Accessing the Milky Way scholarship recipient inspires positive change in generations to come

When news of the Accessing the Milky Way scholarship was released, Jackson Memorial Hospital nurse Lupi Nicholls-Reyes RN, BSN, IBCLC quickly thought of her colleague Santana St. Remy.

St. Remy feeds her baby after graduation ceremony.

“She is an amazing advocate for breastfeeding,” Nicholls-Reyes  writes.  “As a Lactation Specialist, I have seen how she supports mothers with breastfeeding during the night shift because I see the positive effects when I rounded on the mothers during the day.”

St. Remy says she was overjoyed when she found out that she received the scholarship.  

“It has been an important endeavor of mine to be a resource for other women and to make a substantial effort to decrease the maternal and infant mortality rates especially among the most vulnerable population,” St. Remy begins.  “Becoming a mother/baby nurse has been the first step in achieving that goal… The way I see it is if I am able to help one woman as it relates to the care of herself and the nurturing of her baby, I have successfully played a role in creating change in a generation of women. Her children will learn from her as well as her children’s children and so forth.” 

St. Remy says of the Lactation Counselor Training Course (LCTC):

“My experience with the course has been phenomenal. I love the evidence-based research. I enjoy listening to the faculty’s experiences.  I especially enjoy the live video office hours.  

There was a veteran postpartum nurse that recently retired on my unit.  I remember some of the nurses feeling sad that she was leaving. Imagine someone working beside you with a wealth of knowledge that you could just walk up to and ask a question or advice on any situation you may be experiencing. That insight is invaluable.  When you look in a book or you use a popular search engine it just doesn’t compare.   

That is the way I feel about this course; the compassion, care, and empirical knowledge is invaluable.  I have learnt so much and have already implemented a lot of what I learnt into practice.”  

As a night nurse, St. Remy is positioned to help families move through the challenges of new parenthood during a time when, generally speaking, babies are more likely to be given formula during their hospital stay. 

For one, many parents have the expectation that their baby will sleep during the night, and they will be able to rest. 

“The moms only have access to a lactation specialist during the daytime,” St. Remy goes on to explain.  “So, it is up to the nurse to provide the mother with postpartum care as well as breastfeeding support which can be challenging sometimes because for a new mother this requires a lot more time than the nurse can spare.”

What’s more, St. Remy and her colleagues care for a large population of birthing people with high-risk pregnancies, challenged by conditions like Pregnancy Induced Hypertension (PIH) or Pre-eclampsia, Eclampsia, Gestational Diabetes, Chronic Kidney disease, Sickle Cell, and mothers who have endured strokes.

“It is very fascinating to see the capability of a woman’s body to deliver a baby despite having multiple comorbidities,” St. Remy comments. 

It’s with this sentiment that she approaches new families: through encouragement, reassurance and anticipatory guidance despite any roadblock they may be up against.  

“As new parents, it can sometimes be overwhelming trying to figure out how to care for this little human,” she says.  “It really does not matter the race, creed, or socio-economic status, the worries are often quite similar. For moms, the biggest concern is if their baby is getting enough milk.”

St. Remy offers education on what to look for to ensure that the baby is getting enough milk. She also teaches hand expression early on, not only as a visual reminder of the colostrum or milk that is present, but because it is such an important tool for parents to have going forward. 

Families who are not breastfeeding are not forgotten in St. Remy’s practice. She encourages skin-to-skin contact, teaches proper formula preparation and storage and safe bottle-feeding. Mothers who are not breastfeeding also need to learn how to prevent engorgement, St. Remy reminds us. 

With the onset of COVID, hospital staff and families have had to adapt to new visitation policies implemented to help reduce the spread of the virus. 

“In my opinion, mothers have been more receptive about breastfeeding; they want to learn more about ways to protect their newborn during these uncertain times,” St. Remy comments on an ever-changing environment due to COVID.  “It is important to maximize this opportunity by answering their questions and concerns which ultimately builds their confidence. ” 

Limiting visitors at their hospital has presented hardship in many cases; for instance, when doulas are prohibited from attending births, but limited visitors during the postpartum period has sometimes shown to be helpful, especially during the Magical Hour and beyond when newborns and their parents can bond without distraction from friends and relatives. 

Still, St. Remy recognizes the importance of familial support– something she experienced personally.

“I was determined to breastfeed my daughter and we were able to do so for about 2 years and 9 months,” St. Remy begins.  “In the beginning I thought I had everything under control with my background in nursing… it would be a piece of cake! I knew the theory behind it, but the actual lived experience was different.   I did not realize how much support I would need in the beginning and I was fortunate to have the support of my husband and other family members…”

After St. Remy would feed her baby, her husband would take over and spend time with their daughter. 

