Tag: Motherhood

WP_Post Object ( [ID] => 9639 [post_author] => 15 [post_date] => 2025-09-19 12:01:38 [post_date_gmt] => 2025-09-19 12:01:38 [post_content] =>

Too many promising breakthroughs in women’s health research stall out due to a lack of funding. I’m trying to remove the roadblock for just one.

I was flat on my back on the cold tile of my bathroom floor, with a wet washcloth over my forehead, when I first learned about Dr. Marlena Fejzo’s work. It was December 2023. I was four months pregnant. While I had experienced some nausea in my first pregnancy, my second was an order of magnitude worse, and the bathroom floor was where I spent most of my time, always within arm’s reach of a toilet.

But scrolling through the headlines that day, I found a surprising glimmer of hope. Dr. Fejzo had cracked the code on understanding severe morning sickness, proving a genetic link between the mechanism of pregnancy nausea and vomiting for the first time.

As I fought off another wave of my own nausea, reading about her research felt like a lifeline. Someone was figuring this out. And if a scientist had made such a huge breakthrough, surely treatment couldn’t be too far behind. Not for me, of course. But for women after me.

Right?

It’s important to understand how limited the understanding of pregnancy nausea and vomiting (NVP) was before Dr. Fejzo’s work—and, largely, still is. Nearly seventy percent of women experience some degree of NVP in pregnancy, and yet, before Dr. Fejzo and her collaborators, doctors didn’t know what actually caused it.

Prior to 2023, the historical hypothesis was that hormones, such as estrogen and HCG, were somehow implicated in NVP—but a causal link to nausea and vomiting had never been demonstrated. Just eighteen months ago, my own OB told me, “We don’t know what gives some women morning sickness. Probably those pesky hormones.” (Pesky hormones is not, to my knowledge, a medically meaningful term.) The current edition of perennial bestseller What To Expect While You’re Expecting, updated in 2024, also states that “no one knows for sure what causes pregnancy nausea.” As if vomiting were just part of the elusive mystery of sacred motherhood, not a biological phenomenon that deserves care and answers.

Angered by the lack of medical information on the subject, Marlena Fejzo approached NVP research from the perspective of a geneticist, and that of a survivor. In 1999, Dr. Fejzo had herself suffered from hyperemesis gravidarum, or HG, the most severe form of morning sickness—a debilitating condition which can quickly lead to severe malnutrition. Her doctor was dismissive, accusing her of exaggerating her symptoms and attention-seeking, all while she was fully incapacitated and rapidly losing weight. Tragically, despite a last-resort feeding tube and seven different medications, her condition became too advanced and she lost her pregnancy at 15 weeks gestation.

In the 25 years since, Dr. Fejzo has been committed to researching HG. Her early efforts moved slowly, with little to no funding, carried out alongside her day job researching ovarian cancer. (Complicating her efforts, women vomiting to the point of incapacitation have a hard time participating in research trials.) Dr. Fejzo partnered with the Hyperemesis Education and Research Foundation to set up a web portal, then contacted affected patients individually to obtain DNA samples.

Her work took a huge leap forward when she partnered with private genetics company 23andMe in 2010 to include a question about HG in their health surveys. From those responses, and the genetic data of 50,000 women, Dr. Fejzo was able to determine that HG had a strong genetic link. The greatest risk factor was in a gene that codes the hormone GDF15—which occurs in all humans, but is produced at the highest levels by the placenta. This finding was immediately exciting to Dr. Fejzo. High GDF15 levels were already known to occur in late-stage cancer patients with cachexia, a syndrome that causes weight loss, appetite loss, and muscle wasting—all similar symptoms to pregnant people suffering from HG. The evidence was lining up.

Together with international collaborators, in late 2023, Dr. Fejzo released a groundbreaking paper in Nature, titled GDF15 linked to maternal risk of nausea and vomiting during pregnancy. Simply put, Dr. Fejzo and her collaborators had cracked the code on morning sickness. Even better? Their work suggested methods of prevention and treatment.

When Time Magazine named Dr. Fejzo one of its 2024 “Women of the Year,” they noted, “Fejzo is now applying for funding for a clinical trial to test whether the drug metformin—which is approved to treat Type 2 diabetes but is used off-label for numerous purposes and has been shown to raise GDF15 levels—works as a preventive therapy.”

