Sherry Payne, MSN, RN, CNE, IBCLC, is the Executive Director of Uzazi Village, a nonprofit organization devoted to decreasing pregnancy related health disparities in the urban core of Kansas City. She is also the facilitator of the upcoming 2014 Lactation Summit: Addressing Inequities within the Lactation Consultant Profession. Ms. Payne speaks frequently around the country to professional audiences on topics related to lactation and birth disparities (including the upcoming 2014 ILCA Conference). One of the many barriers that aspiring IBCLCs of color face is acquiring clinical hours. The Uzazi Village Lactation Consultant Mentorship Program is an innovative solution, connecting aspiring International Board Certified Lactation Consultants® (IBCLC®) from the Kansas City community to the Uzazi Village Breastfeeding Clinic, which provides free services to area families.
Ms. Payne was recently interviewed by Marie Hemming, IBCLC, a member of the International Lactation Consultant Association® (ILCA®) Medialert Team.
Marie Hemming: Why did you start the Lactation Consultant Mentorship Program?
Sherry Payne: I started this program with the idea that we needed more IBCLCs of Color. I am currently the only IBCLC of Color practicing in my city (though I am the third African-American IBCLC to be certified in my community). This has become a top priority for Uzazi Village – making accessible pathways for lactation educators and peer counselors to become board certified professionals, and then linking those professionals to families in our community who need those services. We already had our free Breastfeeding Clinic up and running two days a week and four volunteer IBCLCs to run it. It was not too difficult to add the mentorship program to it. Three of our IBCLCs qualify to be mentors and there were always plenty of women at our door inquiring about how to become a Lactation Consultant. The research tells us that recruiting and diversifying the ranks of IBCLCs should be a part of the strategy for overcoming disparities in lactation in the African-American community. That’s what we are attempting to do.
MH: Tell us about the Breastfeeding Clinic and how it serves families in Kansas City.
SP: Clients are referred from community-based prenatal clinics and local hospitals that serve low income breastfeeding women who otherwise would not be able to access the lactation support they need. I talk to the local lactation consultants, nurse midwives, pediatricians, doulas and other care providers about our clinic. We receive referrals from Women, Infants, and Children (WIC) and home visiting programs such as Healthy Start and Nurse Family Partnership. We have three to five moms in clinic and home visits each day and we spend an average of two hours with each client on everything from sore nipples, to milk supply issues, to relactation and weaning. We also offer two breastfeeding support groups: La Leche League on Troost, and the Chocolate Milk Café. Our support groups and breastfeeding classes also draw local women into the clinic.
MH: How does the Mentorship Program work?
SP: The interns need to accumulate 300 or 500 hours and we ask that they work at the Breastfeeding Clinic a minimum of one day per week every other week. If they come to every clinic it will take them four to six months or it may take them as long as 10 months to get their hours if they come less often. They are also encouraged to take the WHO/UNICEF Breastfeeding course which is offered every quarter. The interns pay a fee for the program on a sliding scale depending on income.
The program is just starting out, however, we have our first intern beginning in May 2014, with two other candidates seeking placement. We are currently working on getting hospital placement for our interns to do part of their hours. We are also in talks with a local community college to package all the required courses to create a one-stop shopping curriculum for our interns. We hope to be able to simplify things by having classes and clinical experiences all in one program.
MH: What are some of the other barriers that aspiring IBCLCs of Color experience? How is Uzazi Village helping to break down those barriers?
SP: Barriers for aspiring IBCLCs include accessing the educational components, finding mentors, and completing the hours. Women of Color will of course be much less likely to find mentors that look like them, and normative culture mentors may be uncomfortable bringing a Woman of Color into their practice. (I am actually experiencing the same difficulty in my midwifery training.) Many aspiring IBCLCs of Color are found in the ranks of WIC Peer Counselors, but there is no clear cut pathway to move them into the ranks of IBCLCs. It is the presence of these types of barriers that compelled me to create a program at Uzazi Village. International Board of Lactation Consultant Examiners® (IBLCE®) requirements often presuppose educational attainment that peer counselors may not possess, leaving them stranded at the bottom of the professional and economic rungs.
MH: You were invited to Washington DC by the United States Breastfeeding Committee to discuss continuity of care with advocates from around the country. If you could change one thing about our healthcare system to improve breastfeeding outcomes, what would it be?
SP: The Affordable Care Act makes provision for reimbursement for lactation professionals. I would like to see reimbursement for ALL levels of breastfeeding support professionals – direct compensation for the work we do, particularly WIC Peer Counselors. We need our WIC Peer Counselors in our communities. Lactation consultants are most often isolated in hospitals and accessing them is difficult, if not impossible, following hospital discharge. Private practice IBCLCs are cost prohibitive to access among the women we regularly see. Peer counselors have had the greatest impact on increasing breastfeeding rates in our community – they do most of the front-line work and yet they receive the least amount of recognition and pay. I would like to see Peer Counselors and Certified Lactation Counselors compensated by insurance companies for the valuable service and support they offer. This does not take anything away from the board certified professional, but enhances and refines his or her role. We need all levels of expertise.
MH: Of all of the things that you have done, are there one or two things that stand out as being most effective in helping the moms that come to Uzazi Village?
SP: The Chocolate Milk Café, which is a mother-to-mother support group for African-American women, has been groundbreaking. It is designed to meet the needs of our urban moms and has been one of our most successful programs. At Chocolate Milk Café, mothers can attend with their babies and have a safe environment in which to discuss their breastfeeding issues. We are starting to replicate this model around the country.
MH: You are breaking new ground with your work at Uzazi Village, is there someone who has influenced you or mentored you in your own career as a lactation consultant & natural birth educator?
SP: Lots of people have invested in my success over the years, but my primary mentor in lactation has been Charlene Burnett, BSN, RN, IBCLC. She mentored me when I was an L & D nurse, but I worked at a different hospital. She received special permission from her hospital to mentor me 500 hours in a year. I could not have done this without her. She is one of my LC volunteers and she is the Director of Lactation Services at Uzazi Village. We have named a scholarship after her: the Charlene L. M. Burnett IBCLC Scholarship, set aside for a candidate of color in the greater metropolitan area of Kansas, Missouri who has met all requirements to sit for the IBLCE exam. It is our small way of thanking her for all that she has invested in Uzazi Village.
MH: What advice would you give to others hoping to increase access to lactation services for women of Color?
SP: Be creative, assess your community assets and find a way to connect what you have to what women need. When I’m considering a project large or small, I always call to mind the words of the late tennis great, Arthur Ashe: “Start where you are, use what you have, do what you can.” Finally, if you are not a woman of color yourself, join your efforts to someone who is. Allies are important to the cause, but they must take their lead from someone who is a member of a community of color. At Uzazi Village, we counsel many allies around the state and around the country to place women of color in central roles when doing outreaches to communities of color. On our website, you’ll find the success stories (Uzazi Champions) of those we have worked with to improve lactation rates in other communities of color.
Marie Hemming, IBCLC is the mom of three breastfed children (now 20, 16 & 15 years of age). She developed and taught a 20-hour breastfeeding class at the Florida School of Traditional Midwifery. She is currently volunteering as an IBCLC and lay community counselor at Birthline of San Diego, serving families living in poverty.