“He would have skin-to-skin time with her and sing her to sleep,” she remembers.  “She is three now and her favorite song for sleep time I found out a few weeks ago from dad is, Amazing Grace by George Jones.  It must be this specific singer when I ask Alexa to play it. I do not know why this song or this singer but those were the instructions from dad, and it really works.” 

Acknowledging the non-birthing partner as a competent, involved parent is another important facet to St. Remy’s practice. 

Reiterating her earlier statement, “…if I am able to help one woman… I have successfully played a role in creating change in a generation of women. Her children will learn from her as well as her children’s children and so forth…” 

St. Remy’s reach extends even beyond that though. She is an inspiration not only to mothers, but to non-birthing partners and to other maternal child health advocates and health professionals.

Alabama birth worker facilitates holistic, sustainable care for families

*Trigger warning: pregnancy loss

Doula and childbirth/breastfeeding educator Kayla Bitten’s (processing PMH-C. IBCLC student, midwifery student) road to maternal child health advocacy was paved in part by tragedy. 

One day while driving with her cousin and aunt who was pregnant, her aunt swerved into a wall in an attempt to avoid a driver who’d run a stop sign. 

Bitten remembers the aftermath of the crash; her aunt laying in the stretcher, unattended to. Later when transferred to the hospital, her aunt’s concerns about her developing baby were dismissed.

“Everything was fine,” care providers told her and sent her home.  This phenomenon, where Black Indigenous People of Color (BIPOC) are dismissed in medical settings is not uncommon. 

“She knew something was off,” Bitten recalls. 

The next evening, Bitten’s aunt miscarried the baby. 

“Somehow, I was able to doula her through that miscarriage,” Bitten says. “It was very second nature. I knew how to help her breath through it, hold space for her emotionally.” 

“Hearing her say that it hurt so much emotionally and physically triggered something in me,” Bitten continues. 

From that point on, she consumed research, dove deep into conversations about BIPOC health, started writing about birth, surrounded herself with community health workers and studied under their care.  

She started making connections between the generational ailments that challenged the women in her family– things like uterine fibroids and infertility— and the systemic forces at play

Fueled, Bitten launched The Postpartum Clinic, a one-of-a-kind lactation and postpartum wellness facility that centers People of Color.

Through memberships, private appointment sessions, and support groups, The Postpartum Clinic offers comprehensive, inclusive, and culturally competent care to families as well as a network of  local resources for primary care and psychotherapy professionals around Birmingham, Ala.

With nearly 60 percent of Alabama’s population identifying as Black, Bitten notes that “it’s insane” that a care facility like this didn’t already exist. 

“I’m really proud of it and really excited about it,” she says. 

Bitten also leads Coloring Between The Lines – Mothers Of Color Breastfeeding Support (CBTL) which uplifts more than 160 women. The non-profit provides education through virtual and in-person meetings, online mini courses, emotional support, and breastfeeding supplies through donations from local women and businesses at no cost to participants. 

CBTL is rooted in advocacy and activism.

Instead of simply handing out pamphlets and sending families on their way, with CBTL, healthy infant feeding “becomes a sustainable journey not just a one stop shop,” Bitten explains. 

Most of the mothers Bitten and her colleagues work with through their community support groups arrive almost completely defeated by the demands of parenthood and the reality of living as a Person of Color.

“Immediately there are a lot of emotions and literal tears,” Bitten describes. “Once there’s support and community surrounding them, that completely changes.”  

With many of their clients living in North Alabama, skilled birth workers, education and support is hard to come by, so many families have to travel quite far for competent care; interestingly though, the onset of COVID has been mostly positive, Bitten reports. In the midst of the pandemic, different programs have offered free internet to those in need, so Bitten is now able to reach populations she might not have otherwise. 

CBTL partner Jasmine Hammonds and Bitten are conducting research with the goal of policy change in Alabama. The research aims to understand the lived experiences of families and help them pinpoint policies that will support healthy birth and infant feeding outcomes for BIPOC. 

Bitten is a recent recipient of the Accessing the Milky Way scholarship and is currently a CLC student. She says her experience with the Lactation Counselor Training Course (LCTC) has been “really good.”

“What I appreciate most is the different teaching styles… and the evidence-based education,” she says. 

Bitten adds, “With a CLC behind my name, I will be able to not only provide emotional support, supplies, and basic education for  mothers, but I will also have the opportunity to support them with more in-depth services.”

Learn more and connect with Bitten here and here.