I was thrilled to hear it. For women who had experienced HG before, or had a family history of it, or who could, hypothetically, take a blood test to gauge their risk—preventative therapy would be life-changing. And, in some cases, life-saving.

The problem, as it turned out, was finding the funding to do it.

Six months after I first read about Dr. Fejzo—this time, attempting to rock a newborn to sleep—I saw a post on a pregnancy message board about an incredible women’s health researcher who could not get funding for a clinical trial.

I almost scrolled by the post, convinced it couldn’t possibly be about the same researcher I’d first learned about while incapacitated on my bathroom floor. But then, I saw her name—and immediately stopped scrolling.

My first naive assumption: that the great capitalist machine would have a profit motive in preventing a condition that affects millions of women—something those women would do anything to solve. My second naive assumption: that promising research gets funded publicly. The post I was now looking at disproved both—a reality that felt equally disillusioning and enraging.

Part of the problem, as it turns out, was precisely that Dr. Fejzo’s research was such an outlier. Since Dr. Fejzo is the only full-time HG researcher in the country, grant review boards still don’t have the expertise to properly review her applications. When researchers of under-studied conditions do not have peer scientists to advocate for them and their research, their work often goes overlooked. As Caroline Criado Perez writes in her book Invisible Women: Data Bias in a World Designed for Men, “It’s not always easy to convince someone a need exists if they don’t have that need themselves.” As of writing, Dr. Fejzo has been denied seven different grants.

Learning this, my vague notions of “science” and “progress” quickly crumbled. I’d previously had some kind of faith that medical problems existed; and then scientists solved them; and then we all benefited. But of course, there is no abstract body of “science,” and scientists are people who require resources to perform their work. It had never occurred to me to question where, exactly, those resources actually came from.

Scientific breakthroughs do not, on their own, produce follow-up funding. Neither does media attention or critical acclaim. Visibility is important, of course. But it doesn’t automatically turn into dollars. As Time noted, Dr. Fejzo had intended, and still intends, to launch her clinical trial with an existing generic drug, metformin—something already known to have a good safety profile in women trying to conceive, lowering potential risk for participants. But the use of this drug is also why there’s no profit motive for pharmaceutical companies to invest some of the $83 billion—with a B—dollars they put into research and development each year: The drug already exists.

Moreover, resourcing women’s health research funding, already challenging, faces stiffer headwinds than ever. As of 2020, only 5 percent of healthcare-related R&D efforts are targeted specifically at women’s health issues—and most of that is dedicated to female-specific cancers, leaving only 1% of all medical research dollars invested in all other female-specific conditions, including maternal health conditions, menopause, endometriosis, and the like.

While the women’s health gap is a global issue, it feels particularly acute in the United States of 2025, where the current administration has also made abundantly clear that they do not consider women’s health a priority. The New York Times reported that terms such as “female,” “uterus,” and “mental health,” painted with the indiscriminate brush of “DEI,” can get a grant submission flagged for further review. According to JAMA (The Journal of the American Medical Association), overall grants disbursed by the National Institute of Health (NIH) are down $1.8 billion in 2025. Recently, NIH funding for a landmark women’s health study of 40-plus years was revoked, before being reinstated due to public outcry. Meanwhile, even research grants for active scientific projects face termination when they “no longer meet agency priorities.” (A quick perusal of these terminated NIH grants includes plenty with “pregnancy,” “breast,” or “ovarian” in the title… and none with “prostate,” “penile,” or “testicular.” Priorities, indeed.)

In just the last eight months, Dr. Fejzo has spoken at the White House, lectured at Harvard and Yale, and won prestigious awards. Her most recent paper in the American Journal of Obstetrics & Gynecology garnered a great deal of attention from the OB-GYN community; and her work has been extensively profiled both in major outlets such as The Guardian, and influential parenting newsletters like Emily Oster’s ParentData. There seems to be a consensus that this work is essential; that it deserves attention and further research. Yet none of this has actually translated to funding.

This enraged and frustrated me. I found the pregnancy message board post and got in touch with its author—who, it turned out, had been desperately hoping Dr. Fejzo was already conducting clinical trials, and had been devastated to learn they hadn’t even yet begun. She put me in touch with the researcher herself. “In terms of fundraising, I need all the help I can get,” Dr. Fejzo emailed me.

