Co-sleeping denunciation does disservice to Milwaukee families

An adorable, diapered baby sleeps amidst a cloud of fluffy bedding.  He snuggles up to a butcher knife strategically tucked under the pillow next to him. The text reads: Your baby sleeping with you can be just as dangerous.

This ad and others are part of an anti co-sleeping campaign in Milwaukee, Wis. launched in Fall 2011. The campaign responds to Milwaukee’s staggeringly high infant mortality rates and aims to reduce those numbers by 2017.

The city suffers from some of the worst infant mortality rates in the world. Milwaukee ranks seventh worst among 53 of the largest cities in the U.S.

The disparities between African American and white infant mortality rates are even more startling. African American infant death is nearly three times that of the white community’s. [Retrieved from: http://www.jsonline.com/news/milwaukee/milwaukee-infant-mortality-rate-drops-overall-but-disparity-worsens-sp54t7f-148680905.html]Angela

Angela Lang, RN, IBCLC, ANLC and co-chair of the Milwaukee County Breastfeeding Coalition (MCBC) serves on the Fetal Infant Mortality Review (FIMR) through the Racine Public Health Department.

FIMR is designed to learn what can be done to prevent fetal and infant deaths from occurring. FIMR is part of the National Infant Mortality Review.

“If we knew why Milwaukee’s infant mortality rates are so high, we would have solved the problem,” Lang explains.

But it isn’t a coincidence that all of Milwaukee’s infant deaths in 2009 and into 2010 shared one common factor: all of the babies were formula-fed, as reported by Fox 6 News Milwaukee.

Co-existence

In Wenda Trevathan, Euclid O. Smith and James McKenna’s Evolutionary Medicine,  we learn that “Infants and mothers sleeping within arms reach (co-sleeping) with nighttime breast-feeding represents the evolutionary stable sleeping arrangement…”

In fact, “Co-sleeping may facilitate a unique sensory bridge within the mother-infant dyad that maximizes the chances of optimal development…” [Trevathan, Wenda, Euclid O. Smith, and James McKenna.Evolutionary Medicine. New York: Oxford University Press, 1999. 54. Print.]

As a mother who safely bed shares and breastfeeds, I find Milwaukee’s anti co-sleeping ads insulting. But insulting already breastfeeding and bed sharing families is the least of our worries.

Lang says denouncing co-sleeping altogether does a disservice to mothers in general and the way we naturally feed our babies. She agrees it’s part of our physiology to fall asleep while breastfeeding.

Instead of respecting biology, the anti co-sleeping campaign instills a sense of fear in mothers.

“Because women are so afraid of falling asleep with their babies, they fall asleep in rocking chairs or other places that are far more dangerous to sleep with your baby,” Lang explains.

In its Guideline on Co-Sleeping and Breastfeeding, The Academy of Breastfeeding Medicine concludes, “There is currently not enough evidence to support routine recommendations against co-sleeping.”

The American Academy of Pediatrics suggests room sharing but not bed sharing in SIDS and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment technical report.

And in Changing Concepts of Sudden Infant Death Syndrome: Implications for Infant Sleeping Environment and Sleep Position the AAP offers suggestions on how to safely co-sleep and bed share with an infant.

Instead of denouncing co-sleeping or bed-sharing, Milwaukee should focus its efforts on breastfeeding support and safe co-sleeping education.

Breastfeeding itself is protective against Sudden Infant Death Syndrome (SIDS).

However, it is important to note that breastfeeding alone will not protect infants from co-sleeping related deaths. Parents under the influence of alcohol or other drugs should never sleep with an infant. No one should smoke around children. Siblings should not sleep with infants. For other safe co-sleeping guidelines visit: http://kellymom.com/parenting/nighttime/familybed/.

In the article Bedsharing Promotes Breastfeeding, James J. McKenna, Sarah S. Mosko and Christopher A. Richard state that “routinely bed sharing infants breastfed approximately three times longer during the night than infants who routinely slept separately.”

If breastfeeding and bed sharing interlace, can one exist without the other?

Intervention

Lang highlights MCBC’s important collaboration with the African American Breastfeeding Network which serves to address breastfeeding disparities, increase breastfeeding awareness, build community allies and de-normalize formula use.