Milwaukee birth worker embraces the unknown unknowns, especially during global pandemic

In March, just before COVID hit Milwaukee, Wis. Evelyn Rhodes completed her doula training with Doulaing the Doula. Since then, COVID hasn’t slowed her down. If anything, it’s motivated her more to serve families as they’re challenged by the pandemic.

“If you want to be a birth worker, do it now,” she advises.  “Don’t wait for the pandemic to be over. Birthing people need you now. If you have a passion, then you’ll find your place within this work!” 

In only a few months, Rhodes has completed CAPPA training to become a Childbirth Educator through Well Pregnancy and started working with the African American Breastfeeding Network (AABN) through its WeRise doula program. As an Accessing the Milky Way scholarship recipient, Rhodes is well into her Lactation Counselor Training Course (LCTC) material too. 

“It is going really well,” she reports. “I like the set-up and the check-ins to ensure you are learning and retain the information. The videos are very detailed and offer a lot of information, so it is nice to have the quizzes after each section…. It is also helpful that they have live office hours where you can talk to a person if you have any questions.

Rhodes adds, “I’m really learning about how our social dynamic, cultural norms and legislation all impact the ability for women to be successful in breastfeeding.” 

Rhodes calls the scholarship an amazing opportunity to equip people with the knowledge and skills to help others and really make an impact. 

“That is why it is so important that if you have a passion for this, you take the responsibility to do something about it and make a difference in someone’s birthing or breastfeeding story,” she says. 

Since she was a teenager, Rhodes has been interested in working with pregnant people and babies.

“But my passion really erupted when I had my own kids with a lot of complex issues,” she says. 

Over time, she learned that her story was not as isolated as she thought.

“Complications that I experienced… were more the norm than the exception for birthing people who looked like me,” she explains. “I learned about the statistics for women of color and it is scary, especially for women here in Milwaukee. I really wanted to be a part of changing people’s birthing stories and outcomes to be more positive.

Rhodes developed preeclampsia in her first pregnancy. 

“I knew something was wrong but my doctor just kept brushing me off,” she remembers. 

Rhodes took matters into her own hands and moved from Duluth, Minn. to the Twin Cities in search of different care. During her first and only appointment with a perinatologist,  Rhodes’s oldest daughter was born via C-section at 29 weeks.  Although it was a challenging start, Rhodes provided breastmilk for her baby. 

She went on to exclusively pump for her second daughter who was born with a cleft palate and a heart condition that required surgery at three months. When her third baby was born, she managed the challenges of her baby’s tongue tie that was revised, but she did not receive proper aftercare education, which caused another layer of breastfeeding challenges. 

Despite it all, Rhodes says that breastfeeding her babies was an amazing bonding experience. 

She says, “It creates this connection with your child in that ‘I’m the only person that can give you exactly what you need’. Research tells us that when we smell our babies, our breasts like magic respond to that and produce whatever it is that our baby needs. It’s a gift that makes you feel like a Goddess. It makes you feel good when your baby is crying and you’re like,  ‘Awe, you just need your Mama and these boobs with my liquid gold.’” 

At the same time, Rhodes acknowledges the responsibility and stress that can be coupled with that joy. 

“In my work… I try to make sure that moms know if anything is wrong or making breastfeeding difficult, to seek help,” she says. 

The tenacity that guided Rhodes through sometimes challenging birth and breastfeeding experiences has helped her persevere professionally through the environment that COVID has shaped.  

“…Our kids are with us all day everyday so we no longer have the privilege of someone else caring for our children while we work, study or complete training,” she explains. “I’ve had to do training while tending to my kids or set the kids up with snacks, toys and a movie and lock myself in my room to be able to focus on my training taking breaks to check on them, refill their water, and put on a new TV show to keep them occupied. Sometimes my husband and I both have places we need to be virtually. We even went out and bought our kids new LOL surprise dolls, you know the ones that you have to open 50 different tiny things, because we knew we’d be occupied all day.”  

Reflecting further on her professional life, Rhodes says her work with WeRise has been the most challenging. 

“The work we do is very intimate and in order to take precautions to keep everyone safe, we’ve had to interact in less intimate ways than we normally would,” she explains. “For example we’ve held meetings in public places and practiced social distancing and utilized virtual platforms like Zoom and even FaceTime to conduct prenatal meetings and get to know each other whereas we normally would have done this face-to-face and in the privacy of their homes.” 

“Because of the pandemic, our pregnant mothers are dealing with more stress which as we all know can cause more complications with pregnancy, delivery and even developmental issues once the baby is here. So my work has been a lot more emotional support and finding resources for the mother and the family throughout the pregnancy,” she continues. 

