Archive | Breastfeeding Advocacy

Challenges and Opportunities in the Global Lactation Consultant Profession: A Summary and Invitation for Discussion

By Lactation Matters on 18 September 2023 in Advocacy, Breastfeeding Advocacy, Breastfeeding Around the Globe, Uncategorized

by Lisa Mandell, MBA, IBCLC, Global Advocacy Adviser, ILCA

On 13 August, I was honored to moderate the opening plenary session at the ILCA 2023 Annual Conference, which took place in Las Vegas, Nevada, USA. It was truly delightful to work with a varied group of expert panelists, which included:

Nadrah Arifin, Physician and Lactation Consultant (Malaysia)
Paulina Erices, MS, IBCLC (USA; originally from Chile)
Egondu Onuoha, MS, RDN, IBCLC (USA; originally from Nigeria)
Daiva Sniukaite, MA, IBCLC (Lithuania)

The session commenced with a brief outline of just some of the advocacy work that ILCA is engaged with on the global stage, followed by introductions from the panelists. I then shared a startling statistic: Globally, there are about 35,700 IBCLCs; of this, approximately 19,000 are in the United States, leaving only 16,000 IBCLCs in the rest of the world. Many countries have no IBCLCs at all, or very few. In comparison, there are approximately 28 million nurses and 1.9 million midwives, worldwide.

Given these relatively small numbers, the panel discussed how IBCLCs can most effectively impact breastfeeding/chestfeeding. Much of the discussion centered around working with and training peer counselors, removing barriers and partnering with other health care providers, and how IBCLCs can work to coordinate support, which in turn will hopefully increase the numbers of IBCLCs.

Another part of the discussion focused on providing culturally sensitive or responsive care. Agreeing that this is a critical skill, the panelists discussed the need for intentional learning in this area, availability of lactation care providers who come from different cultures, and the importance of being able to provide alternative solutions when one solution isn’t readily accepted in a culture.

A major challenge shared by all panelists was the lack of recognition of the IBCLC – legal or professional recognition allowing providers to work, as well as recognition by other health care providers. The panelists shared their varied experiences working on this issue. This is an important area for ILCA’s advocacy efforts and we look forward to working at the global level and with national associations to address this.

During the session, we also discussed some of the outside influences, such as the lack of regulation of marketing of commercial milk formula and maternity protections, both of which influence breastfeeding. This pointed to the need for more IBCLCs, improved training programs, emphasizing the value and importance of breastmilk and maternal/child health, addressing disparities, and increasing data collection on breastfeeding to be better able to advocate for policy changes.

Our final topic of discussion was how we can best work together with other IBCLCs, ILCA members, peer supporters, health care providers, etc. The key themes of discussion were collaboration, inclusivity, and connection.

Continue the Conversation

As ILCA’s Global Advocacy Adviser, I encourage you to share your thoughts by submitting a comment (click on the though bubble icon below). Consider the following questions: What challenges are you currently facing that were not addressed during the session? Of the challenges addressed, which are ones you don’t face or perhaps haven’t thought of? What other opportunities can you suggest?

Seven Ways To Support Black Breastfeeding Week

By lactationmatters on 25 August 2014 in Black Breastfeeding Week, Breastfeeding Advocacy

This week marks the second annual Black Breastfeeding Week (learn more here). We asked Kimberly Durdin, IBCLC, SMW, to share with us her reflections on her path to becoming an IBCLC, why we need Black Breastfeeding Week, and how we as IBCLCs can support Black women in our profession.

23 years ago, I was a brand new mom, with a weeks old baby daughter, who I was struggling to breastfeed. In spite of the support my mother (who had breastfed) and my husband, I needed more. I struggled with sore nipples, Caesarian recovery and thoughts of giving up. A new mom friend told me about our local La Leche League group and one day, I stumbled into the monthly meeting with my baby in my arms.

I received the support and help that I needed, and with the help of that leaders encouragement, I came back to more meetings and gained a community I didn’t even know was forming around me. Four months into nursing my daughter, this leader encouraged me to do more . . . she suggested I become a La Leche League leader. I had no idea what that entailed and I surely felt unqualified to even attempt that journey. Patiently she keep after me, reminding me of what she said when the suggestion first left her lips: “There are not a lot of black women doing this [breastfeeding and becoming La Leche League Leaders]. You’d be a great role model.”

Although it took me four years and a winding path to actually make that happen, I did become a LLL Leader (yes, one of the few African American ones). I also became a breastfeeding peer counselor through the WIC program and, years later, an IBCLC. Although I have had many mentors over the years that I continue to value and learn from, I can’t thank enough Lucy Koteen, long time La Leche League Leader from Brooklyn, NY for not only seeing something in me that I didn’t see in myself, but for also being such an outstanding, open-minded person. She was aware not only of her privilege, but also of the issues around her, beyond the ones in her immediate world (for example, breastfeeding in the Black community) and sought ways in which she could be of support.

