Transformational travels through the Milky Way

I recently had the opportunity to travel to Orlando, Fla. for Healthy Children’s 17th Annual International Breastfeeding Conference. As a trained journalist, I am ashamed to admit that I cannot find the words to explain how phenomenal an experience it was.
The gathering of speakers including Ann-Marie Widström, Kristin Svensson, Nikki Lee, Katja Pigur, Elizabeth Brendle Froh, Dianne Cassidy, Ricardo Herbert Jones, Linda Smith, Julie Mennella, Kimberly Seals Allers and Healthy Children faculty and attendees created a warm energy that surely renewed and transformed participants.

The lovely Tippy snags me for an interview!
The lovely Tippy snags me for an interview!

Because I am new to the field of lactation and because I have not worked in a clinical setting, I was especially privileged to be surrounded by such an experienced, concerned group of lactation care givers.

When we weren’t engaged in remarkable presentations and discussions, us conference participants were forced to have a lot of fun. (Wink, wink) During group activities, I laughed myself to tears. We enjoyed entertainment from a special guest called Tippy, we raced milk ducks for a great cause and attendees viewed the premiere of Healthy Children’s newest film The Lost Secret of the Throne. Early in the week, we visited Sea World to learn about aquatic mammalian lactation- our Sisters of the Sea.

Milk ducks await the race! Five-bucks-a-duck fundraiser raises money for breast cancer prevention through breastfeeding.
Milk ducks await the race! Five-bucks-a-duck fundraiser raises money for breast cancer prevention through breastfeeding.

Between Monday and Friday, Healthy Children presented breastfeeding education that surpasses the idea that Breast is Best. Although accurate education is still crucial for breastfeeding success, we can begin to focus on the many dimensions breastfeeding connects to: economy, environment, public health, human development, perception of women, ethics, and the list goes on and on.

Below, I reflect on some of the overarching themes discussed at the conference.

Women are not powerless.
Why is it that most birth stories are stories of horror and pain and violence?

For one, today’s women are generally not exposed to the beauty that birth can be. Instead we’re inundated with dramatized, inaccurate versions of birth in the media and our own experiences reflect those.

Second and perhaps more significantly, the medical industry has seized women’s power.

Homebirth and hospital-attending obstetrician/ gynecologist and homeopath Ricardo Herbert Jones, MD explains the many reasons why there is a divide between evidence-based birth and current obstetric practice.

First, he spells out physicians’ fear of litigation. A doctor who performs a caesarean section will not face potential charges because he or she used available technology. People simply no longer believe in the safety of normal birth; instead, we glorify technology.

Intervention is convenient for physicians. Scheduling or calling for an “emergency” c-section allows doctors to make it home in time for dinner. One conference participant calls it the “five-o’clock cut.”

Dr. Jones also explains that intervention supports commercial interest. The more c-sections performed, the less time wasted and the less time mother and baby spend in the OB ward.

“Birthing is a factory process; there is no emotion,” Speaker Nikki Lee, RN, MSN, IBCLC, ANLC, CIMI, CCE, CKC observes.

Dr. Ric Jones presents about birth in Brazil.
Dr. Ric Jones presents about birth in Brazil.

Society does not believe in women’s innate ability to birth our children. We’ve been made to believe that our bodies are defective and untrustworthy and so, we must relinquish power.

Common practices including shaving women’s pubic hair transforms her into a child, a girl who exercises no choice, Dr. Jones explains. He also uses the chilling metaphor that by hooking women to IVs during labor, we become fused to the medical system.

When women are permitted to experience birth fully, the way we choose, it has the potential to empower and transform us.

“Birth mirrors everything that happens in society,” Dr. Jones says.

Babies are not incompetent.

Kimberly Seals Allers speaks about her innovative project Be First Food Friendly.
Kimberly Seals Allers speaks about her innovative project Be First Food Friendly.

Why do we assume neonates are vacuous, otherworldly creatures?