Lang says the African American population has around a 30 percent breastfeeding initiation rate compared to an overall 75 percent breastfeeding initiation rate. These dramatically low breastfeeding rates are linked to high infant mortality.

The numbers call for increased breastfeeding awareness and support within the community.

In 2011, Lang started working at Wheaton Franciscan Healthcare St. Francis, a Baby-Friendly designated hospital in Wisconsin.

Studies have found that implementation of the Baby Friendly Hospital Initiative’s Ten Steps to Successful Breastfeeding is an effective strategy to increase breastfeeding initiation rates in the US hospital setting.

Lang says the biggest contrast between Baby-Friendly facilities and other hospitals is that Baby-Friendly designated hospitals support women in their choice to breastfeed.

“There is a misconception that we try to force everyone to breastfeed,” she says.

In Wisconsin, over 80 percent of mothers initiate breastfeeding but that number plummets to about 16 percent exclusively breastfeeding at six months because too often, mothers are faced with Institutional and Cultural Booby Traps.

When Lang’s first son was born, she experienced pressure from medical staff to feed her baby formula.

“I needed to be an advocate for him against the medical professionals,” she explains.

Wheaton Franciscan recently completed their audit and Lang says that the hospital’s staff does a good job of implementing Baby-Friendly guidelines.

But Wheaton operates under different challenges.

“We don’t own our doctors,” Lang says. “So we can’t enforce trainings for pediatricians, obstetricians and neonatologists.”

That becomes a struggle especially when physicians practice at other locations not Baby-Friendly designated. Inconsistency and unfamiliarity with breastfeeding protocols means trouble for medical staff and ultimately mom and baby.

Public health concern

The AAP released a policy statement last year stating that “infant nutrition should be considered a public health issue and not only a lifestyle choice.”

Over one third of adult Americans are obese but
breastfeeding offers a 30 percent decrease in obesity over a lifetime, Lang says.“If you stop and think about that number, it is unbelievable,” she says.

The United States Lactation Consultant Association (USLCA) recently released a statement for Healthy Weight Week stating that “for the first time in years… obesity and extreme obesity among low-income preschoolers decreased slightly between 2003 and 2010.”

USLCA attributes the lower obesity rates to increased breastfeeding rates.

“…During the study period, the number of low-income mothers breastfeeding their babies increased by more than 10 percent,” the statement includes.

Like the AAP states, breastfeeding is clearly a public health issue; it affects all aspects of the community.

As MCBC and other advocacy groups and individuals continue their mission to normalize breastfeeding, our communities will gradually improve general health outcomes.

Lang was recently chosen by the Wisconsin Association of Lactation Consultants to extend her public health service. This summer, she will travel to Uganda to assist Josephine, an ILCA partner, with breastfeeding trainings.

Lang is also a recent graduate of the Union Institute and University/Health Children Maternal Child Health: Lactation Consulting Program.

Corrections made 3-25: Lang serves on the Fetal Infant Mortality Review (FIMR) through the Racine Public Health Department, not the Milwaukee Public Health Department. She also works at Wheaton Franciscan Hospital St. Francis, not Elmbrook. 

Speech is great, but silence is greater

I’d be willing to bet you’ve never thought to compare a circus clown to a nursing mother and her infant. I certainly hadn’t until I had the pleasure of speaking with Healthy Children faculty Kristin Stewart, BS, CLC.

Jay and Kristin pose in the middle of Clown Alley.
Jay and Kristin pose in the middle of Clown Alley.

“With circus clowning, you can’t speak,” Kristin explains to me. “Someone in the top row of the arena isn’t going to hear you.”

Instead, circus clowns resort to non-verbal communication.

“If you’re good at what you do, the people in the back will know exactly what you’re doing and why it’s funny.”

Somewhat recently, the stars aligned in such a way that Kristin ran into childhood friend and Healthy Children faculty Kajsa Brimdyr. Shortly after, Kristin began working with HCP.

Having nursed both of her children, Kristin tells me that she has always been interested in lactation on a personal level.

“But once you start really learning, you become more and more passionate,” she says. Kristin is inspired by the idea that something so personal has sweeping influences on “the big picture.”

Since working with HCP, Kristin has also become fascinated by the unspoken communication between the breastfeeding pair, similar to clown and audience.

