If you’re reading this, you will likely appreciate this humor originally posted by Doula Nadia Smith: “If your partner can purchase a PS5 he can pay for a Doula!”
Of course there is truth in the statement.
“Shall we talk economics of hiring a doula? Decreased risk of preterm birth, decreased risk of cesarean, decreased risk of perineal and pelvic floor damage… your total cost of healthcare is lower when you have a doula. And why are we putting a price on maternal wellbeing when we are in the most dangerous developed country for birthing?” Danielle Downs Spradlin, IBCLC, CLC of Oasis Lactation Services writes.
Trumbo offers her services on a sliding scale so that doula service is available to all families no matter their financial situation. As an independent doula, she doesn’t name a price; instead she simply asks families to pay for what they can afford. She also volunteers through Hope’s Embrace, an income-based perinatal support organization.
Trumbo’s areas of interest include Pregnancy and Infant Loss and Fertility advocacy.
As an Accessing the Milky Way scholarship recipient, she is also eager to become a Certified Lactation Counselor (CLC) currently working through the Lactation Counselor Training Course (LCTC).
“I can’t wait till I complete my training,” Trumbo shares. “I’m learning so much already…”
Trumbo has been documenting some of her training and revelations on social media.
Currently, Trumbo refers her clients out to lactation professionals, but she says, “I want to be able to provide that support within myself; they already know who I am. We have already built this strong bond.”
Trumbo is passionate about not only making doula and breastfeeding services more accessible, but more visible.
The research echoes Trumbo’s thoughts: “… if we had more families supporting and being open about [breastfeeding] that may give expecting families at least the thought that they can do it.”
Of course representation matters here too, not the insubstantial, rallying cry that author Lauren Michele Jackson writes about in this Vulture piece: “Representation matters. A mighty yet modest observation — that the art and culture around us, consumed and therefore inside of us, which expands and contracts our capacity to imagine living in the world — has gone tinny in its rallying cry, hollowed by the market’s appropriative appetites.”
The culture shift that Brittany Isler contributes to is not billboard flashy, not Hollywood influential nor commercial tokenism. The work that Isler is doing is authentic and sustainable. Her energy as “The Breastfeeding Girl” radiates through her small town of Cleveland, Miss. touching families in various ways, driving community-led impact.
Isler is the mother of an eight-, five- and one-year-old. She did not breastfeed her oldest child because she says she didn’t know anything about it. It wasn’t until an early postpartum appointment that she received a pamphlet on breastfeeding, but she says it felt like it was too late to get started at that point.
“If I ever get pregnant again, I really want to breastfeed,” Isler remembers thinking.
Soon, she started researching infant feeding and landed a great peer counselor. When her second baby was born and spent over a week in the NICU, she knew to express milk for him. They went on to breastfeed for three and a half years.
During this time, Isler affectionately became “The Breastfeeding Girl” among her community as she documented her experiences and breastfeeding photos on Facebook.
In a community with low breastfeeding rates, Isler sparked curiosity, answered questions and started a Facebook peer support group.
During church one Sunday morning, while Isler nursed her son, the former pastor shared in his announcement that “breasts are made for breastfeeding”, publicly celebrating that what Isler was doing is natural and normal.
Isler participates in local Baby Cafes, facilitates community baby showers, and attends breastfeeding classes so that expecting parents can experience the invaluable teaching tool of breastfeeding in action with live models.
“I love, love, love the training,” Isler reports. “I can do it at my own pace and the instructors are amazing…My favorite thing is the song!”
[“When you counsel, when you counsel
Never judge, never judge
Praise mother and baby, praise mother and baby
Don’t command, do suggest”
Sung to the tune of Frère Jacquesfor those of you unfamiliar.]
In this spirit, Isler says, “Let it be known too that I do teach about formula-feeding as well. I support moms whatever their choice is. My goal is to ensure that formula feeding is done safely, prepared and stored properly.”
