By Robyn Roche-Paull, BS, IBCLC, and LLL Leader
As the author of the book, Breastfeeding in Combat Boots, I am often asked by my fellow lactation consultants how to best support active duty military mothers who wish to continue breastfeeding while serving their country. Currently, women comprise nearly 20% of the active duty force in the United States. Most women on active duty are of childbearing age, and at least 15% will become pregnant while on active duty. At this time, 38% of the women in the military are mothers (nearly 80,000 personnel) and, of the children born to active-duty mothers, nearly 40% are newborn to five years of age. As more women enter military service, the number of women planning to breastfeed while remaining on active duty will continue to increase as well. Many active-duty women are choosing to breastfeed because of the benefits for themselves and their infants. Unfortunately, most are not reaching the goals set by Healthy People 2020 and the American Academy of Pediatrics for breastfeeding because of a lack of information and support.
Throughout the United States and overseas, there are Active Duty, Reserve, and Guard military women who are interested in breastfeeding after their return to work at six weeks postpartum. In addition to full-time employment, military mothers also face body weight and physical training standards, uniform issues, hazardous materials exposure, long shifts and inconsistent work schedules, prolonged separations due to deployments, and a military culture that does not always value the role of a mother. However, just like their civilian counterparts, military mothers who are breastfeeding also need information on the basics of breastfeeding, common concerns and pumping. As lactation consultants, you can be on the front lines of providing this much-needed care.
Here are some of the most important things to know when helping a military mother (all of these topics and more are covered at my website):
- Basics & Common Concerns: The basics of breastfeeding and mother’s common concerns are the same for everyone. Military women deal with sore nipples, engorgement, plugged ducts, thrush and mastitis just like the rest of us. The difference here is that they may not have the luxury of staying in bed for the weekend to recover. Keep in mind that they may be wearing heavy gear or not drinking enough fluids due to their work environment that can lead to some of the above problems.
- Policies: Be aware of the breastfeeding policies of the various branches of the military, what they provide (and don’t provide) and where to find them. In a nutshell, the US Air Force, Army, Coast Guard, Navy and Marine Corps all provide at least 6 months deferment from deployment (the Navy offers 12 months) after the birth of the baby. The Air Force, Marines and Navy policies also specify a time and place to pump. More detailed information about each of the policies and downloadble PDFs can be accessed at www.breastfeedingincombatboots.com/militarypolicies.
- Pumps/Pumping/Hand Expression: The average military mother works a 12-hour shift and will need to express her milk at least 3-4 times. She needs the proper pump, one that can last through a year’s worth of heavy-duty pumping and that will keep her milk supply up. Many enlisted mothers try to save money with cheap or used pumps. Steer them towards the personal-use pumps from companies who produce a powerful and efficient pump. Include teaching on hand expression, which is a lifesaver out in the field with no electricity and go over safe storage and handling guidelines according to the Academy of Breastfeeding Medicine protocol.
- HAZMAT (Hazardous Materials): Many mothers in the military work in job specialties that require working with hazardous materials such as jet fuel, lead, or solvents. While there is a lack of information on the safety and transfer of these substances into breastmilk (the latest edition of Medications and Mother’s Milk has information on jet fuels and lead), take the opportunity to go over their exposure levels, ask for copies of the Material Safety Data Sheet, and remind them to wear their personal protective gear. It is important that mothers weigh the risks of theoretical contamination at work against the know risks of formula before making a decision to wean.
- Physical Training (PT): All military members are required to pass semi-annual physical fitness testing and maintain weight standards. US Military mothers have 180 days from the birth to meet those requirements. While breastfeeding is known to help women lose weight, some mothers have difficulty losing the last 5-10 pounds until they wean. Go over safe weight loss tips, and myths regarding exercise and breastfeeding.
- Deployments & Training: Deployments and training away from home are a fact of life in the military. While mothers are deferred from deployment for 6 -12 months (depending on the branch of service), they are not exempt from participating in training exercises or schools. Many mothers will face the prospect of leaving a fully breastfed baby at 6 months and will need information on pumping in the field or overseas and how-to ship breastmilk.
There are many other ways that you can support military breastfeeding mothers such as setting up Active Duty Breastfeeding Support Groups or programs at your local clinic, hospital or private practice. Create or sponsor a loan program for hospital-grade pumps (this is especially useful for the junior and mid-level enlisted personnel, many of whom struggle due to their low pay). Provide education and training to the local military physicians and commanders of the base or post on the basics of breastfeeding and why it is in their best interest to support their breastfeeding mothers. The Business Case for Breastfeeding can be easily adapted for military commands, and has been used to great success at The Navy and Marine Corps Intelligence Training Center (NMITC) already.
Finally, advocate, advocate and advocate for these mothers. They are waging a never ending battle against a culture that values warriors, not breastfeeding mothers. Often these mothers are far from home, without any family nearby, dealing with unsupportive commands and supervisors that don’t understand breastfeeding at all. You may be their only source of information and support. Remind them that breastfeeding in normal and achievable. Due to regulations that disapprove of breastfeeding in uniform, many military women do not ever see another military mothers breastfeeding. Share positive breastfeeding success stories with the active duty moms you see, as they are going to hear plenty of negative stories from everyone from the clerk at the Commissary to their co-workers. Remind them that breastfeeding in the military is not all or nothing. Any amount of breastfeeding they can do, and any amount of breastmilk they can provide is better than nothing! Above all be flexible, supportive and understanding. Unless you have breastfed in a pair of combat boots you cannot know the amount of fortitude, determination and perseverance it requires to be successful. These women deserve our thanks for Giving the Breast for Baby and Country!
This article does not reflect the views nor is it endorsed by the US. Military.
Check out ILCA E-Globe for a feature about Robyn and her recent trip to Aviano Air Base. in Italy
Robyn Roche-Paull, BS, IBCLC, and LLL Leader is the author of the award-winning book Breastfeeding in Combat Boots. In her private practice she primarily helps military mothers balance returning to active duty while continuing to breastfeed. Robyn is not only an advocate for active duty military mothers who wish to combine breastfeeding with military service, she is also a US Navy Veteran who successfully breastfed her son while on active duty as an aircraft mechanic. Robyn frequently contributes to various breastfeeding publications and blogs about breastfeeding in the military at her website www.breastfeedingincombatboots.com and has been a guest blogger at Best for Babes, baby gooroo and The Feminist Breeder. Robyn can be found lecturing at breastfeeding conferences and military bases around the United States and overseas. Robyn is currently enrolled at Hampton University’s Accelerated Bachelor of Science Nursing degree program and lives in Virginia Beach, Virginia with her husband of 18 years, a Chief Petty Officer in the US Navy. She is the mother of 3 long-term breastfed children now 16, 13 and 9. Visit her at www.breastfeedingincombatboots.com and on Facebook at www.facebook.com/breastfeedingincombatboots, you can also follow her on Twitter at www.twitter.com/BFinCB.