Common medical practices wrap infants like a popular Mexican delicacy (the infamous baby burrito), separate them from their mothers and disregard their distinctive language.

When a baby is placed skin to skin with her mother immediately after birth, she performs nine instinctive stages that ultimately allows for flawless latching to mother’s breast. The nine instictive stages were originally identified by Ann-Marie Widström, RN, MTD, Doctor of Medical Science and colleagues. Skin to skin also counters the stress of being born, regulates baby’s body temperature, allows oxytocin to flow freely and has profound self regulatory skill implications later in life. It is common medical practice which demonstrates incompetency when it interrupts this seamless, delicate system.

Healthy Children faculty Kajsa Brimdyr points to one study that indicates neonates’ brilliancy. When a mother’s labor gown was given to a crying baby, the baby stopped crying. So we know scent is a highly developed sense that plays a significant role in newborns’ inclination to survive.

Further, Brimdyr explains that when an infant is placed skin to skin after a vaginal birth, his knees and legs push on mother’s abdomen forcing delivery of the placenta. Another incredible accomplishment baby arranges when allowed to do so.   mail-3

During the nine stages toward the breast, babies often rest. Speaker Ann-Marie Widström says that the relaxation stage is yet another sign of an early survival instinct; keep still and quiet so not to draw attention from predators.

Conference participants explain that it seems nearly impossible for medical staff to remain onlookers during this process and usually allow their impatience to interfere with babies’ instincts.

Healthy Children faculty Dr. Karin Cadwell and Carin Richter sarcastically joke about the contrast between the way we treat infants and other patients:
Why don’t we have the same respect for babies?
It would be absurd to say to the cardiac patient: “Oh, you’re just having chest pain, oh you’re just blue…”
Babies have needs too. Why do we disregard or respond mistakenly to the way they communicate?

Karin Cadwell presents our galaxy, Our Milky Way.
Karin Cadwell presents our galaxy, Our Milky Way.

Birth, breastfeeding and parenthood are a continuum.
Fragmented specialty care in America makes it difficult to provide consistent, clear information for patients.

“Our system divides the nursing mother and baby into two specialty care divisions, peds and OB/Gyn,” Healthy Children faculty Cindy Turner-Maffei explains. “That would be considered ridiculous to do in pregnancy.”

It’s ridiculous too, to expect mothers and babies to be successful at breastfeeding when their birthing experience involves scalpels and suctions when not medically indicated.

And when mother and baby are not given the opportunity to organically bond through skin to skin and breastfeeding, parenting can become an increasingly difficult, unpleasant endeavor with long-lasting effects.

We must remember that birth has everlasting consequences.

When we disregard excuses, we will make change.
How many reasons can you think of why you cannot go on vacation? Brimdyr asks us to brainstorm reasons and the group creates a rather lengthy list.mail-6

“But you always find a way…” Brimdyr concludes.

Applying this idea to the humanization of birth and breastfeeding allows for less intimidating models of change.

Brimdyr, Widström and Kristin Svensson, RN, Midwife, Doctor of Medical Science offer several suggestions to initiate change within our medical system:

Breastfeeding is not a personal or private issue.
Long-time, maternal infant caregiver Nikki Lee, RN, MSN, IBCLC, ANLC, CIMI, CCE, CKC recently wrote The dollar value of human milk. which has an incredible, fresh perspective on the value of breastfeeding. She shares an ingenious equation that calculates the monetary value of breast milk per state. Her post is a must-read. Find it here: http://www.breastfeedingalwaysbest.com/what-the-world-needs-to-know-about-human-milk/.

Specificity is key.

mail-1When The Joint Commission (TJC) expanded its performance measure requirements, many lactation care workers performed their happiest happy dances. Beginning in 2014, all hospitals delivering  greater than 1,100 babies annually will be required to implement the Perinatal Core Measure Set which includes exclusive breastfeeding targets. Hurrah! But wait, TJC’s core set measures exclusive breast milk feeding. Breast milk feeding is not the same as breastfeeding, all of us conference-goers agree.

