National Preparedness Month: the U.S.’s deficit in Infant and Young Child Feeding preparedness during emergencies

Photo by Mika Baumeister on Unsplash

 The editors of more than 200 health journals worldwide just released  ​​Call for Emergency Action to Limit Global Temperature Increases, Restore Biodiversity, and Protect Health ahead of The United Nations General Assembly this month. The authors urge critical action to curb global temperature increases in an effort to  “halt the destruction of nature, and protect health.” 

This  piece details how hotter temperatures are taxing public health systems:

“…Hurricane Ida caused dozens of deaths across several states from flash flooding and other impacts. With the power grid down, some died from carbon monoxide poisoning caused by using generators. In the aftermath of the storm in Jefferson Parish in Louisiana, local officials have been working to provide transportation for those who need dialysis and other medical care. Earlier this summer, hundreds died in a record-breaking heat wave in the Pacific Northwest… Wildfire smoke, increasingly clogging skies with dangerous levels of air pollution, causes spikes in emergency room visits.” 

Many of the current humanitarian crises are related to the climate crisis.  It’s driving human displacement which comes with a multitude of consequences. More on that here

Photo by Adrien Taylor on Unsplash
“While filming a climate change documentary called Thirty Million for the United Nations, I was blown away by the beauty of the Bangladeshi people — both in their character and appearance. Bangladesh faces losing 18% of its land, displacing thirty million people, with one metre sea-level rise. At the end of Ramadan every year, the country has one of the world’s largest internal migrations of people going from the cities to their home villages to celebrate the holiday. This type of migration may soon become across borders as climate change makes life difficult in this stunning country.”

Recent hurricane related power outages and water safety issues bring the importance of Infant and Young Child Feeding (IYCF) during emergencies to the forefront.  

“Breastfeeding provides food security for infants and young children specifically in emergency situations,” as noted in IBFAN and BPNI’s Formula for Disaster. “Economic hardship, conflicts and calamities cause disruption, deprivation and severe stress for families, especially for mothers and their children. During such emergency situations, optimal breastfeeding is a lifeline to ensure survival, food and affection for infants and young children, in addition to providing anti-infective agents to protect against disease.”

Threats exasperated by the climate crisis have become the frequent reality for so many families and yet, our nation is abysmally prepared, especially for those with young children.

Participants of the WBTi Assessment Workshop, April 2016

The World Breastfeeding Trends Initiative (WBTi)–an international tracking, assessment and monitoring system for national implementation of the Global Strategy on Infant and Young Child Feeding (IYCF)– scored the United States zero out of 10 for Infant feeding during Emergencies.  

WBTi uses the following criteria for assessment: 

  • The country has a comprehensive policy on infant and young child feeding that includes infant feeding in emergencies and contains all basic elements included in the IFE Operational Guidance
  • Person (s) tasked to coordinate and implement the above policy/strategy/guidance have been appointed at the national and sub national levels
    1. The health and nutrition emergency preparedness and response plan based on the global recommendation includes:  Basic and technical interventions to create an enabling environment for breastfeeding, including counselling by appropriately skill trained counsellors, and support for relactation and wet-nursing
    2. Measures to protect, promote and support appropriate and complementary feeding practices
    3. Measures to protect and support the non-breast-fed infants 
    4. Space for IYCF counselling support services
    5. Measures to minimize the risks of artificial feeding, including an endorsed Joint statement on avoidance of donations of breastmilk substitutes, bottles and teats, and standard procedures for handling unsolicited donations, and minimize the risk of formula feeding, procurement management and use of any infant formula and BMS, in accordance with the global recommendations on emergencies
    6. Indicators, and recording and reporting tools exist to closely monitor and evaluate the emergency response in the context of feeding of infants and young children.
  • Adequate financial and human resources have been allocated for implementation of the emergency preparedness and response plan on IYCF
  • Appropriate orientation and training material on infant and young child feeding in emergencies has been integrated into pre-service and inservice training for emergency management and relevant health care personnel
  • Orientation and training is taking place as per the national plan on emergency preparedness and response is aligned with the global recommendations ( at the national and sub-national levels)
Photo by John Middelkoop on Unsplash

The United States does not meet any of these criteria. 

“Ironically, some [U.S.] states and territories have well-elaborated plans for the care and feeding of household pets in shelters, but none for infants and young children,” Healthy Children Project’s Cindy Turner-Maffei points out. 

