Human milk is the ideal source of nutrition for infants and is recommended as their only food until they reach 6 months of age.1 Breastfeeding (also called chestfeeding) initiation rates in the United States are high (83%), but continuation rates drop precipitously over the first months after birth.2 In the United States, there are significant disparities in breastfeeding rates by race and ethnicity. For example, at 6 months of age, the rate of exclusive breastfeeding in non-Hispanic black infants is 17.2% compared to 29.5% in non-Hispanic white infants.2 Racial and ethnic disparities in breastfeeding rates persist despite a plethora of research,3 supportive policies,4 encouraging recommendations,1, 4 postpartum provision of lactation consultants, and increasing adoption of the Baby-Friendly Hospital Initiative.5, 6 Why then is this physiologic stimulus-response mechanism difficult to maintain? It is time to take a deeper look at the barriers individuals face when they consider breastfeeding or giving their infant pumped human milk. What in this sea of statistics and research are the take home messages for a midwife or other clinician who is providing care for individual parent-child pairs? The barriers to breastfeeding are like the proverbial elephant with 6 blind men. Each breastfeeding study identifies one body part or reason that partially describes why breastfeeding rates are not optimal, but none of them see the whole elephant or the whole problem. Large epidemiologic studies identify population-based risks such as race and poverty that are associated with lower breastfeeding rates,7 but the findings from these studies don't tell me how to best help the family I am seeing as I conduct postpartum rounds. As I reviewed the manuscripts published in this issue of the Journal, I realized that this group of articles collectively tell a story that goes beyond the statistics. These articles describe the story of breastfeeding barriers and ways to look at this problem that help midwives care for breastfeeding individuals. Let's start with the big picture and work toward the specific: As noted by Gallo et al,8 one of the most common reasons women of all races stop breastfeeding is a belief that they have an insufficient milk supply. I suspect this problem could be alleviated for some individuals with targeted education and counseling that is applied at the right time. Easy access to lactation consultants and health care providers in the first few days after birth may assist breastfeeding initiation, but all that support goes away right about the same time a 3-month-old hits a growth spurt and wants to feed all day and all night. Could we end the 6-week postpartum visit with the offer of another lactation-focused health care visit for a nursing dyad? The breastfeeding individual chooses the timing but leaves my office knowing that as soon as insufficient milk supply is perceived, a health care visit will be provided. That may be the low-hanging fruit. What are other problems wherein midwives can have a positive effect? In general, breastfeeding education is not as robust in obstetric residency compared to midwifery education. Radoff et al describe a breastfeeding education curriculum for obstetrics and gynecology residents developed by the midwifery faculty at Boston University School of Medicine.9 The lectures and simulation workshop are provided by midwives, lactation consultants, and obstetricians.9 This curriculum provides a template for one very concrete way midwives can improve breastfeeding counseling and support in their institutions. The articles in this issue that address pharmacologic management of common breastfeeding ailments by Dogruluk and care of women with primary breast engorgement by Gresh provide content for provider-oriented breastfeeding education.10, 11 While knowledge and education about breastfeeding can be helpful, breastfeeding support will be effective only if it is consistently offered. The pilot study in this issue published by Spisma et al collected data from women during their postpartum hospitalization and found that non-Hispanic white women are significantly more likely to room-in and less likely to be offered formula or pacifiers when compared to non-Hispanic black women.12 These findings provide direct confirmation of population-based studies that have noted similar findings.7, 13 As importantly, the differences in women's exposure to supportive breastfeeding practices stratified by race revealed clear differences by site. The study by Spisma et al was not designed to identify why there were racial differences in the provision of breastfeeding support in 2 different institutions, but the question is critical. Why were all women of color rooming in at one site but only 58% of women of color rooming in at the other site when 100% of non-Hispanic white women were rooming in at both sites? Variation in provision of health care services is a well-known sign of non-clinical factors influencing health care services. Thus, an exploration of institutional assumptions about the families cared for in your institution is an obvious exploration that can be included in breastfeeding education, postpartum rounds, and practice meetings. And the first step in that exploration is to assess the effects of institutional racism, structural racism, and implicit bias. These types of racism are ubiquitous, and the assumptions that underlie these biases influence every one of us. The article by Robinson et al elucidates important individual aspects of the effect of racism.14 Five studies that evaluated perceptions of health care providers and black women were included in this scoping review. As a whole, the providers and patients who participated in these studies confirmed that non-Hispanic black women received less breastfeeding education or support, and more practices that are known to interfere with breastfeeding success such as provision of formula and pacifiers. Implicit bias that assumed non-Hispanic black women are less likely to breastfeed was identified as one reason for these practices. Methods for addressing implicit bias are beyond the scope of this editorial; however, multiple resources are available.15-17 A first step in identifying one's unconscious biases is to listen and learn. So let's now move from the facts, women's documentation of services offered, and identified disparities in breastfeeding support services, to the individual with a newborn. Breastfeeding is an intimate act yet given society's focus on improving infant health, we often forget that the individual providing human milk is fitting childcare into a life that may include employment, care of other children, long commutes, and countless other life necessities. The aphorism “don't let perfect be the enemy of good” is apropos here. Blind dedication to exclusive breastfeeding can ostracize and silence families whose goals are concordant with feeding an infant human milk but may not be concordant with breastfeeding or exclusive breastfeeding. Eagen-Torkko describes how the concept of concordance frames breastfeeding success within an individual's goals that account for that person's circumstances.18 The commentary by Papautsky describes this concept within a patient-centered human factors approach and recommends tailoring breastfeeding counseling to the individual by assessing that person's context to help identify barriers, facilitators, and definitions of success.19 These articles show how a patient-centered perspective is the best framework for helping an individual with goals for infant feeding. Feeding an infant human milk is a complex operation that requires dedication, practice, a lot of time, and upkeep. The goal of exclusive breastfeeding for 6 months shouldn't be the one and only rule guiding all clinical care related to breastfeeding. This recommendation may not work for many families, and it is not a strong enough or deep enough platform for the provision of clinical care to postpartum families. When the editors put out a call for articles that address breast health and breastfeeding, we anticipated a wide variety of manuscripts on several topics. We did not expect to see this clear thematic story emerge from the varied submissions, and it was a joy to watch as it unfolded. It is with great pleasure that I invite you to read the articles published in this issue. More importantly, listen to their messages as a whole story, and use this information to join me in answering my original question. As you stand with your hand on the door handle before seeing a new postpartum family, think about institutional racism in your setting, identify and set aside implicit biases you may have, and then step into the room and look first to your patient. Learn about that person's context, facilitators, barriers, and goals. Now…. settle in and you will see you have some real tools to help this person with infant feeding.