Breastfeeding and the environment: Guest post for World Breastfeeding Week 2020

By Donna Walls, RN, BSN, ICCE, IBCLC, ANLC

Each year the World Alliance for Breastfeeding Advocacy (WABA) chooses a theme for World Breastfeeding Week (WBW) celebrations around the world. WBW is celebrated every year during the first week in August. This year’s theme is “Support Breastfeeding for a Healthier Planet”. 

The 2020 objectives are:

  • Inform people about the links between breastfeeding and the environment/climate change
  • Anchor breastfeeding as a climate-smart decision
  • Engage people and organizations for greater impact
  • Galvanize action on improving the health of the planet and people through breastfeeding

Can breastfeeding really affect climate change and create a cleaner, healthier environment? 

Our planet’s health is closely tied to human health, and so there is a growing interest in learning how to protect the health of the environment. 

Among the many things humans can do to protect the environment, breastfeeding is one of the most important. Breastfeeding is the best example of a clean, eco-friendly action to protect and improve the health of planet Earth. 

Breastfeeding is the ultimate natural, sustainable resource. It requires no raw materials needed for processing and no energy consumption in production or transportation. It does not produce any material waste or by-products, does not require any packaging materials, water resources or electricity, and creates no pollution of the air or water. Lactation is a perfect partner for environmental health and the ultimate example of “eating local”.

Parents who express their milk and feed from bottles or other methods also provide a more planet-friendly feeding method than artificial feeding. Formula manufacturing requires energy, material and transportation. 

The carbon footprint of breastfeeding gives us another glimpse into the environmental impact of breastfeeding. Wikipedia defines carbon footprint as “the total greenhouse gas emissions caused by an individual, event, organization, service, or product, expressed as carbon dioxide equivalent.” In simple terms, it’s a measurement that shows us something’s impact  on the health of the environment. 

The carbon footprint of breastfeeding is based on the production and transportation of food for the mother based on the RDA of an additional 500 kcal/day recommended during breastfeeding. According to research from the United Kingdom, the carbon footprint of breastfeeding is estimated at 5.9 (this varies between countries). 

In comparison, the carbon footprint of formula feeding— which is based on the use of resources, animal and factory production emissions and transportation of the formula as well as supplies, preparation and storage of formula at home— is estimated at 11.0 (again varying between countries). On average, feeding breast milk substitutes had a higher impact on the climate than breastfeeding in all countries studied. This certainly demonstrates the positive impact on the environment when the infant feeding choice is breastfeeding.(Bodkin, 2019 Meade, 2008)

The International Baby Food Action Network (IBFAN) supports optimal infant feeding practices and  advocates for universal implementation of the International Code of Marketing of Breastmilk Substitutes, an international health strategy recommending restrictions on the marketing of all formulas and supplies intended to discourage breastfeeding. In 2015 IBFAN developed their statement on breastfeeding and the environment:

“Breastfeeding protects our health and our planet – right from the start, breastfeeding is the first step towards protecting human health, short- and long-term. It is also the first step towards protecting the health of our environment and conserving our planet’s scarce natural resources. We need to start at the beginning, with infants and young children. Our babies and children are in no way responsible for climate change and environmental degradation, but instead they suffer the disastrous consequences.” (IBFAN, 2015)

 It’s clear that breastfeeding is the most climate-friendly option for infant feeding, but does the environment have an impact on breastfeeding? The answer is yes. 

For decades scientists around the world have studied the impact of environmental contaminants on the mammary gland, and on mothering behaviors. For instance, a study from the Journal of Health Science demonstrated that rats exposed to dietary bisphenol A (BPA) in early pregnancy showed cellular injury to the mammary glands as well as lower prolactin levels. (Miyaura, 2004). 

What’s more, Rochester Medical Center studies reported in Science Daily demonstrated damage to rat mammary glands to the extent that some mother rats were unable to nourish their pups after exposure to dioxins. Researchers noted that some rats were able to recover mammary function by late pregnancy. (Lawrence, 2009). 

In 2013, a study in the Journal of Neurotoxicology and Teratology showed a decrease in maternal behaviors in Wistar rats (less grooming, protection and nuzzling), a concerning finding but not yet demonstrated in humans. (Boudalia, 2013}.

Studies like these are the basis for ongoing research looking into possible negative impacts on human lactation. The studies are also the basis of much education related to how to create a safer environment while protecting lactation.  

