Connecting to Mother Earth: Toxic chemicals and their impact on maternal child health

By Guest Blogger* Donna Walls, RN, BSN, ANLC, ICCE, IBCLC


Every Day is Earth Day!

Donna Walls
Donna Walls

The first Earth Day celebration was in April 22, 1970. The founders of the movement were smart enough to recognize how important it is to care for our planet and soon we were making the connection between the health of the planet and human health. Since that time we begun looking closely into the effects of harmful environmental substances on pregnant women, the developing fetus, infants, children and families.

In 2013 the American College of Obstetricians and Gynecologists and the American Society for Reproductive Medicine released a joint statement that said: “toxic chemicals in our environment harm our ability to reproduce, negatively affect pregnancies and are associated with numerous long-term health problems.” With this statement came a recommendation for all pregnant women to receive information on avoiding toxic chemicals.

What does research tell us about the impact of toxic chemicals, and what implications do findings have for pregnant and breastfeeding mothers?

The environmental chemical exposures that are “of concern” are all around us, including herbicides and pesticides, plasticizing components in all types of plastic, ingredients of personal care products, food additives and cleaning supplies. The specific concerns range from hormone disruption, central nervous system disruptions, cancer and of particular concern to pregnant women are birth defects and pre-term labor. These nasty little chemicals are, unfortunately, hiding in many of the products we use in our everyday life.

One particularly troublesome group of chemicals are known as xenoestrogens or environmental estrogens. These substances are chemically very much like naturally occurring estrogen produced by females and responsible for many of our reproductive physiology. Thanks to estrogen we develop breasts and begin our menstrual cycles in puberty. Throughout our lives the right amount of estrogen helps us prepare for pregnancy and protects us from heart disease and osteoporosis.

Too much estrogen or foreign estrogens can wreak havoc on our reproductive lives. These artificial estrogen-mimicking chemicals will settle into receptor sites on the cells of our breasts, ovaries and uterus, settle into the sites but instead of the normal reaction our bodies react in a “not so normal” way. We are seeing this especially in young girls, with early puberty, sometimes as early as 8 or 9 years old for breast development and menarche or the beginning of the menstrual cycles.

So is this a problem? Doesn’t sound like it, but in fact it is. Remember I said the right amount or right length of exposure of estrogen is good- too much can cause menstrual disorders, infertility and even reproductive cancers. And this is not just a female problem. We first noticed the estrogen feminizing effects in amphibians and reptiles with disappearing genitals after the concentrated use of herbicides and pesticides in the habitat of the Everglade swaps. The same negative effects have been noted in males with newborn males exhibiting smaller penises, scrotums and distance between the scrotum and anus- a shrinking genitalia, with evidence of eventual lower sperm counts.

Some of the most common sources of xenoestrogens are found in foods, plastics and personal care products. Many lotions and soaps contain parabens- labeled as butyl, propyl, ethyl or methyl paraben. Parabens have been associated with breast cancer and lowered milk supply during lactation. Phthalates (pronounced without the ph!) are in plastics and are associated with increased risk of premature birth. Researchers have found that babies and children with high fetal exposures to phthalates had a 70% increased risk of developing asthma, these exposures were through foods- enteric coatings, gels, stabilizers, personal care products, detergents, plastic toys and products, paints, inks, and pharmaceuticals

Another well publicized chemical of concern is bisphenol-A or BPA. Recent studies associate decreased maternal pup rearing behaviors in rats after exposure to BPA during pregnancy. Other negative consequences to BPA exposures include hormone disruption, altered behavior in babies and children, obesity, diabetes, ADHD and cancer. BPA is found in numerous child-related products. Several states: Connecticut, Maryland, Minnesota, Washington, Wisconsin, and Vermont now have laws restricting or banning the sale of child care products containing BPA, such as bottles and sippy cups. Research supports the concern that children are at more vulnerable to the negative effects of BPA. Other sources of BPA include food can linings and an unlikely source is coating of sales receipts.

Tips for a cleaner, safer pregnancy:

  • Avoid using #7 polycarbonate plastic for food or drinks
  • Minimize handling sales receipts
  • Use fewer canned foods- opt for fresh or frozen
  • Use glass, stainless steel or bamboo containers for preparing or storing food
  • Do not heat any plastic food containers in the microwave
  • Breastfeed to avoid bottle exposures- if feeding your milk in a bottle use glass bottles
  • If you are packing food in plastic bags place an unbleached paper towel between your food and the baggie

What about other substances to avoid?

Cleaning products are another source of chemicals of concern. We have all been indoctrinated into the values of being clean, maybe too clean. Some of the cleaning products we are now using are dangerous to our health and maybe destroying the good bacteria our bodies need to maintain a healthy immune system. We love chlorine bleach and believe it may be the best cleaner available- but there is a dark side to chlorine- with too much use it can release chlorine gas that can cause asthma and other respiratory problems. Formaldehyde (also called formalin) is a known carcinogen and is found not only in cleaners but also in bedding and towels- oh my! Ingredients such as Quaternium-15, Quaternium-24, Sodium Hypochlorite (Bleach), Sulfuric Acid, Ammonium Chloride have also been shown to increase respiratory irritation and asthma.

