You’ve just seen a new breastfeeding family for their first visit. You analyzed the situation and gave research-driven advice. You left them with a care plan you feel good about and a schedule for following up. You covered all your bases.
Or did you?
Did you happen to ask what the infant feeding history is in the family, going back one or more generations?
A study by Alexis Woods-Barr, presenter at the upcoming International Lactation Consultant Association National Conference, suggests that understanding a family’s infant feeding history is a critical piece of the puzzle. And failing to understand that dynamic can seriously undermine the effectiveness of your help.
At a time when listening to voices of Black families and communities is being increasingly recognized, Woods-Barr’s research feels especially critical. Particularly in Black families, which are the focus of her research, knowing the multi-generational picture for each family is critical, Woods-Barr says.
“You can say to a mother, ‘Breast is best,’” she explains. “And that may not matter at all, if she is hearing another message from her mother or grandmother or aunt. The older generations are respected, whether they are giving out the latest information or not. What grandma says gets listened to, and she is in close, constant contact with the mom.”
A recent PhD graduate from the University of South Florida, Woods-Barr recently worked with 15 Black families in the United States across two or three generations in a study that explored infant feeding stories, messages, and experiences shared between generations.
Woods-Barr will discuss her research during a plenary talk at the #ILCA2020 Virtual Conference. She will focus on the infant feeding conversations revealed in her study. “I wanted to know, what Black families were talking about as it relates to feeding babies? ” Woods-Barr explains.
Intergenerational messages about infant feeding start in adolescence or even early childhood, and have a huge impact on beliefs and behaviors–usually without the older generation even realizing they are transmitting messages, Woods-Barr says. And it’s not just the messages given to girls that matter. “What are grandfathers and dads saying to their boys?” she asks. “What are moms saying to their sons, and what are dads saying to their daughters? The entire big picture–the whole family dynamic–matters when it comes to infant feeding.”
We are all being called on now to ask, listen, and act in deeper and more thoughtful ways, whether with patients from backgrounds similar or different to our own. IBCLCs who attend the conference will leave Woods-Barr’s presentations with new understanding and tools they can apply immediately to their practices.
“My goal is to help those who work with lactating families understand that there is a role that each generation plays, and that they can leverage the wisdom and knowledge of the older generations,” she explains. “I’m hoping the take-away is that it’s really important to get the mother’s mother, or aunt, or whoever is important in her life on board. Invite the older generation into appointments, see where she stands on the idea of breastfeeding.
“If you don’t know where the family stands, it’s going to be very hard to be effective. The family history of infant feeding determines what advice the older generation gives the younger generation, the reservations that are presented, and the affirmations that are given.”
The good news, according to Woods-Barr, is that when the older generation is invited into the conversation, and their experience and wisdom is acknowledged and respected, they are almost always willing to hear out ideas that are different from theirs. “The beauty of it was that the older generations were open to learning new things,” she says. “That’s something you can pretty much bank on. But you have to teach them. They don’t know what they don’t know.”
Woods-Barr believes her research is broadly applicable, inside and outside the United States where it occurred. “From my experience, in other cultures, respecting elders is supreme,” she says. “I believe what I learned can help in many contexts.”
That is precisely why I do in home visits. And I suggest that any and all “helpers” are welcome to the consult.
I also provide the parents with basic evidence based information to share with family and friends that come to help the mom.
I have been working in China for 20+ years. In my early years as a midwife, visiting women at home, I talked to the expectant or new mom, I gave her the advice according to what I had found… just like I was used to in Holland. But I was soon to find out that it isn’t the mom who decides what happens and what she can and cannot do, but it is her mom or mom-in-law. I realised: I need to involve them too! Whereas in Holland I would invite expectant mom and dads to antenatal classes, I found that in China, it was hard to get the dads involved, and I forgot about the moms(-in-law). So, I continued to invited the dads, but also asked the moms(-in-law) to come… The whole family had to be on board!