An unpublished study from Wright State University looked at mothers with self-described low milk supply and the relationship between environmental contaminants. The 78 mothers in the study were four  weeks to eight  months postpartum and were all given education on reducing exposures to environmental estrogens (personal care products, food hormones and plasticizers). 

Results were seen in one to five weeks and ranged from the mothers stating her “breasts were fuller,” the “babies seemed more satisfied,” and fewer needed supplementation. Some found a doubling of supply (noted with pumping during work hours). Seven had no noticeable increase in milk supply, and of those only two weaned from breastfeeding. The rest continued supplementation. (Walls, presented 2009). 

In a Mexican study of young Yaqui tribe women, those who moved from native land  to new chemical based agriculture, had less alveolar tissue compared to the young women who remained with the tribe and practiced  traditional, non-chemical farming techniques. 

Many of the agri-chemical exposed young women were found to have larger than normal breasts, but less glandular tissue (referred to as “empty breast” syndrome) and many were unable to breastfeed their infants which is viewed as an integral part of mothering in their culture. (Hansen, 2010).

On the surface, these studies can seem discouraging until we really weigh the risks and benefits of breastfeeding in a polluted world. 

First, human milk contains properties that have been shown to mitigate some negative, environmental effects. (Williams, Florence, NYT) 

For instance, human milk contains bio-active components which specifically control and resolve inflammation, promote a thick, healthy gut lining to support an optimum functioning immune system and provide the most nutritious food for optimum general health for infants and children.  

Emeritus Director of the Carolina Global Breastfeeding Institute Miriam Labbok, MD, MPH, IBCLC stated “The fact that studies of child [health] outcomes in highly polluted areas are still better for the breastfed infant . . . would seem to indicate that certain factors in the production of human milk and in the milk itself, immunological and other, may mediate the potential harm of the ambient pollution.”

She went on to say, “… No environmental contaminant, except in situations of acute poisoning, has been found to cause more harm to infants than does lack of breast-feeding. I have seen no data that would argue against breastfeeding, even in the presence of today’s levels of environmental toxicants.”

Sandra Steingraber, biologist and author of Living Downstream and Having Faith: An Ecologist’s Journey to Motherhood agrees: ”We haven’t yet compromised breast milk to such an extent that it’s a worse food than infant formula…..”

The American Academy of Family Physicians (AAFP) has also published that certain components of human milk act to increase the infant’s elimination of some toxins and to protect the infant’s developing brain, central nervous system, and body as a whole.

WABA’s statement  on breastfeeding and environmental contaminants echoes this sentiment and  encourages breastfeeding as the safest feeding choice despite maternal exposure to contaminants. 

Their statement reads: “Is the presence of these chemical residues in breastmilk a reason not to breastfeed? No. Exposure before and during pregnancy is a greater risk to the fetus. The existence of chemical residues in breastmilk is not a reason for limiting breastfeeding. In fact, it is a reason to breastfeed because breastmilk contains substances that help the child develop a stronger immune system and gives protection against environmental pollutants and pathogens. Breastfeeding can help limit the damage caused by fetal exposure.” (WABA, 2005.)

The World Health Organization’s (WHO) review on contaminants and human milk states definitively, “The benefits of breastfeeding far outweigh the toxicological disadvantages that are associated with certain POPs” (persistent organic pollutants). 

To reiterate, considering the safety of human milk even when contaminants have been detected, neonatal intensive care researcher Fani Anatolitou (2012) states, “the detection of any environmental chemical in breast milk does not necessarily mean that there is a serious health risk for breastfed infants. No adverse effect has been clinically or epidemiologically demonstrated as being associated solely with consumption of human milk containing background levels of environmental chemicals”. 

It is important to understand that many of the measurements of POPs in human milk are not clinically meaningful, hence are not a cause for alarm. Even more importantly, as mentioned earlier, a number of components of human milk act to counter potential risks of contaminant exposure (Anitolitou, 2012). The Centers for Disease Control and Prevention (CDC) points out that effects of exposure have only been detected in a breastfeeding infant when the mother was extremely ill.

As lactation care providers we are in a unique position to not only support the optimum health of infants and children, but also be a part of creating a healthier environment for the children to grow and thrive.