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Laney helps Grandma Donna mix up an eco-and-human friendly household cleaner

Here are safer (and often less expensive) cleaners:

  • Vinegar – sanitizes and removes stains
  • Lemon juice – works safely to disinfect
  • Baking soda – a great all-purpose cleaner
  • Borax – all natural cleanser
  • Cornstarch – easy, natural de-greaser
  • Olive oil – great for dusting and furniture polishing
  • Pure essential oils – natural germ killers and natural fragrances
  • A basic bathroom and kitchen cleaner can be made by mixing equal parts of distilled water and white vinegar. Store in a spritzer bottle for easy use.

For more information and how to make safer product choices visit the Environmental Working Group’s Cleaning Guides.

What about personal care products?

We love to use them, smear them on, scrub with them, spritz and spray and rub them on. But what are the concerns with these products? Americans use a lot of personal care products, a lot! That’s how we unfortunately get such high levels of toxic chemicals in our systems. So the first guideline is to use fewer of these products.

The second guideline is to use products with fewer ingredients. For example, a simple moisturizer for face, hands, and body is olive oil; coconut oil is also a simple, clean way to moisturize. And what about soaps? You only need one, a natural plant-based soap is best like castile or glycerin. These can be used for hands, bathing and shampoo, no need for different products with multiple ingredients. We want to limit the ingredients we know are harmful to the planet and humans such as: 1.4 dioxane, parabens, synthetic dyes and fragrances, PEGs, lead, nail polish and phthalates.

Avoid hand sanitizers and washes with anti-bacterial chemicals such as triclosan which destroys our friendly, helpful bacteria along with the unwanted germs. An easy, non-toxic hand cleaner is 1 oz of distilled water with 30 drops of lavender pure essential oil- all natural, safe and effective.

Here is an easy, inexpensive recipe for a basic hand and body lotion:

  • 3/4 cup base oil (olive, sweet almond, wheat germ)
  • 1 cup aloe gel
  • 1/2 cup shea, mango or cocoa butter.
  • Mix well. Add essential oils as desired

The Environmental Working Group also provides guidance on personal care products and cosmetics.

Lastly let’s look at our foods:

We are reading more and more in the news about the need to get back to basic, real food and the advice holds true for pregnancy as well. Health reports surface daily on the side effects of food additives such as food dyes which are linked to cancer and nervous system disorders, preservatives, hormones and genetically modified organisms. Current recommendations for pregnancy and breastfeeding are simple:

  • Eat low on the food chain- lots of fruits, vegetables, nuts and seeds and whole grains
  • Choose organic whenever possible. Check out the “Clean 15” and the “Dirty Dozen” on the Environmental Working Group web site to help you make cleaner food choices.
  • Minimize processed foods with preservatives, colors and ingredients you can’t pronounce and
  • Avoid synthetic sweeteners- use agave, honey or stevia
  • Avoid genetically modified foods- not listed on labels but choosing organic foods do not allow the use of GMOs
  • Choose fish wisely- go to / for current recommendations
  • Avoid pans with non-stick coatings- opt instead for stainless steel or cast iron cookware

Early parenting is a great time to educate yourself about healthy eating habits- it can last a lifetime for your family.

We can’t lock our families up in a pristine bubble but what can we do to protect them?

First, educate ourselves and during pregnancy and breastfeeding we have an extra motivation to learn about the connection between the health of the environment and human health. Then make a plan to make changes: start reading labels, make some simple cleaning products to start using, take a critical look in your kitchen and bathroom cupboards-replace those products that are of concern and talk with family and friends about making simple lifestyle changes. Every positive change you make can make a big difference in the health of your family, and the planet!


*(Ed. Note: Our Milk Way blogger Jess Fedenia is on parental leave for the months of July, August, and September, 2016 to welcome a third child into the family. During Jess’s leave, members of the Healthy Children Project circle are taking up the blogger role.)

“We are here together…I am yours and you are mine”: One family’s experience with breastfeeding

By: Holly Hansen , BFA, Project Manager, Healthy Children Project, Inc.*

Holly Headshot
Interviewer Extraordinaire, Holly Hansen

At my age, finding out that friends of mine are having a baby isn’t uncommon; last summer I was overjoyed at the news that my dear friend, Nora, was pregnant. I knew how excited she was to start a family, so when Nora told me she was expecting, I was over the moon for her!

Then it hit me: Nora’s going to be a mom. She certainly wasn’t the first of my friends to get pregnant; a handful of friends from high school had gotten married and had children years earlier. But Nora was the first really close friend I knew who was about to make a tiny human and then raise it.

