Fathers profoundly influence breastfeeding outcomes

At a WIC clinic a few miles north of Dallas in an immigrant community, a pregnant woman confided in a male peer counselor–part of the WIC Peer Dads Program— that she wanted to breastfeed her baby. Her boyfriend wasn’t at all interested in supporting this journey though. The counselor offered to speak to the father; the mother agreed, so the counselor called him just then. Ring, ring, ring. After introductions, this conversation ensued:

Counselor: We heard you have an issue with breastfeeding.

Father: So you are calling me to convince me that breastmilk is better?

Counselor: No, I just want to give you some information.

Father: I will come to your office. You prove to me that breastfeeding is better.

The next morning, the father arrived at the clinic before it opened.

Source: United States Breastfeeding Committee

“Tell me why she should breastfeed,” the father demanded of the counselor, who was feeling rather intimidated.

The counselor replied: Forty-five years down the road, your unborn son is guaranteed to be the president of the United States. What are you going to do today?

The father looked at him perplexed and laughed.

“You tell me,” his retort.

The counselor handed him a sheet of paper instructing him to write these letters: B-R-E-A-S-T-F-E-E-D, providing corresponding ‘benefits’ to breastfeeding with each letter. (B is for bonding and so on.)

“Dude! You’re good,” the father exclaimed, changing his demeanor. “Ok, you got me,” he agreed to open his mind to breastfeeding.

Mwamba demonstrates ways to hold baby during a class for parents .

Muswamba Mwamba, MS, MPH, IBCLC, RLC, a public health nutritionist, told me this story during a fascinating interview for Our Milky Way. Having worked in nutrition for nearly three decades, Mwamba has acquired a brilliance for carefully interpreting and reflecting on the stories of the people he encounters.

“The guy was bold,” Mwamba remembers of the father. In fact, the father planned to dump his pregnant girlfriend after she became pregnant.

“A lot of men may know how to change diapers, know how to carry the baby,” Mwamba begins. “But something they don’t know is how to befriend the woman. When they don’t know, they run away.”

This couple’s story took a happy turn. Mwamba reports that they married with their peer counselor as their witness.

“You saved my relationship,” the father heartfully expressed his gratitude to the counselor.

After serving nearly 10 years as the City of Dallas WIC Peer Dads Program Coordinator, Mwamba is currently Director to Reaching Our Brothers Everywhere (ROBE), a descendant of Reaching Our Sisters Everywhere (ROSE). ROSE and ROBE are dedicated to reducing breastfeeding disparities among African Americans.

But Mwamba’s career goals didn’t always point specifically to breastfeeding. Always fascinated by nutrition as the foundation of health, Mwamba found himself in a microbiology lab in Belgium completing two master’s degrees in Food Science and Technology and Agricultural Engineering & Human Nutrition.

He quickly realized that he “prefers people to mice.”  So when Mwamba, a Congolese native, came to the States in 1997, he searched for a doctoral program that might better fit his passion for behavioral science. Mwamba made his way to Columbia University in 1999 where he studied Nutrition Education, exploring the intersections between science and behavior, environment and genes.

At the time, Mwamba remembers being happy to be in the U.S. but in retrospect, he says he realizes he was naive about racial disparities in health care. It wasn’t until later that he learned about the historical forces in the United States that make health disparities a reality.

Mwamba pictured with colleagues Brenda Reyes and Mona Liza Hamlin.

“Thinking backward, I didn’t see anyone in my class who was local; they were all caucasian female,” Mwamba recalls.

Except for himself of course, the only Black man, and an immigrant at that. Institutions have policies written to encourage diversity, Mwamba begins.  

“When they see Black, they see diversity,” he says. These policies ignore the heterogeneity of Black culture.

“As an immigrant, I was privileged when I got the scholarship,” he explains. Mwamba already held two master’s degrees and had seen the world. His experience was vastly different from those of the People of Color living in the community he was to serve.

“We have the same color of skin, but not the same stories, not the same backgrounds,” he reiterates.  

