Marisa Ward is the mother of one son, whom she breastfed for about two years, and a Women’s Health Nurse Practitioner. She currently lives in Missouri. She was interviewed by Denae Heartfield, Coalition Relations Coordinator for the USBC.
This interview has been edited and condensed. The full interview is available here.
What did you hear or experience before birth that influenced your decision to breastfeed?
The very first time I ever thought about it was in undergrad. I was a psych major, and I had taken a course from one of my psychology professors. What stands out in my mind, to this day, was a specific lecture or series that she [my professor] gave that was on bonding, breastfeeding, and birth, and how those three things work together from the beginning of life, or the birthing process. She talked about all the benefits: things that happen during birth foster breastfeeding, things about breastfeeding that encourage bonding, and how it all works together for the good of the baby and the good of the mom and all of that. Since I was 19 or 20 years old, when I heard that lecture, I knew that’s what I need to do.
I’m a women’s health nurse practitioner, so I’m familiar with the benefits of breastfeeding already, just from a professional standpoint. And I encourage it with all of my patients. So, I knew before I got pregnant that I was going to breastfeed. That was set in stone. It wasn’t a question at all beforehand.
Please describe your birth experience, especially how it influenced your early breastfeeding.
My birth experience was nothing that I wanted it to be. I had planned for laboring at home and having a vaginal birth. I ended up with my water breaking at home, and I didn’t recognize it for what it was until the next day. So, I had gone to work and everything, I’m having these contractions, nothing too severe, but I’m at work, having contractions, leaking amniotic fluid. Finally, I’m like, this isn’t normal. It took me a while to accept that that’s what had happened. Then, I reported to the hospital.
They were noticing on the monitors that his [my son’s] heart rate was dropping every time I would have a contraction. So, they send me in to have a C-section, because they were concerned that it wouldn’t go well if I had a vaginal birth. I was 35 weeks and six days.
From when I got to the hospital, to when they finally had me on the operating room table, it took maybe two hours and I had like three panic attacks in that period of time. This was not at all how it was supposed to go. I had done everything right: exercise, eat well, take prenatal vitamins, everything. The change in plans and how fast everything was going really took me by surprise.
When my son was born, he was four pounds, 5.8 ounces. He was very small, much smaller than he should have been, for a 36-week gestation baby. I was not able to hold him. They showed me the baby, brought him up to my end of the surgical table so I could see him, and then took him to the NICU. With him being so small, they were concerned that he might have issues breathing.
He was in the NICU for two days and they were giving him formula because I wasn’t producing yet. It was 35 weeks and six days, my body wasn’t really thinking about having to breastfeed just yet. But, I knew what I wanted, and I knew that’s what I was going to do. Looking back, I was really, really determined to breastfeed.
I came by the information that fenugreek can help promote lactation, help promote milk supply. So, I sent my husband out to the store to come back with some fenugreek, fenugreek capsules. I was taking like three capsules three times a day, or something like that, and eventually my milk did come in, so I solved that problem.
The second issue was getting him to latch on. I don’t know if it was me or him because he was so little, but I never did get him to latch on very well in the hospital. The hospital was really good at providing a pump, so I had a really nice, hospital-grade pump. After a day or two, I was pumping milk and providing milk to the NICU for him. But, I had a hard time getting him to latch on.
What was your experience like after you got home?
Things were a little different. It took him, I think, maybe four, five, six weeks before he really got the hang of nursing. I didn’t have the best support at home. My mother, my husband, they were all concerned that he wasn’t getting enough to eat. They were also concerned that I wasn’t getting enough sleep, because he was getting up every two hours. And with nursing, it’s not something you can really pass off to your husband because he’s not lactating. I knew that if I supplemented with formula that would be less nursing, and so, I wouldn’t produce as much milk. So, once again, I think my own background really helped with that. But, if I were someone else, then it would be really tempting to just put a nipple on a little bottle of formula and give it to him so I could go back to sleep.
I did take advantage of my local La Leche League chapter. If you go on the La Leche League website and then find your local chapter, they have a list of women who you can call, for free, and they can help you out over the phone. I found a person who I could call, and I called her up and I explained the problems to her. She offered good tips and advice and support, basically saying, “Hang in there, keep going.” Then finally, after 6 to 8 weeks of it being uncomfortable, we finally got the hang of things.
I remember one day, I had sat on the couch to nurse him and because his latch was still a little off, it would hurt sometimes when he latched on. And that day, it just hurt, and I just started crying. I was like, “Why does it still hurt? Why does it hurt to feed my baby?”
I’m not afraid to say that nursing my child was one of the most difficult things that I have had to master and accomplish. I worked hard at it, looking up stuff on the internet, going on forums, talking to experts. I have friends who are labor and delivery nurses; I have friends who are nurse midwives. I took advantage of every single resource that I had at my disposal to make it happen, just because I knew it was the right thing to do. And it was really the most rewarding experience of my life, nursing my baby. I’m so glad that I persevered and insisted on doing it.
