we’re even just scratching the surface here but even the piece you said about having photos of your son taken breastfeeding, that is so important. I cannot tell you how hard it is to find images of breastfeeding from stock photos or things of anything other than white women and babies. It’s incredibly hard. So thank you for contributing to that as well. Awesome.

 

Well, thank you for being here. And like I said, I’ll link up everything about how to get in touch with Maxine. If you want to follow her on Facebook. She’s got some amazing information there. And you can book an appointment with her there as well.