Over the course of several conversations, hearing about her difficulties in obtaining funding and the incredible promise of her work, I became convinced that someone needed to be a champion for Dr. Fejzo’s work. And it might as well be me. This is how I—a complete outsider, whose last brush with genetics was MOLBIO 101 twenty-odd years ago—launched myself into fundraising for medical research.

Some familiarity with the nonprofit world was a big help. Since Dr. Fejzo works at the University of Southern California, donations to her work are routed through USC as a 501(c)3 research university, making them eligible for tax deductions, some corporate matching programs, and various other mechanisms that make a donation financially advantageous. (And supporters aren’t writing a check to an entity they’d never heard of.) I also worked with USC to set up an ongoing crowdfunding page so that interested people can donate any amount directly to Dr. Fejzo’s research fund and share within their own networks, GoFundMe-style.

I’ve made deep connections in incredible women’s funding networks such as Women Moving Millions, whose bold members are dedicated to advancing women’s well-being in every arena. We’ve hosted a number of webinars where anyone interested could hear from Dr. Fejzo directly. I leaned on the advice of friends in the academic and media worlds; I tapped every alumni and professional network I had. I dug around for matching programs through organizations including #HalfMyDAF and Pivotal Ventures that could leverage existing gifts; I got social media boosts from the HER Foundation, which does incredible work supporting and connecting hyperemesis patients and providers.

And finally, I’ve spent the last 10-odd months talking up Dr. Fejzo’s work to absolutely anyone who will listen. I’ve found that friends and colleagues are pretty interested when you adopt a single-minded crusade against morning sickness. (One stone still unturned: celebrity outreach. I haven’t found a contact for Princess Kate yet, who publicly shared her harrowing experience with HG during all three of her pregnancies. If you happen to know her, put us in touch.)

We’ve raised nearly $750,000 thus far, a testament to the power of collective action. But we still have a long way to go: Dr. Fejzo needs $1.3 million to go forward with her clinical trial—a sum of money which is both significant, and yet so tiny in the scheme of research dollars.

As my fundraising has shown me, though, this is completely doable—because I’m not the only one who feels motivated by Dr. Fejzo’s work. There is a true hunger for her research among women who have previously suffered HG. In fact, many individuals have emailed Dr. Fejzo—who, again, is a researcher, not a medical doctor—to ask whether she might help their own doctors suggest a metformin protocol. Essentially, pregnant people are volunteering themselves as studies of one, outside the controls and protections of clinical trials, out of sheer desperation for a better alternative to the pain they’re suffering through.

I think back to my own experience. I did not have full-blown HG; I had a less severe experience with nausea and vomiting that, while deeply disruptive to my everyday life, was not ultimately dangerous to me or my baby. Yet I still emerged from the experience absolutely desperate for better care. I would have done anything in my power, and paid anything within my means, for the nausea to go away. For women who end up hospitalized, it’s many orders of magnitude worse.

This is also why Dr. Fejzo’s inability to access followup funding makes me so angry. I’m angry that women’s pain isn’t considered a priority. Angry that women aren’t considered reliable narrators of their own experience. Angry that a primary response to any complication during pregnancy seems to be “suck it up.” That women, and pregnant women especially, are given vague assurances like, “Your baby is fine! It’ll get what it needs,” without any evidence to support those claims. (Oh, you’re vomiting multiple times a day? Well, didn’t you want a baby? What did you expect?)

This anger is motivating. But for those suffering from HG, it’s impossible to harness that rage into action while utterly incapacitated, fearing for the safety and health of your baby and yourself. HG can be dehumanizing—taking away your ability to advocate, fight, or do much more than exist. It’s on the rest of us, then, to rally for those who can’t.

Where funding goes, and where it doesn’t, communicates something unmistakable about what society values—and clearly, addressing women’s suffering does not rank very high on that list. So what can we do? Well, we can start by crowdfunding one critical clinical trial, then another, and another. Collectively funding public good is a foundation of society, and perhaps it can continue despite the failure of official systems to support it, if we come together to put our dollars where they count.

Should there be better ways to fund this kind of research? Yes. Are there better solutions than crowdfunding out there? Maybe. But until then, it’s time we reclaim some control, and fund the damn research ourselves.