For more on WBW check out this action folder by BPNI

Resources/References

American Academy of Family Physicians (AAFP). (2018). Breastfeeding, Family Physicians Supporting (Position Paper). Downloaded 17. Jan. 2018 from https://www.aafp.org/about/policies/all/breastfeeding-support.html

American Academy of Pediatrics (AAP), Section on Breastfeeding. (2012). Breastfeeding and the use of human milk (Policy Statement). Pediatrics 129(3), e827-e841. DOI: 10.1542/peds.2011-3552.

AMERICAN ACADEMY OF PEDIATRICS The Transfer of Drugs and Other Chemicals Into Human Milk Committee on Drugs  https://pediatrics.aappublications.org/content/108/3/776/T7

Anadón, A., Martínez-Larrañaga, M. R., Ares, I., Castellano, V., Martínez, M. A. (2017). Drugs and chemical contaminants in human breast milk. In R. C. Gupta (Ed.), Reproductive and Developmental Toxicology (2nd Ed., pp. 67-98). London, UK: Academic Press.

Anatolitou, F. (2012). Human milk benefits and breastfeeding. Journal of Pediatric and Neonatal Individualized Medicine 1(1), 11-18. DOI: 10.7363/010113.

Arnardottir,H. et al. Human milk proresolving mediators stimulate resolution of acute inflammation. Mucosal Immunology, October 2015 DOI: 10.1038/mi.2015.99

Bodkin, H. Breastfeed to save the planet, scientists say as study exposes infant formula damage to environment https://www.telegraph.co.uk/science/2019/10/02/breastfeed-save-planet-scientists-say-study-exposes-infant-formula/

Boudalia, S. et al.  A multi-generational study on low-dose BPA exposure in Wistar rats: Effects on maternal behavior, flavor intake and development. Neurotoxicol Teratol 2013                      Nov 20. pii: S08920362(13)00217-1. doi:10.1016/j.ntt.2013

Climate Change and Health June 2015 https://ibfan.org/docs/climate-change-2015-English.pdf

Dadhich, J,  Lellamo, A. Report on Carbon Footprints Due to Milk Formula: a Study from Selected Countries of the Asia-Pacific Region

BPNI/IBFAN Asia, New Delhi (2015). http://ibfan.org/docs/Carbon-Footprints-Due-to-Milk-Formula.pdf, Accessed 24th Jan 20

Eidelman AI. Environmental Impact on Maternal Breastfeeding Behavior. Breastfeed Med. 2018 Jul/Aug;13(6):397. doi: 10.1089/bfm.2018.29096.aie. Epub 2018 Jul 5.PMID: 29975551 

Goldman, A. Anti‐inflammatory Properties of Human Milk. September 1986.  https://doi.org/10.1111/j.1651-2227.1986.tb10275.x 

Hoffman K, et al. Lactational exposure to polybrominated diphenyl ethers and its relation to social and emotional development among toddlers..Environ Health Perspect. 2012 Oct;120(10):1438-42. doi: 10.1289/ehp.1205100. Epub 2012 Jul 19.PMID: 22814209 

Joffe, N. Support for breastfeeding is an environmental imperative. Oct 2, 2019. www.bmj.com › content › bmj

Karlsson, J.O. The carbon footprint of breastmilk substitutes in comparison with breastfeeding. Feb 2019. Journal of Cleaner Production. https://doi.org/10.1016/j.jclepro.2019.03.043

Kowalewska-Kantecka B. Breastfeeding – an important element of health promotion. Dev Period Med. 2016;20(5):354-357.PMID: 2839125

Mead, N. Contaminants in Human Milk: Weighing the Risks against the Benefits of Breastfeeding Environ Health Perspect. 2008 Oct; 116(10): A426–A434PMCID: PMC2569122 PMID: 18941560

Murínová, P et al. Partitioning of hexachlorobenzene between human milk and blood lipid..Environ Pollut. 2017 Oct;229:994-999. doi: 10.1016/j.envpol.2017.07.087. Epub 2017 Aug 1.PMID: 28778790

Natural Resources Defense Council. 2005. Healthy Milk, Healthy Baby. Chemical Pollution and Mother’s Milk. New York, NY: National Resources Defense Council. http://www.nrdc.org/breastmilk/chems.asp