Research by Cindy H. Hwang, et al found that in all of the emergency situations they studied in middle and high income countries, The International Code of Marketing of Breastmilk Substitutes was violated.  

The authors report: “Donated and distributed infant formula was often labeled … without adequate preparation guidance. Infant formula was repeatedly distributed as part of the standardized assistance package regardless of mothers’ infant feeding practices. The uncontrolled distribution of donated infant formula not only undermined good breastfeeding practices and efforts of mothers, but also increased the health risk to infants. Mothers often had no access to electricity, gas, safe water, and necessary infant feeding supplies to hygienically prepare infant formula.” 

Breastmilk substitute (BMS) companies are known to exploit emergency situations exacerbating child mortality, morbidity, and malnutrition. Authors of Old Tricks, New Opportunities: How Companies Violate the International Code of Marketing of Breast-Milk Substitutes and Undermine Maternal and Child Health during the COVID-19 Pandemic detail this behavior in the context of the current pandemic.  

Different from the U.S.’s preparedness deficit, WBTi congratulates Bangladesh on achieving “green” status, ranking them number one for supporting healthy infant feeding globally.

Photo by Theodore Goutas on Unsplash

Bangladesh scored 10 out of 10 on Infant Feeding during Emergencies. Find the country’s full report here. Other countries that have achieved high scores in IYCF During Emergencies include the Philippines, Sri Lanka, Afghanistan, Bolivia, and Nepal.  

During National Preparedness Month, individuals, families and communities are urged to take a week-by-week stepwise approach to prepare for disasters: Make A Plan, Build A Kit, Low-Cost, No-Cost Preparedness, Teach Youth About Preparedness.   Authors Karleen D. Gribble and Nina J. Berry offer detailed information on what emergency preparedness entails for breastfed and formula fed infants in Emergency preparedness for those who care for infants in developed country contexts.  Individuals can take action with USBC’s online tool in order to influence policymakers to integrate IYCF into future emergency preparedness and response efforts. 

Find general information about breastfeeding during emergencies and more action tools on USBC’s Infant and Young Child Feeding in Emergencies page

Plastic-free parenting

There’s a fascinating snippet of history about the worldview of plastic in the 1960s told in Recycling! Is it BS? by How to Save a Planet

The hosts share editor of Modern Plastics, Inc. Lloyd Stouffer’s famous statement that “The future of plastics is in the trash can”, a deliberate declaration by the industry to influence modern wastefulness at the 1963 National Plastics Conference

Today’s parents are among those most affected by this push. Ethical, sustainable consumption at the individual level can be daunting especially because consumerism is such a powerful beast, to paraphrase Healthy Children Project’s Dr. Karin Cadwell. It’s the power of what happens to us when we’re walking down the supermarket aisles. 

“If it’s there, I must need it,” goes our inner dialogue.  It’s the psychology that infant formula and processed food companies prey on. 

It’s why so many of us fill our carts with single-use pouches full of super-glop (term coined by Healthy Children Project’s Cindy Turner-Maffei) that we toss to our littles ones while we’re on the go. The Packet Apocalypse, where stocked shelves offer an overwhelming array of mostly highly processed snacks and meals in plastic, has largely replaced the art of dining and sharing meals, just as plastics have largely replaced reusable, more sustainable products. 

Parenting plastic-free can seem unattainable, but there are simple adjustments we can make as we strive toward sustainability and address the climate-crisis we find ourselves in. 

 

Practical plastic-free suggestions 

Of course, breastfeeding is the ultimate example of waste-free food

This piece details the environmental impact of powdered baby formula milks sold in North America. It’s not intended to shame formula feeding families, rather hold companies and governments accountable.  

For families who feed their babies differently than exclusively at the breast/chest and require other materials and tools, Healthy Children Project faculty and guest blogger Donna Walls advises using  bottles made of glass, stainless steel or bamboo with silicone nipples. Avoid latex which can leach nitrosamines, she says. 

When pumping is part of infant feeding, Walls calls on us to investigate and invest in breast pumps from companies  that reduce the amount of plastics in the pump. 

“Avoid pumps that are made from PVC plastic, phthalates (labeled as DEHP or DBP), BPA or BPS or formaldehyde),” she explains. 

Business owner and Milwaukee mom to three-year-old Avery Jenna Meier, who appeared on a webinar on plastic-free parenting with Plastic-Free MKE over the summer,  recommends searching for second-hand items that can be sterilized like bottles.

