Tag Archives | breastfeeding

Top 10 Lactation Matters Posts of 2014

Screenshot 2014-12-17 16.07.43As we wind up 2014, we’d like to take a look back at our most popular blog posts of the year. It has been an exciting year at Lactation Matters, as we’ve expanded our reach and put a new focus on content highlighting research and practice from all over the globe. If you are doing something new and innovative in your practice, have a tip or technique to share, or want to tell us about how International Board Certified Lactation Consultants® (IBCLCs®) are impacting breastfeeding families around the world, please send us an email to marketing@ilca.org. We look forward to hearing from you!

Here are our top 10 blog posts of 2014!

Screen Shot 2014-04-16 at 12.54.48 PM#10 – Q&A with Sherry Payne, MSN, RN, CNE, IBCLC: An Innovator in Lactation Equity: In April, we were able to share about the innovative work happening at Uzazi Village, in Kansas City, MO, USA. Sherry’s work not only supports women in her community with birth and breastfeeding but is also is educating practitioners who can expand the work of the center.

#9 – New Strategies for Relieving Engorgement: Tips and Tools from Maya Bolman, BA, BSN, IBCLC: This post, published less than one month ago, is blasting its way to the top of our list of most popular blogs. Including video to demonstrate the technique, Maya Bolman offers time-tested treatment methods for some of our most common lactation related challenges.

#8 – Open Letter: Barriers to the IBCLC Profession: After last summer’s Lactation Summit Addressing Inequities within the Lactation Consultant Profession, the conversation about barriers to entry into our profession has been elevated. We published this Open Letter from Alice Farrow, highlighting her perspective and in it, she calls out a number of challenges that those who desire to be IBCLCs encounter as they pursue the profession.

5464706246_6acccd82f6#7 – A Closer Look at Cultural Issues Surrounding Breastfeeding: This excellent piece explores some of the beliefs surrounding breastfeeding in world cultures and how they impact our work as IBCLCs. As ILCA expands its global perspective, we strongly encourage all practitioners to be knowledgeable and respectful of the cultural beliefs in their own communities and determine how to integrate them with evidence-based practice.

#6 – Freya’s Gold: Milk Donation After Loss: We are so grateful to the Mothers’ Milk Bank for sharing this incredible story from Monique about donating her breastmilk after the loss of her daughter, Freya. It also contains important resources for working with bereaved families such as Clinical Lactation’s article Lactation After Loss, by Melissa Cole, IBCLC.

#5 – Pumped Up: Supporting Nursing Moms at WorkWhat a great post highlighting creative and “out of the box” solutions for pumping in the workplace! Written by Cathy Carothers, it shares resources developed by the U.S. Department of Health and Human Services, Office on Women’s Health. Videos and photos are included to feature workable options in virtually every type of employment setting.

Wondering How To Become An IBCLC-#4 – Wondering How to Become an IBCLC?: We get questions daily about how to get started on the journey towards becoming an IBCLC, and so we published this piece as a “one stop shop” for those interested in entering the profession. We know that many of your are sharing it with all of those who contact you with similar questions and we THANK YOU!

#3 – Traveling as a Pumping Mother: We have  found that posts with real-life tips for breastfeeding families are always well received. We first published this post in May 2013, and it addresses a very common concern for many families who are balancing parenthood and employment. It is a great one to share with your clients and patients.

#2 – Pumping Strategies for the Working Mother: This post, first published in May 2012, has been a strong driver of traffic to our blog. Offering practical and well-researched guidance for working families, it continues to garner comments and is a favorite on social media.

New Research_ Direct Correlation Between#1 – New Research: Direct Correlation Between Labor Pain Medications and Breastfeeding: We certainly hit on a “Hot Topic” because the popularity of this post zoomed right by Pumping Strategies for the Working Motherwhich has held our MOST POPULAR POST spot since 2012! This post has received more than 100,000 views since May (more views than we had on the entire blog in our first two years!) and has opened up a new conversation about the impact of birth practices on breastfeeding.

Did you read all 10?

If not, take the opportunity to get a taste of what Lactation Matters is all about. And be watching in 2015 as we expand our focus and bring you more posts highlighting the strong work of IBCLCs around the world.

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New Resource to Encourage Normal, Healthy Birth

By Jeanette McCulloch, IBCLC

preagnant africanIn the introduction of Linda Smith’s book, “Impact of Birthing Practices on Breastfeeding,” Diane Wiessinger aptly sums up how we can help get breastfeeding off to a good start:

“It’s the birth, stupid!”