Pan IJ, Paediatr Perinat Epidemiol. 2010 May;24(3):262-71Lactational exposure to polychlorinated biphenyls, dichlorodiphenyltrichloroethane, and dichlorodiphenyldichloroethylene and infant growth: an analysis of the Pregnancy, Infection, and Nutrition Babies Study. doi: 10.1111/j.1365-3016.2010.01114.x.PMID: 20415756

 Poore and Nemecek, 2018.  Reducing food’s environmental impacts through producers and consumers. Science, 360 (6392) (2018), pp. 987-992. https://doi.org/10.1126/science.aaq0216

Stigum H, et al. A novel model to characterize postnatal exposure to lipophilic environmental toxicants and application in the study of hexachlorobenzene and infant growth..Environ Int. 2015 Dec;85:156-62. doi: 10.1016/j.envint.2015.08.011. Epub 2015 Sep 19.PMID: 2639804339

Terri Hansen, Today correspondent. Pesticide exposure deprives Yaqui girls of breastfeeding – ever,  Feb 28, 2010. https://www.sej.org/headlines/pesticide-exposure-                              deprives-yaqui-girls-breastfeeding-ever

Toxic Release Inventory http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?TRI

Tran CD, Dodder NG, Quintana PJE, Watanabe K, Kim JH, Hovell MF, Chambers CD, Hoh E  Organic contaminants in human breast milk identified by non-targeted analysis.Chemosphere. 2020 Jan;238:124677. doi: 10.1016/j.chemosphere.2019.124677. Epub 2019 Aug 26.PMID: 31524616

United Nations Sustainable Development Goals and Breastfeeding https://www.un.org/sustainabledevelopment/blog/tag/breastfeeding/

Vermeulen, B.M. Campbell, J.S.I. Ingram. Climate change and food systems. Annu. Rev. Environ. Resour., 37 (1) (2012), pp. 195-222

WABA Towards Healthy Environments for Children Q. Frequently asked questions (FAQ) about breastfeeding in a contaminated environment https://www.waba.org.my/whatwedo/environment/pdf/faq2005_eng.pdf

Fostering connection through technology

Even before Covid-19 forced us to get creative with technology– doulas providing support over Facetime, virtual summits, virtual lactation care visits, and online certifications— so much birth, infant feeding and parenting information and support already existed online. 

Although screens don’t come without risk, they’re a tool to literally meet parents where they are.

In recent months, several noteworthy apps and online resources have emerged, growing and enhancing the information and support available to parents. 

Earlier this month, Global Health Media announced the launch of their smartphone app Birth & Beyond

“Knowing that in-person support of mothers had been curtailed due to coronavirus, we created the app to put our teaching videos right into the hands of mothers and families worldwide,” a Global Health Media newsletter reads. 

The app features 28 videos in 21 languages which can be streamed, downloaded to an offline library, or shared with friends and family. Topics covered include birth, breastfeeding, newborn care, small baby care, and complementary feeding. The app is currently available for Apple iOS phones and soon for Android phones.

In its first month, Birth & Beyond has been downloaded 1,500 times, with the largest number of users in the USA, Australia, UK, and Canada, Global Health Media director Deborah Van Dyke reports. 

The app will continue to be updated with new videos and more languages.

In Fall 2020, we can anticipate the release of Kimberly Seals Allers’ and her team’s app Irth (as in Birth without the ‘B’ for bias), a “Yelp-like” review and rating app for hospitals and physicians made by and for Black women and birthing people of color. 

Irth recognizes that implicit bias is a significant barrier to fair treatment for all; specifically contributing to high Black maternal mortality and Black infant mortality rates, a Tara Health Foundation press release points out. 

The app will allow users to access identity-based reviews which will empower them with peer-based information for health care decision-making.

The World Alliance for Breastfeeding Action (WABA) has connected parents virtually through videos released with their Global Day of Parents 2020 Statement.

The videos feature parents from Guatemala, Malaysia, Sweden and Zimbabwe sharing their perspectives on parenting and breastfeeding during the COVID-19 pandemic. 

“The pandemic poses challenges that affect infant feeding both through the lack of support for breastfeeding parents from the healthcare system, workplace and society at large coupled with the exploitation by the breastmilk substitute industry to market their products to vulnerable populations,” WABA’s Thinagaran Letchimanan explains. 

Parents’ stories demonstrate challenges and triumphs, commonalities and differences and highlight the overall need for support.

