Breastfeeding is Hard. . . or is it?

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We open World Breastfeeding Week 2019 with #RVAbreastfeeds member Cecilia Barbosa reading her 4-minute essay, first delivered at the International Breastfeeding and Feminism Conference, Chapel Hill, March 2019.

Click here to listen.

Breastfeeding is Hard. . . or is it?

“Breastfeeding is hard.” I hear and see this message in social groups, the media, and also in professional groups. I googled the term and 190 entries on 19 pages came back! It does make sense: we know many people have difficulties with lactation. Sore nipples, latch problems, infections, biting. We all know that. And I know many of you can tell lots of stories of difficult experiences.

But is “breastfeeding is hard” a helpful message? Some insist we need to say that because breastfeeding does not come easily and naturally.  Rather it is a skill, and like learning to ride a bike, it takes work, patience and persistence to breastfeed with confidence. 

There is a risk to this message. When we say, “breastfeeding is hard,” aren’t we implying that it’s the failure of the parents’ or babies’ bodies that make it difficult to breastfeed? Aren’t we placing the responsibility for any difficulties squarely on the shoulders of the breastfeeding dyad?

But, is breastfeeding inherently hard or is it that the conditions in which families live make it hard to breastfeed? In contrast to the US where not even 30% of women breastfed at 12 months [1], in 2011, in Mozambique, 87% of 12-17 month old children breastfed [2]. So, if breastfeeding is hard, how is this possible, in a country that has a fraction of the financial resources of the US? I think many of us in this room know or suspect the answer. My guess is that there is strong family, sisterly, brotherly, and societal support, that it is an accepted practice, passed on from generation to generation. That is a special type of wealth.

So, coming back home.

What if, in addition to helping the breastfeeding dyad, we create the conditions for them to be successful in the first place? 

  • What if breastfeeding dyads were welcome in parks, gyms, restaurants and buses? 

  • What if all workers were granted six months of paid leave upon the birth of their child and all employers unquestioningly provided time and space for expressing milk? 

  • What if all new mothers were not released from their hospital beds after 24 hours or even better, births were in beautiful settings that honored this special time in our lives [3]?

  • What if we made sure parents felt comfortable with breastfeeding or were assured good support before sending them home?  

  • What if, when returning home, (and all new parents and babies need a home to go to), family and friends help with chores and meals so that new parents can focus on their new baby?

  • What if, a trained doula, lactation counselor or consultant, visited each new parent after birth? 

  • What if we lived in a society where the breast is desexualized and breastfeeding in public became no big deal?

  • What if we didn’t have to constantly fight the commercial interests that want to thwart and complicate breastfeeding?

Who benefits when we say breastfeeding is hard? Our breastfeeding families? Or, let’s think about that: if we’re saying breastfeeding is hard, aren’t we implying that the alternative, formula, is easy? 

By saying breastfeeding is hard, aren’t we letting our institutions, our laws, our environments continue to ignore the very real and daily needs of breastfeeding dyads for institutional, legal and environmental support?  

Instead, we need to push for consistent and strong societal support and infrastructure, so that each dyad who’s physically and emotionally capable will learn to breastfeed, with patience, practice and persistence. And surely, our breastfeeding families can be just as successful as our friends in Mozambique! 

[1] Centers for Disease Control and Prevention. Breastfeeding among U.S. children born 2009-2015, CDC National Immunization Survey. Accessed at, April 1, 2019.

[2] Ministério de Saúde de Moçambique, Instituto Nacional de Estatística. Moçambique Inquérito Demográfico e de Saúde,2011. March 2013, p. 159.

[3] Attributed to Leslie Lytle, Executive Director of Nurture, Richmond, Virginia, USA.

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Cecilia Barbosa, PhD, MPH: My interest in breastfeeding began during the formula boycott of the 70s when the world was alerted to and alarmed by the deaths resulting from formula being heavily promoted in third world countries and consumed in poor hygienic conditions. I am indebted to an anonymous La Leche League volunteer who patiently helped me overcome initial breastfeeding challenges over the phone. Increasing breastfeeding is a highly impactful public health intervention in this country and around the world.