“There are all sorts of unspoken language,” Kristin explains.

For instance, infants display a wealth of feeding cues other than crying. For more information about infant feeding cues visit: http://www.amazon.com/Pocket-Guide-For-Lactation-Management/dp/1449687784/ref=sr_1_1?ie=UTF8&qid=1360015618&sr=8-1&keywords=pocket+guide+lactation and http://www.nal.usda.gov/wicworks/WIC_Learning_Online/support/job_aids/cues.pdf.

The more time a mother spends with her child, the better she will understand those cues. Kristin explains that this learning of infant body language is not a conscious process. She refers to it as a “subconscious soaking in.”

Health care providers’ disinterest

Kristin describes another non-verbal, subconscious experience.

“I’m sure it’s happened to you,” she tells me. And she’s right.

“You go in to see your [healthcare] provider and you are clearly not what they are thinking about,” she describes the familiar situation. “It’s a subconscious feeling that ‘I’m not important to this person.’”

Because of this scenario she offers this advice to lactation professionals: Really listen, listen to mom and listen to baby.

Kristin knows lactation care workers face unique challenges. She asks us to remember that we’re not alone and to seek support when needed. Getting the support you need will only enhance your ability to encourage mom and baby.

Not your average herstory

After graduating with an Ivy League liberal arts degree, Kristin decided to attend Ringling Bros. and Barnum & Bailey®’s Clown College in the early 90s.

Kristin married her husband and fellow clown, Jay, a few years after graduation. Two years later, they welcomed their first born Karen into the world.

The Stewarts pose with daughter Karen for a Good Housekeeping article.
The Stewarts pose with daughter Karen for a Good Housekeeping article.

When Karen was just eight months old, the Stewarts made a brave choice to leave their vinyl flooring jobs behind and journey to Japan where Jay had been offered a clown position.

“It was terrifying and exciting and all of those things,” Kristin says.

After spending about a year in Japan, the Stewarts were offered a place in the Ringling’s Red Unit where Jay served as Boss Clown.

Currently, Jay performs with Big Apple Circus’ Clown Care a signature community outreach program that offers classical circus entertainment to hospitalized children at 16 leading pediatric facilities across the United States. [Retrived from: http://bigapplecircus.org/clown-care]

Togetherness

Circus life, a life defined by its commitment to family and community, allowed Kristin time to develop the delicate, non-verbal relationship she’s fascinated by with her second born, Nicholas.

He was only three weeks old when Kristin hit the road with the circus again. She wasn’t performing at that time, but she worked in the circus’ nursery. This allowed Kristin and Nicholas to be with one another very often.

“The time that the circus gave me as a mother was hugely instrumental in my breastfeeding success,” Kristin says. “There was never any pressure to go back to [performing.]”

Kristin’s nursing experience with Karen was more of a struggle.

She tells me Karen was born in a huge facility in Atlanta where locating a lactation consultant was a chore.

Lack of and inconvenient lactation care access remains a huge barrier to mothers’ breastfeeding success everywhere. Measurable steps have been taken by the Affordable Care Act to make services more reasonable for mothers.

Not only did Karen face insufficient access to lactation care, she was afraid to ask for help. Why is it that many women feel like they have to do everything alone? Is it the pressure society puts on us to be flawless in every aspect? Is it because we don’t know where to ask for help? Is it because we’ve lost a sense of sisterly community?

“It’s such a cliche but the circus is such a family-centered place to be,” Kristin says comparing her nursing experiences. “Babies in the circus are everyone’s babies.”

Kristin says she felt embraced by this sense of togetherness while nursing Nicholas.

“There are so many great people,” she says.

The Stewarts became especially close to the 12 to 16 performing clowns.

“They became our extended family,” says Kristin.

When Karen was about 20 months old, Lisa, a family friend came to visit the Stewarts on the road. While Lisa carried Karen around backstage during Kristin and Jay’s performance, she recalls at least six people stopping her wondering, “What are you doing with the Stewart baby?”

“She was so happy to know that we were so safe with the circus,” Kristin says.

Consistent prenatal care

The stories of the Stewart family adventures only get wilder.SFE Family shot

A typical week looked like this: Arrive in a given city on Tuesday or Wednesday, load in, perform Wednesday and Thursday night, perform two shows on Friday, three on Saturday and two on Sunday. Sunday night the crew hit the road for the next city which could be anywhere between six and 20 hours away.

