Under a thick, winter coat and layers and layers of clothing, a new mother fumbles to situate her baby to breastfeed in public during a long, cold winter in Great Falls, Mont. Her eyes shift, anxious that she might be approached and shunned by some unapproving neighbor.
Instead of suffer the discomfort, the mother figures she ought to bottle-feed, a seemingly more socially acceptable way to feed her baby.
Elizabeth Chargois, a WIC peer counselor serving families in Great Falls says this situation is not uncommon.
“We have an older generation that isn’t necessarily comfortable with women and babies breastfeeding in public,” Chargois explains. “That becomes even more drastic as the child ages. That can make things difficult for the mom…”
She goes on to explain that Great Falls is behind in breastfeeding initiation and rates at three months and beyond.
Lack of education, employment barriers, breastfeeding misconceptions and access to free formula all contribute to low rates, Chargois says.
Maternal child health advocates in their area, including a strong breastfeeding coalition, are working to change infant feeding culture through communication, social media and various other avenues of outreach.
The cutouts are intended to raise awareness about the importance of breastfeeding and to help destigmatize breastfeeding in public, as originally reported by Enya Spicer of the Great Falls Tribune. So far, one is displayed in a local WIC office and the others will be placed in high traffic areas throughout the community in the next few weeks, Chargois explains.
The coalition meets October 18 when two of the cutouts will get “adopted” by a coalition member who will be responsible for finding it a home.
“Then they would move to another location in time with a different adopter,” Chargois adds.
The coalition will welcome open communication with the managers or individuals at the place of business where the images are displayed.
“I am positive we will get all sorts of feed-back,” Chargois says. “We plan on tracking the campaign efforts through social media and polling the public’s opinion of the cut-outs. The staff at WIC will also inform the clients about the project and see their responses.”
In the meantime, while breastfeeding culture slowly changes, Chargois says Great Falls families have access to many avenues for support.
Almost all the staff in the local WIC office are CLC trained, for instance. Health Department Home visiting nurses, pediatric clinic staff, and many nurses and staff at the local hospital have completed the Lactation Counselor Training Course, Chargois reports. The hospital will host another training in Spring 2020.
Chargois continues, “Our military base has a CLC in their pediatric clinic as well as a home visiting nurse who recently was trained as a CLC.”
And, she adds, community members can reach out to La Leche League.
“Great Falls has support at every turn,” she says.
Although an atypical situation among her clients, Chargois recalls a mother she worked with who was overproducing.
“Christina was able to donate 128 gallons of breastmilk and feed her baby Jayden during her year of breastfeeding her child,” Chargois remembers. “It was incredible!”
Along with their efforts to increase breastfeeding visibility in public, the health department has conjoined with various cancer organizations to educate about breastfeeding’s protective qualities against reproductive cancers.
“We were recently at one of our White Sox minor league Great Falls Voyagers games giving out bracelets promoting Women Against Breast Cancer,” Chargois reports.
The department also recently hosted a table at The Think Pink for the Girls Committee Think Pink Tea fundraiser.
You can follow Great Falls Breastfeeding Coalition on Facebook.
Help Healthy Children Project celebrate National Hispanic Heritage Month (September 15 to October 15) this week by revisiting some of our previous articles celebrating the contributions of Hispanic/Latinx care providers.
During her pregnancy, her family rallied around her, protecting her and her growing baby from the effects of stress.
“My ancestors had a very clear idea and connection about emotion and stress [during pregnancy and beyond,]” Reyes begins. “They knew the impact of emotion.”
That meant household chores were alleviated from her routine during the “Cuarentena,” 40 days after the postpartum period. Food and nutrition were central to the support she received too. She learned from her mother and grandmother about the importance of healthy activity during pregnancy, and the way movement could replace medicalized pain intervention during birth. Once she gave birth, she carried her baby in a rebozo, the same way her mother carried her.
Last year in Self-objectification and breastfeeding, we featured the work of Christine Toledo, PhDc, MSN, RN, ARNP, FNP-C, a PhD candidate at the School of Nursing and Health Studies, University of Miami, and a McKnight Doctoral Fellow. The McKnight Doctoral Fellowship is a program “designed to address the under-representation of African American and Hispanic faculty at colleges and universities in the state of Florida by increasing the pool of citizens qualified with Ph.D. degrees to teach at the college and university levels.”