Mwamba adds that African immigrants are the fastest growing and most educated group of immigrants in the U.S. From 2000 to 2004, four percent of immigrants in the U.S. were African. Today, African immigrants account for 8 to 10 percent, he reports.

Mwamba stresses, money needs to be properly allocated to serve those in need.

“The gap is increasing within the [Black] community,” he says of health disparities. “…Diversity is not the solution for the disparity.”

Little did he know, his opportunity to work to close this gap and to give a voice to “the folks who think they have nothing to say because nobody ever listened to them” was just around the corner.

Discussing a course’s simplicity with his professor at Columbia one day, a woman from Ghana happened to be listening in on their conversation. She was the director of a WIC clinic and recruited Mwamba as a nutritionist one year later.

Mwamba was instantly fascinated by the components of artificial baby milk, inspired by the questions his clients asked, and curious about the effects of clients’ infant feeding experiences.

He noticed that mothers who fed their babies formula often came to the clinic with various complaints.

Then there was a woman he remembers who exclusively breastfed her baby for one year. When she came in, she seemed happy and had only one concern: Why hadn’t her period returned yet?

Mwamba needed to do some research. He read everything he could. He worked to develop appropriate language to discuss infant feeding with his clients.

He began to grasp delicate intricacies like the sexualization of breasts in America. One client in particular expressed concern about her baby touching her “boobs.” (As a self-taught Anglophone, Mwamba never encountered “boobs” in his literature.)

As he discovered more and more about breastfeeding, he shared the information with his team. Mwamba became a breastfeeding champion.

In 2003, Mwamba moved to a WIC clinic in Dallas. Here, he received structured training through breastfeeding modules.

In 2005 he and his wife, an OB/GYN, welcomed their first babies to the world, a three pound baby girl and a four pound baby boy. Over the next couple of years, they added three more children to their family. Mwamba spent several months at home with their infants.

Source: United States Breastfeeding Committee

Aware that a primary reason a mother chooses not to breastfeed is her perception of the father’s attitude toward infant feeding, Mwamba launched the City of Dallas WIC Peer Dad program. The program was promptly a success.

Perhaps most importantly, the clinic was already breastfeeding-friendly. Secondly, there were several men already working in the clinic– including Mwamba who understood rich, complex immigrant culture. As Kimberly Seals Allers puts it, “The experience of being interpreted is different from the experience of being understood.”

Mwamba and his team worked by the motto Prepare, Equip and Empower.

They validated men in their role as a father and gave them tools like how to speak up and say, “Hello, I’m here!” when others failed to recognize their presence.

“Equip the father with tools they can use today,” Mwamba begins. “If you start talking about the future, they won’t get the information. Meet people where they are.”

Mwamba started conversations with his clients in an attempt to get fathers to connect with their relationships with their fathers; Emotion is more valuable than hard science.

For instance Mwamba describes one client, the father of five children, who “was over six feet tall with dreadlocks and his underwear showing.” He remembers this client had an air about him: I’m the dude here.

Mwamba discussed with him his role to protect and provide for his family. He asked, “Is there a man you look up to?” The father reported that he had a close relationship with his big brother. Mwamba wondered if he looked to his own father as a hero, or if he would change his relationship with his father. At that, the father’s voice cracked. He began to sob. This father was in the position to reflect on his role as a father and accept the influence he would have on his family.  And a father’s role is profound. When he is indifferent about breastfeeding, mothers will breastfeed 26 percent of the time; if he is pro-breastfeeding, mothers will breastfeed 98 percent of the time.

Tapping into the generalization that “men like the brag,” Mwamba and his colleagues encouraged their clients to spread forth their infant feeding experiences into their communities.

In his years working with the peer counselor program, Mwamba listened to stories that seriously question one’s capacity to have hope in humanity. In these moments, he didn’t have a script. Whatever rage he felt, whatever sympathy he bestowed, he couldn’t find a book or a module to learn how to accept the rawness, the vulnerability of his clients. Instead, Mwamba offered his presence and his willingness to listen, learn and understand.

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