Imagine going on an extended road trip for the duration of your pregnancy!

Kristin explains that obstetricians many times refused to see her for prenatal care only once while she passed through the city. Luckily, Kristin’s theatrical talent served her well.

“Often I would have to call and say ‘I’m moving to the area…’”

Kristin simply carried her medical records with her. As a second-time pregnant mom, she says she was confident about her pregnancy even without traditional prenatal care.

“The circus provides outstanding health insurance,” she adds.

Several weeks before Nicholas was due, Kristin traveled to her home on the Cape.

“I wasn’t willing to just go to any hospital,” she explains. “It wasn’t a comfortable option for me.”

Once again, the stars aligned in such a way that Jay happened to be performing only a few hours away when she went into labor. He attended the birth.

“The timing was unbelievable,” Kristin laughs.

To read more about responsive parenting and infant self-regulation click here, here, and here.

Please note: it is vital for moms to have access to all lactation care workers. CLCs, advocate for your services by contacting insurance companies and let them know what a difference you make for moms, babies, families and communities.

Coming soon… The Milky Way Movie: Nursing a Galactic Revolution

I have a lot of faith in the future of breastfeeding. Lactation professionals like Jennifer Davidson RN, BSN, IBCLC and Chantal Molnar RN, MA, IBCLC dedicate every cell in their bodies to breastfeeding advocacy.

I recently had the opportunity to speak with them about their feature length documentary The Milky Way Movie: Nursing a Galactic Revolution formerly known as  Bottled Up!. It is scheduled for release in June 2013.

65540_434360679972649_1441959782_nThe nursing mother has disappeared from our cultural landscape; the sexual breast usurped the mothering breast. I’m sure you’ve noticed. The Milky Way Movie is an exposé about breastfeeding in America and intends to restore the Phenomenon of the Nursing Mother to our culture. [Retrieved from: http://www.bottledupthefilm.com/bottled-up-the-film/]

Even though the bottle has become the “most recognizable symbol of infancy,” there’s some good news: Eventually, thanks to projects like The Milky Way Movie, the tides will turn and nursing dyads will flood the streets once again. Ideally, an infant will consume artificial baby milk only when medically indicated.

The less than ideal news: breastfeeding is a crucial public health issue. We don’t have time for the eventual, the pending, the future. Changes within our maternal infant care model need to happen now.

Even so, there’s more good news: The Milky Way Movie is going to have monumental impact. It’s release date couldn’t come any sooner.

We cannot be what we cannot see

The Milky Way Movie has serious potential when it comes to normalizing breastfeeding in our culture through the power of images.

Jennifer Davidson RN, BSN, IBCLC
Jennifer Davidson RN, BSN, IBCLC

Davidson cites the film Miss Representation as inspiration for The Milky Way Movie’s imagery.

“You cannot be what you cannot see,” she quotes. “For us, the imagery is to show mothers and babies doing this amazing thing.”

The duo tells me about their experience filming a medical facility where very tiny, less than 1,000 gram babies, go skin to skin with their mothers, a method often referred to as Kangaroo Mother Care.

The facility accommodates families in big rooms equipped with incubators for each baby and even beds for dads. Babies live on their mothers’ chests almost always..

“She’s with that baby wrapped and skin to skin no matter how many tubes there are,” Davidson explains.

Most infants are discharged once they reach 1500 grams… that’s just over three pounds. Incredible!!

When I ask in amazement, Where is this place you speak of?!, the duo and I half-heartedly joke, Obviously not in America.

While rules vary, most low birth weight (LBW) babies aren’t discharged from hospitals in the U.S. until they reach about five pounds.

Please note, I am not bashing our extraordinary country. The problem is that what Davidson and Molnar filmed should be happening everywhere; it saves lives with minimal resources but for whatever reason(s), we aren’t advancing maternal infant health even when the solutions are quite simple.

Chantal Molnar RN, MA, IBCLC
Chantal Molnar RN, MA, IBCLC

“When you go to Europe, you see imagery… it’s up and around and honored,” Molnar says of breastfeeding iconography. “People can see it and it is a part of their culture.”