In the face of COVID, certain maternity care facilities are limiting the number of support people present during births, so Rhodes and other doulas are forced to find creative ways to offer support.  

With one client in mind, Rhodes explains, “We are going over a birth plan to help her advocate for certain things, practicing positioning and when certain positions will be most helpful and ensuring that we can be set up virtually if mom desires that interaction during labor.” 

The work that Rhodes, other birth workers and maternal child health advocates are doing is making a difference. 

“I have no choice but to be optimistic about the future of maternal child health,” Rhodes says.  “I think at this point, we have no way to go but up.”

She adds, “…Everyone has to continue to be advocates for themselves as well as others. If we know something, we have a responsibility to our community to share that knowledge because there are so many unknown unknowns. Sometimes we know something doesn’t feel right but we don’t know why. Explore that feeling, ask questions, ask for more information. Share your story and your outcomes positive and negative. Someone might learn from it!”

‘Sprinkle chocolate milk on humanity’

In one of our recent posts, Exploring the Rainbow as a Tool in Lactation and Healing, I was primarily looking at how external color sources affect humans during pregnancy and during the perinatal period.  

After we published that piece, Dominique of DommiesBlessed reached out to share a snippet of her experience with color and breastfeeding. 

“On my own breastfeeding journey, I was drawn to pink and white. It was a strong craving for those two colors to the point that I drank pink smoothies and dressed me and my children in white almost daily. I’m sure the white craving was probably due to my overstimulation. We have multiple children and I’ve been breastfeeding for almost a decade,” she wrote. 

Fascinated, I headed to her website to explore more. A piece she’d written called The Melanated Areola jumped out. 

It starts, “It’s pretty majestic how we change colors. Towards the end of my pregnancy, my areola turned a bold black, deeper than the chocolate of my irises, easily becoming one of the most pigmented parts of my body…” 

I was quickly drawn into Dominique’s work and found myself lucky enough to land an interview with her. 

This is when she reminded me that not only does color affect us externally, we create and exude color ourselves

“We are spiritual beings,” she begins. “When we nurse, colors are flowing from our bodies; it’s a metaphysical experience.” 

Dominique continues, “We should honor whatever colors we are attracted to or craving and surround ourselves in that color.” 

She nods to the colors associated with the seven chakras. Green is the color of the heart chakra, the category responsible for love and relationships, connected to the sense of touch. 

“Breastfeeding is a holistic experience,” Dominique continues. 

In Western culture, we often try to separate the breast milk from the mother, but when we honor the entire experience, she says, mothers are healthier, babies are healthier, and it creates a “unified, circular connection.”

“The bond radiates from that dyad and ripples out.”

Liquid love, as human milk is sometimes affectionately called, is the answer to devastating global issues, Dominique says. 

“Sprinkle chocolate milk on humanity,” she encourages on her site. 

DommiesBlessed started as a space for Dominique to detail her experience as soon as she became a mother for the first time. About three years ago though, it morphed into a blog, breastfeeding-friendly space where social media platforms can’t sensor birth and breastfeeding content and a hub for one-on-one, virtual support where she helps families navigate infant feeding as that holistic experience described earlier. 

Dominique has always offered her 30-minute emotional support sessions online, but since the onset of COVID, she’s getting more calls about homeschooling, how to get started and how to set up legal documentation. 

At the same time, she’s available to help breastfeeding families process their experiences and guide decision making through peer support at a time when families might be feeling even more isolated in their experiences than ‘normal.’ 

Dominique is active with the Boston Breastfeeding Coalition where she’s helped curate videos featuring breastfeeding support in the Boston area and continues to promote their online support content. 

During Black Breastfeeding Week 2019, Dominique released a children’s book called ONE in an effort to contribute a diverse experience to children’s literature. 

By harnessing the power of the internet, Dominique has been able to serve other families while centering her own. You can connect with her here

Disasters Don’t Wait: We Must Make Babies a Priority in Emergencies, Guest blog post by Amelia Psmythe Seger

We love this piece so much, we’re reposting Amelia Psmythe Seger’s Disasters Don’t Wait: We Must Make Babies a Priority in Emergencies, originally published on the United States Breastfeeding Committee’s (USBC) blog, this week on Our Milky Way.

____________

September’s National Preparedness Month carried the theme Disasters Don’t Wait. Make Your Plan Today. As we look back on a month that included fires, floods, and hurricanes, that message feels especially urgent.

I live in Portland, Oregon, on the traditional lands of the Multnomah, Clackamas, Tualatin, Wasco, Molalla, and Chinook bands, who were stewards of this land for generations.