When I was asked to write a couple of blog posts (as Jess herself produces a tiny human), interviewing Nora was one of the first ideas that came to mind. She’s a first-time mother living in New York City, and one of the most compassionate and brave people I know. Talking to Nora about her experience with Baby Price helps continue my education into what motherhood means, and I’m glad to share it with you!


Did you always know you would breastfeed?

My mom breastfed both my brother and I so I always knew I would someday.

What was your previous exposure to breastfeeding like?

I worked as a babysitter and my mom had a daycare in my house growing up, so I was incredibly familiar with moms who breastfeeding. I was very lucky to have many families I babysat for who breastfed and so I was exposed to how they did it in New York City. One mom in particular would breastfeed in her carrier while we would walk around the city. She was such a role model for normalizing breastfeeding as a normal, on the go, part of her day.

I also watched a lot of YouTube videos and documentaries on breastfeeding right before I gave birth. Reading articles on so that I would feel confident when starting breastfeeding, or at least know where I could find help if I needed it.

What was it like the first time you were able to breastfeed your child?

Watching my son do the crawl towards my breast was amazing. He needed a little assistance to latch for the first time, but seeing him figure it out and experiencing us figuring it out together and our new relationship was so rewarding. My milk came in fairly fast, and with the help of my midwives, doula, and husband we were able to find success and I felt confident that I was able to create this relationship of breastfeeding.

What (if any) challenges did you encounter while learning to breastfeed?

My left nipple had always been inverted, and so my son would get frustrated when it was time to nurse on that side at first as it would take time to get the nipple to stay for him to latch. So I did experience a couple of plugged ducts on that side and some engorgement which I was able to remedy with a warm wash cloth and Epson salt bath. I loved that I had online resources that helped guide me in clearing up the problem so that I wouldn’t panic. Looking back on it now, it did take time for my nipples to not feel uncomfortable and thank goodness for ice packs and nipple cream! But I knew those minor uncomfortable moments were so worth giving my baby the best nutrients possible.


Nora City Hall
Nora and Price nursing on the steps of NYC City Hall

Have you ever had to feed/pump in a less-than-ideal place/situation (i.e. subway, audition, etc.)?

My friend gave me a book called The Places You’ll Feed which is a take on Dr. Seuss’s Oh, the Places You’ll Go and oh my, was she right! I quickly learned to feed anywhere and everywhere. I got really good at feeding him in the front pack. I’ve fed him on the subway, in the middle of rehearsal–my favorite memory is doing a reading of a new play in which I was feeding him in the front pack while standing still as a “tree”. I was recently on my way to catch the Amtrak train from NYC to Albany and we were on the go and baby needed to eat, so I carried him in my arms with my boob popped out of my sun dress charging down 8th Ave near Penn Station! A police man gave me a double take when he realized I was nursing and then smiled, gave me a thumbs up, along with a “good for you” nod of approval.

There have been a couple of rehearsals I was at where baby did not come with me, and I actually had to hand express milk into a toilet in a bathroom. That was poor planning on my part; I quickly learned to carry little freezer bags and would hand express my supply if I was at a long rehearsal. Most of the time I had my husband or a friend come hold the baby at rehearsal, and would feed him on a break or while I was not immediately working.

How do you balance breastfeeding while working/travelling for work?

I feel very lucky to have two professions that allow me to bring my baby with me, for the most part. As an Independent Consultant for Arbonne International, I can set my own hours of work which entails video conferences from home, coffee dates and group meeting that not only allow me to bring my baby with, but are encouraged. I have lead trainings over video conference in which I tip up my camera and keep baby in my lap while breastfeeding. I also bring him along to my one-on-one consultations over coffee and when he’s hungry I feed him. I’ve also had the chance to travel on the plane and train and car which has led to some interesting places to feed as well. I quickly took on the motto I once heard a Lactation Consultant say,” Boobies are for Babies, if you don’t like it you can put a blanket over YOUR head,” and so I confidently feed whenever we need. I find that when you feed with love, people respect that it’s you loving your baby. I also pump at night to keep a supply at home for those days he’s with Daddy or those days we need coverage for shows and date nights. We have gotten really good at packing freezer bags and milk in our luggage!

Breastfeeding is sadly still not 100% publicly accepted; have you ever found yourself in a situation where you have faced any negative responses?

I have not had any direct negative comments when I feed. I’ve sensed that some people feel uncomfortable when I do, but I think it comes out of a wanting to respect me and my child; I used to do the same thing when I was around women breastfeeding and now I can’t help but think, “Why was I soooo awkward.” I usually give people permission if they feel like they should give me privacy, that for me, I’m okay if they are okay. I feed my baby with that attitude as if this is an everyday, normal activity, because it is! I think I’m so comfortable doing it now, that sometimes people don’t even realize that I am nursing my little guy. That being said, I do love our one-on-one nursing sessions at home or somewhere quiet and alone for us to connect. I love that I have the freedom to be where I need and want to be, and most importantly be where the best place for my son to eat is and I realize that is going to be different for each Mommy and baby. For Price and I, that is usually on-the-go and no covers or blankets because we like to see each other and not feel tangled up and sweaty.