Lorena Quiroz-Lewis is a bilingual health and wellness coach, Certified Lactation Counselor (CLC) and executive director at LABALink (Latin American Betterment Association) working in Mississippi.
“In the Delta, Latino moms are invisible,” Quiroz-Lewis states. “They lack a voice because they are undocumented and either do not speak the language or do not speak well. There is no one to advocate for them, nor do they have the resources to advocate for themselves.”
As a self proclaimed writer and storyteller, Quiroz Lewis documents the accounts of her life; stories from Ecuador, her family’s migration to the States, growing up Latina in New York, marrying and moving to rural Mississippi.
Liz Chang is an established Lactation Care Provider in Pennsylvania. We first featured her work back in 2014.
Ileana Berrios, CLC is a mother, doula and Philadelphia WIC Breastfeeding Manager. She created the group Breastfeeding Latinasto address these disparities, call for culturally appropriate and culturally safe care, and to provide a resource to women of color in her community. Read about her work here.
For more resources, tools and materials related to Hispanic Heritage Month, you can visit USBC’s comprehensive page here.
Little Julia Grace breastfed directly for the first time when she was 11 weeks old.
Before this, Julia Grace’s mom, Ella Gray Cullen, pumped exclusively for those 11 weeks, ten to 12 times each day which amounted to at least 40 hours per week of her pumping routine.
“It was exhausting and tough,” Cullen remembers.
We first met Julia Grace and Cullen on Our Milky Way two years ago when we featured their non-profit, Julia’s Way, an organization on a mission to prove babies with Down syndrome can breastfeed and to help families to “reimagine life with Down syndrome”.
Now, Julia Grace just turned three and attends a bilingual ASL/English pre-kindergarten.
When Cullen first teamed up with Nicole Starr Photography and featured mothers nursing their babies with Down syndrome, they started a movement. This book is really a first-of-its kind; a comprehensive and positive guide for both families and medical professionals.
“It baffled me… that there was not a book like this and it was what I was desperate for when I was pregnant and a new mother,” Cullen comments. “While we were working on the book I heard so many times ‘I wish I’d had this book when I was pregnant!’ I always tried to remember those moms (and myself) during this project and I really hope I’ve given new and expectant moms what they need.”
The book has been very well received, Cullen shares.
“We have seen people from all over the world download it and ask to link to it/use it in their materials,” she reports.
Its release did not come without challenges though, most of them related to time.
Cullen begins: “I’m a working mom of a toddler and this has been a total labor of love. I had no idea how long it would take and everything moved so much more slowly than I thought it would (mostly due to my own constraints).”
“But more than the challenges, what stands out to me is the generosity of the people who worked with me to produce the best possible resources,” she goes on. “They gave their time to write chapters, proofread, provide technical assistance, review content, etc. Their commitment to this project and their support and encouragement really helped me press through when the book seemed like it would never be done!”
In addition to their book, Julia’s Way offers a brochure which has been translated into several languages including Haitian Creole, Vietnamese, and Spanish. The brochures are free of charge and are a “quick start” guide for preparing to breastfeed your baby with Down syndrome, Cullen explains.
Julia’s Way also has a new brochure for medical professionals explaining why breastfeeding is so important for babies with DS and how they can support moms in their desire to breastfeed.
Next up, Cullen has set a long term goal to create a training program for lactation professionals to help them understand how best to support these dyads.
“Eventually, I’d also like to create a peer support model where moms who have breastfed would receive some training,” Cullen explains. “That way a mom could come to our site, plug in her zip code and find both a peer model who would be willing to support her with ‘been there, done that’ advice and cheerleading AND [lactation care providers] in her geographic area who have received our training.”
Cancer is an awful word to hear. It’s the second leading cause of death globally. Last year, it was responsible for an estimated 9.6 million deaths, and treatment is often grueling, crippling and expensive. Most of us have been affected by tribulations associated with the disease.
On a personal note, in just the last week, cancer has wreaked havoc on three dear friends of mine.
