Listening to the Language of Limits

Joni Gray’s, Ed.D, MA, BA, CLC, CLS conversations about infant feeding started when she was little. Her younger sister was born when she was seven, and Gray recalls her mother waking throughout the night to come nurse her sister in the room they shared.

“Mostly, I remember talking about my mom nursing my sister,” she begins. “I remember the conversation and storytelling of why she was able to nurse and why she chose not to breastfeed me.”

Gray’s mother birthed her older brother in 1972 at a time when it was widely believed that mothers needed to “prepare” the nipples to breastfeed. Her mother followed her OB’s instructions to take rough washcloths to her nipples, causing them to crack and bleed.

Unsurprisingly, she had an enormous amount of pain and discontinued breastfeeding, Gray reports.

Two and a half years later, the memory of pain still fresh in her mind, Gray says her mother didn’t even consider nursing her.

“I’ve always joked she clearly loved my sister more than me because she chose to breastfeed her,” she laughs. “Seven years later, she was determined. She knew it was going to be her last baby and she was going to make it work.”

After eight babies of her own, Gray recollects her own birth and infant feeding experiences.

She reports her most rewarding birth experiences being those where she felt most in control. She calls her first son’s non-medicated, hospital birth very empowering.

Her very first birth felt differently though when her water broke three weeks prior to her estimated due date and the hospital, where she didn’t know any of the care providers, was four hours from her home.

When her fifth baby came along, she had had two cesarean births and was unsure if she would be “allowed” to have a vaginal birth.

“The doctor on call was fine with it,” Gray recalls. “[This] birth was empowering because I got to have what I wanted and I felt wonderful after having him.”

Gray considers the births she had by cesarean forced, and both of these babies went straight to the NICU.

“That was a challenge,” she says.

Still, Gray says she tries to embrace each experience.

“Having that focus– that I’m learning through this experience– helped me to get through them,” she explains.

As Assistant Professor of Communication specializing in Health Communication at Fairmont State University (FSU), Gray and her nursling can sometimes be found breastfeeding in class.

Exposing students to breastfeeding is an effective educational tool culturally, but Gray also uses it as an example of how having a connection to your subject matter bolsters credibility.

While breastfeeding as a topic/social justice issue is integrated into all of the classes she teaches, Gray says that in her major courses it guides some of their projects and research.

For instance, while studying generational influences on health decisions, she asked her students to interview their mothers about their birth and infant feeding experiences. Students are currently coding responses, looking for emerging themes, reasons and rationales, and will ultimately discuss how their mothers’ experiences shape their own perceptions and health decisions, Gray explains.

She says, “I’m excited by their response to it. They really embrace it. Some have already talked to their moms about their birth and feeding and sort of knew the story and some have never had that conversation.”

Gray’s dissertation research focused on Appalachian culture and breastfeeding decisions and is helping to shape the conversation about infant feeding for Appalachian families.

Gray will present “Listening to the Language of Limits: Appalachian Women Share Their Experiences with Breastfeeding Education and Their Breastfeeding Decisions” at the upcoming International Breastfeeding Conference in Deerfield Beach, Fla.

Constricted by structural barriers like economic limitations and rurality and cultural barriers like the belief that breasts are solely for sexual pleasure, among other challenges, Gray ultimately found that Appalachian women do not see breastfeeding as a choice for themselves. Respondents reported that they knew artificial baby milk is inferior to human milk, yet they still do not feel breastfeeding is a choice they have access to.

Gray’s conference presentation will include audio clips from some of her research participants. She will also request conference participants engage with the language research participants used.

“It’s profound to have that connection to their experience of the world,” Gray says.

Since completing her dissertation work in 2010, West Virginia has gained three Baby-Friendly Hospitals. Gray is encouraged by families now having access to medical facilities that teach accurate information and provide support for healthy infant feeding.

“[Until recently], we didn’t have that structural support,” she says. “That’s a really amazing and exciting change.”

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