By photographing or painting an image, not only are you creating normal imagery, but you are putting it on a higher pedestal, Davidson says.

“We don’t have iconography that elevates us into that place of honor. It’s amazing what our culture has done to the nursing mother,” Davidson adds.

(By amazing, she means deplorable.)

In places like Norway and Sweden, around 90 percent of infants exclusively breastfeed in their first week of life.

In the U.S., about 75 percent of babies initially breastfeed and those rates plummet once the infant reaches six months .

A chance to get involved

529356_420650754676975_694487862_nThe Madonna Mosaic serves to raise money for the film and to further Davidson and Molnar’s goal to glorify nursing mother imagery.

The Mosaic image will be used in the marketing campaign for The Milky Way Movie.

Here is how it works:
1. Contribute $20.00 to this fundraising campaign in support of the movement.
2. Send your nursing photograph to mosaic@bottledupthefilm.com (please limit the image file size to 2Mb).
3. Images will be collected and the mosaic will be created.

The film’s team offers these incentives:
1. You’ll receive a digital download of the final Madonna Mosaic poster image.
2. You’ll also receive a complimentary digital download of the film upon its release.
3. Your name will appear on our Mosaic Participants page (or you can choose to remain anonymous).
4. Sincere gratitude for supporting Bottled Up! and the movement.

Normal, not super-duper

The Milky Way Movie’s imagery is coupled with important adherence to language advice given by Diane Wiessinger in her article Watch Your Language.

“When you say ‘breastfeeding decreases,’ you are using formula as the norm,” Molnar explains. Instead, breastfeeding normalizes our risk for diseases like breast cancer.

“It is not this special, super-duper thing that is like a vitamin pill,” she continues.

Molnar’s realism is something to appreciate. I have conflicting thoughts about the glorification of breastmilk. On one hand, we need to realize that it really is an incredible, remedial, living substance but on the other, breastmilk’s veneration doesn’t make it normal. Instead, it makes breastfeeding seem unachievable when that’s simply not the case.

It’s increasingly important to use similar language around birthing practices. For instance, natural birth is normal birth. We should be focusing on the harm certain hospital practices do rather than defending midwifery and out of hospital births.

A call for action

As excited as I am about this film, in all honesty, I would prefer that it never needed making in the first place.

The reality: After years of working with mothers and babies at the unique and progressive practice of Dr. Jay Gordon, Davidson recognized a consistent need to provide her clients with essential tools to enable them to trust their bodies, trust their babies, and trust themselves. [Retrieved from: http://www.bottledupthefilm.com/bottled-up-the-team/]

Davidson and Molnar visit a client.
Davidson and Molnar visit a client.

“People that go there are part of a rather elite crowd,” Molnar says of Dr. Gordon’s practice. “Even that select group of people is getting the cultural message that our bodies aren’t good enough.”

Molnar calls her background odd in that she has worked both in the home birth setting and as a labor and delivery nurse.

“When you’ve seen the extent of the influence of the medical system and how women are viewed in our medical world, it’s not a very pretty picture,” Molnar says.

Molnar worked at Irvine Medical Center for over 20 years.

“Doctors are not taught to question, to analyze or to think critically,” she says. “They are taught to be better than the next guy.”

She calls it an ugly, ugly system.

“I’m finally out of it.”

Not unscathed though. Molnar says she feels a sort of PTSD from her work as an L&D nurse.

She is currently writing a book called Failure to Progress which contrasts her experience within a homebirthing model and the formal healthcare setting.

Even now, Davidson and Molnar face challenges as professionals within the lactation field. They both agree that being considered Nipple Nazis can be rather hindering to their intentions. But name calling won’t stop them from helping mothers to trust themselves and their babies, which is what they say is the most important piece of advice out of many.

“We are so excited to make a difference,” Davidson says. “We know that the more you look at the important role of the nursing mother, you realize that it influences every aspect of life.”

For more information, to watch The Milky Way Movie’s trailer and to find out more about how you can get involved in the film, visit http://www.bottledupthefilm.com/ and Like them on Facebook.