As lactation consultants, we know both anecdotally and through research the impact on breastfeeding of common birth interventions in the U.S, including: non-medical inductions; certain labor drugs; lack of freedom to eat, drink, or move about as needed; and unnecessary surgical delivery. While interventions can be lifesaving when medically appropriate, the number of routine interventions has meant an unprecedented impact on healthy, normal birth.

The result? According to Amnesty International: “It’s more dangerous to give birth in the United States than in 49 other countries. African-American women are at almost four times greater risk than Caucasian women.” And what do we know as lactation consultants? The same routine interventions that are impacting birth safety are also creating breastfeeding challenges.

Three leading midwifery organizations in the US formed a partnership to create educational materials designed to help those who are pregnant – or planning to become pregnant – learn about how a normal birth process can improve health of both mother and baby.

The International Lactation Consultant Association has signed on as a supporter of the project’s first handout, which guides women through the process of learning about normal birth and the choices they can make to increase the chances of a physiologic birth.

The handout is available as a PDF download here or you can purchase pre-printed packs at minimal cost here. The materials can serve as a helpful reference in your prenatal breastfeeding class packets. You can also share the link to the PDF widely on your own social media, helping as many mothers and mothers-to-be learn about normal, physiologic birth.

The handout was created in partnership between the American College of Nurse Midwives (ACNM), the Midwives Alliance of North America, and the National Association of Certified Professional Midwives. It has received endorsements from many of the leading organizations working towards increasing normal birth options, including Citizens for Midwifery and the International Center for Traditional Childbearing. For more information, visit the ACNM’s consumer education project here.

JeanetteJeanette McCulloch, IBCLC, is a lactation consultant in private practice in Ithaca, NY. She is also the co-founder of BirthSwell, which is improving infant and maternal health through digital skills for birth and breastfeeding pros and volunteers.

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YouTube for Breastfeeding: Video Sharing as a Counseling Tool

By Jessica Lang Kosa, PhD, IBCLC

youtube-logo2“Do you have any suggestions for how to get a deeper latch?” asks the mom on the phone. I’ve been a LLL leader for years, so I have a lot of experience with phone counseling, but certain questions always leave me struggling for words while illustrating my point with animated hand gestures that are invisible to the caller. Even the best description of a physical technique just doesn’t do it justice – a picture is worth a thousand words, and a video, well that’s priceless. Hence, my YouTube channel.

YouTube is a video sharing website that allows anyone to post videos. They can be restricted to only certain viewers, or can be made public. If a video is public, then other users can share it around by marking it as a favorite, emailing a link, or adding it to a playlist (a collection of videos). The copyright agreement that video creators agree to allows only for open sharing within YouTube – not for downloading the video. Links to a video can also be embedded in a Facebook post, blog, or other social media, but the link goes back to YouTube. A user can simply view other people’s videos, or can create a channel – essentially a homepage, where the host can present their own videos and links and comments on other public videos. Accounts and channels are free. Creators of a video can choose to show an ad at the beginning to generate revenue (both for themselves and for YouTube), and this is what keeps it viable.

As a teaching tool, this is incredibly powerful. A mother calls to say she is engorged and can’t get the baby to latch. I can send her to a video demonstrating reverse pressure softening. Any time I teach a client a technique – hand expression, laid-back breastfeeding, supplementing at breast – I can also give her links to videos. Learning theorists say that we all remember information better when we receive it through multiple routes; verbal, kinesthetic, and visual all reinforce each other. I can also diversify, by offering both my own videos – reminding her of what I taught her in person – and other public videos, usually offering a slightly different approach. She can see for herself a real range of practices, and experiment to find what works for her. One of my favorite things to teach new mothers is nursing while babywearing. Since there are zillions of different carriers, and many ways of nursing in them, collecting a lot of examples in a playlist is super useful.

I’ve posted several videos I made myself; all are short simple ones shot with an iPhone. One of the first videos I posted was a live demonstration of hand expression by a colleague. Within 48 hours, it had thousands of views, and had been flagged as “inappropriate” and removed by YouTube. I fought YouTube, and got it reinstated, now marked “18 and over” and “For Health Education Only.” I also disabled the comments – most of which were coming from people who were not my intended audience.

After that, I switched mostly to videos using props rather than actual breasts. In addition to reducing the troll traffic, props have several advantages. For one thing, they simplify. For another, it’s easy to make a point very quickly. My demo baby (a teddy bear) can be moved around into several different positions, including those that would be uncomfortable for a real baby. Seeing a real baby latch is valuable too, but with my bear, puppet, and knitted breast, I can illustrate the key points several times over in less than a minute. Another lesson I’ve learned is that a 1-minute video is generally more useful than a 10-minute video.