She believed that all women should have support for breastfeeding and sought out ways to bring the information to underserved audiences such as young black and brown pregnant and parenting girls. She knew that someone who looked like them could perhaps deliver a message that may have more impact than hearing it (in her case) from a “wealthy older white lady telling these girls that they should breastfeed.” She got out of the way . . . it wasn’t about her. She didn’t need money and she didn’t have an agenda but to help as many woman as she could. She wasn’t a lactation consultant, and never became one. Because of her, a seed was planted in me and slowly, very slowly – and with the help of many other mentors along the way – a lactation professional emerged. As I grew into this profession, it was not only my own actions, but the support (and sometimes that support was strictly financial) of others who believed in me that actually made my dream of becoming a lactation consultant a reality. I could not have done this without the support of folks like Lucy. Actually, I could have done it, I would do whatever it took, but they helped me navigate looming obstacles. In the process I’ve been able to help innumerable families, many who look like me and many who don’t. (I’ve also been able to help women who look like me enter the profession, too.)

This past July, I attended the Inaugural and historical Lactation Summit 2014 hosted by ILCA, LEAARC and IBLCE. Afterwards, I talked with a number of Summit attendees from the dominant culture. I was surprised to learn that many were unaware of the struggle that women of color have experienced in breastfeeding their own children, in receiving culturally competent care, and in obtaining the required education, mentoring, opportunities and financial support needed to sit for the IBCLC exam. The barriers are financial, cultural, systemic and logistical. When dominant culture women aren’t aware of the challenges that women of color face, that lack of awareness becomes a barrier of its own.

Many also told me their eyes have been opened in a new way to inequities on various levels. These inequities harm Black women, but they also derail our profession.

Would you like to help? Are you wondering what support looks like? Here are some ways you can take action in your community:

One: Give to an educational scholarship of your choosing that will directly benefilt a candidate of color. A great way to do this is to list your educational scholarship or opportunity with The Grand Challenge.

Two: Contribute to cost of trainings for candidates of color.

Three: Offer to mentor candidates. Bring them into your practice. Open doors for them that they wouldn’t have possibly been able to open without your connection.

Four: Contribute to expenses related to obtaining certification such as traveling expenses and testing fees.

Five: Contribute to educational fees associated with obtaining CERPs.

Six: Offer free/reduced price or scholarships for classes you may offer to expectant and breastfeeding parents so that more community members can be educated, and also this helps to seed and grow the next generation of lactation and childbirth pros.

Seven: Respect and understand that some women of color are much more open to receiving health messages from other folks of color. Dominant culture women must learn to respect that and not feel threatened by it. Events like Black Breastfeeding Week help to strengthen cultural pride and awareness around our herstory of breastfeeding . . . our struggles challenges and triumph that are unique to our community, our shared herstory.

I hope that dominant culture breastfeeding supporters do not perceive Black Breastfeeding Week as some sort of woman of color protest. Black women rarely see images of women who look like them breastfeeding. Many breastfeeding promotion campaigns do not include images of black women breastfeeding. Events like Black Breastfeeding Week help black women see breastfeeding as something they do, too . . . not just something white women do.

Kimberly Durdin, IBCLC, SMW, is an internationally board certified lactation consultant, childbirth educator, speaker, trainer, former birth and postpartum doula and a retired La Leche League Leader. She has helped thousands of families have a satisfying and empowering experience of pregnancy, birth, breastfeeding and parenting. Kimberly has served families in New York City, Los Angeles and Washington, DC, where she was named one of the best lactation consultants in 2004 by Washington Families magazine. Learn more here.

Pumped Up: Supporting Nursing Moms at Work

By lactationmatters on 7 July 2014 in Breastfeeding Advocacy, Breastfeeding in the Workplace

When Brandon Wright, store manager for Goodwill Industries in Lafayette, IN, learned that two of his employees were pregnant, he wasted no time letting them know that if they planned to breastfeed, he would provide them with time and space to express milk at work. For Wright, the conversation was more than merely complying with FLSA requirements under the Affordable Care Act; it was about doing the right thing to support valuable employees and help their children get a good start in life. His employees said they appreciated the easy way he began the conversation and instantly established that their family needs would be respected.

Wright found simple accommodations for Melissa and Jessilyn once they returned to work. A clean storage area was made available for them to express milk in privacy, and a simple hand-written sign was placed outside the door to indicate when it was in use. The employees took their usual breaks, and maintained open communication with their supervisor to assure that things worked well for everyone.