[post_title] => Let's Fund the Damn Research Ourselves [post_excerpt] => Too many promising breakthroughs in women’s health research stall out due to a lack of funding. I’m trying to remove the roadblock for just one. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => morning-sickness-womens-health-research-pregnancy-funding-science-studies-hyperemesis-gravidarum-marlena-fejzo-fundraising [to_ping] => [pinged] => [post_modified] => 2025-09-26 16:45:52 [post_modified_gmt] => 2025-09-26 16:45:52 [post_content_filtered] => [post_parent] => 0 [guid] => https://conversationalist.org/?p=9639 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw )

September 19, 2025September 26, 2025

Let’s Fund the Damn Research Ourselves

by Carey Jones

WP_Post Object ( [ID] => 6915 [post_author] => 15 [post_date] => 2024-05-10 18:37:13 [post_date_gmt] => 2024-05-10 18:37:13 [post_content] =>

In hiring a babysitter of my own, have I become the mother I used to nanny for?

When the young woman appeared at my door, braless, pink-haired, and smelling faintly of cigarettes, the only thing I could think about were my shoes.

My daughter had recently gone from being a baby to a toddler, and for the first time in her short life, I’d landed a dream job that would require me to return to the office after a year off. As preparation, I’d spent hours looking for a specific pair of clog boots, the exact shoes I believed I needed to walk into my new office as a new(ish) mom, newly 40, finally in her power era. They had to be either Swedish Hasbeens or from the No. 6 Store—the ones with the shearling on the inside that came to the top of the ankle. Even though I couldn’t really justify spending $400 on a pair of shoes, I was obsessed. Something deep inside me told me these boots would complete a vision of myself that I had been fantasizing about for over a decade: practical but stylish, sophisticated but understated. I felt a primal need to have them.

Then, this manic pixie dream babysitter, complete with the prerequisite tattoos and dyed hair that changed color every week, knocked on my door, and showed me all at once where my girl boss fantasy had come from. I hadn’t put it together until that moment, but my new shoes were the exact same clogs that belonged to the mother I used to nanny for when I was my sitter’s age. Instantly I was transported back to the long oak table in their dining room, the one where I’d linger after my duties for the day were completed. For years, I’d watched this mom strut around Brooklyn in those clogs, living the life I’d desperately wanted. And somewhere in my subconscious, the boots had buried themselves as a symbol—of adulthood, of success, of stability. All the things that seemed so far away from me in my early twenties, when I first started working for her.

And in a way, they were. Fresh out of drama school in London, I had moved to New York at 23 with hopes of becoming a working actress, but instead had become what I call a “professional auditioner.” On average, I would go to something like four auditions a week, but nothing ever stuck. I was terrified of failure, terrified of everything—but more than anything else, paralyzed by what I would do if I actually got any of the parts I went in for.

Like most struggling actors, I was also broke. To make rent, I worked as a babysitter for a family in Brooklyn Heights, watching their two boys over the course of three years. Really, I was their nanny, but that word was verboten in the wealthy creative enclave that I worked under. The title would have legitimized my work, and no one—not the parents who paid me under the table, not the children I watched, and especially not me—wanted to admit that it was an actual job.

To be honest, the kids and I were never a great match; they were devoted to sports, obsessed with talking about soccer and basketball, while my athletic acumen was limited to a two hour yoga class. This didn’t seem to matter much, and the kids didn’t seem to mind, either. I would shepherd them from whatever practice they’d begged to sign up for to whatever music lesson they were being forced to take, make them dinner, give them their bath, kiss their scraped knees—and the whole time, I’d wait for her to come home.

Whenever I babysat, whether I was making broomsticks for a quidditch match in the park or listening to the same joke for the hundredth time, I was mentally elsewhere; rehearsing lines, begging my agent to get me an audition, texting some boy. But the moment Mom walked through the door, I was present; and suddenly, I never wanted to leave. At seven each night, she would swoop in from her job as a commercial producer, dressed in clothes that were always subtle but expensive, on trend but never tacky. She’d kiss the tops of her boys’ heads, take her coat off, and start telling me about her day.

Her stories about office life, about school meetings, her gossip about other parents, left me enraptured. I would study her with a mix of curiosity and fear; I wanted a version of her life, and at the time, it felt painfully unattainable.

When she was at work and the boys preoccupied, I’d spend my days gazing at the awards on her shelves, the artwork on her walls, the beautiful crown molding in her apartment. But it was more than that. As she showed me the secret corners of an adult woman’s existence, I in turn revealed my own desires, not only to her, but to myself. She listened to my ideas with respect and responded to my opinions with interest, allowing me the space to begin to think I might have some big potential I hadn’t yet realized. That maybe I, too, was in possession of the same exceptionality that I saw in all the parents at pick up at her children’s fancy alternative elementary school: the playwrights, the performance artists, the Pulitzer winners. I wanted to make something that mattered to the world—because I wanted to matter, and felt like I didn’t.