How (if at all) has your partner been involved with breastfeeding?

My husband has been so incredibly supportive. He propped pillows up around me in the early days to find the right position, watched YouTube videos on positioning before our baby got here and has told me there is not a more beautiful picture than his wife feeding his child. Those loving words, make me feel like a Mommy Goddess and that has given me so much confidence in my ability as a mom. I know breastfeeding has brought us even closer. Those simple words of encouragement not only make me all happy and twitterpated inside, but I actually have witnessed that when I’m pumping in the living room, if he walks in my let down comes faster! Ah, oxytocin the love drug, how fab is that! He also would rub my feet while I would nurse in the early days, and run my ice packs back and forth.

How long do you plan to breastfeed your current child, and will you breastfeed future children?

I feel incredibly confident in listening to my son and his needs and know that breastfeeding is a relationship, but I am hoping to go for at least a year if not 2 years of nursing with my son. We hope to have more children in the future and I’m excited to see the relationship I will get to build through nursing with them. I am also open to the idea of tandem feeding if we have children close in age.

What has been the greatest help to you while navigating these first few months of breastfeeding?

I was a huge fan of and my doula and midwives were great at prepping me before the baby was here. I also found support in our local mom’s group led by a lactation consultant and sleep coach.

What advice/knowledge do you wish you had known before starting breastfeeding that you would want to pass on to others?

Know that your breasts are going to take a couple weeks, if not a month to get adjusted. I also didn’t realize how many breast pads I would go through. Invest in some really good, comfy sleep/nursing bras to live in. Having to sleep in a bra again was something I wasn’t thinking about pre-baby. I am a huge fan of double layering my clothes. A tank top you can pull down, and a flowing shirt you can wear on top to pull up makes feeding in public feel less exposed. I also highly recommend having nipple cream and cold freezer packs ready for engorgement as your body adjusts to its new function! And most of all, be patient with yourself and your baby. It’s not just about a LATCH, it’s a relationship between two people, it takes time to establish, but that time and focus dedicated to finding out your perfect position is so rewarding. Hang in there and surround yourself with positive people: lactation care providers, moms’ groups, and online support groups are all great to have established before little baby gets here!

How has breastfeeding changed you, your relationship to your partner, etc.?

I feel more confident as a woman, mom and wife breastfeeding. It’s a powerful, yet calm, feeling to be able to be your little one’s sole provider of nutrients. It’s amazing that nature creates the perfect food for our little ones. I feel such a sweet and close connection to my son when we have a nursing session. The way he looks up and smiles at me, that feeling that, “Hey, we are here together! I am yours and you are mine,” that bond is like nothing else I’ve ever felt in my life. To include Daddy, we sing our son the same three songs every night right before bedtime while he nurses. Daddy holds me, while I hold our baby. It’s a great family memory we are creating.

I know many partnerships and cultures avoid feeding in public or don’t even consider breastfeeding because of the sexual nature and association we have with breasts. I’m very much of the mindset that why can’t they be both? I think breasts can be functional and sexy. Life doesn’t have to be black and white. We are flexible beings, and just as a Mom can be strong she can also be vulnerable and I think if we as a culture empower women to follow their instincts, we will begin to release this “shame” about our parenting, birthing, or feeding choices. If we simply just remove the judgement of each other, we can all start to feel strong, confident, and sexy while still being our soft, open, and sensitive selves.

Thank you, Nora, for sharing your experience and insights!



*(Ed. Note: Our Milk Way blogger Jess Fedenia is on parental leave for the months of July, August, and September, 2016 to welcome a third child into the family. During Jess’s leave, members of the Healthy Children Project circle are taking up the blogger role.)


Reflections on the Process of Implementing Change: Highlights from the 2016 MAINN Conference

Guest Blogger: Cindy Turner-Maffei, MA, ALC, IBCLC, Faculty, Healthy Children Project, Inc.*

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Dalarna University, Falun, Sweden

Last week a small team of Healthy Children Project (HCP) faculty members travelled to participate in the Nutrition and Nurture in Infancy and Childhood: Biocultural Perspectives conference in Falun, Sweden. This conference, which is sponsored annually by the University of Central Lancashire (UK) Maternal and Infant Nutrition and Nurture (MAINN) Unit led by the brilliant Fiona Dykes, is held on alternating years in England, or at a different co-sponsoring university. The Reproductive, Infant and Child Health (RICH) unit of Dalarna University hosted the conference, in the shadow of a giant ski jump perched atop the hill over the university campus in rural central Sweden. The conference was attended by more than 150 individuals from 17 countries.

