Raising up breastfeeding champions in rural Montana

unnamedOn her way to a hotel, Gallatin City-County Health Department Lactation Education Program Coordinator Melenie Duval, CLC spoke to a shuttle full of men about breastfeeding. The topic came up casually when a pilot asked her about her profession. Some of the men wondered why women struggle with breastfeeding when “it’s so natural.” Another had specific questions about his wife and baby’s breastfeeding relationship.

“I manage to talk breastfeeding into every conversation,” Duval says.

Duval has been helping breastfeeding families for nearly two decades, but maternal child health wasn’t always her intended career. Most of what she saw growing up in her family was formula feeding, and she wasn’t sure how she’d feed her own children. It turned out, when she had her first child, her husband offered her the most breastfeeding support and guidance. It was through this experience that Duval decided she wanted to reach out to other mothers and become part of their support systems.

She started volunteering for the Nursing Mothers Counsel of Oregon and later started working for WIC. Between this time, she received her degree in Rhetoric and Media Studies- Persuasive Speech, which now helps her teach breastfeeding classes and muster community buy-in. In 2010, Duval completed The Lactation Counselor Training Course.

Early this year, Duval and her colleagues at the Gallatin City-County Health Department received “an amazing grant” from the W.K. Kellogg Foundation to address the lack of lactation support in very rural communities in Montana.

While breastfeeding initiation rates are high, exceeding the 2020 Millennium Development Goals, there are very few “safety nets” for mothers when common breastfeeding challenges arise.

In West Yellowstone– the first rural population the team will reach out to– Duval says there are many Hispanic families who work in the service industry where it is often very difficult to continue breastfeeding once women return to work.

One client she worked with had her baby on a Thursday and needed to return to work the following Monday, Duval says.

Moreover, many of her clients struggle with immigration status, language barriers and extreme poverty. Many of these women find it difficult to speak up to their employers and assert their rights as nursing mothers.

Interestingly, Montana has the most CLCs per capita, but they seem to be concentrated in urban areas, Duval reports.

At the moment, Duval is one of the only CLCs serving most rural communities in the region.

There are currently eight CLCs at the GCCHD who work through home visiting and WIC, in addition to CLCs in Bozeman and Livingston. The new program will allow Duval to reach communities that have little or no lactation support services like Gallatin, Park and Madison counties.

Duval and her team are working to “raise up breastfeeding champions.” Breastfeeding champions come from any background: physicians, other health care providers, mothers, etc.

The Montana State Breastfeeding Coalition is offering scholarships to upcoming Lactation Counselor Training Programs in the state this year. Duval is hopeful this will increase the number of CLCs in rural areas.

Duval recently completed Healthy Children’s Learn to Teach the 20 Hour Course and she uses this knowledge with community leaders, so that breastfeeding support may come from all avenues.

She also meets with local health care providers twice a month to cover vital breastfeeding information.

Just last month, the Gallatin City-County Health Department became one of 75 health departments in the country to be accredited by the Public Health Accreditation Board.

The accreditation “raises the bar for the services we offer and holds us to a higher standard,” Duval says.

During the three year accreditation process, Duval and other health department workers asked, “What is the quality of life we are offering to the people in our community?”

The team approached community members for feedback, making sure not to assume they knew what the community needed.

“Everybody got to have a part in it,” Duval says.

The health department has also engaged in relationships with tobacco and cancer prevention organizations to establish parallel advocacy.

“We are fortunate to have programs specific to chronic disease prevention that include tobacco cessation and cancer screening,” Duval says.

Gallatin is also lucky to have a “thriving” breastfeeding coalition formed by people with an alphabet soup of credentials– nurses and doctors, IBCLCs, CLCs, independent midwives and doulas.

Duval says the coalition is working to bring in more people who have less direct contact with breastfeeding families like local business owners.

After completing other HCP lactation courses, Duval says she was reminded to continue to think outside the box when providing support to breastfeeding families. She says her training has been a key piece to broadening her perspective on infant feeding and allows her to continue to excel at serving her community.
Learn more about the Gallatin City-County Health Department here.

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