We identified four main themes in participants’ narratives about how they experienced and made sense of human milk feeding during the pandemic. First, participants conveyed the loneliness of early parenting and breastfeeding in social isolation using the trope “It takes a village to raise a child.” Second, they approached human milk feeding as a coping mechanism with the crisis. Third, the (in)visibility of lactation within the context of their heightened multitasking appeared as a significant concern. Finally, human milk was socially constructed as a relational link during a time of unprecedented isolation.
Social Isolation—“It takes a village”
For our research participants, the pandemic transformed lactation, a practice that ordinarily thrives with physical closeness and social support, into a solitary experience, from postpartum lactation initiation to breastfeeding toddlers.
The various lactation specialists we interviewed pointed out that the management of the crisis, especially during the first months, led to harmful separation strategies between parents and infants, families and their support system. The Director of a Neonatal Intensive Care Unit (NICU) in the Northeast, Catherine, a White neonatologist, deplored that at her NICU, COVID-positive parents and those who live with them were initially prohibited from visiting their premature babies for 14 days, making the establishment of lactation extremely difficult.
For some households, however, the social isolation resulting from the response to the pandemic helped. Catherine noticed that breastfeeding rates at her hospital rose by 10% in April and May of 2020. She explains,
Women are admitted, and they have their baby, and maybe they’re nervous, and they don’t want their baby to go to the well-baby nursery, so they end up just nursing the baby all night long. They have no visitors, so Uncle George and Grandpa Jim and their well-meaning neighbor are no longer coming to see them… Nobody is saying, “Oh, I want to hold this baby.” Normal processes of moms doing skin-to-skin and bonding with the baby can happen. There’s no interruptions anymore.
But limits on the number of visitors can have a negative impact on lactation, other lactation professionals pointed out, as they may prevent key relatives or friends from helping. Additionally, some participants highlighted that early hospital discharges, which became common, may have contributed to inflating breastfeeding rates in hospitals. Parents were discharged after having been counted as breastfeeding, but before their milk had the time to replace colostrum, thus before most lactation difficulties leading to weaning arise.
Once back home from the hospital, the new parents we interviewed felt extremely isolated. Bethany (Fig. 3), a first-time Black mother and lawyer who gave birth at the beginning of the pandemic, commented, “if I had to use one word to describe that experience it would be lonely. Very, very lonely.” Despite her loneliness and the ordeal she went through to establish lactation without access to in-person lactation support, breastfeeding is a source of intense joy and pride for her—in Botz’s picture she is beaming while feeding her baby. Indeed, isolation can be a blessing or a curse depending on the situation. If some parents missed the emotional and material support friends and relatives would have normally contributed, they were also shielded from the intrusion of outsiders, their judgments, and their gaze. Seclusion allowed a few to express milk or feed at the breast when and where they wanted without disruptive interventions or having to cover up. Anahita, a Black attorney, confided, “one of the unexpected privileges of the pandemic is that there aren’t people coming by.... I can just freely breastfeed in my house and not feel shy about that.” Carla, a Sisseton-Wahpeton lactation consultant and founder of several initiatives to support breastfeeding in Native American communities, observed that the Indigenous families she serves are disconnected from their elders, which is a huge loss, but “at the same time, people don’t have doctors undermining their experience, so they’re really successful in breastfeeding because they don’t have someone that’s constantly checking their babies’ weight and freaking them out about their supply or their babies not getting enough milk.”
The outbreak concurrently diminished the lactation counseling offering by limiting in-person consultations and broadened it with the turn to online spaces. Black breastfeeding advocate Nicole saw a reduction in cost for online lactation counseling, including sliding scale options, suggested donation, and free help. But as White nurse practitioner and lactation consultant Judith remarked, providing remote services “is not easy. When a woman is having difficulties with latching and she’s using a phone, holding it over her shoulder, and I’m talking her through how to latch, it could be difficult. I’ve had two patients turn around and say, ‘I can’t do this,’ and—and, ‘I quit.’... One woman gave up entirely, and one woman said, ‘I’m just going to pump.’” Similarly, Nina, a White midwife, noted,
online resources are better than nothing, certainly. But I just don’t think there’s any way that it’s really going to replace the feeling of getting out of your house and going and being physically with other humans going through the same thing that you’re going through. . . . Finally, now at least there are lactation counselors and postpartum doulas who go in person to make house calls and thank God. Because, you know, for a while, nobody was going. (Fig. 4)
As a mother of a baby herself, she was also speaking from experience. In the picture, she is nursing her son to sleep, while trying to enjoy some rest. Alicia, a White lactation consultant who directs a WIC lactation clinic serving impoverished, primarily refugee and undocumented immigrant populations, noticed that “a lot more people are willing to give breastfeeding a try because they’re home with their babies,” before adding that “there’s more stress involved because they don’t have as much access to support.”