Cadwell and Turner-Maffei created an activity that opened conversation to define breast milk feeding. It was a challenging task! Our groups considered donor milk, wet nursing, cross nursing, shared human milk feeding… There is much room for interpretation. And while indirect human milk provision is still superior to artificial baby milk concoctions, breastfeeding between biological mother and baby is number one on the World Health Organization’s hierarchy of infant feeding.

A call for specificity can be applied to issues surrounding Step 4 of BFHI as well:  Help mothers initiate breastfeeding within one hour of birth. An accurate interpretation of Step 4 is the implementation of skin to skin immediately, continuously and uninterrupted until completion of the first successful breastfeeding. We are getting closer, but what is skin to skin comprised of? Proper skin to skin implementation is a fully naked infant, only diapered, placed stomach down on its mother’s fully naked upper body. So you see when we fail to deliver specifics, moms, medical staff and supporters can get lost in translation.

Linda Smith, BSE, FACCE, IBCLC discusses Lyme disease implications and related tick-borne infections during pregnancy and lactation.
Linda Smith, BSE, FACCE, IBCLC discusses Lyme disease implications and related tick-borne infections during pregnancy and lactation.

A personal thank you to all of the conference participants for enlightening me and for furthering my passion for healthy children, healthy women, healthy families and healthy communities!

Congratulations to Dr. Julie Mennella for receiving Healthy Children’s prestigious Milk Shake award for shaking up lactation-based research. And congratulations to Kristin Svensson who was also awarded a prestigious Healthy Children award for her contribution to advancements in maternal infant health.

For more information about upcoming Healthy Children conferences, cruises and other educational opportunities please visit http://www.centerforbreastfeeding.org/.

Visualizing change

Two tables across from my husband, daughter and me, a woman pulled a fuzzy green nursing cover from her Petunia Pickle Bottom diaper bag and positioned her infant to nurse. Since I have begun paying attention, this is the first breastfeeding dyad I’ve seen in public.

My initial reaction was to hug and kiss the woman and thank her profusely for making such an important choice for her child.

When I calmed down, I remembered that the way she feeds her child is normal. I wouldn’t congratulate her for sending her child to school, nor would I congratulate her for changing its soiled diaper.

As we continued eating our meals, my husband said to me, “You should nurse Willow too so that woman doesn’t feel uncomfortable.”

A simple stop at Red Robin (cringe) turned into something so much more. I was elated to finally watch a mother other than myself breastfeed her child, but I was reminded of how much more progress our society needs to make to support breastfeeding families.

Why do moms bother with fuzzy green nursing covers? Why have I only witnessed one nursing mother in years? Why do we automatically assume mothers are uncomfortable nursing in public?

mailNot long after this experience, I had the opportunity to speak with Nurse Manager and Maternal-Child-Health Coordinator for Penobscot Nation Health Department and Clear Light Holistic Midwife Andrea Mietkiewicz, RN, CPM, CLC.

Because of her enthusiasm and passion for maternal infant health and the projects she immerses herself in, I am optimistic about future breastfeeding outcomes in our nation. But until I see floods of nursing dyads instead of floods of bottle-fed babies, I’m not convinced we are where we need to be.

Mietkiewicz and filmmaker Nicolle Littrell of  Woman in the Moon Films recently released Mothers, Grandparents, Fathers: Breastfeeding, Support, Tradition and the Penobscot Nation, a film documenting a program launched in June 2012 that facilitates and supports breastfeeding in Penobscot Indian Nation on Indian Island, Maine. It’s simply referred to as The Breastfeeding Program.

Breastfeeding 101

The film was funded as part of a grant awarded to United South and Eastern Tribes (USET) by the National Library of Medicine. Because of its previous breastfeeding work, Penobscot Nation Health Department was chosen to implement trainings addressing gaps within breastfeeding education, Mietkiewicz says.

Simultaneously, Littrell worked on her masters thesis on midwifery care and homebirth and suggested capturing the trainings on film.

Andrea and Evelyn at the first training.
Andrea and Evelyn at the first training.

The first training called Passing on Healthy Tradition Through Breastfeeding taught by Clear Light Holistic Midwifery Midwife Apprentice Evelyn Conrad, ICCE, CD DONA, HBCE, CLC, CH, targeted uninformed generations, ones that may have a significant influence on breastfeeding families.

The film calls this generation Wisdom Keepers. The training taught Wisdom Keepers things like the marble-size of an infant’s stomach, the dangers of supplementation and natural infant behavior.

The second training also taught by Conrad included information on natural weaning and general safety training.

Dr. Karin Cadwell of Healthy Children Project taught a third training: How to Help a New Mom be Successful at Breastfeeding.

Addressing barriers

Initially, the film showed within the Penobscot Community but was forwarded to Midwives Alliance of North America (MANA) so that it could be used within necessitous communities.

Mietkiewicz says hospital workers are an important audience.

She specifically cites employees at Eastern Maine Medical Center so they’re able to see the changes being made within maternal infant care in their area.

Mietkiewicz boldly says that anyone in the formal healthcare setting should be ashamed of the gaps in breastfeeding care.

She has a 98 percent breastfeeding success rate in her practice.

“I don’t feel like it’s difficult to obtain,” she says.

Esther nurses baby Aven.
Esther nurses baby Aven.

She explains that in general, hospitals are women’s biggest barrier when it comes to successful breastfeeding by inhibiting skin to skin, promoting supplementation, keeping baby from mother and cutting lactation care workers.

“Breastfeeding is on the bottom of their list,” she says. “You cannot expect to catch up later.”

Mietkiewicz says change needs to come from outside of the hospital.

“We need to show a different picture,” she says.

Painting the picture

In an attempt to normalize breastfeeding, a Penobscot Community art teacher took pictures of Naya and Esther Mitchell, two sisters showcased in Mothers, Grandparents, Fathers: Breastfeeding, Support, Tradition and the Penobscot Nation, nursing their exquisite infants. The artist projected the images on plywood and created large cutouts to display in the community’s walk-in clinic.

Andrea poses with Naya (left) and Esther (right) Mitchell walk-in clinic cut-outs.
Andrea poses with Naya (left) and Esther (right) Mitchell walk-in clinic cut-outs.

“The first thing you see are women breastfeeding,” Mietkiewicz says. “That’s what needs to happen all over the place.”

Amen!

“If we want to attach people to the project, the best way is to personalize it,” Mietkiewicz says. Including images of the community’s mothers and babies is an effective way to get others connected to and excited about the project she adds.

CLCs role in community care

While peer mentoring is an important part of the Penobscot Nation’s breastfeeding efforts, Mietkiewicz says certifying peer counselors as lactation counselors will further strengthen their community care model. She is currently arranging for Healthy Children Project to bring the Certified Lactation Counselor (CLC) training to Penobscot Nation.

Mietkiewicz tells me about a potential breastfeeding challenge unique to a large portion of the Native American population: milk protein allergies. She says a lot of breastfeeding moms report fussy, colicky babies, so they switch to formula thinking this will solve their baby’s condition.

Alexandra nurses Silas.
Alexandra nurses Silas.

Milk protein allergies can usually be eliminated within the first year of baby’s life when a breastfeeding mother restricts all milk proteins like casein and whey from her diet. It sounds awful, but it can be done- I gave up curdy delicacies when my daughter was diagnosed with the allergy.

A CLC can offer unequaled support when surmounting a challenge like this. While I sometimes wish I had encouragement from a fellow CLC, I’m happy to report that Willow is now free and clear of her allergy. Victory.

Mietkiewicz also tells me her community faces extremely high diabetes rates. In fact, many Native American peoples are at greater risk for diabetes. A specific study of the Pima Indians can be found here: http://www.ncbi.nlm.nih.gov/pubmed/9704241. Mietkiewicz cites this as another potential breastfeeding challenge unique to Penobscot Nation. It’s important to remember that “breastfeeding may be particularly important in tribal communities because of its ability to alleviate health problems, such as infant mortality and diabetes…

Saving resources and lives

Mietkiewicz is determined to establish a milk dispensary in her community to assist mothers and babies in uncommon circumstances because donated human milk saves lives.

With money leftover from the USET grant, Mietkiewicz purchased two locked freezers and a pasteurizer. Mietkiewicz says the milk would be offered free of charge. She calls it “native milk for native babies” and stresses the importance of providing live, genetic material for infants in need.

Contented baby Silas.
Contented baby Silas.

Mietkiewicz also says she is pushing for implementation of milk banking at the community’s hospital but has run into a financial obstacle.

“The milk is not a cost hospitals are willing to assume,” she says. “A hospital is a business.”

Spelling out her confusion, she wonders why the businesses won’t swallow the milk’s four-dollars-per-ounce processing fee when not providing human milk to babies in need will incur hundreds of thousands of dollars in future healthcare costs.

“We can save so many resources with just this one simple thing,” she explains.

Requesting assistance with her milk banking efforts, Mietkiewicz recently wrote to First Lady Michelle Obama.

Naya nurses baby Bennally.
Naya nurses baby Bennally.

“There’s never an end to the problem,” she says. “I’m going logistically from one to the next to the next.”

While the fix-it list seems never-ending, Mietkiewicz remains optimistic.

“The whole government is even changing its feeling about the importance of breastfeeding,” she says. “That is a huge step for the government to acknowledge the importance.”

Watch Mothers, Grandparents, Fathers: Breastfeeding, Support, Tradition and the Penobscot Nation here: http://vimeo.com/53639153

Find Clear Light Holistic Midwifery on Facebook.

For more information about Nicolle Littrell’s work click here. She is currently working on a project for Midwives Alliance of North America (MANA) called I am a Midwife.

A dynamic dean for Union Institute & University

Carolyn Turner Dean of Union Institute & University’s Cincinnati Undergraduate Center Dr. Carolyn Turner recently completed Healthy Children Project’s Center for Breastfeeding’s Certified Lactation Counselor (CLC) Training in Milwaukee, Wis.

Can you imagine my excitement when I heard the news?! A bunch of soon-to-be lactation counselors in my neck of the woods- such a treat!

Dr. Turner, who coincidentally studied at Marquette University in Milwaukee, calls the CLC course enlightening.

“I had no idea there were so many facets to breastfeeding,” she says.

Moreover, she says it’s surprising that women breastfeed successfully without proper support, like the kind CLCs can provide.250px-UI&U_logo_square

When Dr. Turner was appointed dean in June 2008, she says she was a fair advocate for the
Bachelor of Science major in Maternal-Child Health: Lactation Consulting.

The program provides evidence-based instruction and is tailored to experienced lactation professionals and newcomers to the field. Graduates “have a strong foundation of research, evidence and skills and will be qualified to professionally counsel expectant mothers and mothers of young infants about best practices for the care and feeding of the young infant.” [retrieved from: http://www.myunion.edu/Academics/BachelorsPrograms/MaternalChildHealthLactationConsulting.aspx] While Dr. Turner says she saw a lot of potential in the program, there was a need for change in organizational structure.That’s when she appointed Healthy Children Project, Inc. (HCP) faculty member Dr. Anna Blair as department chair. Dr. Turner says she wanted to create a powerful synergy between UI&U and HCP.Dr. Blair has overseen, revamped and revised the Maternal-Child Health curriculum as needed.

“It has made all the difference in the world,” Dr. Turner says.

Integrating academics and recruitment activities and creating positive interaction between staff and inquiring students have also been at the forefront of Dr. Turner’s work.

She admits she’s not fond of the paper shuffling which her duties often entail. She says she prefers digging into the majors and engaging in training like the CLC course.

“I can go back to the office with knowledge that I didn’t have and understand how to better support the program,” Dr. Turner explains.

The Maternal-Child Health program combines on-site and distance learning. It also integrates theory and practice.

“It’s a really good example of providing the benefits of a hybrid learning environment,” Dr. Turner explains.

UI&U currently offers eighteen bachelor’s programs and the Maternal-Child Health degree is the only health-related program. Dr. Turner says it’s unique simply in that regard.

She adds that UI&U strives to provide students with social consciousness and responsibility.

“What’s more socially responsible than focusing on babies and mothers?” Dr. Turner asks.

With a hint of pride and a dash of surprise in her tone, Dr. Turner says that she will be able to help moms breastfeed effectively after completing the CLC course.

With the education UI&U Maternal-Child Health: Lactation Consulting graduates gain, she has confidence in what lies ahead.

“They have the potential to change the whole landscape of breastfeeding,” Dr. Turner says.

For more information about the partnership between UI&U and Healthy Children Project, please visit: http://www.myunion.edu/Academics/BachelorsPrograms/MaternalChildHealthLactationConsulting.aspx.

The baby-led way

Willow experiments with food at 6 months and loves it!
Willow experiments with food at 6 months and loves it!

Sensationalism sells. When The Steve Harvey Show covered “extreme” parenting practices back in September, he fueled a fire that burns basic biology.

I cringed at his misunderstanding of the “baby-led way.” Doesn’t he know that baby-led weaning (BLW) is perfectly normal, effective, and so easy?! It made introducing food to my daughter Willow a total blast.

Gill Rapley, second from right, engages in a meeting with parents in a bookstore in Poland.  She is accompanied by a Polish publisher, a dietitian and an interpreter.
Gill Rapley, second from right, engages in a meeting with parents in a bookstore in Poland. She is accompanied by a Polish publisher, a dietitian and an interpreter.

Gill Rapley is a former midwife and health visitor, international authority on BLW and co-author of several books including Baby-Led Weaning and her latest release Baby-Led Breastfeeding which I was fortunate enough to have the opportunity to help adapt for an American audience. Rapley says that there is always going to be a strong reaction to breastfeeding in the media because of the influence of formula companies.

She adds, “The media’s portrayal of baby-led weaning is consistently bad.”

BLW is a method of allowing children to feed themselves complementary foods when weaning begins.


Finding a balance

Often times, media’s discussion ceases to be exciting if it’s not alarmist. Rapley suggests “playing it down” and “sneaking in under the radar” in order to normalize BLW as well as breastfeeding.

She notes that The Steve Harvey Show did not present a balanced discussion because the moms supporting BLW weren’t given a chance to speak.

“They went into it excited about the chance to spread the word about baby-led weaning and they ended up like rabbits in the headlights,” she says.  “Every question they were asked was phrased in a negative way, so that they were forced to be on the defensive and they weren’t given time to respond fully to any one question.”
With the hopes that any news is good news, Rapley anticipates some viewers were prompted to do their own research.
Attempted spoon-feeding. Willow does not approve.
Attempted spoon-feeding. Willow does not approve.

Anecdotal evidence suggests that BLW encourages children to:

• choose a healthy diet with a wide variety of foods
• control his or her own appetite
• chew earlier which may improve facial development and speech
• become more dexterous
• improve hand-eye coordination

“Baby-led weaning generally encourages independence,” Rapley explains. “There is nothing to suggest that spoon feeding will improve any of these areas.”


The research

Rapley suggests not getting caught up in small studies around BLW though.

“The idea that we do feeding to a child is what we need to get our heads around,” she says.

Rapley admits that developing research around BLW is difficult because optimally, longitudinal studies should be considered. Randomized control tests will not work.

“It’s not ethical, but also you can’t randomly assign a parent to practice BLW or not,” she says. “It’s something they commit to or not.”

As with studies concerning breastfeeding and formula feeding, there is a host of other socioeconomic factors when considering BLW.


Nothing new

Willow, 6 months, gnaws a  juicy peach.
Willow, 6 months, gnaws a juicy peach.

