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Less than four, maybe five, hours after the emergency c-section, I was still trying to wrap my mag-addled mind around the fact that at 29 weeks, my daughter had entered this world with a heartrending shriek. A nurse in the step-down unit tried to reassure me. “Don’t worry,” she smiled, “your daughter, she’s a fighting girl, and she has your husband’s good black genes!”

I must have looked as confused as I felt. I glanced over at my husband—yes, he had heard it too, and he was trying desperately to keep a smile in check. Good black genes? Of course she had his good black genes. He was her father, after all.

The nurse went on to explain that little girls of color fared much better in the NICU, more so even than “those wimpy white boys.” She even illustrated her point by stair-stepping her hands: “Best is black girls, then white girls, then black boys, then those wimpy white boys, not so good.”

When she left the room, my husband and I burst into incredulous laughter, chalking it up to a cultural misunderstanding, and “good black genes” became something of an inside joke between us.

I mentioned it to one of the NICU nurses a week or so later. “No, it really is a thing. Black females breathe better, grow faster, and leave here much sooner than white males, even those who were born closer to their due-dates.” She had stories. Other nurses had stories. Most claimed there were statistics to prove it. One even mentioned she had heard it referred to it as Wimpy White Boy Syndrome at a conference.

I was intrigued. I even asked one of our neonatologists about it, but she hadn’t heard of race making a difference in preterm development. “Sex, yes, for some reason, we’ve got fighting girls. But race, no, I haven’t heard anything about that.”

Curious indeed. And patently absurd if you really sit down and think about it.

Anyway, a quick internet search produced links to discussion boards on popular websites like babycenter, What to Expect, and cafemom. There were the mommy blogs, of course, in which Wimpy White Boy Syndrome popped up with some frequency, and I even got a few surprising-but-not-really links to seedy Aryan nation websites.

And the mentions of WWBS weren’t exclusive to the South, either—they seemed to span the nation. Those commentators who attempted to explain their understanding of WWBS referenced statistics, though more often than not failed to produce any bona fide numbers. And those that did provide some sort of linkage, tended to link to this families.com article, which again, proffered nothing substantial number-wise on the topic other than the authoritative voice of the author.

The best article I eventually found was an editorial entitled “WWBS: Fact or Fiction?” published in the March-April 2014 issue of Neonatal Intensive Care. Although Oelberg does not cite studies about the inherent “wimpiness” of white preterm males (because there aren’t any, as he discovered), he more importantly raises the specter of racial bias—as in, are there really wimpy white males, or are there wimpy white males because they’re being sought after?

At any rate, Oelberg concludes that the terminology, while not professional, is mostly harmless, writing, “I have yet to meet a parent who has expressed offense or disgust at the term. In fact, most white parents find the term somewhat endearing because it highlights their roles in the ongoing provision of extra nurturing and patience.”

Perhaps. But I’m more inclined to think that pathologizing race, no matter how cutesy the term or lovingly applied, should be a non-starter. It’s unprofessional. It’s historically ugly. And there is very little evidence to back it up—even if WWBS is meant to be a lazy stand-in for Respiratory Distress Syndrome (RDS), which is an actual diagnosis.

Respiratory Distress Syndrome

Respiratory Distress Syndrome is in part caused by an insufficient amount of surfactant in the lungs of a premature infant. Surfactant acts as a lubricant and keeps the alveoli of the lungs open for oxygen absorption. For whatever reason (most likely genetic), RDS is far more likely to develop in white males delivered early term (between 37 and 38 weeks) and late preterm (between 34 to 36 weeks). Whereas this might have been the original (and still unprofessional) context for WWBS, the term itself is being used much more broadly than that.

It should also be noted that the earlier the gestational age of the infant at birth, the less race and sex matter: nearly all infants born at 28 weeks or less will develop RDS and will require mechanical breathing assistance (or in a few cases surfactant therapy).

And because early preterm births (before 34 weeks) to black mothers are nearly double that to white mothers, this might account for why the infant mortality rate (IMR) for black infants due to RDS is significantly greater than that of white infants. Meaning, while RDS is more frequently diagnosed in white males, black males are statistically more likely to die from it.

Race and Prematurity

Taking it a step further, the term Wimpy White Boy Syndrome itself obscures the racial realities of the preterm landscape:

  • The national birthrate of black preterm infants is approximately sixty percent higher than that of white preterm infants.
  • The national birthrate of black infants with a low birthweight (LBW) was also significantly higher—nearly double.
  • And regarding the IMR, preterm-related causes of death for black infants in 2007 occurred at a rate three times that of white infants—a striking disparity confirmed here.

The birth outcomes between black and white infants are so outrageous, that researchers are urging community leaders to adopt a life-course perspective in order to effect greater change.

So Why Even?

In light of all these racial disparities, why even WWBS, right? My best guess is that it is a combination of two things. One, that it is a coping strategy of NICU nurses who daily observe otherwise healthy infants struggling for breath (perhaps related to the impulse behind a SHPOS diagnosis). Two, it conveniently dovetails with specific racial stereotypes, namely, the myth that black men and women are more athletic and physically robust, you know, as a race.

Oh, and there’s another stereotype that syncs up too, and one which I’ll admit wasn’t immediately apparent to me until I reached out to a friend in Tennessee, wondering if her son had been “diagnosed” with Wimpy White Boy Syndrome. Although she hadn’t heard the exact term, she knew exactly what I was talking about. One of her NICU nurses had encouraged her son to find his inner angry black girl. Yeah, I know.

The NICU should be the last place on earth we should clutter with cultural baggage. There’s maybe enough room for a mother to be wheeled in on her hospital bed to meet her infant for the first time, but that’s about it.

So let’s agree that Wimpy White Boy Syndrome is not a thing. At best, it’s a silly *smh* but they-mean-well sort of racism; at worst, it creates a perception of racial bias in an emotionally charged environment by implying certain infants might be singled out for special treatment or extra attention—or that certain infants might be handicapped as a long-shot or sure-thing simply because of their race. And a bias of that kind will definitely impact patient care.

So again, WWBS, let’s agree it’s not a thing, but as to those fighting girls, well….that’s another story for another day…hooah!