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.

For more information about Mom2Mom of KMC, like them on Facebook.

Baby Steps

The Milky Way is off to a galactic start this year thanks to Progress in Increasing Breastfeeding and Reducing Racial/Ethnic Differences, a study recently released by the Centers for Disease Control and Prevention (CDC).
The study highlights that more women are breastfeeding for longer periods and that the gap between black and white breastfeeding initiation rates narrowed in recent years.

This is all great news. Celebrate!

But the study also found that only 23.4 percent of women breastfed for 12 months, the recommended duration. Twenty three point four percent is a miserable number.

Contributing author Jessica Allen, MPH, MSW
Contributing author Jessica Allen, MPH, MSW

“It depends on which way you look at,” Contributing author Jessica Allen, MPH, MSW says. She reminds me that trends are on the rise.

Still, there’s that enormous number of women not meeting recommended breastfeeding durations. Additionally, she says many mothers aren’t satisfying their personal breastfeeding goals.

That’s where support comes in.

The authors of the study place a huge emphasis on support in order to boost breastfeeding rates and duration and to further close the gap between black and white breastfeeding rates.

“We have to make sure women who want to breastfeed are receiving the support they need,” Allen says. “We need to continue to look at things that we know work.”

For instance, the CDC has compiled a Guide to Breastfeeding Interventions. The guide features information for state and local community members to choose a breastfeeding intervention strategy that best meets their needs.

“Hopefully people become familiar with [women’s] goals and the impact they have,” Allen says. She says she hopes all community sectors do their part to help women in whatever feeding choices they make.

CDC Director Tom Frieden, M.D., M.P.H. comments on Progress in Increasing Breastfeeding and Reducing Racial/Ethnic Differences in a clip featured on the CDC’s website: “Hospitals can make a big difference by becoming Baby Friendly and insuring that every woman has the best possible chance of starting breastfeeding.”

The Baby-Friendly Hospital Initiative backed by a government official. Incredible news for moms and babies everywhere.

Even more, the report cites the Surgeon General’s Call to Action to Support Breastfeeding which outlines a number of actions aimed at increasing support for breastfeeding women.

Best Fed Beginnings, a project supported by the CDC, provides support to close to 90 hospitals to improve maternity care practices that support breastfeeding. The project aims increase the number of Baby-Friendly hospitals in the U.S.

In an effort to establish better support systems for mothers, the CDC “awarded funds to six state health departments to develop community breastfeeding support systems in minority populations.”

Because African American women struggle with breastfeeding more so than other populations, the authors of the report suggest increasing the number of lactation consultants in these communities.

However, just because lactation services are available does not mean that they are accessible. Services need to be covered by insurance. The Affordable Care Act helps to make lactation services affordable for families.

Services also need to be physically accessible to mothers. That is, bring the help into the home like the efforts at Maternity Care Coalition.

Limiting credentials and/or “claiming that one set of credentials is worthy of health insurance reimbursement and not others will severely limit mothers’ and babies’ access to quality care,” as stated in Healthy Children Project’s A RENEWED CALL FOR COLLABORATION AMONG LACTATION PROFESSIONALS.

Award-winning journalist Kimberly Seals Allers recently launched the Be First Food Friendly Movement which serves to transform communities, especially those with extremely low breastfeeding rates, into First Food Friendly environments. Be First Food Friendly is a great example of increased support in all facets of the community so that moms and babies can be successful at breastfeeding.

Multifaceted support is especially important for African American mothers: “…Even when accounting for factors such as socioeconomic status and maternal education, racial/ethnic differences in breastfeeding persist. This persistent gap in breastfeeding rates between black women and women of other races…might indicate that black women are more likely to encounter unsupportive cultural norms, perceptions that breastfeeding is inferior to formula feeding, lack of partner support, and an unsupportive work environment,” the CDC report states.

While some communities suffer from depressingly low breastfeeding rates, initiation rates in the Hispanic population did not increase significantly from 2000 to 2008.