BLW is not different or extreme. In fact, Rapley explains that parents practice BLW all of the time; they just don’t put a name to it.

When the World Health Organization changed its recommendation to introduce complementary food from four months to six months, the need for pureed foods diminished because at this stage most babies are developmentally ready for finger foods.
“Baby-led weaning is going to become the normal on its own through word of mouth,” Rapley suggests.
However, she foresees a unique challenge to be faced by American parents.
“Families in the U.K. rarely see a pediatrician,” she explains. “I imagine families in the U.S. having a more difficult time normalizing baby-led weaning because of the pediatric lobby they have to fight against.”


Breastfeeding challenges and solutions  


But it seems no matter where a family resides, they are plagued with unnecessary breastfeeding battles.

By eliminating breastfeeding related horror stories, Rapley says she believes women will gradually understand the normalcy of breastfeeding and realize that there is no reason not to do it.

9780091935290She and co-author Tracey Murkett see Baby-Led Breastfeeding as a mother’s handbook to sit alongside the Baby-Friendly Hospital Initiative (BFHI). Rapley also suggests it as a reference for healthcare professionals.

Baby-Led Breastfeeding focuses on following baby’s instincts to ensure effortless feeding. Still, Rapley and Murkett are not quick to dismiss formula.

“We didn’t want to alienate any group of readers,” Rapley explains. “We did not want to overtly support formula feeding but wanted to manage to support moms who choose it.”

With an overwhelming wealth of infant feeding information at most families’ fingertips, Baby-led Breastfeeding serves as a “ sensible and sensitive voice” (retrieved from http://theexperimentpublishing.com/ourbooks/parenting/baby-led-breastfeeding/) that encourages moms to get to know their bodies and their babies.

Rapley and Murkett avoid overly scientific breastfeeding explanations in their new release.

“There is a lot of research that I call ‘so what’ information,” Rapley says and stresses the importance of mothers simply spending time with their babies.

For more information about the Baby-Led brand click here. Follow Gill Rapley on Twitter @gillrap.

Breastfeeding integration through collaboration

“Boobie, boobie,” my 16-month-old Willow insists I nurse her beloved doll as she hoists my breast toward its mouth.

“Boobie, boobie,” she reaches down my mother’s and grandmother’s shirts when mine aren’t in sight.

“Boobie, boobie,” she squeals each morning as I groggily stir from slumber.

Infant and young childrens’ admiration for breasts is hilarious at times but also signifies something greater: their natural inclination to survive.

That said, the people who dedicate themselves to mothers’ and children’s breastfeeding journeys, the ones who help advance the field of human lactation and the ones who help families achieve the healthiest starts for their children, should be celebrated.

I feel so privileged to be able to attend Healthy Children Project’s upcoming 17th Annual International Breastfeeding Conference in Orlando where these amazing people will come together to network, learn and have a great time!

Learning from one another 


Screen shot 2012-12-30 at 8.33.16 PM
Of these incredible lactation care workers is Breastfeeding Coordinator at Maternity Care Coalition (MCC) Katja Pigur, MEd, CLC who will speak about developing a collaborative approach to MCC’s Breastfeeding Friendly Philadelphia Campaign. Pigur says she is looking forward to connecting with and learning from other lactation professionals and supporters.

“Every community is really unique and I really believe we can learn from each other,” she says. “At the end, it’s all about joining efforts.”

While Pigur says the field of lactation can sometimes be exhausting, coming together with other professionals and engaging in open conversation will be uplifting and energizing.

“I am looking forward to having a good time together and coming home with new energy.”

CLC diversity

Pigur says she became interested in becoming a Certified Lactation Counselor (CLC) when she started specifically addressing barriers to breastfeeding through her various projects with MCC. Having breastfed her son, she says she is personally familiar with the barriers to breastfeeding.

“The CLC training is really great because you find a very diverse group that offers breastfeeding support in many different ways,” Pigur says. “It gave me insight and passion for breastfeeding.”