Again and again, the parents we talked to cited the proverb “It takes a village to raise a child” to characterize the primary loss they experienced—the sudden and brutal cutting off from their social circle and various support systems. Black critical care nurse Victoria (Fig. 5), who gave birth to her second child in the first weeks of the pandemic, found the postpartum experience radically different than with her first child, “with my daughter, I was part of different mom groups, and I had playdates, and I could go for walks and go the park with different people, and with him... I had to do everything over Zoom, and it’s different than when someone’s physically there with you... it’s more lonely this time.” Similarly, Yael (Fig. 6), a White entrepreneur who gave birth to a second child early in the pandemic exclaimed, “so much of early motherhood is about commiseration with your mom friends. I miss it terribly. I feel that my mom friends are the ones that lifted me up and kept me alive, literally.” In this picture, she is seen breastfeeding her newborn at her parents’ suburban house, where she temporarily relocated, catching up on work for her online business. Queer Afro-Latina new mom and community organizer Aimee (Fig. 7) explained, “the main issue is a lack of community support for women. The majority of people supporting women are other women and that’s how it’s been the same since the beginning of times.”
While caring for infants is extremely demanding physically, cognitively, and emotionally, social isolation creates different hardships for different people. The more privileged, who live in single-family homes or apartments, talked about the fatigue of being one-on-one with their children for extended periods of time, while the least resourced, sharing homes or rooms with multiple people, regretted the lack of privacy. For affluent parents, the crisis was an opportunity—or catalyst—for relocating from urban areas to the suburbs, the country side, or foreign countries. Sienna (Fig. 8), a White bar owner who had been “trying to figure out how to get our kids a backyard and have a little more space for a while,” moved out of the large city where she resided when her bar was “shut down.” In this photograph, she can be seen reading stories to her children while nursing in her city apartment filled up with cardboard boxes in preparation for the move. Li-jing (Fig. 9), a Chinese-American journalist and breastfeeding activist, recounted that “the wealthiest families in the Taiwanese community [in her California town]—the mothers—took the kids and flew back to Taiwan while fathers stayed here to work. They feel that the Taiwanese government is doing a much better job to prevent the spread.”
For less-resourced families, stay-at-home orders were a source of intense psychological and spiritual anguish. Latina tattoo artist Theadora (Fig. 10) gave birth a few days before the March 2020 stay-at-home order went into effect in her state. She was expecting her mother to move in with her to help with the baby, but ended up alone with her husband, ‘You need a village to raise a baby—it’s true 100 percent, and I didn’t know how much until you don’t have that village.’” It all came to a head when she was hospitalized for a breast infection and could no longer breastfeed nor hold her baby due to her debilitating pain and drug regimen. In this picture, she wanted to be represented lying down, feeding at the breast serenely, after recovering from her illness and being able to nurse again painlessly. Natasha, a Latina WIC recipient who immigrated to the United States a couple of years before the outbreak, emphasized that she had to do “everything alone” upon returning home from her Cesarean section. Her main connection to the outside world used to be through her church and outdoor play with her kids. She bemoaned that she “cannot do that” anymore. “That’s heartbreaking,” she added—life has become “very monotonous, because it’s every day the routine, the stay at home.”
Isolation can be particularly challenging in certain life situations and for certain communities. Under the shelter-in-place orders in her state in 2020, Chelsay (Fig. 11), a White nurse, found herself going through chemotherapy while caring for a 4-year old and a baby born with a genetic disorder of bone growth, while her husband worked remotely and faced significant immigration issues. She stresses that “one of the things that I was so frustrated and just really angry about when the stay-at-home order came was that it ripped a lot of my support system away.” She was suddenly cut off from her “very strong village of mamas.” As someone who used to spend significant amounts of time parenting outdoors in the company of others, she resented being stuck indoors in an apartment not “know[ing] how to be a mom at home.”