What was your experience like with your family? What did you find helpful and/or what would you have found helpful?
I would get from my mom, “Oh, he’s not eating enough, maybe you should supplement with formula. Just give him a little bit of formula. Are you sure he’s getting enough?” From my husband I would get, “You know, how about we just give him some formula? Give him a bottle or something, so that way you can sleep, and I’ll feed him.” Their concerns were all rooted from wanting to help, from concern, but I knew that the more I nursed, the more milk I would produce.
I don’t think there is anything that I wish I would have had, other than someone there in person to help me and reassure me that I’m doing it right or help me with his positioning, help me in those days right after coming home from the hospital. That would have been nice, because I didn’t have anyone. My mother, she was there for a few days. She nursed me, but that was 30-something years ago, and she only nursed me for six to eight weeks. I had friends on the phone and was looking at things online, but it would have been helpful to have someone in person. Maybe an at-home doula or something like that, that would have been helpful.
What was your experience like in the community? What did you find helpful and/or what would you have found helpful?
My son was born in September. I live in Missouri, and that year it got cold pretty quickly. I wasn’t out and about much at all, except for church. Everyone at church was so supportive. They even have a place they call the “cry room,” where it has speakers so you can still hear the service, but you can go in there if you and your baby need a quiet space. I go to a pretty small church, and we have nurses and public health servants. So, everyone’s pretty aware, pretty down with breastfeeding. I didn’t get any negative feedback from that.
The few times I did go out to the mall or to a store, I never felt comfortable nursing out in the open. Not because of any kind of perceived hostility from the community, but just because I had been home all winter. To me, nursing was something private. It was a private moment between me and my baby. So, if I was ever out at a store or something and he had to nurse, I would just go to the fitting room.
What was your experience like with health care providers? What did you find helpful and/or what would you have found helpful?
The hospital did have a lactation specialist. I did not see her at all. I asked for her, but I did not see her, but thankfully, the nurses in the postpartum unit were very helpful. They helped try to get him to latch on, gave me tips, had me go over to NICU and try to hold him, try to get him to nurse. I received really good nursing care from them.
Thankfully, even though my son was in the NICU, he didn’t have any breathing problems, he didn’t have any issues feeding or anything. He was just really little. I think the fact that I had already made up my mind that I was going to breastfeed, and the fact that I was so determined, really helped a lot, because there were several barriers in place. And, if I didn’t know about fenugreek, I probably wouldn’t have been able to breastfeed, or if I wasn’t aware that the hospital has pumps and that the more you pump, the more you make, I wouldn’t have continued trying to pump and encouraging that milk production.
After my son was born, I did get sick a few times and needed antibiotics. And, I would always make a point of asking the doctor or nurse practitioner to make sure the medication was safe while breastfeeding. Will it pass into the breastmilk? Will I need to pump and dump?
What was your experience like returning to work? What did you find helpful and/or what would you have found helpful?
I was off for eight weeks and went back to work. For his first three months, my grandmother was with us, so he stayed home with my grandmother. I would pump, bring the milk home, and she would warm it up and give it to him during the day. My workplace is really mother-friendly. I was free to go and nurse whenever I needed to.
At first, I did feel some conflict because I felt guilty taking a break for 15 or 20 minutes to pump when I knew that I had patients to see. But, it’s very uncomfortable when your breasts get full of milk and then they’re hard and warm and swollen. I had the sensation of ants crawling under my skin. I had to get it out. So, I would drop what I was doing and go pump.
I had a little lunch bag that I would put my milk in and put it in the refrigerator. Every day, I’d bring it home, and whatever was excess, I’d freeze it. I didn’t really have any problems with that. It was helpful that there was a policy to allow breaks for pumping, and that there was a refrigerator for me to store the milk in.
What do you think is important for breastfeeding success from an African-American perspective?
I think we need to support our women. We need to support our mothers, our breastfeeding mothers: support them at home, support them in the community, and support them at work.
I recognize that I was privileged enough to have an employer that has a good pumping policy, that I am fortunate enough to go to a church that is progressive, a little on the crunchy side, that supports breastfeeding. And, I’m also privileged enough to have the knowledge and access to information that supported breastfeeding. But, not everyone does.
So, just spreading the gospel that breast is best, that it’s natural, that it’s beautiful. I think if more black women saw more black women nursing, nursing out in public, it would show that they aren’t marginalized, that it isn’t just some quirky subset of the population that breastfeeds. It’s normal and it’s so rewarding. Obviously, my son is my own child, but I just felt so close to him just through the act of nursing and nursing him for something like 22 months. Just having that support and knowing that it’s natural and it’s beautiful. That’s how it should be.