Wright says, “It wasn’t hard at all. It didn’t affect my day to day operations at all.” What he says it did affect was employee morale. “They [my employees] came to work knowing we respected what their rights were as women. They’re still here. I’ve retained them. I think it’s good.”

The Lafayette Goodwill store is one of thousands of companies across America who have found similar easy, low-cost solutions to supporting nursing moms at work, and are enjoying bottom-line benefits of longer retention, lower absenteeism rates due to healthier infants, and improved employee productivity. They are one of 200 companies in 29 U.S. states featured in a brand new online searchable resource for human resource managers launched at the 2014 Society for Human Resource Management Annual Conference and Exposition in Orlando, Florida.

The resource, Supporting Nursing Moms at Work: Employer Solutions, was developed by the U.S. Department of Health and Human Services, Office on Women’s Health. It features hundreds of solutions for businesses in all 22 industry categories, including challenging environments such as restaurants, retail stores, hotels, manufacturing plants, and many others. Videos and over a thousand photos are included to highlight workable options in virtually every type of work setting.

According to Ursuline Singleton, the OWH project officer, the project is designed to give employers a wide range of options and solutions. “We know that Section 7 of the Fair Labor Standards Act (FLSA) requires employers of hourly workers to provide time and space for nursing women at work. We also know that many employers simply don’t know how to do that, and need practical solutions. We established this resource to show them how it’s done all across America. We took some of the most difficult job environments and provide options that are low-cost and easy to implement.”

To learn more, visit the new website at: www.womenshealth.gov/breastfeeding/at-work.

by Cathy Carothers, BLA, IBCLC, FILCA

Cathy is co-director of Every Mother, Inc. and project director for Every Mother’s contracts with the U.S. Department of Health and Human Services, Office on Women’s Health workplace lactation initiatives. She is the author of the HHS Maternal and Child Health Bureau’s Business Case for Breastfeeding, and was lead trainer for state-based training events in 36 U.S. states. She is past president of ILCA, immediate past chair of the United States Breastfeeding Committee, and chair of the Monetary Investment for Lactation Consultant Certification (MILCC). An experienced trainer and speaker, she has provided training programs in every U.S. state and territory and several foreign countries. She is a Fellow of ILCA and an IBCLC since 1996. She was recently honored by the National WIC Association with their 2014 National Leadership Award in the “Friend of WIC” category.

photo credit: Anne Schollenberger

Did your workplace overcome a unique challenge to support lactating families? Please share with us in the comments!

World Wide Impact in 10 Minutes or Less: Using Social Media for Powerful Change

By lactationmatters on 14 November 2012 in Breastfeeding Advocacy, Networking/Relationship Building, Opportunities for Participation, Social Media, WHO Code/BFHI

By Amber McCann, IBCLC

One week ago, Lactation Matters posted a blog entitled If YOU Don’t Advocate forMothers & Babies, Who Will? If there was any doubt that you, the Lactation Matters readers, were willing to step up to the plate, that doubt has been squashed. Within moments of the publishing the post, the initiative to use social media to ask the World Health Organization (WHO) and the Pan American Health Organization (PAHO) about their acceptance of money from major industry, including Swiftmoney Nestle, was gaining ground.

In response to the blog post, over 400 readers have joined a Facebook group, Friends of the WHO Code, to discuss advocacy and activism as it relates to the WHO Code and social media. Discussions this week have centered around gaining the attention of those involved in this situation and those who have the power to influence decisions. The group has worked hard to get the message out that that acceptance of funds that constitute a conflict of interest are unacceptable for an organization whose purpose is to protect the public health of the world. The group is primarily using Twitter as a means to connect and raise a tidal wave of support. And, it has been SUCCESSFUL!

Wednesday morning, those in the group noticed that the World Health Organization was responding to our questions with the following tweets:

In addition, WHO posted the following message on their Facebook page:

The conversation is beginning in the social media space and is a perfect example of how social media has the power to quickly bring all the players to the table. Although the World Health Organization has engaged in conversation with us, there is much work still to be done.

Do you have 10 minutes?

Would you join the conversation?

In a few short minutes, you can play a significant role in this initiative. Please consider taking 10 minutes and doing the following:

Join the Friends of the WHO Code Facebook group
Go to Twitter* and share the following tweets (just copy and paste!):

#WHOCode protects women&babies from predatory marketing. Shame @Nestle for trying to buy seat at the @PAHOWHO table #nonestle #breastfeeding

Tell @PAHOWHO to give back @Nestle $150K #nonestle #WHOCode #breastfeeding #conflictofinterest http://t.co/nnWJCIfX @WHO

We will not be bought! @PAHOWHO please return the money to @nestle . Stand up for mothers and babies. #WHOCode #breastfeeding #nonestle

If you’ve got more than 10 minutes, would you lend your expertise, insight, and skills to the movement?