It was in those thrilling ten minutes that I spent with her each night, trying to soak up everything, that I felt like my life could finally have direction. In those brief interludes between her taking off her coat and me putting on mine, she was a confidante, a mentor, a hopeful oracle giving a glimpse of my future—and, I realize now, a mother to me, as well, in a time where I needed it.

Even so, I found myself battling a dark depression for about a year, flailing and miserable, grappling with the fact that my career wasn’t going anywhere. Eventually, it began bleeding into my work. There was a devastating moment when the nine-year-old, home sick with a stomach bug, caught me crying over yet another rejection. I thought he’d been asleep, and when he walked in on me, it seemed so taboo, I told him I was only practicing for an audition. I felt guilty, like I might have introduced something dark and scary into his perfect childhood—but truthfully, I was humiliated. I could have been so many things, and in that moment, I was a failed actress who wasn’t even allowed to call herself a nanny.

Eventually, I decided to go back to school, to change course. I gave up on acting at the same time I stopped working for the family. Leaving was fine, healthy even, for all of us. The kids, their parents—especially Mom and me—had quickly discovered that we had outgrown the need for each other.

Still, she left her mark. Eleven years later, I’d walk into my new job as a TV producer, in a secondhand version of her clog boots; in a way, a secondhand version of the woman I believed I was supposed to become. I’d amassed my own awards, my own crown molding—but it hadn’t really hit me how much I’d replicated my former boss’ life until my own babysitter showed up, a mirror image of my younger self, now reflecting back who I’d become on the other side.

I was working from home when our sitter first started with us, and watching her sleepy, wrinkle free eyes gaze upon my child was jarring. Not only because it’s always strange to watch someone else mother your baby, but also because I’d only ever played the babysitter’s part, and now, I’d been cast in the titular role, the one I’d always wanted. I suddenly found myself performing a kind of character, speaking a little too loudly when I was on a work call, hoping to impress the 22-year-old rocking my daughter to sleep in the next room.

Each night, before she left, I began to ask her about her life. How long had she been with her boyfriend: Several years, and they planned to get married. What did she want in the future: To work with kids in a small town away from the city. She told me she couldn’t wait to live without roommates and asked my opinion on her next tattoo. Once she gave me a handmade bracelet made of special crystals she had sourced herself. They’d help me through my next big pitch meeting, she said. I almost cried at the thoughtfulness. (She never gave my husband anything.) Was I becoming to this young woman what my former boss was to me, I wondered? Did I even want that?

While I mostly feel grateful towards my previous employer, I still harbor some resentment towards her, too. It was clear to me that while she’d likely had her own salaried caretaker when she was little, the mother I’d worked for had never taken on that job herself. She hadn’t needed to. As such, she’d never given a second thought to the intricacies of my well-being once I stepped foot outside of her apartment, and hadn’t ever really cared for me beyond those ten minutes she gave me each night. I made $20,000 a year working for her, and never had health insurance the entire time. She never offered it to me, and I couldn’t afford it. She trusted me with her children’s safety, with their lives—and yet there was no one I could trust with mine, no one to cover my urgent care bill when I got the flu, no one I could turn to when I needed someone to take care of me.

Of course, my relationship with my sitter is imperfect in its own ways. Like all 20-somethings, she’s subjected to her own hardships; friends let her down, great apartments pass her by, she works a second job catering while her peers all seem to get full time jobs with benefits. Sometimes she arrives at our home with a cloud of sadness that I know too well. Once settled, however, the fog disappears, replaced with a supernatural ability to be present with our baby; then, the next week, she’ll be wishy-washy, often canceling right before she’s supposed to come over.

Recently, she flaked on us again during a stressful moment when she was very much needed. My mother in law told me that there was always something a little off, something a little “unreliable about the kinds of girls drawn to these jobs.” Even though in part, I agreed with her, I was also offended—not only on her behalf, but on behalf of my younger self, too. I knew intimately how precarious this time in a young person’s life could be; how, for me, being “the babysitter” was fun and easy at first, then slowly became a twisted reflection of the life I didn’t have, the life that felt so far away, no matter how hard I tried to get to it.