With that, Guest Blogger Donna Walls’, RN, BSN, IBCLC, ANLC piece Breastmilk: Research shows it can destroy cancer cells!!! is fitting.
A fervent skeptic, I can’t say the information Walls shares gives me hope for any of our loved ones suffering, but it does raise great questions and piques promising potential.
Years ago, maybe 20 or so, I went to a conference session entitled “Breastmilk Apoptosis”. I had no idea what that meant, but a Swedish researcher explained how his team was applying breastmilk to cancer cells in a petri dish and found the milk was actually destroying malignant cells. I was astounded; this breastmilk is really great stuff!
Years went by and I didn’t hear about “apoptosis” again, until just recently. Through the years I have talked with some patients who were using breastmilk during cancer treatments and even heard a bit about milk banks having cancer therapy on their list of uses, but you would have thought if breastmilk was really killing cancer cells, it would have been the lead story on the evening news.
Fast forward to 2019 and there are some research articles surfacing touting the ability of breastmilk to actually destroy cancer cells. Substances found only in breastmilk, alpha-lactalbumin, combined with fatty acids (most commonly oleic acid) have the capability of destroying malignant tumor cells. (Hakansson et al., 1995)
Early breastmilk research began looking at the mechanisms of breastmilk in killing pathogenic germs. They were using cancer cells, as they commonly do with experiments, and were surprised to find the cancer cells being destroyed. They then applied the breastmilk to healthy cells and found no negative effects to healthy cells.
In 1995, Professor Catharina Svanborg of the Lund University in Sweden was working on the application of breastmilk components to cancer cells.
Svanborg stated: “We have very strong data in mice showing dose-dependent reduction of the tumor, to the point of disappearance. And we have laboratory evidence for effects against many different types of cancer cells and its therapeutic use in animal models of brain tumors and colon cancer as well as bladder cancer.” (Hakansson et al., 1995)
The original studies out of Sweden did find raw breast milk (the a-cells, etc.) that demonstrated apoptosis. Using this discovery led to the development of the processed HAMLET cells now being used in anti-cancer drugs.
In another trial study carried out in 2007 by Motol University Hospital in Prague and overseen by scientists from Lund University in Sweden, eight out of the nine patients in the study were found to be passing tumor cells in their urine just two hours after being given an alpha-lactalbumin complex synthesized drug which resulted in decreased tumor size.
In another early trial involving 40 patients with hard-to-treat bladder cancer, it was found that all 20 who were given a drug based on the alpha-lactalbumin complex had whole tumor fragments in their urine. (Mossberg et al., 2007)
This complex of alpha-lactalbumin and fatty acids is referred to as HAMLET (human alpha-lactalbumin made lethal to tumor cells). This complex induces apoptosis which is defined as cell death, cell suicide or programmed cell death. HAMLET has been shown to induce anti-tumor effects on more than 40 different lymphomas and carcinomas. These cells were also able to distinguish between malignant cells and normally functioning cells and did not exert their anti-tumor effects on healthy cells. (Delgado et al., 2015)
So what are the practical aspects of using breastmilk as a treatment for cancer? Synthesis of the HAMLET cell complex is being used in research studies and the development of anti-cancer medications by the pharmaceutical industry “looks promising”. FDA approval of clinical trials included the statement “the unique characteristic of the protein could potentially help battle cancer in adults, some doctors say”. (Delgado et al., 2015).
Dr. Lori Feldman-Winter at Cooper University Hospital in New Jersey stated “There’s promising research that would indicate that in the future the solution for not only preventing cancer, but even treating and curing cancer might be in human milk.” (Zauli et al., 2013)
If in time, breastmilk, or synthesized HAMLET cells, would become a routine part of cancer treatment there could be a concern about the availability of human milk.
“In the past we have had one to two inquiries a month,” said Dr. Deborah Tuttle of the Mothers’ Milk Bank at Christiana Hospital in Newark, Delaware (Major, 2009). Human milk banks have only a limited supply of human milk with premature and vulnerable infants as the priority for the limited amount of human milk available.