Jenna and Avery pose at The Glass Pantry.
Photo courtesy of Jenna Meier

Beyond human milk feeding, Walls suggests using glass or ceramic jars which can be reused after purchasing salsa, sauces or condiments in lieu of plastic.

Walls also suggests swapping plastic wraps for beeswax covered fabric as container coverings. 

“At the grocery store, bring your own containers for bulk food purchases and bring your own non-plastic bags for produce or deli items,” she offers.  “Invest in plant- based ziploc storage bags, often referred to as bio-plastic or ‘plantic’, and made from beets, corn or other plants.” 

 

Melding convenience and sustainability 

Meier says that baby-led weaning was amazing for reducing unnecessary waste.

“…You aren’t buying baby food and for the most part, your child is eating the same meal as you so it just cuts down on separate packaging and waste,” she begins.  “…As my child grows and we are on the go a lot more and packing daycare lunches, the single use packets become a lot more tempting. And they’re ubiquitous, like even if I don’t buy little packets of something, he comes home with birthday favors or holiday treats or all sorts of things I wouldn’t typically buy.”

Meier recognizes the grey areas in convenient choices. 

“It’s not all good or all bad,” she says. When buying packaged food, Meier opts for organic options, B corp companies, and local options. 

“I also shop at my local co-op instead of the big chain stores, so overall my money is going to a better business,” she continues. “We buy locally made frozen pizzas and I feel that it’s a way to have the benefit of a quick meal on a hectic night while still supporting my local economy.” 

There’s a way to simplify efforts toward sustainability.  

“Even if you find yourself opting for convenience 99 percent of the time, at least there is that 1 percent that you are sticking to,” she explains.

It’s veggie broth for the Meier family; they never buy it packaged.

Photo courtesy of Jenna Meier

“And it’s a great one for teaching little ones because they can help with every part,” she explains. “We save veggie scraps in a bag in the freezer and then we have enough we make the broth, doing each part of the process together. So that is one ritual that has made it into our lives without feeling like I have to force myself to do it because we truly enjoy it.” 

Walls echoes the sentiment of simplicity coupled with convenience and addressing the climate-crisis.

“Making  better, more environmentally conscious choices is really about making small changes in our everyday habits,” Walls says. “For example, making sure you always keep reusable bags in your car or keeping a supply of cloth produce bags in your purse or diaper bag. Once you have made the initial investment in earth-aware supplies, it is really just a matter of making new habits.” 

 

Sustainability and health 

Meier goes on to suggest that sustainable living is about becoming present, intentional, and conscious of all of our daily habits and choices. 

“Including our food choices, which is such a big one because we eat all day, every day!” she exclaims. “Processed convenience foods do the opposite of connecting us to our food. They make it so we can eat mindlessly and not think about the input or the output. We don’t make the food ourselves so we don’t look at the ingredients. We don’t have to deal with the trash ourselves so we don’t mind throwing the packaging ‘away.’”

This satisfies the goal of consumerism, Meier continues. 

“Of course our health suffers. Not only are we eating crappy food that makes us sick, but we give up our agency and are disempowered in our own lives. All of this has effects on our physical, mental, and emotional health. Becoming intentional in our day brings agency back into our lives. Choose with care and notice how different food tastes when you choose it intentionally for reasons that align with your values. If supporting organic growers or local farmers is important to you, buying from those businesses will bring joy and fulfillment into your life. If you are inspired by living low waste, shop in the bulk section. You will be giddy as you unpack your groceries. It really is that simple. Living in line with our ethics brings harmony into our lives and in turn, benefits health in all areas.” 

 

Individual and systemic action 

As we address the climate crisis, there’s an argument pertaining to individual efforts versus policy impact that goes something like this:  Individual efforts make a miniscule difference unless individuals are sharing their eco-friendly practices.

Meier lives by example. 

“When you adopt the mindset of becoming an example of how you want the world to be, you find it easier to live in line with your values,” she comments. “You are now an ambassador of the lifestyle you want more people to live. And when you see the ripple effects of your actions, you recognize your responsibility and role and how important it is. When I stopped confronting people and started focusing more on myself, I saw much greater effects. People started coming to me asking questions more, or giving me new ideas. I found community in places I never thought I would. And I stopped thinking I had all the answers and was able to learn and grow so much more with that different attitude. I love the idea of calling people in instead of calling them out.” 