Two thoughtful ladies responded to last weeks Call to Action with this quote from Margaret Meade:

“Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has.”

The time is now. Let’s change the world.

* If Twitter feels like another language to you, we understand. Check out the support from Birth Swell and Twitter’s Help Center.

Amber McCann, IBCLC is a board certified lactation consultant in private practice with Nourish Breastfeeding Support, just outside of Washington, DC and the co-editor of this blog. She is particularly interested in connecting with mothers through social media channels and teaching others in her profession to do the same. In addition to her work as the co-editor of Lactation Matters, the International Lactation Consultant Association’s official blog, she has written for a number of other breastfeeding support blogs including for Hygeia, The Leaky Boob, and Best for Babes. She also serves on the Social Media Coordinator for GOLD Conferences International and is a regular contributor to The Boob Group, a weekly online radio program for breastfeeding moms. When she’s not furiously composing tweets (follow her at @iamambermccann) or updating her Facebook page, she’s probably snuggling with one of her three children or watching terrible reality TV.

How IBCLCs Can Make an Impact Through Social Media

By lactationmatters on 13 November 2012 in Breastfeeding Advocacy, Cultural Issues, IBCLCs in the News, JHL article, Private Practice, Social Media

Written by Robin Kaplan, M.Ed., IBCLC

With 93% of adults born after 1982 (the Millennial Generation) communicating online and nearly 3 out of 4 using social networking websites, such as Facebook and Twitter, breastfeeding promotion and support has been taken to an entirely new level. In the Journal of Human Lactation article, Establishing an Online and Social Media Presence for Your IBCLC Practice, authors Amber D. McCann and Jeanette E. McCulloch, present findings that encourage all of us in the breastfeeding community to step into the minds of these Millennial mothers and engage with them about breastfeeding in their preferred medium.

Why does breastfeeding promotion and support need a social media presence?

While health care providers continue to be the first choice for most people with health concerns, 80% of US Internet users have sought health advice online. Plus, 44% of US women spend more time online after a new baby is born. We live in an amazing time where we can find answers online in an instant when we used to have to wait until our doctor’s office opened the next morning. The scary side of this is that there is so much misinformation online about breastfeeding and how easy it is for mothers to access this incorrect advice. Even formula companies have breastfeeding advice sections on their websites… this is NOT where new mothers should be receiving their evidence-based breastfeeding information and support….right next to a Enfamil advertisement!

Also, with breastfeeding being such a HOT TOPIC in the news, mothers are often bombarded with this negative press. It goes viral in an instant! The Time Magazine article, ‘Are You Mom Enough‘ and Mayor Bloomberg’s initiative to ban the formula bags in all New York City hospitals flooded the Internet and social media networks in record time. Negative comments about breastfeeding were abundant! While Best for Babes and Kellymom are doing all they can to turn this bad breastfeeding press into something positive, they need our help to further provide breastfeeding education and support online.

So where are these Millennial mothers and what are they doing online?

The four most dominant social media platforms are Facebook, Twitter, blogs, and Pinterest. What these platforms have in common is that they ALL promote engagement among Internet users. This is not like reading a book for information, which is a one-sided conversation. Using social media allows you the ability to comment, ask questions, and agree/disagree with the author and other commenters. It’s a conversation. When a mother posts a question on a Facebook page, she is actively seeking advice from her peers or an ‘expert.’ When a mom reads a blog article, she is looking to make connections with the author to help make sense of her world and often seek advice on a particular topic. Twitter is all about conversation and engagement and Pinterest is now a hub for articles and driving more traffic to websites than Facebook. We may not live in a village anymore, but the Internet is revitalizing the village mentality. It’s all about the need for support and belonging.

How can an IBCLC use social media effectively, without feeling like it is a waste of his/her time?

Creating a social media plan can be extremely helpful or you might find yourself being led down the time-sucking social media rabbit hole. As McCann and McCulloch suggest, create a plan that is appropriate for the size of your business or organization.
Decide who your target audience is and the purpose of your engagement.
Choose a social media platform or two that you feel is manageable and decide how much time you plan to dedicate to it a week.
Spend some time just watching and listening. You will figure out pretty easily what your audience is looking for.
Keep in mind that social media is all about sharing information. While you don’t want to give away everything you know, the more information you benevolently share online, the more appreciative your audience will be and encouraged to return to your platform in the future. You may have the chance to influence the greater masses with your positive messages about breastfeeding!

What about ethical concerns and client/patient confidentiality?

McCann and McCulloch stress the importance of upholding our Code of Professional Conduct, Scope of Practice, and Standards of Practice. The authors state that while these documents ‘do not contain a specific social media policy, IBCLCs may want to review the American Medical Association’s Policy on Professionalism in the Use of Social Media’.