Women don’t breastfeed, cultures do

Explore your community. Do nursing mothers have a safe place to feed their children in grocery stores, airports, places of worship, medical facilities? Are obstetric and pediatric offices void of infant formula marketing? Do your community’s billboards and bus stop advertisements feature breastfeeding mothers over images of bottles and artificial baby milk? Does common public sentiment support breastfeeding mothers and babies?

 

IMocha fabulous, breast feeding awareness.f you answered no to these questions, you’re living in a First Food (Breastmilk) Desert. 
Leading commentators and breastfeeding advocates Kimberly Seals Allers and Isabel Barillas, MPH recently launched the Be First Food Friendly Movement in several southeastern, predominantly African American cities with some of the lowest breastfeeding rates in the nation. The project aims to define and designate “first food deserts,” or under-resourced communities lacking breastfeeding support mechanisms. [Retrieved from http://befirstfoodfriendly.org/about-us/] Be First Food Friendly will eventually expand to become a national campaign.Seals Allers explains that it’s time to realize that what we have been doing has not gotten us to the goal of normalizing breastfeeding.

“This is the next frontier for helping mothers and babies,” she says of the Be First Food Friendly Movement.

Seals Allers is asking members from all communities to take action. The project features three key suggestions: Share Your Story, Spread the Word, and Sign the Petition.

Seals Allers is creating a story bank of community experiences about breastfeeding as participants share their accounts.

In her interactions, Seals Allers has found that people struggle to remember the last time they saw a woman nursing in public. (Perhaps because most nursing mothers are discreet and contrary to popular belief, we don’t whip our breasts around.) More seriously, a lack of community stories means a lack of breastfeeding. To reach more mothers, Seals Allers has extended the Share Your Story portion to social media platforms.

10/2/2012 Mocha fabulousThe Be First Food Friendly Petition requests the governors of Mississippi, Louisiana and Alabama take immediate action to transform key communities in their states into First Food Friendly environments. The goal is to collect 2,000 signatures by the end of Black History Month. Seals Allers makes clear that the petition is for everybody, not just the starting point areas. Click here to sign the petition.

Seals Allers has been engaging in the breastfeeding conversation for years.
She says she realized that women know the facts about breastfeeding, but they can’t figure out “how to fit it into the reality of everyday life.”

Through her exchanges, Seals Allers says she became increasingly aware that women feel burdened by providing healthy feeding options for their infants. Some women anticipate being restricted to their homes and that breastfeeding will minimize their life to the size of a teaspoon, as Seals Allers puts it. Others report concern that people will look at them strangely when they nurse in public and others worry about going back to work.

Seals Allers says she was inspired to bring others into the conversation to lessen mothers’ burdens.

“Women don’t breastfeed, cultures do,” she says powerfully. “Once we can capture the cultural shift around breastfeeding, that’s the next piece.”

The Be First Food Friendly Movement is innovative and exciting. Seals Allers is brilliant, energetic and influential. But the issue at hand is depressing and dark.

Seals Allers explains in a video featured on the project’s website that “culturally relevant” lactation professionals are hard to come by.

She further explains the problem in Lactation Consultants Need to Diversify Yesterday.

How can a mother in need succeed at breastfeeding when she doesn’t have access to lactation professionals who understand her culturally?

Seals Allers tells me this: If African American women have positive experiences with breastfeeding, they will become champions for other mothers. This is the bottom up approach. But she adds that there are also barriers like access to and cost of lactation professional training.

“There needs to be a change in thinking from the people that are leading the movement,” Seals Allers says. She suggests these groups become more welcoming, open and accessible.

“There really needs to be an effort. It’s not going to change itself.”

10/2/2012 Mocha fabulousLactation professionals of all backgrounds and colors play a crucial role in a landscape where women have been taught to mistrust our breasts. Seals Allers says that our ability to breastfeed is more socially than biologically influenced.

We don’t wake up thinking, “Oh, I don’t know if my liver is going to work today…” Seals Allers role plays. We certainly do second guess our breasts’ function though.

What happens when mistrust of our breasts is muddled with other cultural nuances?

Seals Allers writes a beautiful recollection of her thoughts about receiving support from a white lactation consultant in Lactation Consultants Need to Diversify Yesterday.

Breastfeeding can be an intimate and profound experience between mother and baby and mother and herself. At the same time, we need public supports to nurture our motherhood journeys.