So I try to extend some grace to the girl who has come to look after my child. Whenever she’s late, I remind myself that this is not what she felt put on this earth to do, that for all of us, this is temporary. While I can’t give her the opportunities she’s chasing, the life she’s running towards, I hope to give her the same ten minutes a day that, with enough accumulation, might make their own kind of guidance, draw their own kind of map, like the one that had been given to me. Sometimes I wonder if one day she might go through the same thing I’m experiencing now, and hire a babysitter of her own, continuing this cycle of nannies and mothers, mothers and nannies.

Often I find myself surprised by the largeness of these maternal feelings—how far they can extend out from my daughter towards everyone around me, how they extend to her, too. Once, I came home and found the babysitter asleep on our bed, the baby tucked against her, both of them breathing peacefully, their eyes flickering back and forth beneath their lids. I was almost dizzy looking at her, a vision from my past come to sleep in her future self’s bed. All these versions of who I was, who I am, and who I have yet to become, were suddenly in the room with me, asking me to take off my clogs before finding a way to nestle against these tender bodies. But of course, I did not do that. Instead, I covered them both with a blanket, closed the door gently behind me, and let them sleep.

[post_title] => The Babysitters Club [post_excerpt] => In hiring a babysitter of my own, have I become the mother I used to nanny for? [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => babysitter-nanny-mother-mom-relationship-childcare-motherhood-care-work-labor [to_ping] => [pinged] => [post_modified] => 2024-09-13 19:24:34 [post_modified_gmt] => 2024-09-13 19:24:34 [post_content_filtered] => [post_parent] => 0 [guid] => https://conversationalist.org/?p=6915 [menu_order] => 58 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw )

May 10, 2024September 13, 2024

The Babysitters Club

by Lacy Warner

WP_Post Object ( [ID] => 5856 [post_author] => 15 [post_date] => 2023-05-12 19:32:09 [post_date_gmt] => 2023-05-12 19:32:09 [post_content] =>

After my daughter was born, I struggled to produce milk. Why did I feel like I had to keep trying?

When I was sixteen, I went to see my mother in a community theater production of John Steinbeck’s The Grapes of Wrath. Though Mom performed a chilling death scene as Grandma Joad, it was the character at the center of the play, a young woman named Rose of Sharon, who ended up haunting me. In the third act, Rose has just given birth to a still born baby—a particularly cruel fate given what the Joad family had already endured on their journey West. But then, grieving and broken, the family encounters a young boy and his father, who is dying of starvation, in an abandoned barn. Rose of Sharon, with her milk having just come in, unbuttons her blouse and nurses the dying man back to health.

Even as a teenager, I sensed some great superpower, a gift that I couldn’t wait until it was my turn to receive.

A few years later at a coffee shop, I watched a young mother, dressed in a blue tube top with light brown hair hanging down to her waist, wrestle with her hungry baby. I stared transfixed as she casually pulled down her top and popped out a small, perfect breast. Her baby immediately latched on. The woman was sitting in the window, warm afternoon light flooding behind her, and for a moment, she seemed to occupy a holy air: her long hair curtaining them off as the baby nursed with a practiced ease, a profound sense of calm flowing outward from them.

In December 2021, a few days before Christmas, I gave birth for the first time. Immediately after cutting the umbilical cord, my daughter was put to my breast; I felt a little pull and suddenly she was working away. I gasped. We stayed like that for about an hour, completely still except for her suckling. Her cheeks and my breasts were both so large at that point it was hard to know where she ended and I began. It would be the last time that breastfeeding was easy for us.

Two days later, I was told by a nurse that my daughter's weight had dropped and that she probably wasn’t latching correctly. A lactation consultant kindly showed me a better angle to hold the baby while nursing. I adjusted. My daughter latched on. “Everyone thinks the cradle way is easiest,” she said. “But that’s because of what we see in the movies.” And in literature, and plays, and paintings, and in coffee shops, I thought.

I believed everything was going fine until around 3 AM the following morning, when I was awoken by another lactation consultant, this one much harsher than the last. Standing over my bed, she sported a neon fanny pack and a buzz cut on one half of her head, her vibe much closer to Nurse Ratched than Mother Theresa. I honestly can’t remember most of what she said, except for one phrase that she repeated over and over: “This is an emergency.” She told me that my milk hadn’t come in yet because I’d had a c-section and my body was prioritizing healing. Strike one against mama, the c-section. Strike two, bad nipples.