I have 20+ years’ experience in public health - as independent consultant; Director, Division of Child and Adolescent Health, Virginia Department of Health; and ED, Virginia Public Health Association. I received a PhD in social and behavioral health from VCU, Masters’ degrees in Public Health and City Planning from UC Berkeley and a BA in Biology from Smith College. I chair the Virginia Latino Advisory Board, serve on the Jenkins Foundation and Dancing Classrooms of Greater Richmond boards, and RVA breastfeeds. A citizen of Brazil and USA, I am fluent in Portuguese, Spanish, and French.

Black Breastfeeding Week RVA 2018

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#RVAbreastfeeds is pleased to announce the first ever Black Breastfeeding Week RVA, a social media campaign celebrating breastfeeding within the African-American community. The local campaign occurs in conjunction with National Black Breastfeeding Week, which takes place across the United States August 25 - 31. Black Breastfeeding Week RVA is sponsored by #RVAbreastfeeds, a local coalition that seeks to reduce childhood obesity through policy, infrastructure, and environmental changes that promote a breastfeeding-friendly community. 

The Black Breastfeeding Week RVA Celebratory Kickoff will take place at 16thAnnual Happily Natural Day, a celebration of black consciousness that promotes cultural awareness, holistic health and social change throughout the Black Diaspora. Festival attendees can expect music, culinary workshops, demonstrations, vendors, urban agriculture and more.

The social media component of Black Breastfeeding Week RVA will highlight the challenges and triumphs of breastfeeding while black. "Black Breastfeeding Week is so integral and essential because, even today, black women do not breastfeed at the same rate as their whites counterparts. Mothers lack the education, advocacy and support that they need in order to be successful at nursing. I hope that we can change this statistic one city at a time," says Tasha Dixon, member of the Black Breastfeeding Week RVA planning team. 

Black Breastfeeding Week RVA Celebratory Kickoff
at Happily Natural Day

Saturday August 25
12 noon - 8 pm

Fifth District Mini Farm
2208 Bainbridge St
Richmond, VA 23225

Blessing of New Families - 6:30 pm
Latch-On and Photo Shoot - 6:45 pm

Connect with us on Social Media
August 25 - 31

Saturday August 25
Black Breastfeeding Week RVA Celebratory Kickoff
Facebook Live: Blessing of New Families • 6:30 pm
with Janine Bell of Elegba Folklore Society

Sunday August 26

Monday August 27

Tuesday August 28

Wednesday August 29
Facebook Live: Ask the Lactation Counselors • 6 pm
with Shakeya Lewis and Kaylani Christine Morrison

Thursday, August 30
Throwback Thursday #breastfeedingTBT

Friday August 31
Friends and Family Friday
Facebook Live: Fatherhood Roundtable • 6 pm
with Vincent Ellis White, Ram Bhagat, Rashad Lewis, and Ryan Gilbreath

Information about the Happily Natural Festival can be found at and on Facebook at @happilynaturalfestival. 

The Black Breastfeeding Week RVA planning team members include Tasha Dixon, Nikiya Ellis, Courtney Glenn, Shakeya Lewis, Rashad Lewis, Leslie Lytle, Kaylani Christine Morrison, and NyTasha Stevens, with additional support provided by #RVAbreastfeeds coalition members. 



Breastfeeding Matters: It Takes A Village

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This story is shared with permission by a Greater Richmond Metropolitan Area mother who wishes to remain anonymous. She hopes that her story will be received as an opportunity to reflect on the impact of the actions described, and that local school systems, businesses, and organizations will examine their policies to ensure that they are compliant with Virginia's public breastfeeding law and respectful of parents’ need to breastfeed whenever their baby is hungry. 

One of the most humiliating and violating experiences I've gone through was at my kid’s elementary school while having lunch with my son. 

I had my baby with me. He was also hungry, and since I exclusively breastfeed that is what I did without hesitation, having breastfed many times in many different places before. I was covered and discreet. None of the other students were paying any attention and were too busy talking with each other. 

As I went to switch sides I noticed the principal crouched down slightly to see what I was doing. She then abruptly stood up and said loudly "No ma’am, no ma’am, absolutely not, no no no, you cannot do that here!" 

She made it abundantly clear that she was appalled by my nursing. I was shocked and just froze, not knowing how to react. I didn't say anything and tried my best not to cry so I wouldn't embarrass my son but I couldn't keep from crying. He and his classmates asked me why she did that and I didn't know what to say. My son was so confused by her disturbing response, because he had seen me feed his younger siblings like this many times before. He didn't see it as anything other than exactly what it was . . . feeding a baby! He too started to cry, laid his head on his arms, and didn't finish eating his lunch. 

I'll admit my first emotion was guilt and I felt like I had done something perverted. Then once it started to sink in I felt nothing but disgust in her reaction. 

After lunch was over she approached me and said she didn't mean to cause a scene, but that she just couldn't believe I thought I could do that in front of other students because they don't understand. I told her I felt sexually violated (and believe me I did!) She still said she could not allow that at her school. 

I contacted the school board, told them all I wanted was an apology and to be told that I could breastfeed as that is my baby's and my right! The principal's apology consisted of telling me first that she was aware of the current laws, but was trying to protect the children and that she was sorry if she upset me. I told her that she was supposed to be an educator, and had just taught her students that breastfeeding was wrong and shameful. She was visibly upset by my comment and said she did not agree. My son never got an apology for how she spoke to his mother and humiliated him in front of his classmates.

This incident happened months ago and has plagued me ever since. I never felt like I got the apology my son and I deserved. Not only was I humiliated and denied my rights, but I had to see the person who violated those rights on a regular basis. Knowing that person is an important leader in my children's education, who is not only intolerant but also admitted that she is entitled to break the current laws! This whole experience has made me lose faith in the education system if this is who we let run our schools! 

On the last week of school she and I spoke. I told her how hard this school year had been for me following the incident (I am at the school often because I volunteer). That she had tainted something so beautiful and sacred to me. 

Her response was "well I'm sorry but I have never seen anyone do that before." I realized she hadn’t learned anything and still thought I was in the wrong. 

This is why I finally decided to share my story, so hopefully other women will not allow people who are in higher positions intimidate them into not saying anything. We need to educate our children to know that breastfeeding is not sexual, nor is it something that women do to get attention or try to make people uncomfortable. It is a biological need to feed our hungry babies. Period. There really is no argument. It's science, plain and simple. And people who think it's wrong to do it in public need to ask themselves . . . is it wrong or does it simply go against your social norm? I can very well say, just because something might not be the social norm does not always mean it's wrong. 


Community Guidelines:
Our goal is to promote a breastfeeding friendly community. You are encouraged to share your thoughts as they relate to the topic being discussed. We expect comments generally to be courteous. 
To that end, comments are reviewed according to the following guidelines. We reserve the discretion to remove comments that: 

  • Contain personal attacks or insulting statements directed toward an individual;
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2nd Annual RVA Breastfeeding Symposium Announced

First Food: The Intersection of Health, Race, Policy, and Practice

Richmond, VA – The 2nd Annual RVA Breastfeeding Symposium will take place on August 4 at the Virginia Historical Society. The focus of this year’s symposium is First Food: The Intersection of Health, Race, Policy and Practice.

The morning session of this day-long event will bring together citizens, policymakers, healthcare and social service providers, and community advocates to examine the structural and cultural barriers that undermine women’s ability to reach their breastfeeding goals, and explore the connection between infant feeding and food access issues. The afternoon session is a workgroup reserved for area health and social service providers who come into contact with pregnant and postpartum families.

The keynote speaker is Kimberly Seals Allers, an award-winning journalist, author and nationally recognized advocate for breastfeeding and infant health who is the project director for The First Food Friendly Community Initiative (3FCI), a W.K. Kellogg-funded pilot project in Detroit and Philadelphia to create a national accreditation process for breastfeeding-friendly communities. Elizabeth Gray Bayne, who holds a Masters of Public Health from Yale University and an MFA in film from the Art Center College of Design, will present excerpts from Chocolate Milk, her documentary exploring African-American women’s experiences with breastfeeding.

“It’s been estimated that if 90% of US women could achieve the American Pediatric Association recommendation of 6 months of exclusive breastfeeding followed by continued breastfeeding for 1 year, we could save $17.4 billion in maternal health care costs and an additional $13 billion in pediatric health costs each year,” says Leslie Lytle, Breastfeeding Coordinator for the City of Richmond. “Yet most women struggle to reach their breastfeeding goals and there are significant racial disparities in breastfeeding initiation and duration. Our goal with this year’s Symposium is to spark conversations among folks who might not think of breastfeeding as a foundational health equity issue.”

  • Where: The Virginia Historical Society, 428 N. Boulevard, Richmond VA
  • What: The Second Annual RVA Breastfeeding Symposium: First Food: The Intersection of Health, Race, Policy, and Practice.
  • When: Friday, August 4, 2017: 8 a.m. – 12:30 p.m.
  • Cost: Free and open to the public; however pre-registration is required. Register on-line here

The RVA Breastfeeding Symposium is sponsored by #RVAbreastfeeds (formerly Richmond Health Action Alliance), a coalition funded by the Virginia Foundation for Healthy Youth and administered by the Richmond Healthy Start Initiative, a division of Richmond Department of Social Services. #RVAbreastfeeds has sponsored a variety of events to raise community support for breastfeeding families over the last five years.

The #RVAbreastfeeds planning team consists of representatives from Richmond Healthy Start Initiative, Richmond City Health District, Richmond City WIC, Anthem Healthkeepers Plus, and the RVA community. The RVA Breastfeeding Symposium is made possible through funding and in-kind support from the Virginia Foundation for Healthy Youth, Richmond Healthy Start Initiative, and Richmond City WIC.

Please contact Leslie Lytle at or call 646-3612 for more information.


RVAbreastfeeds Campaign Announced

For Immediate Release Contact: Michael Wallace  Friday, July 17, 2015 (804) 646-2772 

“RVA Breastfeeds” Social Media Campaign Launched to Raise Support for World Breastfeeding Week, August 1 – 7 

Richmond, VA – The social media campaign, RVA Breastfeeds, has been launched to raise community support for breastfeeding mothers during World Breastfeeding Week, August 1 – 7. The campaign is sponsored by the Richmond Health Action Alliance, a coalition funded by the Virginia Foundation for Healthy Youth and administered by the Richmond Healthy Start Initiative, a division of Richmond Department of Social Services. The Richmond Health Action Alliance seeks to reduce childhood obesity through policy, infrastructure, and environmental changes that promote a breastfeeding-friendly and physically active community. 

During the campaign, life-sized cutouts of breastfeeding women and families that reflect the cultural diversity of Richmond will be strategically placed throughout the area. Other campaign components include community leaders serving as “Breastfeeding Champions,” the dissemination of breastfeeding facts, and peer-to-peer support in the form of tips for expecting and breastfeeding mothers. Local retailers and restaurants that display “Breastfeeding Is Welcome Here” stickers will also be highlighted. The multi-faceted campaign will take place via Facebook, Twitter and Instagram, allowing for broad community participation. 

The Richmond Health Action Alliance has sponsored events during World Breastfeeding Week at the Virginia State Capitol for the past three years. “Breastfeeding has profound short and long term impacts on the health of children and their mothers, yet it is often framed as a women’s issue. Given the recent passage of Virginia legislation protecting women’s right to breastfeed in public, we thought the time was right for a much broader conversation,” said Leslie Lytle, Breastfeeding Coordinator for the City of Richmond. “Women don’t breastfeed in isolation. The support of fathers, family members, health care providers, and the larger community is critically important in helping women achieve their breastfeeding goals. A social media campaign provides a vehicle to get the word out to multiple audiences that this is an important public health issue in which everyone has a role.” 

“African-American mothers face particular challenges when it comes to breastfeeding, such as lack of access to culturally appropriate resources and support. This campaign allows us to highlight some of those challenges and to recognize community change-makers who are helping our most vulnerable families reach their breastfeeding goals,” said Rose Stith-Singleton, Richmond Healthy Start Initiative Project Director. 

The RVA Breastfeeds team consists of the Richmond Healthy Start Initiative, Richmond City Health District, Richmond WIC, Nurture, Healthy Hearts Plus II, cBe Consulting, Virginia Breastfeeding Taskforce, VCU Medical Center, Bon Secours Richmond Health System, HCA Richmond, Anthem Healthkeepers Plus, and the Institute for Public Health Innovation, with technical support provided by The Spark Mill. RVA Breastfeeds was made possible through funding and in-kind support from the Virginia Foundation for Healthy Youth, Richmond City WIC, Richmond Healthy Start Initiative and Nurture. 

The campaign can be found online at, and on Facebook, Twitter - @RVABreastFeeds, and Instagram - @RVABreastfeeds. 

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Putting the love back into it

Blog reposted with permission from Nurture.

Cordelia Miller and granddaughter Joanne Lathon, great-granddaughter Tia Javier, and great-great granddaughter Mia.

Cordelia Miller and granddaughter Joanne Lathon, great-granddaughter Tia Javier, and great-great granddaughter Mia.

When Cordelia Miller, 91,  was a young mother working in the rural fields of Texas, she didn’t think twice about how to feed her baby.

“You went and got the baby from under the shade of the wagon, breastfed it when it was hungry, put the baby back under the wagon and went back to work,” says Ms. Miller, who attended a Nurture photo shoot in June focused on breastfeeding mothers.

Ms. Miller accompanied her daughter and great-granddaughter (a breastfeeding mother and subject of the shoot) and infant great-great-granddaughter to show her support for breastfeeding. Images from the photo session will be turned into lifesize cutouts for a City of Richmond campaign during World Breastfeeding Week August 1-7 to spark conversations about the topic.

Women from all different socioeconomic levels and backgrounds volunteered because they are passionate about breastfeeding becoming as commonplace and accepted as walking, sleeping, or eating. They are each pursuing a dream of improving the health of all mothers and children in our community. Many were accompanied by family members – husbands, partners, grandmothers – who were also staunch advocates for breastfeeding.

When Ms. Miller walked into the Round House at Byrd Park for her great-great granddaughter’s photo shoot, I knew immediately that something special was unfolding. While Nurture photographers worked to capture the mothers and their babies, I talked with Ms. Miller about what we were up to.

Her response to the the campaign, which is sponsored by the Richmond Health Action Alliance* and seeks to promote a breastfeeding-friendly and physically active community, was immediate and unequivocal.

“I don’t understand why we got away from it [breastfeeding],” she says, “It used to just be what we did.” She told us how proud she was of her great-granddaughter for breastfeeding her child.

She told us about giving birth to her own child in a segregated hospital here in Richmond, the city she’s lived in since she was 18. Miller brought to life, without bitterness or rancor, the racial divide that continues to separate our citizens and their access to health and wellness resources.

Grandma Miller talked about appreciating her own times, about being concerned about the times her grandchildren are growing up in. “But I guess we all like our own times better,” she says.

To have a great-great-grandmother in our presence – especially one who was such an obvious breastfeeding advocate – along with three generations of her family seemed like an occasion that needed to be honored. So we pulled a bench under the shade of a tall tree to snap a family portrait.

Cordelia Miller and granddaughter Joanne Lathon, great-granddaughter Tia Javier, and great-great granddaughter Mia.

Afterwards, I accompanied Ms. Miller for the short, slow walk back to her car. She said again, emphatically, “I don’t know why we got away from breastfeeding. It’s important. It puts the love back into it.”**

By the time we reached the waiting car, I was in tears, the good kind, the kind that fall when you know you are in the presence of a wise and mighty spirit.

Ms. Miller reminded me of how hard we’re working to get back to basic, primal human instincts – in part by supporting practices like breastfeeding that are grounded in biological and behavioral connection, which evidence suggests leads to much better health outcomes.

This is the essence of what we hope to do through Nurture – to provide resources that support and enhance the fundamental relationships and processes that emerge during the critical transition of pregnancy, birth, and early parenting. And to make access to these resources a level playing field, so we don’t perpetuate the disparities that hold our children back from being all that they could be.

Ms. Miller so beautifully reminded me of the essence of our goal: “to put the love back into it.”