Plastic Pollution Coalition’s Healthy Baby Guide and Plastic Pollution Coalition’s Healthy Pregnancy Guide offer Take Action Tools which amplify individual voices while targeting systemic change at a policy level. 

For instance, the action tool populates emails to representatives urging support of the  Break Free From Plastic Pollution Act of 2021 which aims to tackle the exploding crisis of plastic pollution and transform waste and recycling management in the United States. 

There’s a petition that puts pressure on corporate plastic polluters exploiting the pandemic too.  

Photo by Volodymyr Hryshchenko on Unsplash

Meier says she would love to see single use plastics banned.

“This would make it easier to avoid and they are just so prevalent and irresponsible,” she says. “We know better as a society; I’m sure it’s something most would agree on.” 

The Plastic-Free MKE Coalition is a collaborative of organizations, including Meier’s business, doing their part to reduce single-use plastics. 

Walls is responsible for creating the Green Team at Miami Valley Hospital which became a model for shifting individual responsibility to systemic responsibility. 

Since then, Walls says she has been heartened by the strides we are making in creating “greener” families.

Photo by Larry Crayton on Unsplash

“I see marketing aimed at young families focusing on eco-friendly products and more educational information available on the health benefits to children and all family members,” she says. 

Walls has written extensively about green-living. You can find some of her work here and here

On September 9, ANU Institute for Climate, Energy & Disaster Solutions; ANU Gender Institute; BPNI/IBFAN South Asia; Australian Breastfeeding Association; WBTI Australia; Alive & Thrive Southeast Asia will present Breastfeeding: where healthy and sustainable food systems begin. Register for the free event here.

Young, determined and capable: celebrating youth advocates within maternal child health

Photo by Marcin Jozwiak on Unsplash

Of parents’ many responsibilities is helping our children navigate what’s “right” and “wrong”. 

“Rocks are not for eating,” we guide a curious toddler. 

“We don’t hit people,” we guide a frustrated sibling. “You can punch a pillow instead.” 

“Please put your helmet on,” we guide the active kindergartener on her bike. 

Sometimes this guidance is less about safety though and more about “rights” and “wrongs” in a moral sense. 

These lessons on morality are rarely black and white, they vary from family to family, culture to culture. I’ve often found that children do a better job teasing out and teaching moral lessons than the reverse. Children possess a moral clarity that often muddies somewhere along the path to adulthood. 

Not long ago, I was working on a piece about the PUMP Act for Our Milky Way. My kids and their friends played a version of tag while I typed on my laptop. One of the soon-to-be fifth graders approached me, curious about what I was working on. 

I described  to him the need for workplace protections and lactation accommodations and then held my breath waiting for his reaction. Had I done an adequate job summarizing this fairly complex issue? 

“They should definitely pass that legislation,” he replied matter-of-factly. “It’s only fair.” 

I was so pleased. A young male in favor of maternal child health protections. I offered him a fist bump and then he trotted back to his game of tag. 

Thinking more about that interaction, perhaps the most striking component was that he came to the conclusion of fairness so quickly;  no further questioning, no negotiating (as there often is with pre-teens).  

For a moment, like a movie montage reeling, I imagined our world with children in charge, making important decisions that shape policy. 

Fading back to reality, I remembered that young people do indeed mobilize and influence the world around us. 

“At certain points in history, when institutions and established leaders have failed to step up and take action, it falls to the youngest among us to take charge,” authors ​​David Gergen and James Piltch start off their piece Young people offer urgent moral clarity to do-nothing adults. 

Gergen and Piltch remind us most recently of Parkland students Cameron Kasky, Emma Gonzalez and David Hogg and activist Greta Thunberg.

“What stands out about both of these young groups of leaders… is the sense of urgency and purpose they bring to public life,” the duo writes. 

In an exchange between Dr. Jane Goodall and Dr. Ayana Elizabeth Johnson in Goodall’s Hopecast, they too discuss the importance of youth activism.

Photo by Thiago Cerqueira on Unsplash

Dr. Johnson calls it a critical importance. 

“The moral clarity that children bring.. is just invaluable,” she says in Hope Is Courage And Taking Action Together. 

As we get older, she goes on, we get used to compromising and negotiating through the existing systems.  

“Kids are like, ‘there’s a right and a wrong.’ That of course is so powerful and really drives grown ups to get their act together…” she says in the episode. 

