This World Breastfeeding Week, I’m inviting Palestinian Mothers to the Table
By Elizabeth Moore Simpson
[Trigger warning: infant loss]
“The children are always ours, every single one of them, all over the globe; and I am beginning to suspect that whoever is incapable of recognizing this may be incapable of morality.” —James Baldwin
There is a universality of feeding our babies that all parents share. All forms of infant feeding require a deep connection, as a baby’s life depends on their caregiver. Many different ingredients create the recipe that feeds babies: milk sharing, co-nursing, wet nursing, combo feeding, formula, and more. Our ability as humans to nourish our babies, others’ babies, and each other is a magic second only to the magical adaptability of human milk and the miracle that is formula.
I feel a special kinship with the milk donor moms who shared their milk with my baby in the first six months of E’s life. I have a special fondness for their babies, whose milk was designed for their nutritional needs, yet nourished my own child’s through the process of glandular tissues communicating with the baby’s spit to reformulate the nutrition based on her baby’s needs at the time. I would prop myself on the counter in the dim early morning light of the kitchen, warming bottles of frozen breastmilk, reading the dates and times the milk was pumped, for their baby or mine, lovingly, painfully, exhaustingly. In return, I wrote love notes on replacement storage bags and sent them back with hand-packed satchels of lavender.
I would give my baby a bottle with a side of apology, “We didn’t get to share so much. I wish I could’ve given you a personalized compound of exactly what your body would tell mine to create for you.” I felt like a lesser mother. A mother who couldn’t provide the most natural sustenance, human milk that my body was designed to create, but could not. I staved off my depression and guilt with a never-ending quest to sustain an exclusively donor-milk fed (EFD) baby, for which I ultimately failed.
Always vigilant, I was constantly planning where, how, and who was going to pick up the next day’s or week’s worth of breastmilk. Who would deliver it to us? Which mom was in a position to share at any given time? Calculating how many more ounces she needed for each feeding, the anxiety mounted. I would open the fridge and see just a bag or two of “liquid gold.” I could only manage that hustle for 6 months before reluctantly transitioning to formula. The American Academy of Pediatrics (AAP) recommends, “exclusive breastfeeding for approximately 6 months after birth….Furthermore, breastfeeding, or the provision of human milk, should be considered the reference standard to which all forms of infant feeding are compared from a biological, medical, and scientific standpoint.” (“Policy Statement: Breastfeeding and the Use of Human Milk”)
There are many reasons that parents can’t or don’t, feed their babies human milk. What does the American Academy of Pediatrics say to those parents and their infants, like me? And what is their response to Palestinian mothers unable to feed their infants as a result of the mental trauma and physical violence of the Israeli siege of Gaza, funded, overwhelmingly, by US tax dollars?
In 2022, when national formula shortages swept through the United States and locating cans of formula was a sick and twisted scavenger hunt for frantic parents, my heart ached, holding those parents tenderly in my heart in their desperate search to fill their babies’ bellies. Along with dozens of other concerned moms, I participated in community resource sharing, documenting formula supplies in various grocery stores, and collecting the specific cans our PS-WA clients needed.
The following year, we exclusively formula-fed our second child, Z. I was unable to release myself from the grip of guilt and expectation attached to the benefits of breast milk, but I was thankful for easy, consistent, and reliable access to formula. Although not the biological food for infants, formula is a modern miracle, providing the consistent 20 calories an ounce needed to sustain a delicate, fragile, precious newborn. I often thought of those desperate parents when I repeated the same hypervigilant loop of the meticulous sterilizing and portioning of formula we made for our second child during his first days in the NICU. I wondered how, on top of everything else, I would have managed to traverse the city to find his specific formula during such a tender postpartum period.
How fortunate I am now to reflect from afar on my very different but equally exhausting, demoralizing, and tearful postpartum periods and feeding journeys. At night, as my chunky toddler curls up in my armpit, complete with his bottle, I succumb to doom-scrolling on social media. I watch Palestinian parents clutching their emaciated babies who are clinging to life, or worse, babies clinging to their dead parents in Gaza. This experience highlights the unimaginably devastating catastrophe of postpartum realities for parents and babies in Gaza, whose access to basic life-sustaining necessities is nearly non-existent. Parenting in homes reduced to rubble, cooking over open flames without access to clean water, and being assaulted in so-called ‘safe zones,’ hospitals, schools, and queues for food.
We bear witness to many atrocities on social media, locally, and globally, that connect to our work at PS-WA. I recently revisited resources circulating in birthwork spaces about bodyfeeding in an emergency in response to the flash floods in the American South. The CDC, in its guide on Infant Feeding in an Emergency, dictates, “Breastfeeding is the safest way to feed a baby during an emergency. It provides the nutrients and infection protection that babies need” (“Infant and Young Child Feeding in Emergencies Toolkit.”) During an emergency, sanitation, hygiene, and access to potable water are impacted. The CDC continues,
“Powdered infant formula feeding requires safe water to prepare the formula and cleaning supplies to clean bottles, nipples, and other parts. These resources may not be readily available in an emergency. Powdered infant formula cannot be made in advance without adequate refrigeration. These requirements can create difficulties for families using infant formula.”