Isler comes from a family of teachers, so she anticipated that she would become one too, she explains.
“I guess I’m a teacher in another way,” Isler reflects.
“My main goal is to just keep looking for ways to educate myself,” she says.
Some of that education includes unlearning.
“I’m dispelling myths and starting to replace them with facts.”
The fact is that “… exposure to breastfeeding is linked to more positive attitudes toward breastfeeding (including public breastfeeding) and a greater intent to breastfeed one’s own child …” (Austen, Dignam & Hauf, 2016, p. 2).
Isler acknowledges that infant feeding method isn’t always a choice; sometimes it’s decided for parents depending on where they live, what they see, and what care they have access to. Her approach is to populate her community with breastfeeding dyads with the ultimate goal of healthy future generations.
“Interestingly enough, [human milk] donations are a little bit up,” Urbanski says. “Our milk supply is really healthy right now.”
Urbanski theorizes that the increase in milk donations is because many mothers are working from home, making breastfeeding and pumping more convenient and comfortable in certain cases.
She directs our attention to Casey’s Donor Story which describes how a change in this mother’s work situation due to COVID opened the opportunity to donate her milk. Urbanski says that her story echoes what they’re hearing from many other donors.
Groff acknowledges that although the pandemic has increased stress globally, in North America, there seems to be less hustle and bustle, to-do lists have shrunken, and partners are often in the home to help support the breastfeeding parent.
As a result of COVID, Mothers’ Milk Bank of the Western Great Lakes milk depots and dispensaries had to get creative about how they functioned, switching from walk-ins to curbside pick ups, but that didn’t necessarily affect their traffic, Urbanski explains.
Milk banks, milk bank depots and donor milk distribution sites have an important communal presence, not only providing milk to babies in need but also providing education, collaboration and support, Groff says. Support looks different now with virtual meetings, contactless drop-offs and mobile phlebotomy, but it’s “most certainly still there and still personable.”
Drulis’s piece reflects the collective experience of North American milk banks and donations.
“We attribute, in part, our recent upsurge in milk donations/donors to Covid-19. We never have received such an outpouring of milk, so much so that we purchased 6 additional double door upright freezers in the last 6 months.
Some of our depots with full freezers are serving as holding sites temporarily. This is a vital role of depots, one we infrequently utilize, and when we do, it is mainly because of driver availability and scheduling.
Our service has gone contactless, depot volunteers bring the milk outside to the driver. For milk deliveries, donors call when they arrive, put their precious donations in coolers in our lobby and return to their vehicle. Thereafter, the milk is taken to a freezer. When dispensing outpatient milk, the routine is similar, the recipient family calls, leaves the documents/prescription in a folder in our lobby, we fill the prescription and put the milk in a cooler in our lobby. The milk is then retrieved by the family. The procedure for shipping milk was already contactless, the driver picks it up in our lobby.
This increase in donated milk has taken the Mother’s Milk Bank of Iowa to the next level, we are poised to serve more hospitals and home recipients thanks to the generosity of milk donors.”
Director of community relations at The New York Milk Bank, Inc. Roseanne R. Motti, BA, MFA, CLCsays they expected to have fewer people calling to donate milk during the pandemic.
“We saw just the opposite!” she exclaims.
Groff says the same: “At the onset of the pandemic, the initial reaction was honestly fear- based. We thought, ‘What will happen? People aren’t going to donate, they might not want to come out of their home…’ but it has been this awe-inspiring. There’s been an outpouring of support from moms and a willingness to give. Moms who donate milk at any time are heroes, but now it’s just extraordinary.”
Motti adds that the average amount a donor is willing to donate also increased.
“Many of these women were working remotely and no longer had a need to keep their freezers full since their babies were home with them,” she goes on.
The New York Milk Bank, Inc. had to purchase four additional freezers to hold their increased donations.
“Many of our sister milk banks saw the same,” she adds.
Motti explains how their bank got creative to keep their donors, families and milk safe during this uncertain time.