Carla emphasized the immense intergenerational and spiritual costs of COVID-19:
for most of our tribal communities. The postpartum period—those first 40 days after a baby is born are—is sacred. There are ceremonies. This is a time when the baby would be cared for by the mom who would be cared for by her mom and her aunties and her grandma, and people would be cleaning and cooking and just loving on them so that they can just focus on nursing and getting to know each other, and families do not have that.
Given the health disparities affecting Native-American communities as evidenced by the skyrocketing per capita coronavirus infection rate in the Navajo Nation during the spring of 2020 , Carla notes that people are “afraid to have elders come into their homes; they’re afraid of exposing them to the virus.... but because of that they’re missing out on the teachings.” For the next year, or possibly longer, she laments that critical rituals such as sweat lodges, pow wows, canoe journeys, and the honoring of the newborns will not take place, with “devastating” consequences given “the importance of ceremony and culture and the reclaiming of cultural practices for health and wellbeing. For a lot of people ceremonies is what keeps them sober. It’s what keeps them alive because they’re part of a family that’s healthy and takes care of them. And how are we doing that during this time?”.
Milk as a coping strategy—“the milk... is gold for her. She’s gonna get antibodies”
The second theme we identified is the construction of human milk feeding as doubly necessary during the crisis because of its protective effects against COVID-19 and many parents’ near-constant proximity to their children. Human milk became a means to cope with the health and social effects of the crisis: the risks of falling ill to COVID-19 and the intense stress of being isolated without support.
Breastfeeding and human milk are glorified in US society as “‘liquid gold,’ believed to provide immunological benefits unparalleled by infant formula” . The initial uncertainty as to whether SARS-CoV-2 could be transmitted via bodily fluids, coupled with the politicization of the health crisis destabilized this social construction of human milk for some, while reinforcing it for others. Li-jing (Fig. 9) says that many new mothers in her community chose not to breastfeed: “They speak limited English, and they still rely on information from their home country—say, from China, from Taiwan, or from the Philippines and since the outbreak, the Taiwanese and the Chinese governments have been telling moms to switch to formula.” It is also a “trust issue,” stemming from the anti-Asian coronavirus rhetoric encouraged by former President Trump, which is “failing Chinese-American moms. They don’t trust the American CDC as much as before.” Li-jing continues, “we already know that second- or third-generation mothers breastfeed a lot, but it’s the first-generation moms; they don’t. It’s harder for them to get started. They don’t get the support they need in the hospital” in part because of the dearth of lactation consultants who identify as Asian or speak their languages . With the crisis, these parents found themselves more than just physically, socially, linguistically, and culturally isolated—according to Li-jing, they felt less comfortable seeking and accepting support from outside their community given the surge in anti-Asian violence as well as anti-mask sentiment.
Nearly all the parents in our sample expressed that the pandemic changed their infant feeding patterns and goals. Several cited the potential immunological benefits of human milk against the coronavirus as a reason for not weaning and even for relactating. Carla reported hearing from the communities she works with “lots of people wishing they were breastfeeding” to provide their children with antibodies. She added that “the number of people who reach out to us for inducing lactation, asking about relactation, or upping milk supply has gone up.” For Chelsay (Fig. 11), a perinatal nurse, COVID-19 was an additional reason to feed her infant human milk. She discovered that she had breast cancer when she was 35 weeks pregnant, just a few weeks before COVID-19 exploded in the United States. Of her diagnosis, “the most devastating part,” she says, was that she “wouldn’t be able to do that [breastfeed] for her” daughter. Her oncologist gave her “three weeks and a day to nurse her” baby, after which she had to wean abruptly to begin treatment. She found mothers in her community who gave her some of their extra milk. On this image, she is seen in her living room feeding her baby donor human milk. Both she and her daughter are immunocompromised, which Chelsay explained made human milk feeding even more critical—“she’s [her daughter] getting antibodies from all of these moms and building up this great immunity.” As a health worker working on becoming a certified lactation consultant, Chelsay knew that human milk was not a vector of SARS-CoV-2 contamination. She even hoped that one of the batches of milk she received was from a COVID-positive donor—“that milk might be extra special,” as it could include SARS-CoV-2-specific antibodies.