Conference Convenor Renée Flacking

After a warm welcome from the effervescent conference convenor, Renée Flacking, Dalarna University Prov Vice Chancellor Marie Klingberg-Allvin spoke of the university, known for net-based learning as well as traditional classroom instruction.

Dr. Klingberg-Allvin highlighted a Dalarna University collaboration with Somaliland Universities to offer graduate degree program to midwives in Somalia and Somaliland, where mothers and infants die at one of the one of the highest rates in the world. The potential impact of this work on infant and maternal mortality is immense, and is the subject of a brief, moving video.

Lars Wallin

First keynote presenter and Dalarna professor Lars Wallin spoke about the NeoKIP (Neonatal Knowledge into Practice) study, which examined a community-based “bottom-up” strategy for reducing infant mortality in 44 Vietnamese communities. This project identified and trained community-based facilitators who were members of the Women’s Union. The facilitators worked with focus groups of health professionals in every targeted community to identify barriers and design and employ strategies to address key barriers using a Plan, Do, Study, Act approach. A lovely descriptive video may be found here.

Kajsa Brimdyr

During her keynote presentation, HCP faculty member Kajsa Brimdyr CLC, PhD spoke on the topic of Implementing Practice Change Immediately after Birth: An ethnographic approach. Trained as an ethnographer, one who studies cultural practices, Kajsa introduced an ethnographic research frame in the research work conducted by HCP, a midwifery team from Karolinska Institute in Sweden, and the Egyptian Lactation Consultant Association, to study hospital practice around skin-to-skin immediately after birth. Kajsa’s experience, and that of other ethnographic research teams, are also presented in the recently published book edited by MAINN team members Fiona Dykes and Renée Flacking: Ethnographic Research in Infant and Child Health.


Fatuomo Osman

Fatumo Osman, a doctoral student at Karolinska Institute, shared lessons from the Ladnaan Project. Ladnaan is a Somali word for “a sense of health and well-being). This project explored the parenting support needs of Somali refugees living in Sweden. Introducing a theme that resonated through several conference presentations, Ms. Osman highlighted the importance of involving members of the target population in identifying needs, and designing and evaluating programs to address needs.




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Anna Blair

Anna Blair of the Healthy Children Project spoke on the topic of maternal identity, social stigma, and social justice in maternal child health.





Drs. Flacking & Brimdyr introduce Happy Birth Day

On the first evening of the conference, an evening reception at the lovely modern Dalarna University library included entertainment by a musical group, a juggler, and a screening of a segment of Healthy Children’s Happy Birth Day series focusing on gentle, low-intervention birth stories.



Karin Cindy MAINN
Karin and Cindy

Karin Cadwell and I presented a crash course on the role of breastfeeding in epigenetics, sharing knowledge about the several ways that human milk (as well as other substances ingested) may signal the expression of the infant’s genetic code.



Drs. Cadwell & Brimdyr also spoke about research they’ve conducted with Swedish-American teams exploring the impact of epidural medications and synthetic oxytocin on the expression of the primitive neonatal reflexes. (Click the links to view the article and video describing the outcomes regarding epidurals.)

We enjoyed so many other thought-provoking presentations, including these and others:

  • Ragnhild Maastrup of Denmark, sharing results of her study examining the progression of preterm infants to the breast, and factors associated with earlier breastfeeding proficiency in these little ones.
  • Schmied _ MAINN
    Virginia Schmied

    Elaine Burns and Virginia Schmied of Australia exploring the impact of professional, peer counselor and mother support on feeding outcomes. The appreciative inquiry approach of one study was particularly interesting.

  • Doctoral student Victoria Fallon of England, presenting “’Bottled Up’: The emotional and practical experiences of formula feeding mothers.” One of her most striking findings was that a very high percentage of mothers in the study reported feeling guilt, stigma, and the need to defend their infant feeding plans, regardless of how they intended to feed. The impact of these experiences on maternal emotional health could be detrimental.
  • Hannula_MAINN
    Leena Hannula

    Leena Hannula of Finland presenting about the Neo-BFHI initiative, an initiative developed by a Scandinavian and Canadian team of researchers; recommendations of the Neo-BFHI group can be found here. Later Dr. Hannula presented fascinating findings from a survey of “Adolescents’ breastfeeding intentions in five countries: the influence of attitudes, social norms and shared-parenting beliefs.”

Gill Thomson
  • Gill Thomson of the University of Central Lancashire (UK) tackling the thorny topic, “Shame if you do, shame if you don’t: women’s experiences of infant feeding.” The potentially devastating impact of shame on maternal self-image is a powerful force to consider in designing campaigns and interventions.



  • Doctoral student Nicole Bridges of Australia presented “The faces of breastfeeding support: experiences of mothers seeking breastfeeding support online,” a study model utilizing Facebook for research.
  • Cartwright_MAINN
    Angela Cartwright

    Graduate student Angela Cartwright of England, presenting findings of a qualitative study of “Mothers’ experiences of feeding infants with Down Syndrome.” The themes emerging from this study indicate that much more support is needed by mothers tackling the task of feeding babies born with his challenge.

  • Dr. Elizabeth O’Sullivan of Ireland sharing quantitative findings of her research into human milk feeding strategies, intriguing findings to pair with the qualitative findings described earlier by her team.
Silke Mader

On the final day of the conference, Silke Mader spoke eloquently about her experience as a mother of twins born at 25 weeks gestation in the late 1990s in a presentation entitled Improving the Empowerment of Parents – What do parents need to take over care? The lack of emotional and physical support her family received during her emergency medical treatment, the death of her infant daughter, and the several month long NICU hospitalization of her infant son led eventually to the creation of the European Foundation for the Care of Newborn Infants (EFCNI), which works across Europe to strengthen parent support, and drive the implementation of evidence-based neonatal practice through endeavors such as benchmarking care NICU support and care practices. She reminded the group to seek parental support, and drew special attention to the needs of fathers as well as mothers, as their needs are often invisible to the health care system.

Drs. Flacking & Dykes closing MAINN 2016


Our time at this conference reinforced our belief that people-centered change in supporting birth, infant and child health, and the development of the parent-child bond is possible; in fact, it is happening throughout the world! It was wonderful to be surrounded by so many individuals questing for a better beginning for our families. We left Sweden full of gratitude for the passionate, curious, and innovative hearts and minds that are hard at work to understand the challenges and fuel progress in this crucial field.

Group at Dinner_MAINN
Celebrating MAINN 2016 at the conference dinner Back row: Flacking, Blair & Thomson Front Row: Turner-Maffei, Maastrup & Brimdyr


*(Ed. Note: Our Milk Way blogger Jess Fedenia is on parental leave for the months of July, August, and September, 2016 to welcome a third child into the family. During Jess’s leave, members of the Healthy Children Project circle are taking up the blogger role.)

Ruminations on Motherhood

By: Holly Hansen, BFA, Project Manager, Healthy Children Project, Inc.*

Holly Headshot
Holly Hansen

I don’t want children. It’s something I’ve known about myself for a long time. I always preferred playing with stuffed animals to baby dolls; I did have one, named Christina. Oddly, I never really played with Christina as if I was her mother and she my child—Christina was a character in my stories, someone who could interact with my stuffed bears as I, their director, saw fit (is it any wonder I went into the theatre?). It can be marked back to when I was six years old and watching “Sarah Plain and Tall”; there’s a particularly harsh scene of childbirth (or at least it seemed at the time). I turned to my mother and said, “I don’t want to have babies.” It’s a perfect portrait of how media portrayal of childbirth and motherhood can put us off of them. I thought motherhood meant pain.

Of course, as I got older and received a proper sexual education, there was a clearer understanding of the act of childbirth; pain could be involved, yes, but it was obviously about and worth more than that. But the idea of becoming a mother still wasn’t my preference. Still, in middle school (when many my age began to babysit) I went with my sister on one of her babysitting jobs.

Pandemonium. The father hadn’t even finished writing down his emergency contact information before his two toddlers were naked, screaming, and running around the house. Now I associated motherhood not with pain, but with chaos.

Through my high school years, I was far too busy with class and friends and getting into a good college to even contemplate motherhood. After all, that was a problem for Future Holly to debate about. Motherhood was a task for which I didn’t have the time.

Then came college (specifically my sophomore year), when a production of Wendy Wasserstein’s The Heidi Chronicles had me deeply considering single parenthood. Compelled by the drama of the play, the drama of being new to sexual relationships, and the overall drama of being just so complicated because I was 20 and nobody understood me I had an “epiphany” that I really wanted to be a single mom. I was looking at motherhood like a television event, a storyline to draw in ratings to my super dramatic life.

I got over that thought real quick.

Then came life post-college: truly living away from home, proper jobs, ugly bills, and actual adult relationships, where discussions of starting families and potential children’s names became the appropriate brunch time filler talk. Talks with engaged friends, married friends, pregnant friends, and so many, too many, family members—being a childless, adult female meant that I couldn’t escape conversations with any of them when it came to the subject of motherhood.

Motherhood became a topic I wished so heartily to avoid, because apparently, “it’s not for me” wasn’t a good enough answer.

Motherhood was something I resented because it wasn’t in my plans, it wasn’t something I wanted, and even now—happily engaged—it isn’t something my fiancé and I desire for our future. It can be tiring to have to constantly respond to questions about motherhood. Will there ever be an acceptable response to my lack of desire to become a parent?

But I have realized more and more, especially becoming educated about birth and breastfeeding, that there are so many ways to be a mother, even if it’s not in the traditional sense.

Motherhood is supporting my friends who have children and are happy and exhausted and content. Motherhood is listening to those who want children but cannot have them, and being compassionate. Motherhood is supporting women’s health issues and being aware and open-minded about the different debates going on in the world.