Since my goal in posting videos is to have an easy teaching tool, I have not put ads on my own videos. But it’s an option, and a popular video can make some significant ad revenue. For those who just want to use videos to support their work with mothers, the first step is to create an account, and browse. Search terms like breastfeeding, twins, pumping, whatever you find yourself describing often. When you find something you like, click “Favorite”, or “Add to Playlist.” For a playlist, you will have a chance to create a new playlist, name it (such as “Twin nursing positions”), and add a description. A playlist is good for when you want to organize multiple videos on a topic. Then, you can email or text links to individual videos, or a playlist, or your “channel.” (Or to my channel, which can be found HERE.) This is not a time-consuming process, and it’s free. And it’s much easier than describing that invisible latching baby over the phone.

Jessica head 4Jessica Lang Kosa is an International Board Certified Lactation Consultant in private practice in the Boston area.  She offers home visits for comprehensive breastfeeding help, and teaches courses in breastfeeding support for professionals who work with mothers and babies.

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USDA Child Nutrition Program and Breastfed Toddlers in Day-Care

By Laura Spitzfaden, LLLL, IBCLC

Under the USDA Child Nutrition Program guidelines, infants and children 1 year of age and older, who are in licensed day-care programs, must be offered fluid cow’s milk (or approved alternative milk) in order for their day-care providers to be reimbursed for their meals. This is in conflict with what is best for employed mothers of breastfed toddlers and their day-care providers, who have limited breastfeeding friendly options under these guidelines.

iStock_000016831831SmallMany employed mothers, knowing that their breastmilk provides excellent nutrition, antibodies, and a sense of security for their older babies, continue to breastfeed when they are with their babies, even if they no longer express milk while they are at work. A breastfed baby, who is 1 year of age or older and eating nutrient dense solids, needs approximately 15 ounces of breastmilk each day to meet child nutrition standards. If a mother and baby breastfeed at least 3–4 times daily, the baby will receive age-appropriate amounts of milk and will not need a milk-substitute when separated from the their mother.

In order to support the breastfeeding relationship, a day-care provider may choose not to be reimbursed for the meals the breastfed child consumes that do not include milk, however this option is economically punitive to the provider and may affect how much they charge for their services. In order to take the burden off the day-care provider, the mother may send food from home for the child to consume at day-care but this creates extra work and expense for the mother. Alternatively, the mother’s own expressed breastmilk may be served at meals. This satisfies the milk requirement under the USDA Child Nutrition Program, but continued breastmilk expression may be unnecessarily burdensome for the mother of an older baby who doesn’t need this extra milk.

Expressing breastmilk takes a great deal of dedication and time; pump-weaning can be a welcome relief for the employed breastfeeding mother of an older baby. No longer does she have to cart her pump to and from work or have to scramble to accommodate for the occasional misplaced or broken pump part. Break times become actual breaks and lunches can be enjoyed without the hassle of setting up a pump, expressing and storing milk, and cleaning pump parts.

If a breastfeeding mother allows cow’s milk or other alternative milks to be offered at her child’s meals, she may risk their breastfeeding relationship. One mother who had pump- weaned but whose toddler continued to breastfeed when they were together writes, “when I got to that point with [my daughter], she just stopped getting milk at daycare. She is getting enough mama milk straight from the source when we are together. She just drinks water at daycare. We didn’t originally do it that way—we gave her cow’s milk for a couple of days—then she drastically reduced nursing, so I took her off of cow’s milk. She went back to nursing like normal.”

The Healthy, Hunger-Free Kids Act of 2010 states “In the case of children who cannot consume fluid milk due to medical or other special dietary needs, other than a disability, the caregiver may serve non-dairy beverages in lieu of fluid milk….If a non-dairy milk substitute is served that does not meet the nutritional standards outlined in Title 7 CFR 210.10(m)(3), then the meal is not reimbursable.” According to Kelley Knapp, MS RD from the California Department of Education Nutrition Services Division, there is another option in USDA’s Child Nutrition Programs. The child’s physician can fill out a form, “…stating that the child cannot receive milk due to a disability.” In this case, the toddler may be offered a physician-determined alternative (e.g. water or juice) with meals and the meal may still be reimbursable.

These options do not address the unique needs of the breastfed toddler who does not have a disability or a medical condition, but just doesn’t need additional milk in their diet. It doesn’t address the concern that offering non-human milk to a breastfed toddler can reduce the amount of breastmilk that is consumed and replace it with an inferior substitute that is linked to allergy and obesity.