Human milk feeding was not just a way for parents to protect their children from the virus. Several also experienced it as a form of coping mechanism when they were isolated from their support system and yet in near-constant contact with their children. This increased proximity intensified lactation. In many households, there were no more schedules, no more breaks, no more boundaries. Several women indicated that their baby or toddler sought nursing at breast nearly constantly. Midwife Nina (Fig. 4) declared enjoying being home more than usual with her continually nursing toddler, but “then sometimes I just feel like, ‘Just get your hands off me, please.’”.
Before the virus hit, a number of research participants had planned to wean or increase their milk expression regimen to gain more autonomy. They reversed course. The decision was not only motivated by the desire to “protect” their children from infection. It was also a response to the continual closeness to their children. Li-jing (Fig. 9) says of her toddler, “I think this pandemic has prolonged our breastfeeding plan because he has been home with me, and he became very attached to me, and it’s very hard to wean him in this situation.” She chose to be photographed during her children’s bedtime routine. She is seen reading a book to her oldest son, while nursing her youngest.
In early March 2020, stay-at-home mother Vera (Fig. 12) was prepared to pump so as to leave the house from time to time, allowing others to feed her baby, “but now it just sounds like a horrible idea.” She let go of her nanny; her niece, who used to live with her and help out, left. She’s alone all day with her kids while her husband works long hours from their basement. In the picture, she nurses her baby, while playing with the sunlight with her toddler. These two images—Li-jing’s and Vera’s—illustrate how the pandemic affected the meaning and practice of lactation, but also how, more than ever, lactation has become a task to combine with many other paid and unpaid ones, such as here caring for older children.
Multitasking—“I have to breastfeed while I’m working”
Nearly all the parents we interviewed expressed their frustration with the need to combine lactation with a host of other paid and unpaid forms of labor. Essential workers talked about having to express milk at work using heighted precautions to avoid contamination with SARS-CoV-2, which they feared could be present on hands and surfaces, while holding onto jobs that often failed to provide them with adequate lactation breaks and facilities. Even for Nina (Fig. 4), who enjoys a favorable social and professional position as an independent midwife, and access to her hospital’s on-call room and hospital-grade pump, the decision and logistics around whether and how to express milk was fraught, “I went back and forth a lot in the beginning about should I even be pumping at all when I’m at the hospital? Is that a safe thing to do, you know, in terms of COVID prevention? Not pumping at all was not an option because for my own physical well-being I needed to pump, but then, should I toss that milk and not save it? Is it not safe?” Victoria (Fig. 5) went back to working 12-h shifts as an ICU nurse in June 2020 after giving birth to her second child in April. She was only able to maintain her lactation thanks to the $500 high-tech, wearable pump she purchased out-of-pocket, as it was not covered by health insurance,
because of the pandemic and everything, we’re really short-staffed, so there is no way I could get away four times during my shift and pump. With my Spectra [a regular electric pump], I usually pump 15-20 minutes, but . . . we only have one lactation room for the whole hospital, so I have to go down to the third floor, set all my stuff up, then actually pump, then pack up all my stuff, take it back to my unit, clean everything—it would take, easily, 30 minutes, and I can’t do that four times per shift.
In Botz’ photograph, Victoria is seen at home feeding her baby at the breast and showing a picture of her wearable breast pump on her phone. This pump allows her to express milk while caring for patients unbeknownst to others. While pumping, she can empty catheters, push stretchers, pull up, turn, and transport patients, and take them to get MRIs or CT scans. Other than bending over, which could spill the milk, when she is wearing the pump “there’s nothing I can’t really do, so, it allows me a lot of freedom.” Lactation is still “a lot of work” she emphasizes, before expanding, “the whole pumping thing is a lot of work, and trying to figure out the schedule and—if you do have a regular pump break—or even if like me you are using the wearable pump, you still need a supportive environment.”