“They started so high,” Allen says. “It’s like taking an A student to an A+.”

My hope for the moms who aren’t meeting breastfeeding recommendations or personal feeding goals is that with increased recognition for support, national breastfeeding rates will continue to creep upward.

Even while we make baby steps, I remain skeptical.

In the study’s full report we learn that “Breastfeeding initiation was assessed by asking, ‘Was [the child] ever breastfed or fed breast milk ?’ Breastfeeding duration was assessed by asking, ‘How long was [the child] breastfed or fed breast milk ?’ The wording of the breastfeeding duration question changed slightly in 2006 to ‘How old was [the child] when [the child] completely stopped breastfeeding or being fed breast milk ?’”

This Pediatrics’ study discusses characteristics of breastfeeding practices among U.S. mothers: http://pediatrics.aappublications.org/content/122/Supplement_2/S50.full.pdf+html.

Allen says that Progress in Increasing Breastfeeding and Reducing Racial/Ethnic Differences’ questioning didn’t allow researchers to decipher whether baby consumed breast milk straight from the source or from another vehicle. The study includes baby’s consumption of breastmilk in any form. One may assume then that breastfeeding and breastmilk feeding are created as equal in the scope of the study.

We must remember though that breastfeeding and breastmilk feeding are not the same. For instance, babies fed from a bottle are less likely to self-regulate milk intake.

Will increased awareness for breastfeeding support help more mothers breastfeed or breastmilk feed?

We know that any amount of breastmilk given to baby is beneficial but nothing compares to the biological norm of mother feeding baby at the breast.

“We are really encouraged to see some of these increases, but at the same time there is a long road ahead of us,” Allen says.

For more information on how support affects breastfeeding rates please visit: http://summaries.cochrane.org/CD001141/support-for-breastfeeding-mothers

To hear more from CDC Director Tom Frieden, M.D., M.P.H. please visit http://www.cdc.gov/breastfeeding/resources/breastfeeding-trends.htm and scroll down to “MMWR News Synopsis.”

Collaboration promotes Baby-Friendly Hospital Initiative

Tobey Hospital staff at its press event announcing Baby Friendly designation.

A laminated sign hung on the nursing staff’s entrance at Tobey Hospital announcing the newest Baby-Friendly designated medical facility in early summer 2011.

Nurse Manager of Family Centered Unit at Tobey Hospital Southcoast Hospitals Group Mary Ellen Boisvert, RN, MSN, CLC, CCE reports ecstatic squeals as employees read the exciting award.

“We were so elated,” Boisvert says of receiving Baby-Friendly designation.

Working together  

Baby-Friendly USA recently designated its 150th facility. The prestigious award is most certainly something to celebrate; “Baby-Friendly designated hospitals in the United States have elevated rates of breastfeeding initiation and exclusivity” according to a 2005 Pediatrics publication.

As a mother who did not deliver in a Baby-Friendly Hospital and initially struggled with breastfeeding because of that, I find Tobey’s dedication to normal birth and breastfeeding exciting and inspiring. The hospital’s Baby-Friendly appointment separates it from other medical facilities, but its collaboration with other medical facilities to inform and assist them in their Baby-Friendly journey is what really deserves applause. Since its designation, Tobey participates in breastfeeding collaboratives like the Massachusetts MotherBaby Summit to inform and assist others in their journeys to become Baby-Friendly.

Tobey Hospital is part of Southcoast Health System, a not-for-profit community based health delivery system which offers an integrated continuum of health services throughout Southeastern Massachusetts and Rhode Island. Southcoast Hospitals Group also includes Charlton Memorial Hospital and St. Luke’s Hospital. The group recently developed a system-wide task force that focuses on promoting things like skin-to-skin immediately after birth to improve breastfeeding rates and duration.