The benefits of bodyfeeding, in an emergency or not, are evident. This led me to explore the CDC and other public health institutions’ research gap about a manufactured emergency like the US-backed genocide in Gaza, which limits access to resources essential for infant feeding of any kind. But the CDC and other public health institutions do not provide guidance on how to navigate public health emergencies created by genocide or other sociopolitical atrocities, limiting access and creating a culture of silence around resources essential for all infant feeding.
What is not lacking in data are the merits of bodyfeeding; benefits are innumerable for a baby’s growth and development. Babies fed human milk have more protection against some illnesses and diseases; they have a lower risk of type 1 diabetes, asthma, and sudden infant death syndrome (SIDS), ear infections, and stomach bugs. There are also many benefits for the birthing person. “Breastfeeding has health benefits for the mother too! Breastfeeding can reduce the mother’s risk of breast and ovarian cancer, type 2 diabetes, and high blood pressure.” (“Infant and Young Child Feeding in Emergencies Toolkit.”)
But what are the parents of Gaza to do when they are too malnourished to produce milk and there is no formula, let alone the specific one for their baby’s needs? The wide-reaching impact of the siege, preventing food and medicine, the chronic stress, the displacement, and the compounding losses experienced by parents can only be conjured in my worst nightmares. According to the World Health Organization (WHO), this year’s World Breastfeeding Week comes as “an alarming 99% of breastfeeding women [in Gaza] are unable to produce sufficient milk due to their malnutrition, further highlighting the cascading effects of the crisis.” (“Malnutrition Report – Ten Months of Monitoring Acute Malnutrition in Children, Pregnant and Breastfeeding Women in up to Six Healthcare Facilities in the Besieged Gaza Strip.”)
My Palestinian counterparts in what feels like another dimension of reality, miles across the Atlantic, are grieving, among other incalculable losses, a bodyfeeding relationship with their babies as they are too malnourished to produce milk. As one mother told the Associated Press, pleading, “I just wish a doctor would tell me, ‘Your weight is good.’ I’m always malnourished.” (Ali) But bodyfeeding mothers need proper nutrition and hydration to produce enough milk to feed their infants. Without adequate maternal nutrition, infants can’t get the human milk required to fight diseases and infections.
Bodyfeeding requires, on average, 2,500 calories a day and at least one session of at least 4 hours of uninterrupted sleep. This nourishment is also essential to the mental health outcomes for postpartum parents. That required caloric intake is impossible in Gaza, as the Palestinian population is being intentionally starved through aid blockades. A report from the Oxfam stated, “People in northern Gaza have been forced to survive on an average of 245 calories a day – less than a can of fava beans – since January [2024], as Israeli forces continue their military onslaught.” (“People in northern Gaza forced to survive on 245 calories a day, less than a can of beans”) It’s hard to imagine that the minimal sleep conditions for mothers in Gaza are attainable. In my sleepless nights, contact-sleeping with my anxious toddler rarely provides me 4 hours of uninterrupted sleep; however, when he wakes us from night terrors, I know I can soothe him, reassuring him with sincerity that we are safe.
“According to a WHO report…. undernutrition during lactation is one of the determinants of women’s health and the health of the next generation. The nutritional status of lactating mothers is an important public health issue since their nutrition status may influence both the quantity and quality of nutrient concentration of breast milk, and also maintaining the nutrients in the breast milk further depletes their own body stores. A lactating mother is not only living for herself but also for the infant, family, and society and she carries great responsibility in the family. Chronic undernutrition among women is a major risk factor for adverse birth outcomes.” (Wubetie and Mekonen)
As I rush to manifest a breakfast my children might eat, I plunge my face into the fridge’s cold to shield my children from my tears for Jouri Al-Masri, a three-month-old who died on June 27th, 2025, after her mother lost the hunt to find the lactose-free formula she needed (Ali). My heart breaks for her mother, who watched her precious new baby wither away. At three months old, E also struggled with undernutrition and was diagnosed with Failure to Thrive. In partnership with her entire medical team, closely assessing her growth, we followed a regimented and methodical care plan to increase her body weight. The availability of resources and early attention was the vital course-correction needed to support my daughter, the lifesaving care Jouri and her mother were denied.