There is also a concern that adult cancer patients, out of desperation, might seek sources of breastmilk that provide unsafe products claiming to have benefits as cancer therapies.
We know that breastfeeding reduces the risk of many cancers in infants as well as reduces the risk of breast and ovarian cancer in breastfeeding mothers. There are many benefits of human milk, and with this research, another promising treatment for cancer without the side effects of current treatments can be added to the list.
Delgado, Y., Morales-Cruz, M., Figueroa, C.M., Hernández-Román, J., Hernández, G., and Griebenow, K. (2015). The cytotoxicity of BAMLET complexes is due to oleic acid and independent of the α-lactalbumin component. FEBS Open Bio 5, 397–404.
Håkansson, A., Zhivotovsky, B., Orrenius, S., Sabharwal, H., and Svanborg, C. (1995). Apoptosis induced by a human milk protein. Proc. Natl. Acad. Sci. U.S.A. 92, 8064–8068.
Mossberg, A.-K., Hun Mok, K., Morozova-Roche, L.A., and Svanborg, C. (2010). Structure and function of human α-lactalbumin made lethal to tumor cells (HAMLET)-type complexes. FEBS J. 277, 4614–4625.
Zauli, G., Monasta, L., Rimondi, E., Vecchi Brumatti, L., Davanzo, R., Demarini, S., and Secchiero, P. (2013). Levels of TNF-related apoptosis-inducing ligand (TRAIL) show a long-term stability in the breast milk of mothers of preterm infants. J Hum Lact 29, 350–353.
For more information
Aits, S., Gustafsson, L., Hallgren, O., Brest, P., Gustafsson, M., Trulsson, M., Mossberg, A.-K., Simon, H.-U., Mograbi, B., and Svanborg, C. (2009). HAMLET (human alpha-lactalbumin made lethal to tumor cells) triggers autophagic tumor cell death. Int. J. Cancer 124, 1008–1019.
Brinkmann, C.R., Thiel, S., and Otzen, D.E. (2013). Protein-fatty acid complexes: biochemistry, biophysics and function. FEBS J. 280, 1733–1749.
Fontana, A., Spolaore, B., and Polverino de Laureto, P. (2013). The biological activities of protein/oleic acid complexes reside in the fatty acid. Biochim. Biophys. Acta 1834, 1125–1143.
Gao, Z., Wang, R., Qin, Z.-X., Dong, A., and Liu, C.-B. (2018). Protective effect of breastfeeding against childhood leukemia in Zhejiang Province, P. R. China: a retrospective case-control study. Libyan J Med 13, 1508273.
Hallgren, O., Aits, S., Brest, P., Gustafsson, L., Mossberg, A.-K., Wullt, B., and Svanborg, C. (2008). Apoptosis and tumor cell death in response to HAMLET (human alpha-lactalbumin made lethal to tumor cells). Adv. Exp. Med. Biol. 606, 217–240.
Hill, D.R., and Newburg, D.S. (2015). Clinical applications of bioactive milk components. Nutr. Rev. 73, 463–476.
Ho, J.C.S., Nadeem, A., and Svanborg, C. (2017). HAMLET – A protein-lipid complex with broad tumoricidal activity. Biochem. Biophys. Res. Commun. 482, 454–458.
Mok, K.H., Pettersson, J., Orrenius, S., and Svanborg, C. (2007). HAMLET, protein folding, and tumor cell death. Biochem. Biophys. Res. Commun. 354, 1–7.
Mossberg, A.-K., Hou, Y., Svensson, M., Holmqvist, B., and Svanborg, C. (2010). HAMLET treatment delays bladder cancer development. J. Urol. 183, 1590–1597.
Rath, E.M., Duff, A.P., Håkansson, A.P., Vacher, C.S., Liu, G.J., Knott, R.B., and Church, W.B. (2015). Structure and Potential Cellular Targets of HAMLET-like Anti-Cancer Compounds made from Milk Components. J Pharm Pharm Sci 18, 773–824.
Rath, E.M., Cheng, Y.Y., Pinese, M., Sarun, K.H., Hudson, A.L., Weir, C., Wang, Y.D., Håkansson, A.P., Howell, V.M., Liu, G.J., et al. (2018). BAMLET kills chemotherapy-resistant mesothelioma cells, holding oleic acid in an activated cytotoxic state. PLoS ONE 13, e0203003.