My husband and I were directed to feed the baby tiny bottles of formula while I was put on a pumping schedule of every two hours for fifteen minutes at a time. By the time I left the hospital, my nipples were cracked and bleeding, looking like a pair of skinned knees. According to Ratched, the clock began when I started the pump, not when I finished, which, after the obligatory clean up and sterilization of the pump’s various parts, meant that I was sleeping in bursts of an hour to an hour and a half. I started to lose my grip on reality from the sleep deprivation. All the while, nothing was coming out.

Once we got home, I became obsessed with solving the riddle of my broken breasts. I saw a total of six lactation consultants. According to these experts, I had already done so much wrong: taking Dayquil when I came home from the hospital with a cold, sleeping through a couple of my pumping alarms, not being hydrated enough, not eating enough calories, being too stressed for the oxytocin to release and help the milk flow. So I ate all the lactation cookies, drank all the teas they recommended, and even went to an acupuncturist. I created Excel spreadsheets to track my progress, which I made my husband and mother fill out in detail every time they fed the baby. I continued the relentless pumping schedule that had been prescribed to me.

To make matters worse, I was spending less and less time with my baby. I was still trying to nurse her, still trying to recreate every beautiful feeding scene I’d witnessed, but the reality was that until I started to produce milk, she still needed to eat, and the bottle kept her from being interested in the breast. I’d always heard that newborns were like breathing, dreaming appendages, attached so firmly for the first few months that they don’t feel like separate beings. But whenever I looked down, instead of seeing my baby, there was only a mess of wires, and a buzzing pump always alerting me that I was more machine than mother. Over the constant noise, I’d strain to hear her cooing and crying from the other room, where my husband and my own mother held her, and changed her, and fed her.

One morning, I woke up with a breast infection so painful it made me forget the intense abdominal surgery I’d just undergone to remove my daughter from my womb.

I’d known about mastitis and blocked ducts, but this felt like broken glass inside my nipples, now shiny and hot as though they each had their own intense fever. One nurse told me she thought it could be thrush, a type of fungal infection, but another was suspicious since my baby didn’t have it in her mouth. A third said I just needed to “toughen my nipples up” and suggested dipping them in black tea. But the more I pumped and tried to nurse, the worse the pain became. I had stopped taking the powerful painkillers prescribed for my c-section recovery, but started taking them again to deal with this new agony. (Later, after I moved to formula feeding exclusively, the pain lessened but still took months to go away altogether.) It seemed to me that my body was saying something important, something it had long been trying to tell me but that I wouldn’t let myself hear. I walked around in a cloud of such sadness that I felt like my soul had the flu.

My pregnancy had been difficult. Almost immediately, I’d developed hyperemesis, which is like morning sickness on steroids. It had landed me in the emergency room twice with dehydration, and once at the dentist when a molar, weakened by copious amounts of stomach acid, disintegrated and fell out of my mouth. I had imagined myself as a pregnant glowing earth mama, all supple curves, completely in tune with nature and myself, but there were times the vomiting was so extreme that I just wanted to die. Then, I had a c-section, further cementing the idea that my body wasn’t meant to do this at all. That my breasts could not “correctly” produce milk was the final nail in the coffin.

The internet, unfortunately, agreed with me.

At the same time that I was struggling to produce milk, America experienced a terrifying formula shortage after a contaminated batch at an Abbott plant led to a widespread recall, revealing the fragility of the formula supply that so many families depend on. But for every woman who was vocal about how the shortage should be considered a national emergency, there was someone, usually a man, asking why women couldn’t “just breastfeed.”

Suddenly total strangers from around the world were chiming in to validate my inadequacy. But in the midst of this turmoil, my breasts still vibrating with mysterious pain, rather than feel rage or frustration, I felt a perverse relief. The world seemed to agree with that little nagging voice in the back of my head. I simply wasn’t meant to be a mother.

How much of the breastfeeding debate is really about the health of the child, and how much is about the control of women's bodies and, moreover, about the performance of successful womanhood?

I found myself thinking about this question a lot in my baby’s first months of life. The internet’s unsympathetic reaction to the formula shortage further demonstrated that many believe the difficulty of breastfeeding to be a modern predicament; that as women have gotten more agency, and more rights, they’ve abdicated more of their motherly duties. But breastfeeding has been complicated since the beginning of time. Women have always experienced issues like mastitis, which before the advent of penicillin was an often fatal infection. And babies have always experienced tongue ties, premature births, and trouble latching. Add to that centuries of malnutrition, as well as external traumas like giving birth in famines, war zones, or while enslaved, and the body’s ability to produce milk becomes less and less likely. We’ve always needed alternatives.

Before formula, parents searched far and wide for methods to replace breast milk. Author Carla Cevasco notes in The Atlantic that early options ranged from cow’s milk to bone broth and nut milk—some of which provided hydration but not necessarily nutrition, and could be deadly due to contamination and poor food preservation capabilities. Historically, the surest way to keep a baby fed was a wet nurse, another woman who had also recently given birth and could breastfeed. Wet nurses were commonly poor or enslaved women who were forced, either by poverty or slaveholders, to feed other’s babies as their own starved at home.

These women’s experiences should remind us that the history of formula feeding is not a stain against a woman’s ability to mother, but in fact quite the opposite: a testament to the incredible act of keeping one’s baby alive.

I knew all this, so why couldn’t I let myself believe it? I thought of every poster hanging in every doctor’s office, waiting room, and maternity ward that depicted mother and child in complete harmony with the tagline “breast is best”—a mantra made popular in the 1950s by a group of Catholic women who called themselves La Leche League and believed breastfeeding was “God’s plan.” And I couldn’t stop seeing that young mother in the coffee shop from my twenties, how she had no problem nursing her infant, the two of them a recreation of every painting I’d ever seen of Madonna and child come to life.

Even before getting pregnant, I had already internalized the cultural messages surrounding breastfeeding so deeply, it had become something much bigger than a simple act. It had bloomed into a dangerous omen.

During my maternity leave, my husband and I spent the late nights re-watching the entire seven seasons of Mad Men. In one episode, a pregnant Betty Draper, played by January Jones, gets asked by a nurse whether she intends to breastfeed. Betty answers with a bored “no” and the nurse nods in agreement. My husband was shocked. Here we were, struggling so intensely, and there was Betty, not even intending to try. What’s more, no one seemed to have a problem with it.

Where my husband saw a kind of permission for formula feeding, I saw something different: an inverse reflection of the very expectations I had failed to live up to, and that are placed on so many birthing parents, regardless of gender. In the 1960s, formula feeding became the norm, with, as historian Amy Bently writes, only 20-25 percent of babies starting their lives being fed breast milk. The primary reason for this shift was the urging of pediatricians who were intent on lowering the infant mortality rate, and saw formula feeding as a more consistent and regimented way to keep babies fed and alive. More women were also working outside the home and needed to be able to leave their infant with a caregiver as they went into the office.

Little of this was relevant to Betty, a wealthy housewife who didn’t work—and so her reasons for bottle feeding were probably similar to the reasons I wanted to breastfeed: It was a cultural marker of being a “good woman.”

After six excruciating weeks, the end of my breastfeeding journey was sudden, unexpected. Eventually, when calling the nurse for the umpteenth time to describe a new pain in my breast—a swelling lump that hurt to touch—I received the kindest advice I’d been given thus far. “Honey, just give up,” she said. “You don’t need to do this.” Her tone was frank but measured; her South Boston accent rough but comforting. I didn’t know how much I’d needed her permission to stop.

I was free—almost. For a couple more weeks, I still tried to nurse, but then during a blizzard that lasted the weekend, I gave up cold turkey. I made my husband run out into the storm to collect little baggies of snow that I would then sneak into my bra sandwiched between cabbage leaves, an old wives’ remedy for weaning. Lying on the couch, icing my swollen breasts, I thought about how on New Year’s Eve, just a few days after we’d returned from the hospital, my husband and I had waited for the clock to strike midnight, my baby in my arms. While giving her a bottle, I started to cry. “Why can’t I feed my child?” I asked him. “Look at you right now,” he replied. “You are literally feeding your child.”

I glanced down at my daughter, her eyes wide, slowly blinking, and saw her taking in all of me. The Christmas tree lights glimmered behind us, lighting us both up with a starry glow. How long had she been staring at me like that? I wondered. Her tiny hand wrapped around my finger, her skin pressed against my skin. I felt like I was seeing my baby for the first time, and noticed that I was, in fact, feeding her.

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May 12, 2023August 28, 2024

A Personal History of Breastfeeding

by Lacy Warner

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