Employed mothers should not have to continue to express milk for their children past the age when it is needed and they should not have to jump through hoops for their children to continue to enjoy a health promoting breastfeeding relationship. Day-care providers should not have to take an economic hit in order to support their breastfeeding clients. It is imperative that this gap in the USDA food program be closed, so that we may continue to support breastfeeding mothers, their babies, and their care providers, whether their breastfeeding relationships are measured in terms of months or years.

References:

Child & Adult Care Food Program Reimbursable Meals and Snacks

Long-Term Breastfeeding: Nourishment or Nurturance? Kathleen M. Buckley, PhD, RN, IBCLC, J Hum Lact November 2001 17: 304-312

Breastfeeding Past Infancy Fact Sheet

Feeding Infants: A Guide for Use in the Child Nutrition Programs, Chapter 3

USDA FCS INSTRUCTION 783-7 Food and Nutrition Service REV. 1 Milk Requirement Child Nutrition Programs

The Healthy, Hunger-Free Kids Act of 2010, Public Law 111-296, Section 221.17(g); USDA Policy Memo CACFP 21-2011-REVISED; USDA Policy Memo CACFP 04-2010 Fluid Milk and Fluid Milk Substitutions (Revised)

Child Nutrition Programs PHYSICIAN STATEMENT FOR FOOD SUBSTITUTION

LauraLaura Spitzfaden is a private practice IBCLC in Charlotte, Michigan. She has been a La Leche League Leader since 1998 and an associate area professional liaison (AAPL) for La Leche League since 2012. She has three children whom she breastfed for a total of 10 years. Laura has a passion for helping moms to reach their own breastfeeding goals and has created an informational breastfeeding website dedicated to providing moms with accessible breastfeeding help and resources so they may solve some of their own breastfeeding difficulties. She has written many articles on breastfeeding topics including, bed-sharing, milk-sharing, tongue and lip-tie, birth practices and milk-supply and provides these articles freely, to support breastfeeding moms and their babies.

Laura has a special interest in early childhood development and has worked in preschools and her own child-care business, creating hands-on, science based curriculums for toddlers, preschoolers and young 5’s. She has also presented multiple science workshops for young children and for adults who work with young children and has worked in a children’s science museum in exhibit development. Additionally, Laura has a love of dance and has studied tap, jazz, lyrical, modern and ballet and performs each year with The Community Dance Project.

© 2013 Laura Spitzfaden, LLLL, IBCLC

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Insights into Working with Breastfeeding Mothers Who Have Experienced Trauma

By Dianne Cassidy, IBCLC

Photo by 55Laney69 via Flickr Creative Commons

Photo by 55Laney69 via Flickr Creative Commons

When I first began working with new mothers, it was with a local community program.  The more women I met, the more I saw a link between breastfeeding and trauma.  Most of the women that I assisted had a limited support system available to them, and limited education.  In many instances, we were the only ones who offered the support they needed to initiate breastfeeding.  As a bond was built during pregnancy, sometimes a new mother would open up and talk about her personal history, things that she may have endured during childhood, or in the not-so-distant past.

I have heard some terrible stories.  Many of these stories come with a happy ending of sorts – the fairy tale where the woman finds her strength and confidence and realizes that she is capable.  Some are not as favorable, and can haunt you for years.  I became more and more interested in how abuse can impact a woman’s decision to breastfeed.  I decided to make this the topic of a research project while completing my Bachelor’s degree a couple of years ago. While important, coming face to face with the emotional scars of many of these women was very challenging.

While doing my research, the literature review unearthed some interesting information about abuse and breastfeeding, particularly child sexual abuse (CSA) and how it may impact breastfeeding initiation.  When working with the community programs, one of the focuses of breastfeeding support was teen age mothers.  We have a high rate of teenage pregnancy here (enough that there is an entire high school dedicated to teen mothers) and teen mothers have been known to have a low breastfeeding rate. Childhood sexual abuse prevalence among adolescent mothers is close to 50%. Adolescents who have been abused as children are more likely to become sexually active at a younger age than those not abused.  Adolescent survivors of CSA were 3x likely to become pregnant than those who were not abused.  Studies reflect that breastfeeding is not readily initiated among adolescent mothers.  This is not to say that these mothers will not initiate breastfeeding at all, but those who do initiate are more likely to wean earlier than adolescent mothers who are not victims of CSA.