The WABA statement emphasizes that “parents should have access to support from all levels of society to enable a successful breastfeeding journey” and looks forward to World Breastfeeding Week 2020 as an “important opportunity for society to galvanise actions in support of breastfeeding for a healthier planet.”

“There is an ongoing need to advocate for breastfeeding as a public health intervention that saves lives and prevents infections and illness in the population at large especially in the context of COVID-19,”  Letchimanan emphasizes. “Essentially we need to create a warm chain of support for breastfeeding that considers the needs of all breastfeeding families. Join us in celebrating WBW2020!

Photo by Raul Angel on Unsplash

It’s easy to argue that technology has the potential to disconnect us– eyes cast over glowing screens, swiping, scrolling digits–  but the pandemic has offered a new outlook on how to connect meaningfully through technology. Tools like Birth & Beyond, Irth and WABA’s campaigns promote connection and a shared goal to achieve better health outcomes for families, communities and ultimately our planet. 

There are of course products to be leary about,  such as ‘smart’ diapers embedded with RFID chips that notify caregivers electronically when baby has a wet or dirty diaper. “Convenience” seems valued over connection.

In response to these inventions, Healthy Children Project’s Karin Cadwell PhD, RN, FAAN IBCLC, ANLC replies, snark on point, “This way you don’t have to interact so much. You have the remote to inform you of cries and the diaper to tell you [when] wet. Perfect! The babe can enjoy the $15,000 nursery room and you can watch TV uninterrupted.” 

As lactation care providers, we can help families achieve balance by directing them to reputable resources and channeling technology use for connection rather than distraction or detachment.

Constitutional challenge to lactation consultant license moves forward

The team at Reaching Our Sisters Everywhere (ROSE) exemplifies resilience through tumultuous times. A bright spot shone through tragic recent events when the Georgia Supreme Court unanimously ruled in May 2020 that ROSE’s constitutional challenge to the state’s 2016 Georgia Lactation Consultant Practice Act will go forward.

Source: United States Breastfeeding Committee.

Our Milky Way spoke with ROSE Chief Empowerment (CEO) and Change Leader Kimarie Bugg, DNP/FNP-BC/MPH/IBCLC/CLC, Vice President Mary Nicholson Jackson, CLC and Program Director Andrea Serano, CLC, IBCLC who provided an update and commentary on the case. 

The team says that the recent reversal feels like a victory because it means that the 2016 law is still not enforceable and lactation care providers (LCPs) with any credential can continue their work. 

“The problem is that it’s still being misinterpreted in some places,” Jackson explains. “Sometimes trying to figure out what’s going on is the real concern.”

The Georgia Lactation Consultant Practice Act calls to prohibit provision of lactation care and services for compensation without obtaining IBCLC licensure. But in June 2018, the court put a freeze on the implementation of the law after Jackson, in partnership with the Institute for Justice (IJ) and ROSE, filed a lawsuit to preserve the right to earn an honest living.

The recent reversal affects close to 1,000 Certified Lactation Counselors (CLCs) among other breastfeeding helpers practicing in Georgia, all of whom would have not been lawfully permitted to continue their work under the law after July 2018. 

The ROSE team explains that while LCPs continue to legally offer services and support, there’s still some confusion within the community. Individuals lobbying for the Lactation Consultant Practice Act have offered up erroneous guidance at places of employment for example.

Especially in the current context of Covid-19, the team expresses relief that they and other lactation supporters are still able to provide support to families. Many long-standing and already-dire situations have been illuminated and compounded during the pandemic, like labor and birth support. 

In Georgia, only one support person is allowed to accompany a laboring person in certain maternity care facilities, and that support person is not allowed to leave and return to the hospital.  In many cases, this restriction is not sustainable for families who have other children or employment obligations.  

“We know that if [the law] would have been in effect, [birthing people] could not fall back on the resources that they know of and are familiar with after already being traumatized after labor and birth,” Bugg explains.  

Source: United States Breastfeeding Committee.

Racial inequities and structural racism have been brought to the forefront of our national conversation especially in light of Covid-19, and the issues at hand are no different in the world of lactation.

Not surprisingly, some have suggested that the entire premise of the Lactation Consultant Practice Act is fraught with racism. 

The case is not only about economic freedom, but equally important, access to lactation care especially in marginalized communities. 