Dr. Goodall goes on to point out that children have to learn though that the world isn’t black and white, and that compromise can play a key role in influencing change. 

Advocates for Youth– a nearly 40 year-old organization that works to promote effective adolescent reproductive and sexual health programs and policies in the United States and the global south– has put together a Building Effective Youth-Adult Partnerships Fact Sheet  which provides guidance on how adults can tap into youth’s energy, passion, and commitment and how youth can become involved in policy change. Advocates for Youth also designed the Young Parents’ Advocacy Toolkit for individuals inspired to drive community change. 

Interestingly, the field of lactation has been criticized for being largely advanced in age, and rightly so. The United States Lactation Consultant Association’s (USLCA) 2019 demographic report shows that over half of IBCLCs are 51-70 years old. The Academy of Lactation Policy and Practice (ALPP) 2019 demographic report shows that just under 40 percent of CLCs are between the ages of 25-34 and 35.5 percent are 35-50. 

So where are the young maternal child health advocates? 

Southern Birth Justice leads The Young Mamas Leadership Institute, a 5-day immersive training for young black and indigenous mothers who have an interest in social and birth justice. During the training, participants are exposed to concepts of activism, community organizing, radical self care and learn about career opportunities as birth workers, as explained on their Facebook page. (Find more info here.) 

A partnership between the Institute of International Education and Harvard School of Public Health created the Maternal Health Young Champions Program. Ten  young people passionate about improving maternal health were selected for a nine-month research or field project internship in their home country. You can find the list of the champions along with a description of their project and impact here

A group of young Latina mothers from the Southwest side of Chicago trained as Breastfeeding Peer Counselors by HealthConnect One, have been assisting young mothers with breastfeeding through the Opciones Saludables program of Heartland Alliance. This group has presented at the Illinois Caucus for Adolescent Health (ICAH) Youth Summit for Pregnant and Parenting Young People. ICAH is another organization working in partnership with young people, advocating policies and practices that promote a positive approach to adolescent sexual health and parenting.

Photo by Zachary Nelson on Unsplash

It isn’t unheard of for young activists to be criticized as zealots or short-sighted. Gergen and Piltch discuss this in their piece. But it’s their future they’re fighting for.  Their determination should be celebrated, not shunned. Young people have the power to spur action and they tend to do so with a sense of urgency, which is precisely what we need within maternal child health and more broadly, what we need in this world. 

We have only highlighted a few youth organizations in this piece. Help us uplift others’ work by sharing in the comments below, or by emailing us at info@ourmilkyway.org.

Jamaa Birth Village celebrates “The Big Pause” Black Breastfeeding Week 2021 and other milestones

“Rest is resistance.”

“Rest is always necessary in a revolution.”

“Reclaiming our rest is reclaiming our power.”

Photo Courtesy of Jamaa Birth Village

These powerful messages are delivered in the Black Breastfeeding Week (BBW) co-creators’ “The Big Pause” BBW2021 video as we celebrate the last week of National Breastfeeding Month (NBM).

In harmony with this year’s theme, Jamaa Birth Village, a non-profit Maternal Health organization in Ferguson, Mo., has collectively curated the “Black Breastfeeding Luxury” gift box which contains care items for Black breastfeeding people that help care for their entire selves.  The self-care items are sourced from Black Indigenous People of Color (BIPOC) creators.

“For some low-income or under-resourced individuals, we often skimp on how we care for ourselves,” Jamaa Birth Village Founding/Executive Director and Missouri’s first Black CPM Brittany “Tru” Kellman, CPM begins. “We want to enrich the lives of people.”

Photo Courtesy of Jamaa Birth Village

Jamaa Birth Village started in October 2016 out of Kellman’s living room. Then last year, on Juneteenth she and her colleagues launched Jamaa Birth Village’s Equal Access Midwifery Clinic during the pandemic. In one year, the clinic obtained:

  • 97% Vaginal Birth Rate
  • 99% Full-Term Birth Rate
  • 100% Breastfeeding rate at Discharge
  • 0% Maternal-Infant Mortality Rate
  • 353 Clients Served
  • 536 Care Hours in Clinic
  • $12k+ in donated lab services for underinsured and uninsured clients
  • 253 Herbal Apothecary Donations
  • 75 Full Spectrum Sliding Scale Doula Care Services
  • 89 Free Mental Health Care appointments
  • 82 Graduates of Tru’s Community Doula Training

“It’s been absolutely beautiful yet challenging,” Kellman says. 