Healthy Children Project's “Learn to Teach the 20 Hour” course in Philadelphia
Healthy Children Project’s “Learn to Teach the 20 Hour” course in Philadelphia

For instance, healthy newborns naturally crawl to the mothers’ breast after birth to nurse when immediately placed skin to skin without interference.

“When I saw the breast crawl video, it was an ‘aha!’ moment for me,” Pigur says.

She says she realized that often healthcare is not focused on moms’ and babies’ needs but more so on what is normal for health care providers. After her CLC training, Pigur says she realized maternal infant care sometimes needs to be “hands off.”

Comprehensive care model

Although Pigur suggests a hands-off approach at time, the services that MCC provides are very involved.

Services provided to families are home-based.

“It’s a very different perspective when you go into the home of the clients,” Pigur explains. She says that home visits provide a unique opportunity to involve the whole family in breastfeeding education and support.

To encourage breastfeeding from the start, MCC integrates breastfeeding education into its pregnancy programs.

MCC is currently engaged in a pilot project that sends doulas also certified as lactation counselors to areas of the community with very low breastfeeding rates.

“The program really provides comprehensive support,” Pigur says.

Eventually, MCC plans to expand services to a larger area.

Extending services

MCC’s Breastfeeding Friendly Philadelphia Campaign (BFPC) launched in 2010 to support employers and healthcare facilities in their efforts to implement breastfeeding support.

Efforts are funded by the Get Healthy Philly campaign of the Philadelphia Department of Public Health and the W.K. Kellogg Foundation. [Retrieved from: http://maternitycarecoalition.org/public-policy-blog/breastfeeding-critical-to-infant-and-maternal-health/#.UNXumo5hWfQ]

2012 Breastfeeding Friendly Model Employers honored at a public ceremony during World Breastfeeding Week.
2012 Breastfeeding Friendly Model Employers honored at a public ceremony during World Breastfeeding Week.

BFPC works closely with four of the six birthing hospitals in Philadelphia, all of which are on their way to achieving Baby-Friendly designation, Pigur says.

BFPC also helps business owners comply with the 2010 Patient Protection and Affordable Care Act which ensures breastfeeding employees are provided breaktime to pump for nursing children. For more information on MCC’s Breastfeeding-Friendly employers, visit http://maternitycarecoalition.org/professionals/public-policy/breastfeeding/employer-spotlights/.

To further breastfeeding support, many Philadelphia business owners have pledged their businesses Breastfeeding-Friendly by placing a “Breastfeeding Welcome Here” decal in their windows. BFPC asks that business owners train employees to accommodate breastfeeding patrons. Find a list of Breastfeeding-Friendly employers and businesses here.

Starting conversation

When BFPC was in its infancy, Pigur says that it was difficult to get the conversation going about breastfeeding.

“You have to find the right people that are open to talk,” she says.

Pigur also explains that in a difficult economic environment, breastfeeding support isn’t always a priority for business owners. In reality, supporting breastfeeding employees saves a business money even if it is initially perceived as a financial hurdle.

“There is still a lack of acknowledgement of the far reaching consequences of not supporting [breastfeeding],” Pigur explains. “People don’t really see it as a public health issue.”

To remedy this, Pigur suggests creating open conversation about breastfeeding within the community.

For other communities looking to implement a program similar to BFPC, Pigur has this advice:  Don’t be afraid of conversation. Think strategically. Involve yourself. Initiate change.

Additionally, she says that it’s always good when you can show some kind of success.

“When you start something, look for low hanging fruit,” Pigur explains. “When you have those you can build up a track record of success.”

She adds that reinventing the wheel is wasted energy.

When implementing BFPC, she looked across state borders at other programs and adjusted them to the needs of her community.

Remaining in a bubble won’t change anything she says. Instead, Pigur again suggests approaching everyone in the community to open greater conversation.

“That gives you the opportunity to address concerns and doubts,” she says. “The more you talk about it, the more you’ll normalize breastfeeding.”