As an avid blogger and social media user, I have a phrase that I use very regularly when I receive a comment or question that takes information from general breastfeeding advice to specific for one mom and baby and it goes something like this…. “It definitely sounds like you have some very important questions that would be best answered in a private conversation with an IBCLC. If you would like to discuss this further, please contact me at …..” This lets the mother know that I would love to help her, but this is not the appropriate place to discuss private, personal information and I want to protect her privacy.

So, even if you feel like you are not Internet savvy and social media gives you hives, all you have to do is start off slowly. Lurk a little on these social media platforms and just listen to what mothers are saying and asking for. Check out the Lactation Matters article, Great Breastfeeding Blogs to Read, and start sharing these articles on a social media platform. Begin a conversation on a Business Facebook page and see where it takes you. My guess is that you quickly see your calling to offer breastfeeding-supportive and evidence-based guidance to our Millennial mothers. And you never know… you might just have a ton of fun, as well!

Robin Kaplan received training to be a Certified Lactation Educator and an International Board Certified Lactation Consultant from UCSD. She holds a Masters in Education from UCLA, a multiple-subjects teacher credential from UCLA, and a BA in Psychology from Washington University in St. Louis, MO. In 2009, Robin started her own business, the San Diego Breastfeeding Center, where she offers in-home breastfeeding consultations, free weekly support groups, breastfeeding classes, and online support through her business blog. In addition to her private practice, Robin was the founding Co-editor of theInternational Lactation Consultant Association’s (ILCA)blog, Lactation Matters, and a regular contributor toILCA’s E-Globe newsletter. She also is the host/producer of The Boob Group online radio show and the Director of Marketing for NaturalKidz.com. Robin lives in her native San Diego, where she enjoys cooking, hiking, trying new trendy restaurants, and traveling with her family.

If YOU Don’t Advocate for Mothers & Babies, Who Will?

By lactationmatters on 8 November 2012 in Breastfeeding Advocacy, Opportunities for Participation, WHO Code/BFHI

Written by Jennie Bever Babendure, PhD, IBCLC

As IBCLCs, part of our Code of Professional Conduct (IBLCE November 1st, 2011)calls on us to adhere to the World Health Organization’s (WHO) International Code of Marketing of Breast-Milk Substitutes and Subsequent Resolutions. For those of us who hold this Code in high esteem, the news that WHO is accepting corporate funding and instant payday loans for its obesity initiative is enough to turn our stomachs many times over. According to the article, the Pan American Office of the WHO (based in Washington, D.C.) has begun to accept funding from fast food makers, among them the food giant and WHO Code violator Nestle.

As I struggled to reconcile the idea that an organization focused on world health would accept funding to fight obesity from the organizations that stand the most to gain from creating it, I began to feel crushing discouragement. How on earth can we, as a small band of mothers and breastfeeding professionals supporting the WHO Code, compete with multinational corporations with seemingly endless supplies of money? How can we succeed at supporting the WHO Code when the WHO is taking money from one of the worst offenders?

This is the point in the story when the hero has been soundly defeated. She goes back home with her eyes on the ground kicking stones in the path. She decides she will never win, so she might as well give up and just make noodles for the rest of her life (oh wait, I think that might be from one of my son’s favorite movies).

After a long night of frustration, writing, and a little alcohol, I chose to reframe the issue as a CALL TO ACTION. And if the WHO violating the WHO Code isn’t a call to action slapping me in the face, I don’t know what is!

But what can we do?

Most of us are doing our darndest to help mothers and babies start and continue breastfeeding in the face of tremendous marketing and cultural pressure to do otherwise. We stay awake nights worrying about how to best help a mother struggling with thrush or low supply, pour over research on tongue-tie and search the web for resources for new mothers. What more can we do?

The time has come for us to see our roles expand. Our job as lactation professionals must not only be to provide individual breastfeeding support, but also to advocate for maternal and child health on a larger scale. If we don’t begin to protest the status quo and work to change the political and cultural barriers that mothers face in their attempts to reach their breastfeeding goals, we will be fighting the same battles for the next 100 years. The International Baby Food Action Network (IBFAN) has long been at this fight. They shouldn’t have to fight alone.

In many places, we are beginning to see policies and legislation changing. We need to harness that momentum to move the tide even further. Now more than ever, mothers and babies need us to advocate for them and they need us to empower them to demand change themselves. Not just in the clinic or hospital, but in the grocery stores and restaurants, in the hallways and on the floor of congress. When mothers and babies protest a mother being asked to leave for nursing in public, we need to show up. When our congressmen and women debate policies that impact breastfeeding, we need to show up. When a news station wants to run a story on breastfeeding, we need to show up. When the WHO takes money from Nestle, we need to show up!