“We contracted with a mobile phlebotomist to go to our donors’ homes during the worst of the pandemic. The phlebotomist changed her PPE for each home she went to. She agreed to meet the donor outside her home or wherever the donor felt most comfortable, so long as it was a clean and safe place. This made blood testing so much easier for our donors.
Our milk bank and our milk depots made dropping milk safe and secure for our milk donors by scheduling appointments. Some of our depots even met our milk donors at their cars to make it safer.”
Several states over, in Missouri, Milk Bank Systems Coordinator at Bronson Mothers’ Milk Bank Theresa Woloszyk says their donations have increased too, again attributing the influx to mothers working from home.
“We are very thankful that so many mothers have taken the time to donate their milk, even with everything that is going on in the world,” Woloszyk says.
Motti expresses deep appreciation as well.
“We are grateful for the women who have agreed to become milk donors during this trying time and to our many milk depots across the tri-state area for keeping everyone safe so that the babies who are in need of safe, pasteurized donor human milk had an abundant supply,” she writes.
If newborn supplementation is necessary for any reason, including maternal separation, families deserve the option of choosing donor milk.
It’s up to individual maternity care facilities to decide who has access to PDHM and in many cases, it’s reserved for babies in the neonatal intensive care units (NICUs). Urbanski makes the important point that a small amount of PDHM can be all that is needed to bridge the gap until mothers are able to supply enough of their own milk for full feedings. Donor milk is beneficial even for full term neonates.
With such small quantities of milk needed by newborns coupled with a surge of donations, let’s hope there will be widespread use of PDHM when needed.
Groff says, “My hope is aspirational that moms continue to feed their own babies and the need for donor milk goes down. I really hope that moms continue to be so generous, that they’ll tell their friends and maybe [this surge] will be sustainable in some way in the future.”
Rose Hurd once looked to her great grandmother’s stories as a midwife for inspiration. From a young girl curious about childbirth, to a teenage mother, to a certified birth doula, gentle birth educator, postpartum care provider, Certified Lactation Counselor (CLC) student and now grandmother, we look to Hurd for the same wisdom she found in her great grandmother.
Immersion in the birth world at a young age allowed Hurd to connect to her culture, she says, although it wasn’t always easy. As an African-American woman not knowing which of the 54 African countries her family originated from, she gleaned whatever she could about African people, she explains.
Interested in her Indigenous ancestry too, Hurd digested all of the knowledge her mother shared with her, passed down from her mother’s mother, about using plants to heal and food as medicine.
In her work today, Hurd takes this anthropological approach to serve her clients, melding clinical care with their lived experiences. She embraces holistic care which includes the whole mother, the mother baby dyad, and the family unit.
Reflecting back on her first birth experience, Hurd says that a lot of her health decisions were made for her and not with her.
“There was no Google back then,” Hurd chuckles.
Decades ago, birthing people often didn’t know about the options that they had, she explains. Today, the internet’s influx of information can mean a few things, Hurd points out. Birthing people may have access to more information, but it doesn’t necessarily mean that they are well-informed or that the available options fit well in the context of their lives.
With more information, more questions arise, and in our medical insurance steamed systems, birthing people are often shuffled through doctors’ offices without much time to talk about their concerns or ask their questions.
Hurd sees herself filling this need.
“I am able to sit down, weed out concerns, do the evidence-based research and help families make decisions,” she explains.
Listening and doubt
The keystone to helping clients make informed-decisions about their health, Hurd says, is listening.
As an Accessing the Milky Way scholarship recipient, she says that the Lactation Counselor Training Course (LCTC) allows her to connect even deeper with her clients.
Hurd has found that although most of her clients are part of marginalized communities, they want to know how to breastfeed their babies.
“They are willing to learn,” she says.
There is a shadow of doubt often cast over families living in marginalized communities that they can’t, won’t or don’t want to breastfeed.
Hurd’s own breastfeeding story as a teenage mother offers a porthole into that world.