One of the most wonderful things about breastfeeding is the close, intimate connection between mother and baby.  For a survivor of CSA, this may be an unfamiliar, unwelcome sensation.  Intimacy disturbance and dissociation are consequences that are likely to influence feeding decisions of adolescent mothers.  CSA victims and survivors may struggle with trust issues, building relationships and emotions.  Abusers are often someone that the victim is familiar with – family friend or relative for example, leading to feelings of betrayal and vulnerability.

Trust is a tricky thing.  It’s important that a woman has a good relationship with her provider, a trustworthy relationship.  Without this, information is skewed.  Communication is key.  It may be difficult for a survivor to confide her concerns regarding her feeding choice to someone if a relationship of trust has not been established. When preparing for labor, a provider can gain the trust of their patient if they listen carefully and validate her feelings, exploring what concerns she may have in regards to breastfeeding.  When working with expectant women, or in particular adolescent mothers, education is an important part of breastfeeding initiation.  Educate expectant mothers about their feeding choices in a non judgmental manner.  Mothers with CSA history are likely to have come from a family environment that is chaotic, deprived and emotionally dysfunctional.

As a lactation consultant, it can be difficult to explore options other than breastfeeding with a new mother.  We know that breastfeeding is the optimal choice, and mothers know this to be true as well.  Sometimes, exploring other alternatives is necessary.  The role of the provider is to offer the patient evidence-based information so that the patient can make the appropriate decision.  Once the information has been disclosed, it is the role of the provider to offer support, no matter what that decision is and how the provider feels about that decision.

Every new mother and baby deserves the opportunity to enjoy a breastfeeding relationship, free of distress, no matter what the history may be.  I feel honored that I have been able to assist with offering this to survivors, encouraging mothers and babies to get the best start in their life together.

References:

Bowman KG (2007). When breastfeeding may be a threat to adolescent mothers. Issues in Mental Health Nursing, 28(1), 88-89.

Brooks, EB (2012). Legal and Ethical Issues for the IBCLC. Jones and Bartlett.

photo-2Dianne Cassidy is a lactation consultant in Rochester, New York. She became interested in the field of lactation consulting after breastfeeding her own children.  After spending thousands of hours working with new mothers and babies, she was able to sit for the board exam, which qualified her as an International Board Certified Lactation Consultant (IBCLC). In 2010, she completed her Advanced Lactation certification and BS in Maternal Child Health/Lactation.  She is dedicated to serving mothers and babies, and has the unique ability to identify with the needs and concerns of new mothers. She also has experience working with older babies and mothers returning to work and wishing to continue their breastfeeding relationship. She has worked extensively with women who have survived trauma, babies struggling with tongue tie, birth trauma, milk supply issues, attachment, identifying latch problems, returning to work and breastfeeding multiples.

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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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Racial Inequities in Breastfeeding: My Commitment to be a Mentor

By Betsy Hoffmeister, IBCLC

Recently, some of my colleagues in private practice were discussing the topic of IBCLC® mentoring. I’ve only been an IBCLC for four years, but I receive many phone calls per year from women looking for a mentor.  Some of my colleagues mentioned the uneasy sensation that they are training their own competition.  I want to add a different perspective.

iStock_000016195932SmallIn June, the two-day Inequity in Breastfeeding Support Summit in Seattle was the site of passionate discussion about barriers to breastfeeding support, for and by women of color. Women of color in the US have a lower rate of initiation and duration of breastfeeding, and women and their babies suffer higher rates of morbidity and mortality that could be mitigated by breastfeeding. There are also few IBCLCs and other breastfeeding support people who are women of color.

In the Greater Puget Sound Area, there are very few (possibly zero!) private practice lactation consultants who are also black, Latina, Asian, or Native American. I know of one Seattle-area Native American woman who just sat the exam and I can’t wait to hear her results! There are a few IBCLCs who are women of color who work for WIC or for hospitals. Why is that? There are many, many, MANY obstacles.  One obstacle cited was the barriers to entry – the bar keeps getting raised and it’s terribly expensive. Here in Washington State, for a variety of reasons, we have few to no La Leche League (LLL) Leaders who are also women of color. Since Leadership used to be the traditional route to becoming an IBCLC, lack of Leaders who are women of color is also a challenge. LLL of WA has been actively working to address this.

Conversely, what we learned from the women of color in attendance at the Summit, is that while the breastfeeding rates, especially in the African American community are very low, there are no visible black breastfeeding role models (calling Michelle Obama, we want your photos!!) Very often, women of color would feel more comfortable working with a breastfeeding helper who had similar life experiences. IBCLCs are typically compassionate, wise, lovely women – and yet, at least here in WA State, we have not walked in the shoes of the African American experience. I have come to understand and honor the desire of women to want to work with someone who not only has experience and training, is compassionate, wise and lovely, but also shares life experience and understanding. Incidentally, that’s why the following video is so important. I’m thrilled that when I first saw it, it had less than 10,000 hits and now it has more than 300,000!