For some, showing up means planning and attending nurse-ins and rallies, for others it is talking, blogging and posting information on the cultural and political barriers to breastfeeding on websites, twitter and Facebook pages. Still others have the ability to influence corporations and other organizations they are a part of by changing the way they do business, who they work with, and how they support their employees. Even beginning to have conversations with the mothers you work with about choosing to support companies that uphold the WHO Code can have an impact!

We can also leverage our resources by joining forces with other organizations working to improve maternal and child health. In addition to IBFAN and the World Alliance for Breastfeeding Action, Natasha K. Sriraman has written about the organization 1000 Days for the Academy of Breastfeeding Medicine. With a goal of improving life by improving maternal and infant nutrition in the first 1000 days –pregnancy through the second birthday—1000 days seems like a natural ally of lactation consultants and maternal-child health advocates. Working with like-minded organizations will increase our ability to impact policies and legislation that prevent corporations like Nestle from sabotaging breastfeeding in both developed and developing countries by marketing their products directly to mothers.

When I was younger, I was under the illusion that if something important were happening, someone else would take care of it. As I’ve gotten older I’ve realized that is rarely the case. When the WHO takes money from a formula company, something is terribly wrong. If we don’t do something about it, who will?

If you are interested, please consider joining the “Friends of the WHO Code” Facebook Group to discuss violations of the WHO Code, especially those on social media, and how we can empower lactation professionals, volunteers and mothers to stand up for its importance.

Jennie Bever Babendure, PhD, IBCLC: I am mother to 2 active boys and an Assistant Research Professor in the College of Nursing and Health Innovation at Arizona State University. As breastfeeding researcher, I am constantly scanning the literature for articles that guide my research and inform my clinical practice. One of my goals is to increase the evidence base of our profession as lactation consultants. I feel it is important for lactation professionals to be aware of and contribute to breastfeeding research, especially when so much of it is fascinating! As an ongoing contributor to Lactation Matters, it is my hope that you will find the articles I highlight as interesting and informative as I do, and that you will use them to guide you in the important work of lactation professionals and breastfeeding advocates. For more research news and commentary, check out my blog at www.breastfeedingscience.com. I can be reached at jennie.bever@gmail.com.

A Day in the Life of Breastfeeding Support and Promotion in Public Health

By lactationmatters on 1 November 2012 in Breastfeeding, Breastfeeding Advocacy, Public Health, WIC

By Lisa Akers, MS, RD, IBCLC, RLC

I have worked in public health for over a decade and it never ceases to amaze me the number of people who truly do not understand public health or the work that public health officials seek to accomplish. Public health by nature is preventative medicine. Public Health can better be described as “the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals” (1920, C.E.A. Winslow). According the World Health Organization, public health is “an organized effort by society, primarily through its public institutions, to improve, promote, protect and restore the health of the population through collective action.” Public health seeks to prevent disease and is not in the business, necessarily, of treating disease. Breastfeeding, by nature, is disease prevention and by this fact alone, is positioned high on the national public health agenda.

It is important to understand these facts before understanding my role in breastfeeding promotion and support in public health. I am, in fact, the State Breastfeeding Coordinator for the Commonwealth of Virginia. My job is to manage breastfeeding support and promotion endeavors for the state. My responsibilities vary from day-to-day, but they typically includes such things as the development of public policy, media campaigns, curricula, publications and training; oversight of the Virginia WIC Breastfeeding and WIC Breastfeeding Peer Counselor Program; collaboration with numerous non-profit and academic entities, and service as the Virginia Department of Health liaison to the Virginia Breastfeeding Advisory Committee. This is by no means a comprehensive list, but simply a taste of the many things that I do from day-to-day.

Our emphasis in public health is on educating the practitioner as well as educating the general public in the support and promotion of breastfeeding. Since this article seeks to give readers an idea of what a typical day looks like in the field of public health, let me first start by painting a vivid picture for you.

You are a new breastfeeding mother, who has just given birth two weeks ago to a baby girl. You are a single mother, who receives no financial support from family or friends. You are concerned about making ends meet and providing for your daughter, so you plan to return to work within the next week. You currently work two part-time jobs at a retail establishment and a local restaurant. You make too much money to qualify for federal aid or entitlement programs, but luckily do quality financially to receive WIC benefits. Your biggest concern at the moment is continuing to breastfeed while returning to work and also being able to afford quality childcare that is supportive of breastfeeding for your daughter.