Surely numbers aren’t the only measure of success; it is the birth village in its entirety that demonstrates what is possible. BIPOC are challenged by life-threatening realities, but this narrative does not need to be the overarching theme, Kellman says.

Photo Courtesy of Jamaa Birth Village

“As we shed light on the difficulties, we must make sure that the solutions and the possibilities are readily accessible and tangible for people,” she says. “Having a beautiful birth experience is possible. We want to make sure that the challenges aren’t so daunting, that we don’t plant these seeds of hopeless, traumatic experiences. It’s really crucial that we shift our narrative. In America, Black people, we have our own solutions and they are viable and we are carrying those out right now and seeing a shift in our community.”

For instance, in the normal OB model of care in the U.S., postpartum care is seriously lacking, but Jamaa Birth Village has stepped into that void. 

“With our Family Support Program, we step outside of the medical parameters,” Kellman explains. “Having a baby changes every single aspect of your life– family income, how you see yourself, how you eat, romantic aspects, absolutely everything.”

So Kellman and her team offer postpartum care that extends two years from birth, not just the typical six week follow-up. 

“Someone is going to walk alongside them and help them actualize their goals and help ensure that their family is thriving,” Kellman adds. 

Supporting those in their infant feeding experiences is Jamaa Birth Village Breastfeeding Coordinator Eboni Hooper-Boateng, CD, CLC who recently completed the Lactation Counselor Training Course (LCTC)

“I really enjoyed the course. I learned so much– who even knew there was this much to learn?!” Hooper-Boateng exclaims. “The other thing is I really enjoyed the process of unlearning.” 

Hooper-Boateng  says she was glad to see that the course was intentional about including images that show bodies with different skin tones.

Photo Courtesy of Jamaa Birth Village

Continuing to highlight the importance of diversity, Hooper-Boateng points out the need to not only diversify the field of lactation, but to also diversify the entities that provide the training in order to better provide culturally competent care. 

Hooper-Boateng and Kellman both express their excitement over the Missouri Department of Health Services providing scholarships to the LCTC, and Jamaa Birth Village adding four more CLCs to their team this year. 

Because Black Midwives make up three percent of the entire U.S. midwifery population, they’re excited to welcome more BIPOC midwives to their team too

“Black student Midwives have to train under white Midwives who oppress and discriminate against them, while they have to serve a majority white population with no pay,” this Jamaa Facebook post explains. “This produces unjust trauma and early burnout for the new Midwife… We’re here to disrupt the system and welcome a new Black Midwife to our team to nurture her, grow with her, support her in flourishing and assist her in learning how to provide for-us-by-us care in a sacred and safe space.”

With their solution-based strategy and momentum, Jamaa Birth Village has received a lot of local and national media attention

“It’s really important for the Black population to see a community provider uplifted in news media coverage,” Kellman says. 

She explains that there is a myth within BIPOC communities that unless a provider is white and belongs to a prestigious institute, that the care is somehow subpar. She says she and her colleagues are working to reverse the need for oppressive systems to validate BIPOC care providers. 

“In the meantime, we’re trying to get a lot accomplished,” she says. 

Find ways to connect with Jamaa Birth Village here including Hooper-Boateng’s BBW virtual roundtable discussion August 25 from 12 to 1pm CST. Register at https://us02web.zoom.us/meeting/register/tZYuceqrqD8qHN3OhKufmkBkeOaTrGQjrCaE?ltclid=50cb3875-5739-4722-a584-75fb0581e022. .

For those interested in supporting community care providers, there are many avenues to do so. Jamaa Birth Village’s donation page offers several ways to donate and options to tailor donations to specific causes. Find those options here.  

#JamaaBirthVillage #JamaaMeansFamily #CollectiveRest #CollectivePower #NBM2021 #BBW2021

It’s Asian American Native Hawaiian and Pacific Islander (AANHPI) Week: “Reclaiming Our Tradition”

Seven years ago this month, To-Wen Tseng’s breastfeeding discrimination lawsuit was settled. Tseng, a former journalist for the Chinese-language newspaper World Journal, was discriminated against after requesting a private space to pump her milk.