One agenda item strongly suggested at the close of the Summit was for IBCLCs to seek out and mentor women of color as IBCLCs. And, if at all possible, NOT charge for it if the woman in training is low income. I don’t depend on my IBCLC income to run my household. I can afford to take on a free mentee. I don’t feel like I’d be training my competition. Right now, my clientele are mainly white, Asian, and Southeast Asian. I see the occasional Latina and very, very rarely an African American mother. If I could mentor an IBCLC-in-training who was also a woman of color, I feel like I’d be training valuable colleagues who could support women in my community who desperately need the services but are not seeking me specifically. I publicly committed at the Summit and here commit again: when I achieve my 5-year status and go through the process of becoming a mentor, I commit to actively seeking out a woman of color in my community who wishes to become a breastfeeding counselor and mentoring her through the process of becoming an IBCLC. I know I will learn much in the process and become a better helper to all mothers as a result.

sixBetsy Hoffmeister, MPA, IBCLC, has been a LLL Leader since 2002 and a private practice IBCLC since 2009. She lives in Seattle with her husband, who makes chocolate from beans, (but sadly, without sugar), her son who just became a Bar Mitzvah and her 8 year old daughter. In her spare time, Betsy reads, gardens, and is experimenting with knit and crochet breast patterns. She only recently got turned onto anti-racism and equity in breastfeeding support and is excited and passionate about helping the movement. Contact her atbetsy@betsysbabyservices.com.

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Fathers, Breastfeeding & Bonding

By Dr. Lucas Godinez, DO, IBCLC

Reprinted with permission from the Breastfeeding Center of Pittsburgh

At the special moment a baby is born a lot of changes occur instantly.  For the father, new relationships and responsibilities begin.   They transform from being a husband and “expectant” father to the husband and “new” father.  Their role in the family dynamic becomes structured with guidance, strength, teaching, leadership, support and encouragement.  They must nourish and love more than one person and divide their time into multiple unpredictable circumstances.  As a father of three children myself, fatherhood is the most wonderful, frustrating, exciting education to embrace.

Photo by Ben Heine via Flickr Creative Commons

Photo by Ben Heine via Flickr Creative Commons

One of the first important decisions to make as a father and mother is to choose the nutrition for your baby.  Breastfeeding is the best natural way to feed an infant to help them grow.  This essential nourishment also causes change for the father.  It “continues the exclusive relationship the mother and infant experienced during pregnancy” as stated by Pamela Jordan (She is a researcher and associate professor in Department of Family and Child Nursing at the University of Washington.)  However, a father may feel inadequate because he cannot provide his own nutrition and does not know how to even assist with feedings.  The baby’s nutritional needs can begin to physically interfere with a father’s intimate desire with the mother.  What fathers need to learn is how to support breastfeeding and to develop their special bond with the child.  As Anne Altshuler (RN,MS,IBCLC, LLL Leader) states “a father is the first person to teach his baby that love doesn’t have to come with food.”

Ways to be there for mother and baby:

  • Love and nourish your baby’s mother.  Mother’s physical wellbeing will help her milk production and longevity of breastfeeding.  Listen intently and offer encouragement when necessary.  Be patient if the mother is less interested in intimacy after the baby is born.  Hormones, tiredness, anxiety can lessen their physical desires.
  • Take over mother’s chores and responsibilities when she cannot perform them and be there to help out whenever you can.
  • Help the mother with breastfeeding – your eyes can make sure the infant is latching appropriately at the breast (I tell dads to look for the fish lips of the infant) and you can help position the baby for the mother.  Often times, you can get an extra pillow to make it just right.
  • Talk and sing to your baby.  A baby can recognize your voice at birth and hearing is one of their most precious senses in infancy.  Take the opportunity to read or tell stories.
  • Hold your baby any moment you can and providing skin-to-skin contact will enhance other senses – touch and smell.  Baby carriers or slings can free up your hands to do other things and allow the baby to experience what dad is doing.  Holding the baby to sleep/nap allows them to feel your heartbeat and the rhythm can be mesmerizing/soothing.
  • Bathe your baby and get a little wet yourself.
  • Change diapers.  Diaper duty begins in the hospital with the first meconium poops the baby makes.  Make it a fun experience – opportunity to talk and laugh face to face with the baby, challenge/perfect your techniques and efficiency with changing a diaper, learn about/appreciate smells (sometimes challenging how long you can hold your breath to avoid the smell).
  • Become the go-to-person for the other children in the family – they need time to adjust to a new baby and its distractions for the mother.  Your relationship with your other children can become stronger and deeper with this opportunity.