Witnessing your baby starving compounds another crisis: mental health. A birthing person and their support system need to be constantly monitoring and problem-solving around feeding challenges, which are challenging enough in the safest and most resourced of conditions while recovering postpartum. The current access to perinatal care for birthing people and their babies in Gaza is heartbreaking, knowing that parents are lacking the necessary layer of care and holding, traditionally provided by mental health providers, doulas, and midwives.
In discussion with Special Supplemental Nutritional Program for Women Infant and Children (WIC) counselor and International Board certified Lactation Consultant (ILBCC), H shared, “Feeding relationships, whether by human milk or formula, are cited as major contributors to the outcomes of their parents’ mental health. Good feeding relationships can lead to increased sleep, a positive outlook, and a strong relationship in the dyad. Whereas challenges with feeding lead to the inverse, a more strained relationship, worse sleep, worse self-esteem.” What is to be done for the perinatal parents whose children and infants are dying of malnutrition?
Hurriedly, I pack lunches, distracted by the news of five-month-old Nidal Shoraab and 10-day-old Kinda al-Hams, babies admitted to the NICU who died shortly after of starvation. “The fortified formula required for newborns is already out of stock at Al-Rantisi Hospital in Gaza City, its director, Dr Jamil Suliman, said.” (Ahed) The full impact of the chronic stress during pregnancy and lactation is yet to be concluded as the situation continues to devolve and worsen. The horrors can only be imagined in my worst nightmares, and yet medical professionals on the ground are resolute: “We don’t need to wait for future impact. The risks are emerging now” (Jahic).
The feminist adage that the personal is political rings more true than ever in the most intimate settings of pregnancy, birth, and infant feeding. Lactation consultants, mental health providers, birthworkers, parents – we all owe the mothers of Gaza our urgency this World Breastfeeding Week. The liberation of Palestine is a perinatal mental health issue, it is a food justice issue, and it is a reproductive justice issue.
What is preventing our society at large and, more specifically, our parenting communities and professional forums from collectively caring about this systematically induced perinatal trauma? If these were our neighbors, like those who couldn’t find formula in 2022, or those who can’t find it now in Texas, New Mexico, and North Carolina, would it be easier for us to digest and act on how devastating and inhumane these conditions are?
The American Academy of Pediatrics (AAP) published a policy statement, updated in 2024, stating clearly that children should be protected from the direct effects of armed conflicts and their food, housing, health, and other basic needs safeguarded: “As pediatricians, pediatric medical subspecialists, and pediatric surgical specialists, we understand that the profound cost of any war is measured in children’s lives—those lost to violence and those forever changed by it. We know that what happens to these children today and what we do for them will help determine what becomes of this generation tomorrow.”
I asked my friend Eva, a Seattle-based pediatrician, to reflect on this statement from the AAP. She synthesized the connections between her feeding journeys and her clinical knowledge: “This is accurate in so many ways, both from my lens as a pediatrician and a mother who has breastfed three children. We know the effects of trauma on a developing brain are life-altering. This happens indirectly: stress from your parents living in unsafe environments and poor nutrition, increasing stress hormones, which can lead to pre-eclampsia, low birth weight, premature birth, and other complications. It also happens directly from living in this same environment once born, as well as a lack of adequate nutrition. When I was breastfeeding twins, I felt like I didn’t have enough room in my stomach for all the calories I needed to eat and fluids I needed to drink, and yet, despite having all of this at my beck and call, the twins were still supplemented with formula. Now imagine that you are not able to access enough nutrition for your body to produce milk, and you cannot find sanitary water to mix formula. This is not an acceptable outcome in our modern world. ”
What prevents us from seeing these Palestinian mothers and babies as worthy of our advocacy and concern? Bringing Palestine into the conversation about World Breastfeeding Week is the minimum. Birthworkers, providers, and parents have an obligation to contact their representatives to demand an end to the siege of Gaza, which is preventing essential aid and relief like formula and food vital for successful bodyfeeding. How can we, parents and providers, leverage our power and privilege to provide the political, psychological, and material nourishment to parents and babies in Gaza? Our bodies and the essential interrelatedness of nourishment serve as reminders of our collective responsibility to ensure that all of our children are fed.
My depression and helplessness, which threaten to swallow me if I let them, propel me to advocate for Palestinian liberation with other parents. Along with Seattle Families for a Free Palestine and dozens of other parents across the country, I will participate in The Parents Fast for Gaza to bring awareness to, “the 1.1 million children living in the Gaza Strip, nine out of 10 are experiencing severe food poverty according to Save the Children” (“Mothers and Doctors in Gaza Say Formula Shortages Risk Babies’ Lives, Blaming Israel’s Aid Blockade”).
This August, parents, caregivers, and friends across the country are launching a solidarity fast to bring attention to the genocidal starvation of the people of Gaza by Israel, demanding an immediate arms embargo on Israel and the immediate, unrestricted flow of aid into Gaza.