This is a typical scenario that is seen day-in and day-out both internationally and nationally. From the time that I start work every day, this is the scenario that continually plays in my mind. On a typical day, I am managing several million dollar budgets to ensure that this breastfeeding dyad is both supported and protected. These budgets help to run the breastfeeding support endeavors for the WIC program (including the WIC Breastfeeding Peer Counselor Program), support statewide policy initiatives related to breastfeeding, provide training opportunities and curricula to both clinicians and childcare providers, provide technical assistance to businesses and employers seeking to better understand and comply with the Patient Protection and Affordable Care Act, and provide training opportunities to public health personnel seeking to improve their knowledge of lactation management. On any given day, I handle correspondence from constituents, WIC participants, employers, childcare providers, clinicians, colleagues, and many others. A day in the life of public health breastfeeding support and promotion is ever-changing and never dull!

Public health gives me the autonomy and utilizes my creativity in many ways. One such way is in the development of numerous educational initiatives for clinicians and public health personnel. Most recently, this came to fruition in the development of two web-based educational opportunities for clinicians. The first is a web-based learning initiative, www.BreastfeedingTraining.org, which seeks to expand clinician’s knowledge of lactation management. The second web-based performance improvement initiative, www.BreastfeedingPI.org, seeks to improve the individual practice of clinicians. Both offer continuing education units and were developed in collaboration between the public and private sector in an effort to increase the knowledge base of healthcare professionals. Yet another avenue of education was in the development of an internship opportunity for WIC personnel. Most recently, we created an IBCLC internship for WIC personnel seeking to become IBCLCs with the ultimate goal of having at least one IBCLC in each WIC clinic site. This, not only, will help support the new breastfeeding mother in the above mentioned scenario, but will also aid in increasing the morale of WIC staff and WIC breastfeeding peer counselors, who seek job advancement and satisfaction.

Whether it be through education, policy, financial management of programs, or other avenues, my satisfaction in working to support and promote breastfeeding in public health comes from seeing the mother pictured in the scenario above reach her full potential.

Lisa Akers is a Registered Dietitian (RD) and an International Board Certified Lactation Consultant (IBCLC). She completed her Bachelor and Master of Science Degrees in Clinical Dietetics from James Madison University. Lisa has been working in the field of public health and human lactation for over 12 years. Her current position as the State Breastfeeding Coordinator. In addition, Lisa serves as the List Serve Coordinator for the Women’s Health Dietetic Practice Group (DPG) and is the Academy of Nutrition and Dietetics’ delegate to the United States Breastfeeding Committee. She also served as an Expert Workgroup member for the Academy’s Evidence Analysis Library, as a reviewer for the Academy’s most current position paper on the Promotion and Support of Breastfeeding, and as a reviewer for the reproductive section of the Nutrition Care Manual. Lisa is also the current 2012 World Breastfeeding Week Coordinator for the International Lactation Consultant Association.

In her spare time, Lisa enjoys sewing, quilting, and taking long motorcycle rides with her
husband in the Blue Ridge Mountains of Virginia where she currently resides.

Supporting Active Duty Military Mothers as an IBCLC

By lactationmatters on 25 October 2012 in Breastfeeding, Breastfeeding Advocacy, Military

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.

Major Beth Lane,USAF, C-17 pilot pumping in the crew “Breast” area

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.

Robyn, with her own son at 3 months, in her uniform

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.

American Academy of Pediatrics Section on Breastfeeding Launches New Facebook Page

By lactationmatters on 22 October 2012 in America Academy of Pediatrics, Breastfeeding, Breastfeeding Advocacy, Breastfeeding News, Networking/Relationship Building, Social Media

By Jennifer Thomas, MD, MPH, IBCLC, FAAP, FABM

The internet has increasingly become a tool for people seeking health By Jennifer Thomas, MD, MPH, IBCLC, FAAP, FABM
information. A Pew Internet and American Life survey in 2011 showed that 80% of internet users have visited a website for information or support for a specific health problem, 19% of whom searched for information on pregnancy and childbirth.

Social media has increasingly become a tool for organizations, such as the American Academy of Pediatrics (AAP), to share information pertinent to the goals, mission, vision, publications and achievements. It has become a way to promote new products. It increases awareness about current issues, and can, unfortunately, generate misinformation which can be quickly disseminated widely. As the AAP is the recognized authority on the care of children, in addition to provide accurate information to physicians and breastfeeding mothers, we see this misinformation as a problem which needs to be addressed.

The American Academy of Pediatrics Section on Breastfeeding recently launched a new Facebook page. It was created to:

Raise awareness of activities, products, and resources produced by the Section on Breastfeeding.
Highlight our members achievements.
Recruit new pediatricians to our membership.
Highlight pertinent evidence-based practices and publications.
Present evidence-based information in response to trends on social media which may be detrimental to the experience of new breastfeeding mothers.
Join in the discussions, currently occurring in social media about breastfeeding.

The Facebook page has the potential to be many things but it will not be a place for our section’s members to offer clinical advice. It will be for the dissemination of information only.

We invite IBCLCs and other breastfeeding professionals and volunteers to come “like” our page and engage in the conversation with us. A strong collaboration between pediatricians and other members of a baby and their family’s health care team is vital to their breastfeeding success.