Enjoy being a father and embrace the new roles with it.  The more supportive you are of mother and baby the longer breastfeeding will be and the more confident the mother will feel about their ability to do so.

Dr. Lucas Godinez

Dr. Lucas Godinez graduated from the University of Dallas and went on to complete his medical degree at the Lake Erie College of Osteopathic Medicine. He completed his Pediatric residency at the Mercy Hospital of Pittsburgh and immediately joined Kids Plus Pediatrics in July 2004. He is board certified in Pediatrics and is also an International Board Certified Lactation Consultant. He is a member of the American Academy of Pediatrics and the American Osteopathic Association. His special interests in medicine include breastfeeding medicine, preventative pediatric medicine, sports related injury including concussions, and osteopathic manipulative treatments. When not at work, he enjoys fishing, gardening, biking, and carpentry, but most of all he enjoys “being a kid” with his three children.

 

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ILCA Conference Speaker Highlight: Lisa Jackson Pulver

During the weeks leading up to the 2013 ILCA Conference, we will be highlighting a number of conference speakers.  Watch this space every Thursday for more profiles.

lisajacksonpulver-jpgWe are so pleased to have Lisa Jackson Pulver as one of the speakers at our conference in Melbourne in just a few short weeks.

Professor Lisa Jackson Pulver holds the Inaugural Chair of Indigenous Health, is Professor of Public Health and Director of Muru Marri Indigenous Health Unit at UNSW. She is also a Wing Commander in the RAAF Specialist Reserve, an Adjunct Professor at UC and in 2011 was made a Member of the Order of Australia (AM). As an Aboriginal woman, Lisa is acutely aware of the lack of data or development and use of appropriate methodologies to identify underlying issues affecting the health for Aboriginal people. Along with her colleagues at Muru Marri, Lisa is working to provide that data. She is a member of a number of committees and working groups, including the Scientific Resource Group on Equity and Health Analysis and Research, World Health Organization; the Advisory Group on Aboriginal and Torres Strait Islander Statistics (AGATSIS), the Australian Health Survey Reference Group at the Australian Bureau of Statistics and is a current member of the Australian Statistical Advisory Council. She is Deputy Chairperson for AHMAC’s National Advisory Group Aboriginal & Torres Strait Islander Health Information and Data (NAGATSIHID). Lisa is a member of the Lowitja Institute, serves on the Board of her Medicare Local and is the co-founder of the Shalom Gamarada Scholarship Program, responsible for enabling over 55 students to receive a residential scholarship on campus at UNSW.

On Sunday, July 28th, at 3:45pm, she will be presenting a plenary session at this year’s conference entitled “Aboriginal Health in Modern Australia: Where Breastfeeding Hits the Wall”. Don’t miss this important session!

In addition, she will be presenting:

Concurrent Session on Saturday, July 27

  • 2:00pm:  A Time of Thought and Translation: “A Perspective.”

For more information about our upcoming conference and to register, please visit the Conference Page on our website.

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Black Mothers’ Breastfeeding Association: Narrowing the Disparity Gap

By Anjanette Davenport Hatter, BMBFA President

On May 24, 2013, Black Mothers’ Breastfeeding Association (BMBFA) held our 4th National Seminar, Innovations in Breastfeeding Support in Detroit, MI, USA. The Seminar consisted of a plenary address, keynote speaker and lecture sessions from some of the most notable experts in the field of lactation. Topics were directed toward maternal-child healthcare professionals on innovative solutions that address the cultural road blocks in breastfeeding support.