Elisabeth Millay/BreastfeedLA and API Breastfeeding Task Force

The newspaper ran a piece called “Breastfeeding photos embarrass Chinese-American to death,” which cited anonymous resources, labeled breastfeeding photos as R-rated and described breastfeeding images as “disturbing” and “disgusting,” as Tseng describes in one of her pieces for the San Diego Breastfeeding Coalition 

Since enduring this discrimination, Tseng has become a champion for breastfeeding people, working to normalize breastfeeding especially in the Asian American Native Hawaiian and Pacific Islander (AANHPI) communities

Tseng has moved on to dedicate her career to speaking up about breastfeeding barriers in her community. Tseng was selected for HealthConnect One’s Birth Equity Leadership Academy, is the co-founder of the Asian Pacific Islander Breastfeeding Task Force of Southern California and 2019 recipient of United States Breastfeeding Committee’s (USBC) Emerging Leader Award. Tseng collaborates with the Asian Breastfeeding Task Force of SoCal, BreastfeedLA, and PHFE WIC

Tseng’s advocacy work started while working with a small, hyper-local group, but has expanded to a national scale. This week, as part of National Breastfeeding Month 2021, we celebrate Asian American Native Hawaiian and Pacific Islander Week: “Reclaiming Our Tradition”. 

“It’s very exciting for all of us,” Tseng begins. “It’s amazing to see what we have gone through starting with this little task force of ten of us. We had this big idea that we wanted to promote equity in our community… but we were able to make it a national event. We are really thrilled.”  

Tseng’s town of Los Angeles is home to the largest Asian American population in the U.S. with over half a million Asian Americans and 7,000 Native Hawaiians and Pacific Islanders residing in the San Gabriel and Pomona Valleys. 

Elisabeth Millay/BreastfeedLA and API Breastfeeding Task Force

She points out that almost half of Asian Americans in the San Gabriel Valley have limited English proficiency, yet less than six percent of lactation professionals in Los Angeles County speak an Asian language.  

When language is a barrier, Tseng explains, pregnant and lactating people resort to searching for information online most often from ethic media. Imagine as a new parent happening upon the World Journal article shaming breastfeeding. 

“We are hoping to … create a voice for mothers and [show]  there is  nothing to be ashamed of, there is no stigma,” Tseng says.   

What’s more, as an Asian immigrants, assimilation often equates to survival here in America, and with that often comes formula feeding, she continues.  

While AANHPI breastfeeding rates are among the highest in the nation, Tseng clarifies that there is great diversity within this lumped-together ethnic group and that looking at the data alone can be terribly misleading. 

First, she says, many Asian Pacific Islander (API) communities are missing in the data. 

In Los Angeles specifically, where most API families are first generation immigrants, they suffer from the lowest in-hospital breastfeeding rates– 52.9 percent of Asian families breastfeed in the hospital while 79.5 percent of white parents are breastfeeding in the hospital, she shares.  

In a USBC blog, Tseng also points out that Asian American women have been shown to introduce foods other than mother’s milk to their infants earlier than any other ethnic group.

The post goes on to explain that “Lack of appropriate language and culturally humble lactation support, as well as aggressive infant formula marketing, are the two biggest barriers to breastfeeding in AANHPI communities. According to a 2020 WHO report, the incessant promotion of breastmilk substitutes is especially harmful to Pacific Islander families….

AANHPI breastfeeding families are also one of the most underserved groups in the United States. Nationwide, there are only four cultural breastfeeding coalitions currently serving API communities: (1) API Breastfeeding Task Force of Southern California, (2) ASAP! of North California, (3) Hawaii Indigenous Breastfeeding Collaborative, and (4) Hmong Breastfeeding Coalition of Minnesota.” Tseng says it is her and her colleagues’ goal to connect with these organizations in hopes to amplify their voices.

Elisabeth Millay/BreastfeedLA and API Breastfeeding Task Force

In the meantime, Tseng and her colleagues are excited about BreastfeedLA’s new Baby Cafe at the Dede Diner. The support group not only offers assistance to families, but provides experience for the next generation of lactation care providers (LCPs). BreastfeedLA provides an API scholarship for a comprehensive lactation consultant education program in order to increase the number of culturally competent LCPs in their area.  

The API Breastfeeding Task Force has also recently collaborated with PHEF WIC launching the “I Breastfeed” video campaign coordinated by Wendy Fung. The API Breastfeeding Photo Project is another new initiative.   Tseng says that the release of these photos gives her the “joy of revenge”, showing that breastfeeding is indeed not “disturbing” and “disgusting” as once described, rather beautiful as she and so many others see it.