For teleworking parents, being home was both a benefit and a burden depending on their professional and life circumstances. White-collar jobs with good salary and benefit protections afforded parents the financial ability to secure in-home childcare or at least the flexibility to work around their lactation schedule, rather than the other way around. For instance, Latina neuroscientist and single mother of two Iris (Fig. 13) is an exclusive pumper—she only feeds her infant expressed human milk with no suckling at the breast. In the photograph, she is expressing milk while catching up on emails and keeping an eye on her baby who is looking at her from his play gym. As she notes, “the only advantage [of the pandemic] is that, since I am working from home, and I am at home, I sit next to the machine [the breast pump] all day and all I have to do is run to the kitchen and get my stuff and just strap it on.” When her nanny watches her children, she can pump through meetings and classes from the comfort of her apartment, rather than juggle the complicated logistics of pumping at work.
Brielle, a Black certified breastfeeding specialist and teleworking mother heard multiple reports from her own practice and the online support groups she moderates that many low-income women were forced to give up breastfeeding due to the difficulty of obtaining adequate support and the overwhelm caused by the loss of jobs, health insurance, and childcare. One of her clients told her, “I can’t even nurse the little one anymore because I have the three older ones all over me all day, and I never get a moment.” Another confided, “Listen, you know, I’m getting WIC. I’m getting food stamps. It’s a little bit easier to just order and pick up the formula, but, you know, I’m out here still trying—in the middle of a global pandemic—to find a job with a six-week-old. It’s just not worth it, you know [to attempt to breastfeed].” Still another stated, “I’m home with all four of my children now. You know, I don’t get pump breaks.” Brielle commented, “you have to respect that you don’t know what she’s going through. Breastfeeding works when it works, but when it doesn’t work for a family, it sometimes can be more of a burden.”
If multitasking is arguably an essential part of parenting, the pandemic has brought it to a new level. In many instances, lactation became an extra burden in addition to wage work, housework, homeschooling, caregiving of children and adults, and admin, among other tasks. But lactation could also be a pleasure and an asset when putting a child at the breast soothes them, keeping them quiet and happy while their parent could complete a work task, a conference call, or interact with another child or relative. Stay-at-home orders saved Talulah and Valentina, both White and married, time and money by relieving them of their commutes to city jobs. On the downside, their children’s daycares and schools closed, necessitating constant juggling so as to combine breastfeeding with other responsibilities. Talulah (Fig. 14), a photographer, is seen editing pictures while nursing her toddler. She shares the childcare with her husband, who also works from home. But unlike her, he does not lactate on top of working, “we divide the days in half, and that, of course, always means that I have to breastfeed while I’m working.”
High school math teacher Valentina (Fig. 15) shared the difficulty of teaching back-to-back classes and attending online student and faculty meetings while home alone with her toddler and two older kids. Her husband works outside the home trying to keep his restaurant business afloat. She was photographed seated in a makeshift home office in a corner of her living room while participating in a professional video-conference meeting with her toddler on the breast. Given her circumstances, nursing sometimes allows Valentina to be a more engaged worker, as she can simultaneously interact with her various work constituencies and keep her daughter happy:
I’m supposed to be present with you [colleague or student]. She’s [her daughter] on my boob. . . . The baby is often on my lap, and they’ll see—she’s on one, and then I flip her, and they’ll see her flipped to the other. I wasn’t hiding the video…. I kept everything on because it’s easier to talk while nursing than to type while nursing. I would get these text messages when I was done . . . Other nursing moms would notice what was happening, but I’m not sure anybody else did.
For women suddenly home due to the COVID-19 crisis, the inability—or reduced ability—to work could be both enraging and financially difficult.At the same time, it could alleviate the dissonance they frequently feel between the expectation that they be nurturing and present for their children and that they be productive and competitive at work. Talulah thus recounts,
for two or three months, I wasn’t really working that much so I was really with the kids more than I normally am. While there was of course the tension of feeling like I wasn’t accomplishing anything or I wasn’t getting to work or I was just caretaking, there was comfort in that, and it was nice to be able to just be with him [her breastfeeding toddler] and to be available for that rather than that tension that you find as a mom when you’re, like, “Okay, I’m going to drop you off at school and go to work for eight hours, and that’s going to be hard for us emotionally but it’s also going to make me a good mom and make me sane.”