The beautiful mountains and volcanoes around us are reminders that our family may one day face a catastrophic earthquake. Our family has taken comprehensive steps to prepare for the possibility of an earthquake, but I can tell you emphatically – we were not prepared to live through nine days of breathing hazardous air imposed by the substantial wildfires taking place up and down the West Coast throughout September, as 5.8 million acres burned in California, Oregon, and Washington this year alone. We’re going to need to change our disaster kit to be better prepared for future fires that are now tragically predictable here.

The look, the feel, the impact of fires on that scale is almost impossible to describe. The skies were red, orange, or gray, depending on proximity to the areas – plural – that were burning all around us. We refreshed Air Quality Index apps compulsively to learn the AQI throughout each day. We tracked the progress of the fires and the patterns of evacuation. We fashioned homemade air filters from box fans and furnace filters, then watched them turn sooty while stores were sold out of replacements and everything outside became coated in ash and grit. All the while, we managed the edge of panic caused by the awareness that if a major metropolitan area needed to evacuate there would be literally nowhere to go.

And yet… as a household and community, we were far from the most impacted. Our house, neighborhood, and city were safe from flame, while so many others lost their homes and livelihoods. Even as I write, the fires are not yet all extinguished. I cannot imagine experiencing this with an infant or young child in my care. I’ve read many first-person accounts of escaping the fires, including tales from families with young children in tow.

Take a pause and consider right now – if you had 15 minutes to leave your home, perhaps forever: do you know what you would take? What if you have a day’s notice? Consider that anything left behind may be gone forever. You’ll have life and loved ones in arms, but the sense of place and the familiar may be altered for quite some time. Now consider this is happening in the context of a pandemic that we know is transmitted through droplets – where our breath and proximity may be dangerous rather than life-affirming.

Unfortunately, our shared context of global pandemic and climate crisis, requires that we not only imagine such complexities but prepare for them with deliberation. At the state and community levels, such plans also need to include equitable access to immediate help and long-term support.

Babies are born each and every day; therefore, our emergency response and preparedness efforts must account for the presence of infants and young children in disasters. The New Orleans Breastfeeding Center is leading the way with their Infant Ready program, including Emergency Feeding Kit for parents, and their educational materials for caregivers, emergency responders, and health professionals.

We are seven months into this pandemic. The babies born today were conceived in another time—in what feels almost like another world—before the pandemic, masking, and social distancing disrupted our world.

As a nation, we have a long way to go to ensure that families are held with kindness and care during emergencies. There is a desperate need for thoughtful, intentional support as we collectively work through a scale of loss that we all hoped to never have to face—and the breastfeeding field has risen to this challenge.

The USBC-affiliated COVID-19 Infant & Young Child Feeding Constellation is a collaborative group of 43 organizations, including government agencies and medical authorities, that have worked together to shape and respond to infant feeding policies and practices throughout the pandemic. Together we have had ongoing bidirectional learning and communication to center family and provider experiences and to explore the complex and multi-faceted issues that this pandemic has created in the context of infant feeding.

Individuals from these organizations, located all across the nation—in the midst of uprisings in their communities, raging wildfires, violent hurricanes, and a surging pandemic—showed up to do the high stakes and incredibly difficult work that was needed.

We’ve influenced, disseminated, and interpreted guidance for maternity care centers, published the Statement on Infant and Young Child Feeding (IYCF) in the Context of COVID-19 in the United States, and called for the infrastructure investments that are needed to meet the needs of breastfeeding families. As we collaboratively support successive iterations of public health guidance, I’m reminded of Maya Angelou’s quote, “Do the best you can until you know better. Then when you know better, do better,” on a collective scale.

Through this work, we’ve learned that emergency and disaster relief work has three phases: response, resiliency, and preparedness. We are in the midst of emergency response efforts on many fronts, but the concept of resiliency as a planned stage of emergency and disaster relief work is one of the things that keeps on giving me hope. We will, eventually, sufficiently build the systems of pandemic response to a stage where we will begin, like many other parts of the world, to focus on rebuilding our resiliency.

The world as we’re coming to know it requires us to be responsive, flexible, adaptable, and resilient in the face of ambiguity and even danger. We can build our capacity to recover by holding one another in care—and you can help your family and community get there.

National Preparedness Month urges everyone to take a week-by-week stepwise approach to prepare for the inevitable disasters that are now coming faster than ever: Week 1) Make A Plan; Week 2) Build A Kit; Week 3) Prepare; Week 4) Teach Youth About Preparedness.

Disasters don’t wait. Taking steps today can make a world of difference for tomorrow. One of the steps you can take today is also one of the easiest—use the USBC easy action tool to urge policymakers to make babies a priority in emergencies!