Shortly after birth, her baby was in the nursery. She called up and told them that she needed to breastfeed her daughter.
“There were a few eyebrows that raised up. ‘Oh! This little, Black girl wants to breastfeed? Black people don’t breastfeed. Teenagers don’t breastfeed.’ That was the statistic,” she remembers the air in the room.
Hurd continues her story, “I was sitting up and this tiny little, Black nurse comes in with my five pound 11 ounce baby, gives her to me and I am fumbling around with my little top on and as she was leaving the room, she backed up and came to me.”
“‘Here, Baby,’” Hurd remembers her voice as she approached to help. “She helped me prop up the baby and said, ‘Try to get as much of the brown in as you can. Feed the baby whenever she is hungry.’ I was so blessed that this lady came in…”
Two weeks later, Hurd’s daughter had doubled her birth weight. She shattered any doubt or any statistic that might have otherwise discouraged her success.
Part of this mission includes providing education that extends beyond the mother baby dyad. She often works with mothers who may be the first in their generation to breastfeed, so she educates entire families on what breastfeeding might look like and how to support a breastfeeding dyad.
Especially through COVID as doulas’ access to their clients is limited, Hurd has provided instruction to family members on how to support the laboring person through real-time, virtual platforms.
Before the onset of COVID, families living in four catchment areas on Long Island: Glen Cove, Islip, Wyandanch, and Southampton, could find breastfeeding support groups at many community establishments. In-person baby cafes followingBaby Café USA’s structure were hosted at community centers, libraries, food pantries, churches, etc.
On a mission to create supportive, breastfeeding-friendly communities along the care continuum– in obstetric and pediatric practices, child care centers, worksites, and community support groups– theBreastfeeding Resiliency, Engagement, and Empowerment (BFREE)Team at Cohen Children’s Medical Center has adapted to COVID times and is now offering free virtual breastfeeding support groups led by lactation professionals each week so that families can continue to access lactation services amidst the pandemic.
BFREE aims to reduce racial, ethnic, and community disparities in medically underserved neighborhoods. Their efforts are part of a five-year grant funded by the New York State Department of Health. Today, BFREE uses a virtual HIPAA-compliant video platform that families can easily access twice a week, no matter where they are, with the option of Spanish translation. They also offer a toll-free telephone conference line.
“They’ve expressed liking the ability to get help in the comfort of their own homes,” she says.
With this in mind, when COVID limitations begin to lift, the team plans to resume in-person support groups, but they’re also considering the option of maintaining a virtual platform for those who prefer this method.
This summer, Long Island weathered a storm that left many families without power. One mother during the virtual baby cafe expressed concern about safely storing her milk. Another mother heard her worry, and offered to drive to her home to retrieve her milk, and store it for her until her power returned.
“It’s awesome to see mothers in nearby communities willing to help each other out even when socially distanced,” Coco comments.
She adds, “It’s also awesome to see moms who continue to return to our groups and become mini experts based on their own experiences.”
Several BFREE team members and Former Associate Program Coordinators are Certified Lactation Counselors (CLC). Coco is currently completing theLactation Counselor Training Course (LCTC). She says the content is “really applicable” to their work, specifically to better support mothers, but also to help them engage with community partners and to provide educational resources.
“Having a deeper understanding [of infant feeding] has been extremely influential in helping us be able to do our jobs better,” she says.
Overall, Coco reports that community organizations are receptive to their work, although they have run into some roadblocks with religious organizations who think their work is “a little too progressive,” she says.
What’s more, “during Covid, so many people are overwhelmed and don’t think they have the capacity to take on another project,” Coco explains.
She notes that a lull here hasn’t been particularly detrimental considering they have already saturated neighborhoods with breastfeeding-friendly establishments.
“It’s a good problem to have,” she laughs.
Fostering partnerships and strengthening networks not only makes advocates’ jobs easier, it makes the job of being a parent easier too.
You can connect with BFREE and their services onFacebook.