Motherhood is painful, and chaotic, and time-consuming, and dramatic, and completely normal, all at the same time.



*(Ed. Note: Our Milk Way blogger Jess Fedenia is on parental leave for the months of July, August, and September, 2016 to welcome a third child into the family. During Jess’s leave, members of the Healthy Children Project circle are taking up the blogger role.)



USBC Legacy Awardee Karin Cadwell Calls for Recognition of Structural Racism

(Ed. Note: Our Milk Way blogger Jess Fedenia is on parental leave for the months of July, August, and September, 2016 to welcome a third child into the family. During Jess’s leave, members of the Healthy Children Project, Inc. circle are taking up the blogger role.)

On August 7, 2016, the United States Breastfeeding Committee awarded legacy awards to the following legendary members of breastfeeding intelligentsia in the U.S.: Kimarie Bugg, Karin Cadwell, Miriam Labbok, and Marsha Walker. [After this post was published, we were saddened to learn of the death of Miriam Labbok on August 13, 2016. Dr. Labbok’s legacy is beautifully described here.]

This week’s post contains the Karin Cadwell’s acceptance speech, followed by remarks by USBC chair Jeannette Crenshaw regarding Karin’s work. Heartfelt congratulations, Karin, from your colleagues at Healthy Children Project for this recognition of your leadership, scholarship, and your amazing capacity to speak the truth!

20160807_162108 (1)USBC Legacy Award Acceptance Speech, Karin Cadwell, RN, PhD, ANLC, IBCLC:

First, I want to thank you for the honor of this award. I am humbled by the recognition of my years of service to mothers and babies here in the United States and in countries around the world. When Jeannette (Crenshaw, Chair of the United States Breastfeeding Committee) interviewed me about receiving the Legacy Award it gave me the unusual opportunity to take stock and consider the trajectory that brought me here.

I was breastfed because my mother and father were immigrants to this country. Breastfeeding was what they knew. So, my first experience breastfeeding my own baby should have been easy. I was

Breastfed myself!

Well educated!

Well nourished!

Well hydrated!

Well motivated!

But it wasn’t easy.

The hospital policy was

               Day 1: 1 breast 1 minute every 4 hours

               Day 2: 1 breast 2 minutes every 4 hours

on up to day 5 – BOTH BREASTS, 5 minutes on each side, every 4 hours.

When I brought the baby home on day 5, I followed the instructions and nursed her on each breast for 5 minutes at 6pm and put her in the crib. She cried. I checked the discharge instructions to be sure I had gotten them right – Do NOT pick the baby up or feed her from 6 at night to 6 in the morning- OR ELSE! (The scariest or else was that she wouldn’t have friends in kindergarten.)

While she was crying I decided to unpack baby clothes sent to me by a relative who thought (wrongly as it turned out!) that she would no longer have any use for them. On the top of the first box was an original and well-worn copy of the Womanly Art of Breastfeeding. I probably was only a few pages in when I picked up the baby and nursed her. The next morning, I walked to the pay phone on the corner and called up my mother. She drove 10 hours to come and get me.

There was a lot of social justice in the milk my mother gave me and I have been compelled to ask why breastfeeding, an act that is necessary to the survival of a species, is so difficult. I have spent more than 40 years travelling around the country giving lectures and workshops, facilitating problem solving with mothers who are struggling with breastfeeding, done research, written books and articles and served as a mentor to you women coming up in the field. In the asking I always found more work to be done,

               As a teacher trainer for ICEA

               As a breastfeeding counselor for CEA-GP

               As a founder of ILCA and NABA and NABA REAL

               As convener of Baby-Friendly USA

               As chair of international Baby-Friendly Coordinators meetings

As a founder of the Breastfeeding Leadership Roundtable which became the United States Breastfeeding Committee

As a facilitator of the US submission of the WBTi.

Since 1991, the Innocenti Declaration has been my map:

               Baby-Friendly in the US :  √ (check)

               A National Multi-Sectoral Breastfeeding Committee – √ (check)

Imaginative Workplace Legislation – hmmm more is needed, especially for non-hourly employees and we need PAID MATERNITY LEAVE!

Legislating the International Code on the Marketing of Breast Milk Substitutes. USBC has a group working on that! I’m hopeful.

But equity…..we have a long way to go to achieve equity. There are surmountable hurdles….but hurdles nonetheless. Hurdles of individual and structural racism. I believe that individual racism feeds into structural racism. As a teenager, I thought these were easily overcome.

I hopped on the bus inspired by Mrs. Peabody, our governor’s mother, to sit-in and integrate lunch counters and restaurants. But it’s not as simple as I thought it was as a high school girl. I was SO young and naïve. But not now.

Which races of babies have the highest rate of mortality in the US?

 African American (11/1000) and Native American (7/1000… US Average 6/1000).

Which US babies have the highest risk of dying from pneumonia?

