*cross-posted at parenthoodphd.com*
Last week, I took my son to the doctor for his 15-month check-up. I tried to keep my son entertained while the nurse went through the standard battery of questions, entering my answers on her laptop:
Is he in a rear-facing car seat? Yes.
Are there smoke detectors in the home? Yes.
Does anyone in the house smoke cigarettes? No.
Is he exposed to wood smoke? No.
Is he still breastfeeding? Yes.
Does he drink cow’s milk, too? Yes.
But then she followed up with one that required more brainpower.
Does he drink whole milk or two percent?
If I had been on my A-game, I probably would’ve gone with the “right” answer (whole milk). But I was trying to keep my son from catapulting himself off the exam table, so I went with distracted honesty: “Uh, a mix of both.”
The truth is that I *never* buy whole milk. My son gets whole milk at daycare. But at home I either breastfeed him or give him some of the 1% milk I buy for the rest of the family. Because when it comes to cow’s milk, my son rarely drinks more than 12 ounces a week at home. He’d much rather have breastmilk or water. So it seems ridiculous to waste money and fridge space on whole milk that will just go to waste.
I probably could’ve explained all that to the nurse. I probably could’ve reassured her that I’m a “good” mother, despite my milk-buying flaws.
But instead, I just waited to see what the nurse would say. At first, she seemed surprised—as though she couldn’t believe I was the kind of parent who would give my toddler two-percent milk. And she paused for a long moment, as if waiting for me to explain. When I didn’t, she launched into a lecture about how, at my son’s age, the fats in whole milk are “absolutely critical for brain development.” I don’t remember exactly what she told me after that (I was still trying to keep my son from jumping off the table). But I know she used the phrase “brain development” at least three times.
When the nurse finished, I said something like: “Okay. Just whole milk. I can do that.” The nurse nodded approvingly and then continued down the laundry list, asking about whether he’s still using bottles, whether he’s been to the dentist, and whether I brush his teeth regularly at home.
The whole interaction left me thinking about parents whose circumstances prevent them from being able to give the “right” answers to that laundry list of questions. And especially about parents who are marginalized by racism and economic inequality, whose “wrong” answers can quickly lead to scrutiny, scolding, and shame.
In their research on food and families, sociologists Sinikka Elliott and Sarah Bowen find that racially and economically marginalized parents are regularly criticized by their children’s healthcare providers for making the “wrong” food choices for their children. As one white grandmother of three explained:
They treat you like you’re dumb as dirt. You’re doing something wrong, the kids are fat, they’re in the upper 95 percentile or the top 100 percentile, way above some of the other kids. They tell you they’re too fat, but you let them lose a pound, your next visit they chew you out because they lost a pound. But they’re telling you the visit before they’re fat. Don’t give them the whole milk. First give them whole milk, then don’t.
Essentially, Elliott and Bowen find that healthcare providers are quick to judge marginalized parents who appear to be making the “wrong” choices about their children’s diet and weight.
And those judgments create real fears for parents. They worry that healthcare providers will call Child Protective Services (CPS) and that their children will be taken away. As a Black mother in Elliott and Bowen’s study explained, those fears are why she worries about her daughter being underweight:
Because that’s when CPS comes into play and they definitely do take action. You think they’re not watching but they are, and a lot of us young mothers are scared of that, getting CPS’s attention in a negative light because we don’t want our kids taken away from us. For the ones that do care, we don’t want our kids taken away from us for anything; and it’s something as simple as, “She looks skinny.” That, to me, seems a little outlandish and rude, but you can’t do anything about it.
Economically marginalized white families also worry about healthcare providers reporting them to CPS (see Elizabeth Gage-Bouchard’s research on families of children with cancer and Annette Lareau’s classic study of social class and childrearing). But Elliott and Bowen find that those fears are particularly pronounced among Black families. And those fears are justified. Black families are disproportionately targeted for investigation by child welfare agencies. The bulk of those investigations find no evidence of harm. But they leave families deeply fearful of further scrutiny.
Those fears make it difficult for racially and economically marginalized families to trust their healthcare providers. And that lack of trust is amplified by the structure of the healthcare system, by the way the healthcare system policies marginalized patients, and by the demographics of the doctors patients see.
As an affluent, white parent, it’s easy for me to trust the medical system. Because the medical system trusts me. Most of the time, I have the “right” answers to that laundry list of questions. And even when I don’t, I still look like the kind of parent who has a “good” reason why.