Archive | Public Health

The Legacy of a Hurricane

By Regina Roig-Romero

HurricaneAndrew 2

Every year at about this time, I think of Hurricane Andrew. Sometimes I wonder why. Twenty-one years ago, I was inside the tropical buzz saw known as Hurricane Andrew, a Category 5 storm that hit South Florida in August of 1992. When a storm of that strength is just outside your door, the smartest thing you can do is suppress your curiosity and not look out your windows, which hopefully are boarded up anyway. And we were smart, so from that frightening night what I mostly remember are the sounds – the storm, whistling like an oncoming train about to roll full-speed ahead into the closet we were hiding in, and the knowledgeable, calming voice of meteorologist Bryan Norcross on my radio. I remember the darkness. And I remember my 16 month old daughter nursing….and throwing up.

But Hurricane Andrew wasn’t just a personal milestone in my life; it was also a professional one, my first serious venture into my future as a public health IBCLC. That night was all about Andrew’s sounds, but from the moment the sun returned to our skies, its sights took over. South Florida – indeed the country – could not remember when the nation had last witnessed such devastation from a natural disaster.  Three of our five La Leche League (LLL) Leaders lost their homes to Andrew. I – a newcomer to breastfeeding advocacy, having only become a Leader one year earlier – was one of the two that didn’t. Once we were all finally able to see what had just happened to our city, those of us in LLL were immediately panic-stricken at the prospect of the city’s newborns being fed infant formula under such conditions – no water, no electricity, no refrigeration, no grocery stores. It was as if overnight we had all been transported to a 3rd world country and were now living inside of Gabrielle Palmer’s book, The Politics of Breastfeeding.  “Well, not in my town, and not on my watch,” I thought, so I had an idea – take all of the money that LLL folks from around the country had donated to us, spend it buying copies of the Womanly Art of Breastfeeding, and then give them away for free in South Miami-Dade where the storm had hit worst.

It seemed like a great idea and so we bought the books and packed them – along with our idealism and our kids – into our cars and set out for “tent city”:  the huge collection of tents in Homestead where many of the instantly-homeless were now living. And that is when I came across the most enduring sight, for me, of Hurricane Andrew:  a huge green tent full of infant formula, can after can after can of it piled high and being given away. Our books seemed so tiny and unimportant by comparison! Just as defining for me was the virtual wall of disinterest that we were met with when we tried to explain to the powers that be that after a disaster breastfeeding is even more important than it is before it. But our passion and idealism fell on deaf ears; I felt afterwards like we’d failed miserably to make a difference.

My idealism died in tent city; two things replaced it: the conviction that the most important thing we can do to promote breastfeeding after any disaster is to normalize breastfeeding *before* it, and an intense and mercilessly unrelenting desire to make a difference that drives me to this very day. Twenty-one years later I am an IBCLC with 17 years’ experience as a Lactation Consultant for the Women, Infants and Children (WIC) program, a public health professional on the brink of graduating with a Master’s degree in Public Health, a member of the National WIC Association’s Breastfeeding Promotion Committee, and a Board Director of the International Board of Lactation Consultant Examiners. I neither imagined nor planned any of it. But it all began with Andrew – with the whistling wind, the frustration of failure, the implacability of apathy, and a tent full of formula. No wonder I still think about that hurricane…..

ReginaRoig-Romero_IBLCE BOD picRegina Maria Roig-Romero was a La Leche League Leader for several years beginning in 1991, and is currently the Senior Lactation Consultant for the WIC breastfeeding program in Miami, Florida. She has assisted as an IBCLC in the program’s creation, development and leadership since its inception in 1996; in 2011-2012 she led the implementation of a worksite lactation support program at the health department in Miami. From 2002-2011, she successfully mentored thirteen Peer Counselors to become IBCLCs. In 2011, Regina served as an invited member of the USDA Food & Nutrition Service Expert Panel on the revision of the Loving Support Peer Counselor Training curricula. Her major speaking engagements include: the National WIC Association’s (NWA) Washington Leadership Conference & Breastfeeding Summit in 2010, two Spanish-language sessions at the 2012 ILCA annual conference, and an upcoming presentation on perceived milk insufficiency at the American Public Health Association Annual Meeting in November 2013.  Regina was appointed to the NWA Breastfeeding Promotion Committee in August 2012, and was elected to the Board of Directors of the International Board of Lactation Consultant Examiners in September 2012. In December 2013, she will graduate with a Master of Public Health (MPH) degree in Health Promotion and Disease Prevention from Florida International University.

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

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.

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