Conversely, especially when their wages and benefits are vital to the family, some women may find relief in having to loosen their parenting standards to get work done. Meals become snacks children fix for themselves. Home schooling is not happening. The home is messy. Videos are the new babysitters. As mother of two Victoria (Fig. 5) avowed, “I lowered a lot of my expectations as far as the things I will be doing around the house. I make my life super simple.... it is impossible to just do everything and watch the two of them all day so I’m just trying to be more realistic.” Mother of three Valentina (Fig. 15) stated, “there’s a lot of screen time.... the baby’s watching TV, which I never, before quarantine, would have allowed.” Li-jing was the only parent to say that her “parenting standards are still the same. I’ve heard many parents who have loosed on screen time, but in our house it’s still the same.”
Several participants thanked us for conducting a research project on lactation, as they felt that this aspect of their unpaid, gendered labor had become even less visible with the pandemic, now that it was mostly confined to the home. For instance, Chelsay (Fig. 11) announced, “I’m so happy that you’re doing this research—that you’re interested because I think it’s this kind of unseen impact on mothers that really reaches right to your soul as a mother, but it doesn’t get talked about.” Lactating mothers yearned for visibility and recognition for what they consider to “a lot of work,” as Victoria repeated several times. At the same time, the condition of confinement, can liberate some parents from some of the force of oppressive norms around nursing in public. For instance, as noted earlier, Anahita felt freer to breastfeed in her own home without fear of censure or worry of offending anyone. Since no one was visiting, she could breastfeed without the unwanted visibility that comes with complex attitudes around lactation.
For other participants, the pandemic and the move to online work and socializing brought about increased visibility to their lactation. Some needed or chose to breastfeed in a new sort of public venue—videoconference meetings. Valentina’s colleagues could now watch on Zoom (if they paid attention) her wage labor redoubling as lactation labor (Fig. 15) as she often fed her daughter at the breast during remote faculty meetings. In ordinary times, this sight would have been unavailable, either because she arranged her lactation schedule around her work hours, or because she expressed milk at school inconspicuously in an enclosed, designated space.
For White breastfeeding mother and teleworker Greta (Fig. 16), online public lactation proved more fraught than in-person public lactation. Before the pandemic,
nursing in public and nursing around other people was a priority—not that I was ever intending to shove it down people’s throats or be flamboyant about it, but I think that it’s cool and you have to feed your baby when your baby’s hungry, no matter where you are, and it’s not a big deal, and we should all recognize that.”
Now that she was home working remotely, she turned off the camera during meetings—and sometimes her mic too—when feeding at the breast or pumping. But to be as efficient as possible, she carried on with her work assignments as she expressed her milk, as seen in Botz’ picture. Similarly, Iris (Fig. 13) disabled her camera when she pumped during work meetings.
By contrast, Valentina (Fig. 15) kept her camera on when nursing during faculty and staff meetings. Bethany (Fig. 3) did too, though she “tilts it up” so that her feeding at the breast is barely noticeable (but still hearable). White dance artist and body worker Ailey, who transitioned to teaching movement classes online to an audience predominantly composed of adult women, stated, “if I’m in Zoom and I needed to breastfeed, I would breastfeed.... My baby’s, like, very mobile now, so he often just, like, stands up and kind of crawls over and pulls my shirt down, which is what he’s kind of doing right now.” If breastfeeding in plain sight while working remotely was not experienced as problematic for these mothers, Greta and Iris only felt comfortable expressing milk off-screen. This difference reflects American culture’s growing acceptance of feeding at the breast in public but the continued perception of milk expression as a practice that should be kept hidden, as will be discussed below.
Human Milk—“Human connection”
The final theme we identified is that at a time when they felt lonely and isolated, parents saw human milk as a “human connection,” a link to others—a “liquid bridge” to use Tanya Cassidy’s expression . With multiple crises raging—health, racial, political, economic, environmental—many parents yearned for the emotional and physical connection lactation can foster.