Boisvert says she thinks most medical facilities are excited about the Baby-Friendly Hospital Initiative. In order to make the task manageable though she suggests promoting relationships between hospitals as Tobey has done. Working among colleagues allows for painless execution of plans of action she says.

“That way you don’t have to reinvent the wheel,” Boisvert explains. “We have to work together to promote the best start for mom and baby. That’s where we all want to be.”

CLC led team

Boisvert tells me about the nursing team at Tobey; they are just as inspirational as she. They seem nothing like the impatient, uninterested and uneducated nurses who interfered with my daughter’s breastfeeding initiation. Instead, Boisvert’s team of nurses express interest in lactation counselor certification (CLC) because they genuinely want to help their patients.

“It became something [we] saw as valuable,” Boisvert says of the CLC training. “We want to be able to give full care, whatever needs our moms and babies have.”

Currently, nearly 30 percent of Tobey’s nursing staff are CLCs and several more express interest in coordinating near future training.

“Breastfeeding is part of the whole package of a mom and baby,” Boisvert says. “And in order to give complete care to that couplet, before delivery, you have to be setting them up for success.”

Boisvert stresses the importance of creating an environment that encourages breastfeeding and she says that her CLC training has helped her put that into practice.

Somewhat simple tasks

Tobey has always been committed to natural birth; the least amount of intervention provides the best outcome for mother and baby. This ideology made for a relatively simple Baby-Friendly assessmentbecause many of the requirements were already well ingrained in Tobey’s culture, Boisvert explains.

Tobey Hospital’s press event announcing the Baby Friendly designation back in August 2011.

Tobey eliminated its free formula giveaways nearly five years ago. As of July 2012, all Massachusetts maternity facilities are bag-free. To find out about the status of hospitals in other states, visit banthebags.org.

Several years ago Tobey also stopped accepting pens, measuring tapes, due date wheels, crib cards and other vendor promoting materials. Tobey now advertises itself on crib cards. Boisvert says ceasing to accept free products did not set them back financially. She also explains that the hospital no longer sends mixed messages to its patients.

Uninterrupted skin-to-skin contact immediately after birth was a fairly simple qualification for Tobey to meet as well.

“It was so much easier than we expected it to be and it’s because the benefits showed themselves,” Boisvert says.

As for the no-pacifier requirement, Tobey staff simply picked a date and removed them all from the facility. When medically indicated, pacifiers are used, for example with premature infants. Tobey staff provide education to parents who request pacifiers when not medically indicated.

It is so refreshing when evidence-based research is actually practiced. When my daughter and I were in the hospital, one of the nurses advised I give her a pacifier so she wouldn’t “tear my nipples up” with her constant desire to suck “for no reason.” I’m hopeful that, with Tobey’s and others’ dedication to promoting BFHI, maternity facilities everywhere will adopt its guidelines so that all moms and babies can reap the initiative’s benefits.

Minimal challenges

Tobey’s Baby-Friendly journey was not travelled challenge-free. Boisvert says that while they have always promoted rooming in with mom and baby most of the time, their biggest challenge was keeping mom and baby together all of the time. She says the nurses believed they were doing mothers a favor by taking babies to the nursery.

“One of our leadership nurses who didn’t see how [rooming in] was going to work, became one of the biggest supporters,” Boisvert says.

Practicing rooming-in around the clock allows for more efficient procedures like PKU and hearing tests to be completed Boisvert explains. Even the small population of bottle-fed babies at Tobey remain close to mom during these procedures.

When considering Baby-Friendly designation, it’s always important to consider these promising stories of success especially when the initial task seems daunting or impossible.

Collaboration with facilities already awarded the designation can be a vital resource when embarking on the Baby-Friendly voyage.

For more information about the Baby-Friendly Hospital Initiative, visit http://www.babyfriendlyusa.org/ or Baby-Friendly USA on Facebook.
More information about Southcoast Health System is available at www.southcoast.org.
Connect to Southcoast through social media at www.southcoast.org/connect/.
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