Jackson’s petition points out that “the Act defeats its own purpose of promoting public health because it will, overnight, put hundreds of highly qualified lactation consultants… out of business. This will dramatically reduce breastfeeding support statewide, particularly in the minority and rural communities where CLCs are most active.” 

Pages 19 to 25 of the petition detail ways in which the Act causes harm to LCPs including those who work as milk lab technicians, Baby Café support people, military families, and the list goes on. 

In Why is That IBCLC Licensure Lawsuit in Georgia Such a Big Deal? author Liz Brooks, JD, IBCLC, FILCA details how lactation professionals of color are disproportionately impacted by the 2016 Act citing one example in particular where an African American RD IBCLC practitioner of many years had her application halted.

Brooks writes, “The systemic racism is made obvious because an IBCLC of color now has to take the time, and money, and lawyer up, and dig through paper work from 29 years ago, and file an appeal, and show people that she is an excellent, honest, forthright person who just wants to **continue** working to help families breastfeed/access human milk, which is what she was showing them when she filed her license application in the first place.” 

IJ explains that the “drive toward licensure is not motivated by health or safety concerns, but rather by IBCLCs’ interest in billing health insurance companies for their services.”

“In 2010, the Affordable Care Act mandated that insurance companies provide coverage for lactation services. Since then, insurance companies have used licensure as a means of limiting the expense of that coverage. To ensure they could bill insurance companies, the IBCLCs’ lobbyists have begun pushing state-mandated licenses across the country to artificially differentiate IBCLCs from CLCs,” the IJ statement continues. 

Source: United States Breastfeeding Committee.

SELCA released a response in regard to the Georgia Lactation Consultant Practice Act claiming that the law’s passing “has already improved access to clinical lactation care” citing new jobs, a community college program, and the promise of in-network lactation consultants for mothers using Medicaid. 

The ROSE team reports that this large scale change has not transpired. 

“That panacea that they thought was going to happen has not happened,” Bugg says.  

Again in Why is That IBCLC Licensure Lawsuit in Georgia Such a Big Deal? Brooks makes note:

“Who in the heck thinks any license, waived high over their head by an IBCLC, will now instantly generate credibility, job offers, insurance company cooperation, money in the bank? Anything having to do with payment for/coverage of health care services in the USA in 2018 is a humongous pain-in-the-neck. Ask any hospital, doctor, nurse, midwife, speech therapist, dentist, etc etc etc just how easy-peasy it is to see patients, spend quality time with them, have all services fairly and easily covered, and so on. Yeah. Not so much.

I’ve said it countless times: The issue should be about HOW to pay [for lactation care, from counseling on up through skilled clinical care], not WHO to pay [which is what flawed and even better-than-most licensing bills necessarily must focus on].” 

While ROSE moves forward, Serano urges maternal child health advocates to keep the issue of licensure on the radar on a state-by-state basis. When legislation is presented, look at it through an equitable lens, she suggests. Educate local and federal legislators. 

On this note, starting at the state level is an effective way to vindicate rights for others, as pointed out in IJ’s video Can the Government Throw You Out of Work? (Not in Some States!). An IJ attorney explains that the U.S. has a long history of looking at what state high courts have done, and that it’s a traditional method for achieving constitutional change. 

It’s important to make clear that it is not solely the fault of one or a handful of organizations or individuals for carrying out a racist agenda. We are all called to this work, striving for an antiracist society. 

You can stay up to date and support this ongoing case here.  

Spotlight on Fédora Bernard, Program Officer at The Right Livelihood Foundation

Fédora Bernard is currently Program Officer at The Right Livelihood Foundation, an organization established to “‘honour and support courageous people solving global problems’… now widely known as the ‘Alternative Nobel Prize’”. 

Bernard presenting in Rio.

Before transitioning into her work at The Right Livelihood, Bernard served as Geneva Association for Baby Food and International Liaison Office of the IBFAN Network (GIFA) Program Officer beginning in April 2019, having just newly graduated from the Institut des Hautes Etudes Internationales et du Développement with a Masters in International Affairs. 

This week, Our Milky Way is pleased to share a Q&A session with Bernard. 

Q: Please share a few highlights during your time with IBFAN. 