“When we start engaging other people in the process, we are a much stronger force to do the work we want to do,” Seals Allers says. “The community is powerful.”

Photos taken from http://befirstfoodfriendly.org/ with Kimberly Seals Allers’ permission. 

Support group targets military specific challenges

2012 CLC Course at Landstuhl Regional Medical Center, Germany.  Course hosted by Mom2Mom of KMC, taught by Healthy Children’s Center for Breastfeeding.  Photos courtesy of Public Affairs, Landstuhl Regional Medical Center.
2012 CLC Course at Landstuhl Regional Medical Center, Germany. Course hosted by Mom2Mom of KMC, taught by Healthy Children’s Center for Breastfeeding. Photos courtesy of Public Affairs, Landstuhl Regional Medical Center.

Lactation didn’t become interesting to me until I became pregnant with my now 18 month old daughter. My mom exclusively breastfed both my brother and I, otherwise I had never had exposure to milk-producing breasts in my adult life. I may have witnessed nursing moms and babes in my adventures, but I’d never taken the time to stop and notice. Now lactation is all I can think about and I’m not afraid to admit it. Human milk is fascinating. Women are incredible and babies are little bundles of brilliance.

A while back, I was in touch with Amy Smolinski, CLC and Community Outreach Director of
Mom2Mom of Kaiserslautern Military Community (M2M of KMC) in Germany,  a network of breastfeeding families that helps new mothers overcome the difficulties of living far from family support to reach their personal breastfeeding goals. [Retrieved from: http://www.facebook.com/M2MofKMC/info] She, in conjunction with M2M of KMC’s four other board members, shed light upon the unique challenges military families face when it comes to breastfeeding their children.

I was so excited to learn about such a unique community and the breastfeeding services M2M provides.

Mentor influence

M2M is mainly comprised of peer mentors all of whom volunteer their time. Smolinski calls them the backbone of the organization.

M2M mentors must have breastfed for at least six months and have considered it a positive experience. Mentors must also complete a six hour, free training course offered through the organization.

“Mothers learn best from other mothers who have been through similar circumstances, or are going through them together,” Smolinski says. “Mom2Mom is about building a community network of support for breastfeeding families, and the most effective way to do that is to build one-on-one relationships.”

2012 Big Latch On/World Breastfeeding Week Celebration, Ramstein Air Base, Germany.  Photos courtesy of Emily Karissa Photography
2012 Big Latch On/World Breastfeeding Week Celebration, Ramstein Air Base, Germany. Photos courtesy of Emily Karissa Photography

M2M mentors have breastfed preemies, twins, or tandem. Some have induced lactation for adopted children. Others breastfed while working at civilian jobs or on Active Duty.  Smolinski says the organization tries to ensure that its mentors can support each mom in her individual circumstance.

“We don’t tell mothers how to succeed in breastfeeding, we ask how they define breastfeeding success–and from there we offer support to help each mother succeed according to her own goals,” she explains.

Smolinski also says it’s typical for members to start as mentees when they are pregnant and eventually become mentors.  Many former members have gone on to start Mom2Mom organizations at other military installations.

CLC involvement

2012 CLC Course at Landstuhl Regional Medical Center, Germany.  Course hosted by Mom2Mom of KMC, taught by Healthy Children’s Center for Breastfeeding.  Photos courtesy of Public Affairs, Landstuhl Regional Medical Center.
2012 CLC Course at Landstuhl Regional Medical Center, Germany. Course hosted by Mom2Mom of KMC, taught by Healthy Children’s Center for Breastfeeding. Photos courtesy of Public Affairs, Landstuhl Regional Medical Center.

M2M of KMC hosted Healthy Children Project’s Certified Lactation Counselor (CLC) Training twice in recent years.

In fact, the organization includes a rolling subcommittee dedicated to bringing the CLC Training to their area about every 18 months.

Mom2Mom of KMC requires board members to be lactation counselor certified.

“We need to be able to provide adequate support not only for breastfeeding mothers with questions, but also for mentors who may encounter breastfeeding issues outside of the scope of a peer volunteer,” Smolinski says.

She says M2M includes a pledge to provide financial support to help any future new board members take the CLC training.

