Beyond Breastfeeding Support:
The Systems That Shape Infant Feeding
By Aunjrya Fleming, EDI Lead, Doula School International
Throughout this article, I use the term "breastfeeding" because it reflects the language used by World Breastfeeding Week, Black Breastfeeding Week, and much of the current research. At the same time, I recognize that not everyone who feeds human milk identifies with that term, and I honour the many ways people describe their own feeding experiences, including chestfeeding and bodyfeeding.
Every August, World Breastfeeding Week and Black Breastfeeding Week invite us to celebrate human milk and recognize the many ways breastfeeding supports the health and well-being of babies, parents, and communities.
The conversations we have during these observances often focus on individual choices and individual success. But these narratives can unintentionally suggest that breastfeeding is simply a matter of motivation or determination.
As an IBCLC, I’ve learned that a different question often leads to a more meaningful conversation.
Instead of asking, “How do we help more parents breastfeed?” perhaps we should be asking, “What kind of society makes breastfeeding possible?”
Because breastfeeding happens within the context of healthcare systems, parental leave policies, workplace protections, family support, community resources, and the everyday realities of a person’s life. While breastfeeding is deeply personal, the ability to meet one’s feeding goals is often shaped by factors far beyond an individual’s control.
Breastfeeding Is More Than a Personal Decision
When a new parent encounters feeding challenges, one instinct is to focus on the feeding itself.
Can the latch be improved? Can pumping efforts be increased? Position? Alignment?
While important, these questions are only one small piece of the puzzle.
A family’s feeding journey is also shaped by questions like:
- Can they afford to take time away from work after birth?
- Do they have access to timely lactation support?
- Can they find an IBCLC in their community?
- What guidance are they receiving from their healthcare team?
- Do they have transportation to appointments?
- Do they have supportive family or community around them?
- When they ask for help, do they feel listened to, respected, and believed?
As birthworkers, we see that feeding challenges often exist alongside financial pressures, housing insecurity, navigating healthcare, and adjusting to a completely new season of life.
Breastfeeding outcomes are often a reflection of the systems surrounding families rather than an individual’s effort.
Black Breastfeeding Week Invites Us to Look More Closely
If strong support systems matter for everyone, then we also have to ask another question:
Is access to these supports equitable?
For many Black families and other historically marginalized communities, the answer is still no. This is why Black Breastfeeding Week is so important.
Sometimes the conversation begins and ends with history. The legacy of slavery disrupted breastfeeding traditions, separated families, and fractured generations of knowledge and trust. That history is real, and its impacts continue to be felt today.
But if we stop there, we risk overlooking the barriers that Black families continue to face today.
Today's Barriers Are Still Shaping Breastfeeding
When healthcare professionals encourage parents to “reach out for support,” there is often an assumption that support is available to everyone in the same way. Of course, the reality is much more complex.
Time is one of the greatest predictors of feeding success and is deeply connected to financial stability. Around the world, families experience very different levels of support after birth. In the United States, for example, there is no federally mandated paid parental leave, leaving many families to rely on employer benefits, state programs, or unpaid time away from work. Even in countries with more comprehensive leave policies, income replacement, eligibility requirements, or informal employment can still create significant financial pressure during the postpartum period.
Financial realities are not experienced equally. Across many countries, Black families and other historically marginalized communities continue to experience lower wages, greater employment insecurity, and wider wealth gaps because of longstanding structural inequities. These economic realities influence how much time families can spend establishing breastfeeding, whether they can afford pumps or lactation support, and how quickly they may need to return to work. When breastfeeding success depends on having time, income, and workplace flexibility, economic inequity becomes a breastfeeding equity issue.
Representation also matters. Many Black parents still move through pregnancy, birth, and postpartum care without seeing providers who reflect their lived experiences. They may attend parenting groups or feeding clinics where they are welcomed, but not necessarily represented. Feeling seen and understood helps build trust, encourages families to seek support early, and creates a stronger sense of belonging.
Accessibility is another challenge. Breastfeeding is widely recognized as one of the most effective public health strategies for improving the health of babies and lactating parents, yet access to IBCLC care remains inconsistent around the world. In many places, families must pay out of pocket for specialized lactation care, rely on insurance plans with varying levels of coverage, or navigate limited publicly funded services. Geography, provider shortages, cost, and insurance barriers can all delay families from receiving timely support when they need it most.
Discrimination, bias, or dismissal within healthcare can compound these realities for Black families. Eroded trust makes asking for help much more complicated.
None of these barriers exist in isolation. Together, they shape whether families are able to meet their infant-feeding goals.
Moving Beyond Awareness
As birthworkers, we cannot redesign parental leave policies, eliminate systemic racism, reform healthcare systems, or create universal access to lactation care overnight.
But we can strengthen the systems immediately surrounding the families we support, ideally prenatally, by:
- helping families navigate healthcare systems, insurance systems, and community resources
- connecting families with IBCLCs, peer support groups, culturally responsive organizations, and other local supports
- advocating for informed, respectful, and equitable perinatal care
- recognizing when feeding challenges are rooted in structural barriers rather than assuming a lack of commitment or effort
- creating spaces where families feel safe enough to ask questions, share concerns, and define success for themselves
As birthworkers, our role extends beyond teaching feeding techniques. We are advocates, navigators, and trusted members of a family’s support network. By understanding the systems that shape infant feeding, we become better equipped to recognize barriers, connect families with meaningful resources, and advocate for more equitable care.
Wherever we practice, if we want more families to meet their feeding goals, we must continue building communities where every parent has access to the support, trust, and resources they deserve.
About the Author: Aunjrya Fleming
Aunjrya is the EDI lead for Doula School. She is a Registered Nurse and International Board Certified Lactation Consultant (IBCLC) with a deep commitment to reproductive justice. She brings years of experience working with racialized, refugee, and 2SLGBTQIA+ families as a maternal health navigator, educator, and advocate. Aunjrya is passionate about building equity-informed spaces that center safety, dignity, and agency for all birthing people.
Learn More About Lactation Support
Want to deepen your knowledge and confidence in supporting families with their feeding goals? Explore our Lactation Support Continuing Education course for birthworkers and doulas.