Breastmilk is amazing. It seems like every week there is a new report detailing yet another miraculous thing the breastmilk can do. It also seems that every week we hear of another woman who received some form of judgment or criticism about the way she chooses to feed her baby.

There are signs that the world is improving for breastfeeding and pumping mothers, but the sad reality is that we still have a long way to go. A recent survey conducted by Aeroflow found that 24% of people think that it is inappropriate to breastfeed or pump in public. Worse than that, 61%—well over half—of people do not think that women should breastfeed or pump in a restaurant.

When it comes to the workplace, even though Aeroflow found that 90% of people think that women should be allowed to pump at work, only 31% believe that workplaces should provide a place for women to do so.

We want her to breastfeed, but she shouldn’t do it anywhere where we can see it, nor do we want to be inconvenienced at work by it. The uncomfortable truth is that despite all the progress we seem to have made, the negative aspects of the patriarchy are alive and well.

So the question is, how exactly is a woman supposed to succeed at breastfeeding when this is the climate she is forced to do it in?

If you are fortunate enough to have a strong foundation of breastfeeding support, I am truly happy for you. I did, and I am forever grateful.

Breastfeeding was relatively easy for me. I am the midwife daughter of a midwife, so my family members and fellow midwives were always incredibly supportive. I had access to my mom, as well as co-workers who could answer any questions I had, help me address a problem just as it started, or simply share the perfect piece of encouragement I needed to hear on the hard days.

But the truth is this is not the experience that so many women in this country have, and we need to start doing a much better job of showing them empathy, not judgment.

We simply do not know other people’s stories, and to judge them for making decisions that are different than our own is not only unfair, it’s mean.

A woman may be giving her baby formula because:

She has a medical condition such as PCOS or hypoplastic breasts that inhibit her body’s ability to make milk.

She had a traumatic birth.

Her baby spent time in the NICU following birth, or she herself was in critical condition, and for a related reason was unable to establish a latch and milk supply during those first vulnerable days.

She is a survivor of assault and the act of breastfeeding is triggering to her PTSD.

She had to return to work at two weeks postpartum (or one month, or three months) and her work environment and schedule do not allow for pumping breaks.

Her baby has a medical condition that inhibits their ability to drink from the breast.

She did not receive supportive care from her birth and immediate postpartum team (i.e. they gave the baby formula despite her request for them not too, they did not provide a pump when her baby was not with her, and more).

Her family, partner or friends do not support breastfeeding and give her a hard time about it every time she tries to nurse.

She’s received misinformation (or no information) about breast and formula feeding.

She has postpartum anxiety or depression, and breastfeeding became too much.

She did not have access to a lactation counselor or consultant to help her when she ran into an obstacle. Not surprisingly, research has found that when a geographical region has more lactation consultants, women in that area tend to breastfeed for longer. Access to professional support helps women overcome early breastfeeding challenges. But in many states, lactation consultants are not covered by Medicaid and are much harder to find.

Also, a patient of mine gave birth in one of the worst winters in history—she made it home fine, but then a huge storm hit and roads were closed near her home for over a week. Her lactation consultant couldn’t get to her when she developed a complication, and by the time the roads cleared and she could, my client’s milk supply was gone.

And here’s one: She is simply choosing not to, and no justification or explanation is required.

There are probably hundreds of other reasons I could add to this list. The point is that we do not know the story behind what we see. So be kind, or be quiet.

Instead of judging a mom for not breastfeeding, here are five things to do that will actually help:

  1. Write or call your local and national decision makers. Tell them about your concerns and request their support in forming legislation that is more supportive of breastfeeding and pumping women. (Psst: Have you tried yet? It makes it so easy to connect with policymakers.)
  2. Keep an eye out for women who are breastfeeding and pumping in public. If you see them being bullied, support them (ask if they want it first, of course). I’ve actually rehearsed this one, just in case. My plan is pretty simple and (hopefully) non-confrontational. If I ever see a breastfeeding woman being harassed, I will just ask if I can sit next to her, and then pretend that we are friends that haven’t seen each other in a long time—I’ll strike up a conversation with her about something random. The point is to just be with her, so she doesn’t have to bear the burden by herself. My guess is that most harassers will just walk away, but if not, she won’t have to defend herself alone.
  3. Talk to your place of work. Whether or not you are expecting or nursing, ask your company about their lactation room availability, and applicable policies. If they don’t have a room, suggest a solution.
  4. Reach out to your breastfeeding friends. Not to make sure they are breastfeeding, but to make sure they are doing okay in general. Let her know she’s not alone, and that you are a safe person to come to with challenges, vents and worries.
  5. Check yourself. I know this sounds harsh, but we all need to do this to make the world better, in general. We all have biases and judgments that will surface subconsciously. The work is then not to react to them, but to observe them. “Wow, I am getting angry seeing that women breastfeeding here in Target. I need to sit with this and see if I can figure out why.” In the meantime, just walk away. Approaching her, yelling at her or even talking to her in a tone you think is kind is not going to help your cause at all. So leave it—and her—alone.