Click HERE to connect with the American Academy of Pediatrics Section on Breastfeeding’s new Facebook page.

Bryson’s Legacy: A Story of Milk Donation and the Love of a Family

By lactationmatters on 4 October 2012 in Breastfeeding Advocacy, Breastfeeding Videos, Milk Banking, Opportunities for Participation

Those who attended the 2012 ILCA Conference had the wonderful privilege to view a video presented by Ryan Comfort, of Milk for Thought, which told the story of Amy and Bryan Anderson and their son, Bryson. There was an intense emotion in the room as they shared of their milk donation since his birth and death and we wanted to offer an update of their journey.

[youtube http://www.youtube.com/watch?v=PmId_ekok9s]
Amy shared with us the following:

Bryson’s legacy begins eleven years after I fell in love with my high school sweetheart. We had been married for five years and were already the proud parents of two precious children. Our firstborn, Brody, was a passionate 3½ year old boy. And our Joey Skylor was born into heaven in December 2009 for unknown reasons early in the second trimester. Our family felt prepared for the additional joys and love that a new baby would bring, so we were all overjoyed with anticipation to find out we were expecting a baby boy due to arrive March 28th, 2011. However, the Lord had special plans for our precious baby Bryson.

After a month of constant medical interventions to save our son from the complications of a rare condition called LUTO (Lower Urinary Tract Obstruction), Bryson went home to join Joey on heaven’s playground. It was a beautiful, sunny and windy day on that October 30th, 2010 at 1:04pm when I finally stopped trying to hold onto my baby boy as his body was torn from mine. It was the hardest thing I have ever had to do, relax and let go of my precious baby, whom I had been incessantly praying for and loving for what seemed like an eternity… I remember as soon as I felt him leaving I bawled and tearfully called out. I was hopeless and helpless. My whole body shuttered with the reality of what was happening. I just wanted him back, I already missed him so badly.

My husband and I were beyond ourselves, completely lost in our grief and despair and yet so proud of our son’s journey/life. Daddy noticed how he already resembled his big brother especially in the brow… that warmed our hearts. What a beautiful and fragile baby he was… I can only imagine how gorgeous he is in heaven, no longer weakened by his delicate body. Bryson’s body was 13oz and 10in of perfection, with 10 tiny fingers and toes with nails already formed on them. I fondly remember watching him on the dozens of ultrasounds we had… he certainly was a fighter and a persistent little one, much like his mommy. His personality was very strong and he had every intention of being a significant part of our family and our hearts… in that respect his life was a complete success! He has made a huge impact in the lives of many.

As we heard at the conference, Amy began pumping and donating her pre-term milk. Their “Donation Through Grief” has totaled 3,239 ounces of milk to Mother’s Milk Bank of New England and 8,523 ounces to Mother’s Milk Bank of Ohio…that’s nearly 92 gallons of breast milk! Bryson’s milk was literally sent all around the country and even around the world.

Amy and Bryan are currently involved in advocating for bereaved parents by educating medical professionals and the community at large in how to care for those who have lost infants, especially in terms of lactation options after a stillbirth or earlier loss. Amy says,

I’m persistently advocating to amend the US federal law “Break Time for Nursing Mothers” under the Fair Labor Standards Act. The law is intended to support appropriate break time for expression as needed at work for “nursing mothers”. However, this verbiage has made it possible for my place of employment to say that the law doesn’t apply in my situation because I don’t have a nursing baby, therefore am not considered a “nursing mother”. Regardless of the fact that my body was lactating uncontrollably even though my baby was not at home to latch on. My goal is for the law to pertain to any “lactating women”, so employers cannot use the law to discriminate against a bereaved mother whose already experiencing unfathomable grief.

So far I’ve been completely unsuccessful with getting the attention of any of my state representatives, the Department of Labor has directed me to my local La Leche League, and the White House has also yet to reply to my e-mails (lol, yup, I even reached out to the president/first lady). My best bet so far is to get as many people as possible to hear my Bryson’s legacy. People need to know lactation can happen even after only 20 weeks gestation (and even earlier), and that donating their baby’s breastmilk is a precious, much appreciated gift that gives meaning their baby’s short life and helps with the grief process. I’ve already recieved a few responses that our story inspired a couple other moms to “Donate Through Grief” which is huge to me (though I understand it’s a very personal choice, the option needs to be available to the mom).

At Lactation Matters, we are proud to share Bryson’s story and know that there are many in our community who would have unique insight for the advocacy that the Andersons are pursuing. Please contact Amy at aranderson33@gmail.com if you’d like to help take up the cause.

Have you worked with bereaved mothers to donate milk? How has this practice positively impacted them?

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