For mentors looking to become CLCs, the course is an approved licensure under the MyCAA program for military spouse tuition assistance.  Smolinski says the application process is rather lengthy, but eligible military spouses interested in using MyCAA to fund their CLC training should contact the appropriate continuing education office at their nearest military installation.

M2M is currently in the process of planning to host another CLC training in early 2014.

Community involvement

2012 Big Latch On, Photo courtesy of the Stars and Stripes
2012 Big Latch On, Photo courtesy of the Stars and Stripes

In addition to peer mentoring, M2M of KMC also offers a weekly Breastfeeding Cafe, an informal setting where moms and tots get together and socialize. Moms share their experiences over a loosely-guided discussion topic, Smolinski explains.

M2M offers a quarterly newsletter, community outreach events and open houses to reach new-to-the-area pregnant and breastfeeding moms.

“We are working to expand partnerships with other community and health organizations that work with breastfeeding families in our area,” Smolinski says.

Each August, M2M holds an event in conjunction with World Breastfeeding Week and National Breastfeeding Month.

The organization recently began participating in the Big Latch On.

M2M’s current projects include revamping and expanding Active Duty programs and pursuing Baby-Friendly Designation at Landstuhl Regional Medical Center (LRMC), the only U.S. military medical center in all of Europe and Africa.

Pursuing Baby-Friendly Designation

2012 Big Latch On/World Breastfeeding Week Celebration, Ramstein Air Base, Germany.  Photos courtesy of Emily Karissa Photography
2012 Big Latch On/World Breastfeeding Week Celebration, Ramstein Air Base, Germany. Photos courtesy of Emily Karissa Photography

KMC, which includes Ramstein Air Base, Landstuhl Regional Medical Center and several other smaller military installations, is home to the largest population of Americans outside of the U.S.

LRMC has a Level 3 NICU so high-risk pregnant mothers from other areas are frequently brought to LRMC until they deliver safely and mother and baby can travel home.  KMC’s  local population averages between 75 and 100 births per month.

With such a large population served, obtaining Baby Friendly Designation at LRMC would positively impact large numbers of families.

“Our goal in seeking Baby-Friendly Designation is to ensure that all hospital staff who work with breastfeeding mothers and children are adequately equipped with accurate information to support them,” Smolinski says.

Military hospital staff face unique challenges which directly impacts mothers’ breastfeeding success.

“Between moves, deployments, and clinical rotations, continuity of policies and training is very difficult to maintain,” Smolinski explains.  “Also, each provider, nurse, and technician comes to a military treatment facility with different training and ideas about breastfeeding.”

LRMC’s eventual Baby-Friendly Hospital Designation will provide a streamline, effective and beneficial system for staff members and families.

Unique challenges

2012 Big Latch On/World Breastfeeding Week Celebration, Ramstein Air Base, Germany.  Photos courtesy of Emily Karissa Photography
2012 Big Latch On/World Breastfeeding Week Celebration, Ramstein Air Base, Germany. Photos courtesy of Emily Karissa Photography

Military families face several unique challenges to breastfeeding.
“We all live far from family support,” Smolinski explains.  “We don’t have our mothers, aunts, sisters, or best friends down the street or across town to help out when a new baby arrives.”

She adds that because of frequent deployments, trainings, and other military career duties, mothers often times don’t even have their partners around when their babies are born.

Military families move frequently, so it’s not unusual for a woman to arrive in an unfamiliar place either pregnant or with a newborn.

“Military spouses learn quickly to seek out support from each other, and we are all willing to lend support to a newcomer,” Smolinski says.  “This is especially important for breastfeeding mothers, who are making these huge adjustments with young children.”

M2M has a large population of Active Duty servicewomen who require special support while breastfeeding. Smolinski says the organization strives to ensure that all breastfeeding Active Duty mothers have access to the support of an Active Duty peer mentor. M2M also aims to foster a community that understands breastfeeding Active Duty mothers’ exceptional challenges.

M2M’s correspondence with Robyn Roche-Paull, author and founder of Breastfeeding in Combat Boots, offers a special resource for Active Duty moms.

It’s overwhelmingly inspiring to hear the different stories, challenges and triumphs that breastfeeding mothers experience. It is vital that lactation professionals consider and understand the many contexts nursing mothers encounter so to better assist them in achieving their healthy children goals.

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