seminar presenter bmbfa founding directorThe Seminar began with Beth Eggleston MS, RD of Michigan Department of Community Health offering the plenary address where current breastfeeding rates in Michigan were shared and a lively discussion was held about why disparities exist. The information provided about Baby-Friendly Hospitals was particularly interesting as it not only described the 10 steps to achieving Baby-Friendly designation but also explored realistic strategies to eliminate barriers presented by hospital administration as well as mothers of newborns. Allison Benjamin RN, IBCLC of Harlem Hospital (retired), described her instrumental role in assisting Harlem Hospital in becoming the first Hospital in New York City to receive the distinguished Baby-Friendly designation. While breastfeeding provisions are still a work in progress, Leila Abolfazli, J.D., of Washington, DC, shared that the Affordable Care Act offers insurance coverage to breastfeeding mothers for services such as breastfeeding support, supplies and counseling. Interestingly enough, breast milk is being viewed as preventive healthcare according to Leila. BMBFA’s Founding Director, Kiddada Green, M.A.T., of Detroit, MI, shared strategies necessary to organize and sustain a breastfeeding support group using a model that has proven successful as it has expanded its reach throughout the Detroit area. Other strategies for sustaining community based breastfeeding support suggested by Sade Moonsammy-Gray, B.A. and Kathleen Logan, RN, CPNG, IBCLC of Community of Hope Family Healing and Birthing Center, Washington, D.C. included education, self-efficacy and empowerment of breastfeeding mothers while utilizing evidence based interventions. Dr. Paula Schreck of St. John Mother Nurture Project in Detroit, MI, offered valuable insight into community based breastfeeding support as she compared and contrasted the Mother Nurture Project with traditional hospital-based programs. Dr. Schreck facilitated the first Physician led outpatient breastfeeding clinic in Michigan. I can’t wait to begin planning next year’s seminar. I’m sure it will be yet another stellar opportunity to provide education and resources to breastfeeding professionals.

community partner st. john mother nurture projectI’m excited to report that BMBFA has made significant progress in our efforts to support breastfeeding mothers and healthcare professionals in our community. We have increased our breastfeeding clubs from once monthly to four times per month with various times and locations throughout the city of Detroit. This expansion has enabled us to reach a far greater target population and minimized barriers to our mothers receiving necessary support. How awesome is that!

breastfeeding club mtgAnother area of significant progress is our breastfeeding peer counselor program. We recently graduated 11 women who have completed a rigorous curriculum assisted by Health Connect One, which has enabled them to provide breastfeeding counseling to women in the Detroit area with hopes of increasing breastfeeding initiation and duration rates. Surely this will help our mothers by overcoming obstacles that may otherwise lead to breastfeeding cessation.

bmbfa bf peer counselorsWe have formed amazing relationships in the community with those who share our enthusiasm and passion in which reciprocal support is provided to breastfeeding mothers and public health professionals. These relationships include Neighborhood Service Organization Harper Gratiot Service Center, Wayne CHAP (Children Healthcare Access Program), WIN (Women Inspired Neighborhood) Network, Detroit Black Community Food Security Network, Focus Hope and First Beat. Our relationship with the St. John Mother Nurture Project has flourished as we forge our efforts to diversify Lactation Consultants (IBCLC) in the state of Michigan. The Michigan Department of Community Health awarded BMBFA a $117,000 grant to supplement our work to eliminate breastfeeding disparities.

bmbfa board.founding directorBMBFA has also received a $400,000 grant from the W.K. Kellogg Foundation. The funds will be used to strengthen organizational capacity by building management systems, expanding existing programs and developing new programs, leading to sustainable growth to improve the quality of life for vulnerable, poverty stricken children, while causing social change for the greater good.
BMBFA’s community approach to breastfeeding support has been deemed innovative due to its explicit focus on narrowing the disparity gap that exists in breastfeeding rates.  In Michigan, only 50.9 percent of black children ever receive breast milk as compared to 68.5 percent of white children. Strengthening BMBFA’s infrastructure will lead to long-term increases in breastfeeding rates and work to create a monumental social impact that restores the emotional, psychological and physical health of the Detroit community.

We are looking forward to following our passion and doing incredible work in our community as we continue to answer the US Surgeon General’s Call to Action to Support Breastfeeding. Please visit our website at bmbfa.org to learn more about our breastfeeding programs and services. Also follow us on Facebook and Twitter!

Anjanette Davenport HatterAnjanette Davenport Hatter is the President of the Board of Director’s for Black Mothers’ Breastfeeding Association. Mrs. Davenport Hatter has dedicated her time to eliminate breastfeeding disparities for African American families. She understands how breast-milk decreases the risk factors for developing chronic diseases and has worked extensively with organizations such as Gift of Life MOTTEP, National Kidney Foundation, Children’s Hospital of Michigan and as a member of Alpha Kappa Alpha Sorority Inc. Her tireless efforts in working to improve health outcomes in her community has led to her nominations for the WEGO Health Activist  Award and the National Advisory Council on Maternal, Infant and Fetal Nutrition-Breastfeeding  Promotion. Mrs. Davenport Hatter holds Master’s Degree in Social Work from Wayne State University. She is a dedicated wife, mother and social worker.

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