In our work at Perinatal Support Washington, we support parents in the feeding journey they desire while honoring their right to self-determination. From a practical end, this can include connecting them to lactation coaching, medical resources on tongue ties and mastitis, enrollment in WIC for formula, bottle suggestions, or troubleshooting breast pumps. In terms of carrying the emotional weight attached to feeding, we often grieve with parents the feeding relationship they wanted, aid in the emotional processing of this change, and normalize the challenges. Having struggled so significantly with my guilt and shame, I find this work to be the most rewarding. My children, now far from those early feeding challenges, are healthy and nourished, even if they are refusing most meals in lieu of popsicles this summer. While they may only remember our feeding issues somatically, I share their stories with them to illuminate the connection to the nourishment of others. They are my biggest advocates in preparation for the solidarity fast, replete with questions, plans for my fast-breaking meals, and sharing their perspectives. They know the importance of our collective responsibility to nourish each other by advocating for Palestinian liberation and that they, too, have a place at the table.
This World Breastfeeding Week, let us center the hunger of Gaza’s 50,000 pregnant women, 5,500 of whom are due to give birth within the next month. (“Women and Girls in Crisis in Gaza”) into our professional and personal spaces because their liberation is inextricable from our own. With our advocacy and support, the families and future generations of Palestine will be nourished and liberated.
Works Cited
Ali, Eman Alhaj. “Gaza’s Babies Starve as Israeli Blockade Cuts off Baby Formula.” The New Arab, The New Arab, 2025, www.newarab.com/features/gazas-babies-starve-israeli-blockade-cuts-baby-formula.
Aziz, Ahed. “Two Gaza Infants Die under Israeli Siege amid Baby Formula Shortage.” Middle East Eye, 2025, www.middleeasteye.net/news/gaza-formula-shortage-two-infants-die-malnutrition.
El Deeb, Sarah, et al. “A Pregnant Woman in Gaza’s Ruins Fears for Her Baby under Israel’s Blockade LEE KEATH.” AP News, 29 Apr. 2025, apnews.com/article/israel-palestinians-hamas-war-pregnancy-childbirth-816e743a4d9ef190f55d03bd01b9881d.
“In Gaza, Daily Food Intake Has Fallen Well below ‘survival’ Level | UN News.” United Nations, United Nations, 5 June 2025, news.un.org/en/story/2025/06/1164076.
“Infant and Young Child Feeding in Emergencies Toolkit.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 2024, www.cdc.gov/infant-feeding-emergencies-toolkit/php/index.html.
Jahic, Naida. “Malnutrition in Gaza: An Overview.” The Borgen Project, Naida Jahic https://borgenproject.org/malnutrition-in-gaza/
“Malnutrition Report – Ten Months of Monitoring Acute Malnutrition in Children, Pregnant and Breastfeeding Women in up to Six Healthcare Facilities in the Besieged Gaza Strip.” Médecins Du Monde, 3 July 2025, www.medecinsdumonde.org/en/publication/malnutrition-report-ten-months-of-monitoring-acute-malnutrition-in-children-pregnant-and-breastfeeding-women-in-up-to-six-healthcare-facilities-in-the-besieged-gaza-strip/.
Meek MD, MS, RD, FAAP, FABM, IBCLC, Joan Younger, and Lawrence Noble, MD, FAAP, FABM, IBCLC; “Policy Statement: Breastfeeding and the Use of Human Milk.” American Academy of Pediatrics, U.S. National Library of Medicine, 2022, pubmed.ncbi.nlm.nih.gov/35921640/.
“Mothers and Doctors in Gaza Say Formula Shortages Risk Babies’ Lives, Blaming Israel’s Aid Blockade.” MSN, www.msn.com/en-us/news/world/mothers-and-doctors-in-gaza-say-formula-shortages-risk-babies-lives-blaming-israel-s-aid-blockade/ar-AA1HsVdg?ocid=BingNewsSerp. Accessed 10 July 2025.
“People in Northern Gaza Forced to Survive on 245 Calories a Day, Less than a Can of Beans.” Oxfam GB, 2024, www.oxfam.org.uk/media/press-releases/people-in-northern-gaza-forced-to-survive-on-245-calories-a-day-less-than-a-can-of-beans-oxfam/.
“Women and Girls in Crisis in Gaza.” USA for UNFPA, 24 May 2024, www.usaforunfpa.org/women-and-girls-in-crisis-in-gaza/.
“Undernutrition and Associated Factors among Lactating Mothers in Rural Yilmana Densa District, Northwest Ethiopia: A Community-Based Cross-Sectional Study.” Wubetie, Biruk Yazie, and Tigist Kefale Mekonen. Food Science & Nutrition, U.S. National Library of Medicine, 12 Dec. 2022, pmc.ncbi.nlm.nih.gov/articles/PMC10002878/.