Svensson, M., Düringer, C., Hallgren, O., Mossberg, A.-K., Håkansson, A., Linse, S., and Svanborg, C. (2002). Hamlet–a complex from human milk that induces apoptosis in tumor cells but spares healthy cells. Adv. Exp. Med. Biol. 503, 125–132.
This is Chauntel Norris, CLC, a DONA trained doula, and Lamaze trained Childbirth Educator, on her way to hand deliver mothers’ milk to newborns after collection at the Julia Tutwiler Prison for Women in Wetumpka, Ala. In cases where babies live far from the prison, Norris ships the milk overnight.
She along with a team of four other doulas, serve inmates at Tutwiler where they also lead a weekly childbirth education class and serve family-style, nutritious meals.
“We come around, and we serve them, and it’s really an hour and a half for them to step outside of the prison and just be moms, enjoy each other’s company and just talk about mom stuff,” Norris recounts.
In terms of infant feeding, for many of the moms at Tutwiler, Norris begins, breast/chestfeeding is something totally new to them.
“So we talk about what might make it a good idea,” Norris says.
And the number one driver for inmates to provide milk for their babies is connection. It’s something that only they can provide for their babies, regardless of being separated.
“The majority of women want to be good mothers regardless of their circumstances, so anything they can to do maintain a bond, they will do,” Norris says.
That’s shown by the seventy six percent of moms who have chosen to participate in the Mother’s Milk Initiative.
“They’re all success stories and I’m proud of everyone who participates in our program,” Norris says. “I’m most excited when moms are able to provide the majority of milk for their baby.”
She recalls one mother who sends enough milk home for her baby that only two supplemental bottles of formula are needed per week. This mother’s goal is to exclusively provide her own milk, so she has coordinated adding extra pumping time to increase her production.
“It’s not the amount that matters, it’s their energy. It reinvigorates me,” Norris shares.
The Alabama Prison Birth Project somewhat recently merged with the Minnesota Prison Doula Project and is in the process of expanding their program, training more doulas and lactation care providers. In fact, Tutwiler’s Director of Nursing is a CLC.
Norris says that while she didn’t start work with Tutwiler at the height of the abuse and poor conditions, she’s been able to observe some of the positive shift.
One thing she’s noticed is that there are a lot of women working there.
“When you have women in charge of taking care of women, and someone who actually cares, then change is created,” Norris explains.
She also senses community building within Tutwiler.
“The women that we serve are affected by us, but when we walk down the halls the other women know who we are,” she says.
Exchanges between Norris, her colleagues and officers have demonstrated an appreciation for their work too. Officers have admitted that they’re not equipped to handle birth and that they’re glad the program exists.
Alabama Prison Birth Project is making a big impact in a small community, but their efforts are part of a much bigger need.
Female imprisonment is on the rise in the U.S. In fact, it’s sky-rocketed; over the past 30 years or so, female incarceration has gone up 750 percent, Norris explains.
She goes on to provide some context behind the statistics about female imprisonment.
The median income of women the year prior to their incarceration was 14 thousand dollars.
Two thirds of incarcerated women have children under 18. “That is a huge driver of incarceration, coming from an impoverished background. They’re doing what they have to do to survive. [They’re] trying to figure how to literally keep their families alive.”
Ninety percent of incarcerated women have endured physical or sexual abuse, often during early childhood.
Some incarceration is drug related. “A lot of these women have addiction issues; perhaps they might be better served by treatment.”
Norris encourages finding out what’s going on in your local correctional facilities. Are pregnant inmates getting prenatal care? Are they shackled during birth? How is their nutrition? Norris reminds us that doula support improves health outcomes which help save medical costs for correctional facilities.
Hold people accountable, she continues. And have conversations with local birth workers to put together a collaborative plan on how to make an impact.
In their partnership with the Minnesota Prison Doula Project, Norris and colleagues are curating a curriculum to train people to become prison doulas. This project will roll out in the next year.
In the meantime, you can stay up to date with their mission via the following channels: