Baby Friendly in the military community abroad

DELLISHealthy Children faculty Donna Ellis, RN, MSN, IBCLC has spent the past 30 years living and working in Germany with the U.S. military. For six years, she served on active duty in the Army Nurse Corps, working in general medicine until she and her husband started their family.

Much of Ellis’ nursing career was spent working in community health in the late 80s and early 90s.

“The community I served was composed of frontline soldiers, tankers and people from lower socioeconomic backgrounds,” Ellis says. “Domestic violence and poor knowledge of child rearing skills prompted me to look at the impact of breastfeeding and skin to skin contact.”

Observing a wide variety of parenting approaches and skills, Ellis asked herself, How do you get mothers and babies close to each other?

“I just wanted some way for mothers and babies to have closeness and to fall in love with one another,” she says.

At this time, WIC was not present in the U.S. military communities abroad and many individuals were struggling to put food in their babies’ mouths. While some fought for WIC services like artificial baby milk substitute aid, Ellis thought, This breastfeeding thing is a really reasonable way to do this.

Ellis’ personal infant feeding experiences influenced her professional ventures. She breastfed her eldest son but due to extensive traveling for work, she formula fed her second son. She acknowledges very different health outcomes between her children.

“There has to be a connection there,” she says.

After certifying as a lactation consultant, Ellis created a lactation professional position at the Heidelberg military hospital.

She was also instrumental in working with staff to become a Baby-Friendly (BFHI) certified birthing facility.

“It was painful at times and it was frustrating at times,” Ellis says of implementing BFHI. Becoming Baby-Friendly is never an effortless task, but Ellis explains the challenges unique to certifying a military hospital.

“Our staff turned over every three years; a third of our staff went away,” she says. “Our [hospital] CEO changed every two years.”

Staff training is often one the biggest concerns and challenges for hospitals, especially those with such high turnover rates. The online format of the 20 hour course made training simpler, more efficient and more accessible.

Heidelberg’s high turnover rate had an “up” side. New staff members had little say in their training so implementing changes in policy and practice was sometimes made less difficult.

“The Ten Steps are powerful and no matter what your resources are, [Baby-Friendly status] is possible,” she says.

Ellis also spent some time working at Landstuhl Regional Medical Center in Germany. Here, she encountered a “crusty obstetrician” who was very skeptical about taking The Lactation Counselor Training Course.

“He sat there with his arms crossed,” Ellis remembers. But after being presented the information, his mind quickly changed about the importance of skin to skin contact and breastfeeding. He has been highly influential in keeping babies delivered by cesarean skin to skin with their mothers immediately after birth.

Ellis sometimes finds other CLC participants in similar situations.

“You often start out with a group of individuals who aren’t sure they want to buy into this information and they come with feelings and judgements and uncertainties,” she explains. “But by mid-week you can just see the light switches go on; ‘Oh my gosh, I can do something about this.’ They’re ready to make a difference.”

Ellis is “very optimistic” about the future of maternal child health for these reasons.

“Healthy Children Project is a huge part of that because of the information they put forth and the lives that they touch,” she says. “I see them making a huge difference.”

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