Native American and Alaska Native babies are 4 times more likely to die from pneumonia.

Which babies have the highest risk of becoming diabetic?

Native American babies. And diabetes is significantly related to higher death rates in later life.

Which babies could benefit most from the miracle of mother’s milk?

African American, Native American and Alaska Native babies, since being breastfed reduces the risk of mortality in general and of contracting diabetes and pneumonia.

Which babies are the least likely to be breastfed?

African and Alaska Native and Native American babies

Which race of women is most likely to have breast cancer diagnosed at a later stage and die of breast cancer?

African American women who die of breast cancer at the rate of 28/100,000. The US average is 20/100,000.

Which race of women is most likely to have metabolic syndrome and die from the resulting heart disease and stroke?

If you guessed African American women you are right!

Who are the women that breastfeed at the lowest rates in the US?

 If you thought it was African American, Native American and Alaska Natives, you would be correct!

Which women could benefit the most from having breastfed?

If you thought it was African American, Native American and Alaska Natives, you would be correct again!

I believe the low breastfeeding rates among African Americans, Native Americans and Alaska Natives is because of STRUCTURAL RACISM.

Several states have recently had their restrictive voting laws overturned. The rationale for passing these restrictive laws was given as “voter fraud” however, it was demonstrated that the legislators had requested data about African American and Native American voting practices before knowingly and systematically legislating to disenfranchise these peoples.


They say “voter fraud”.  I’ll say “structural racism”. The courts agreed with me!

Which hospitals are least likely to be Baby-Friendly in the US? 

According to Lind and colleagues at the U.S. Centers for Disease Control and Prevention (2014),  hospitals that serve African American families.

To those who say that “Baby-Friendly is too hard (too expensive) (too whatever),” I’ll say “structural racism”

Groups that put forth restrictive licensure legislation or diatribes against other professional lactation care givers when they know (and have admitted publically) that they are not a group representative of the population of the US, are enforcing structural racism.

When I hear that lactation legislation will improve “access to care” but the sayers are not able to articulate what this really means, I’ll say “structural racism.”

When I hear that licensure is for “protecting the public” but that sayers are not able to articulate what this really means because what it really seems to mean is “protecting members of your club” (that is known to be, let’s just say, not-representational), I’ll say “structural racism”.

The problem is (as been written before me so articulately) that

“When you are accustomed to privilege, equality feels like oppression.”

Until we face structural racism head on–acknowledge it, name it–we cannot work on it. Breastfeeding rates will continue to climb at the barely noticeable pace they are now. Mothers and babies will continue to be denied their right to optimal health.

As Doctor King so wisely told us

               “Injustice anywhere is a threat to justice everywhere.”


Jeannette T. Crenshaw, DNP, RN LCCE, IBCLC, NEA-BC, FAAN, Chair, United States Breastfeeding Committee introduced Dr. Cadwell’s award with the following remarks:

Karin Cadwell’s introduction to breastfeeding came from a person near to her heart, her mother. In a time when not many women were doing so,  Karin’s mother  nsisted on breastfeeding her from birth, and in fact, while they were still in the hospital, Karin’s mother’s milk was used to help an extremely ill baby in the hospital at the same time as them. The baby survived and went to school with Karin, and as she grew up she identified as the mother of a “milk goddess.” When she gave birth to her first child, she struggled to follow the hospital and obstetrician’s guidelines on breastfeeding. When she found a fatefully placed copy of The Womanly Art of Breastfeeding in a box of donated baby things, she quickly knew she would dedicate her life to making sure women had access to breastfeeding support. As she says, “how could I, the daughter of a milk goddess, a well-educated, well-read, well-motivated woman, a woman with every privilege, how could it have been so hard for me to breastfeed?” That’s the question she has been asking and answering ever since.

When people who have been on the long journey with USBC look back at our growth, Karin Cadwell, together with fellow Legacy awardee Marsha Walker, are appreciated for their role in recognizing the need to form a multi-sectorial organization to elevate breastfeeding in the United States, as called for in the international Innocenti Declaration.

When Karin is asked to look back on her accomplishments in the breastfeeding field, she promptly informed me that she doesn’t look back, she just looks forward at “the work there is still to do.” She speaks of continually finding new challenges and continually responding to new generations and their needs.

Like her organization,  the Healthy Children Project,  Karin’s legacy and mission is one that holds space and creates opportunities for others to succeed. Her vision of the idea that babies have a right to good health right from the beginning of their lives inspires women coming up in the field, both as a role model and a mentor. Her close colleague,  Cindy Turner-Maffei points to Karin’s “amazing mind, amazing heart, and amazing commitment to serve all families” when speaking about her legacy. In 25 years, Karin hopes the legacy Award will go to people who have worked for legislation to hold in place all of the current and future achievements of the breastfeeding field, ensuring a world where breastfeeding is protected and supported.


Reflections on Karin’s Contributions to the Field with Cindy Turner-Maffei