As White lactation consultant Katie shared,
I’ve gotten three texts in the last week from people I know who are isolating with their breastfeeding toddler, and they’re like, “All he wants to do is nurse all day long.” . . . Kids are so perceptive, and they know when we’re stressed out or when we’re having big emotions, and so they respond by wanting connection, by increasing their attachment. And…it’s normal, but it can be overwhelming, and it doesn’t mean that it’s easy.
Lactation in quarantine proved a strange mixture of loneliness and bond in which human milk feeding connects parents and children, but also families and friends through the peer sharing of human milk—the practice of donating and receiving human milk directly from family to family without resorting to an intermediary institution such as a human milk bank.
Some of the parents reported producing and giving away more milk than they anticipated. They were spending more time at home with their children and thus had less (or no) need for expressed milk to feed them in their absence. They wanted to help out and empty their freezers to make room for solid foods at a time when frequent grocery trips were discouraged. Greta recounts, “I had built up this supply thinking I would go back to the office, and it was taking over our freezer. I think I donated—the first donation was 200 oz or something.” For Brielle, the pandemic was a motivation to relactate so that she could donate milk and boost her own son’s immunity. She had been missing lactation since she had weaned him a few months earlier. In early March 2020, while at a breastfeeding conference, she received an email from a panicked new mother who wrote, “I’m supplementing, and they’re saying that there’s not going to be enough formula if we go into a lockdown. I don’t know what to do.” Brielle “came back home from the conference that day and said, ‘I’m going to relactate. We are going to do it.’” In just twenty days, she was able to build up her supply back to 20 oz per day, allowing her to donate to local parents as well as military moms.
Before the pandemic, informal human milk sharing used to be a venue for various forms of relationships among families, such as socializing and community organizing [35, 36]. With social distancing requirements in place, milk exchanges moved to porches and empty parking lots with no (or minimal) physical contact. Yet, they continued to be prized opportunities for connection. Stay-at-home mother of two Marwa (Fig. 17), who identifies as Arab and Muslim, has donated hundreds of ounces of milk to a devout Christian mother. They meet “masked up” on her front door or driveway. They do not get the chance to talk much, but Marwa appreciates that they share a “similar faith,” giving them “a bit of a connection.” In this picture, Marwa can be seen with her older son. She is holding three large bags full of her bottled expressed milk ready to hand off to the receiving mother, who is standing in the corner of the picture’s foreground.
When the pandemic hit, Aimee and her husband (Fig. 7), who live in a large urban center, purchased a car, which proved key to collect donor milk around the city and beyond when she had to supplement and then quit nursing. Initially, “it was like going out to get supplies during a zombie apocalypse.” But with some donors, they “were out in the yard together with masks on”—a rare occasion to meet in person and socialize. The picture shows her back home feeding her baby donor human milk while wearing her Black Lives Matter tee-shirt.
Socially distanced milk sharing can represent a unique way to maintain an emotional connection in some instances. Ittai, a White academic, and his husband had a daughter days before COVID-19 was declared a pandemic. Their gestational surrogate volunteered to donate her milk, but she lived on an island connected to their town via a ferry service that was curtailed due to government restrictions to curb the spread of the virus. Instead of visiting with one another regularly, as they had hoped for to maintain their close connection, they ended up sharing milk via an uncommon type of transportation. Initially, Ittai looked into using traditional shipping carriers, but “they were all difficult now or expensive or it wasn’t possible.” Desperate, he turned to a seaplane company that usually operates a touristic and high-end commuting route. When he called, he thought, “there is no way that they are going to do it... But they were very skilled about it and very laidback, easy. They said, ‘Of course, bring it,’ and gave some instructions. It wasn’t even as expensive as I thought it was going to be.” When he collected the first batch from the airport, it was the first time he had left the house after three weeks of strict quarantine. It felt surreal. Attired with gloves and a mask, he walked empty streets to the terminal, “there was no one in line, of course, because who would even use them [seaplanes] these days?”.
Milk sharing—be it peer-to-peer or through milk banks—epitomizes the pandemic’s twin effect of concurrently bringing people closer together by exchanging a bodily fluid and keeping them apart by effectuating this exchange at a distance. When community transmission rates of COVID-19 are high, sharing the same room, water bottle, or breath of air can put one at risk of infection with SARS-CoV-2, but human milk can to circulate among families with little risk so long as the exchange itself is socially distanced .