A: I am deeply passionate about human rights and GIFA was specialized in exactly that. I think that throughout my time at IBFAN, some highlights would probably be the sessions of the Committee on the Rights of the Child that I attended and advocated at, the World Health Assembly, the fifth session of the Open-ended intergovernmental working group on transnational corporations and other business enterprises with respect to human rights and of course, the World Breastfeeding Conference in Rio. They were all avenues where we could raise awareness and advocate for better national policies.

Q:  What would you consider your greatest triumph with IBFAN?

A: I am not sure I could speak of triumph, at the end of the day my time with IBFAN was quite short and all I did was trying to keep up with the amazing work that has been done by the Geneva office for the past 40 years. Nevertheless, I am very proud of the achievements with the Committee on the Rights of the Child, as during my time with IBFAN, “breastfeeding” was mentioned in almost all concluding observations.

Q: In November 2019, you had the opportunity to present IBFAN’s Green Feeding documents. What was that like? How was it received by participants at the World Breastfeeding Conference? 

A: It was an incredible experience, it was an honor to prepare this with Alison Linnecar, who wrote the document and to present it along with experts in the field. I don’t think that I can define myself as an expert, let alone a breastfeeding expert, but I am starting a career in advocacy. I therefore decided that I wanted to emphasize how the Green Feeding Documents could be used as an advocacy tool from an environmental perspective. Therefore, while Alison explained the science behind all of it, I focused on the link between breastfeeding and human rights, more in particular how it can be used in relation to the right to a safe, healthy environment. At the end of the presentation, I was so happy to see that most people in the audience wanted a copy of the green feeding documents…I thought that 30 copies would be enough, but clearly, I was wrong! I wish I had brought more.

Jose Angel Rodriguez-Reyes, expert of the Committee on the Rights of the Child pictured alongside Bernard.

Q: In your piece BREASTFEEDING: BEYOND “WHAT IS BEST FOR YOUR CHILD”, you mention the WHO/UNICEF Global Strategy on Infant and Young Child Feeding to Protect, Promote and Support Breastfeeding. We have the framework for better global health outcomes; What is holding us back? Is there one significant barrier standing in the way of a better world? 

A: I believe that from a political perspective, two things are holding us back: The first being the patriarchy and political systems dominated by men. As long as women will not be allowed to play a greater role in global health governance and domestic politics, public health issues such as breastfeeding or issues surrounding menstrual health will not be given the right amount of attention. 

The second element is political will, which is deeply related to the first. Breastfeeding is only seen as a public health issue in developing countries, and aggressive marketing from the formula industry has managed to convince women themselves that they are actually more empowered if they don’t breastfeed. Breastfeeding is thus seen as a weight imposed on them rather than a right that should be protected, promoted and supported by governments. In some societies, it is indeed currently a real hurdle for women to achieve their breastfeeding goals but instead of women in their breastfeeding journeys benefiting from policies, they are given a bottle. I am of the idea that improved breastfeeding policies are not only a matter of public health but also of women’s rights. 

Q: Any advice on how to navigate a climate where people dispute basic facts?

A: That is a very difficult question…Especially because those disputing basic facts are often deeply attached to their position and will give you alternative “facts”…I believe very much in trusted sources, and would always advise these people to check their sources and question them. For instance, if someone shows me an article from the industry containing “facts on breastfeeding” I would draw their attention on why this article could be biased and not based on adequate scientific evidence.

Q: Breastfeeding is a topic that spans across all disciplines. Will you please give us a glimpse into the work you’re doing at The Right Livelihood? 

A: The Right Livelihood Foundation honors and supports courageous people solving global problems, in all disciplines. IBFAN is actually one of them. With civil society space shrinking all over the world, human rights defenders are facing increasing difficulties, which is very true also for breastfeeding advocates. My work at the foundation therefore consists in using the advocacy skills that I developed with IBFAN, to support laureates all over the world.

Lactation Counselor Training Course (LCTC) offered completely online for first time ever

In this uncertain time, it can be helpful to remember that we have control over the way we respond to the things we don’t have control over. Healthy Children Project joins individuals, businesses and organizations that have had to adapt to this strange, challenging Covid-19 situation. 

“When you face challenges, we have two choices: Let it stop you or find a way to grow and make a difference, even during challenging times. Now, more than ever, lactation counselors are needed to promote, protect and support breastfeeding families, even though we temporarily find ourselves in a place where face-to-face courses can’t happen,” says Karin Cadwell, Healthy Children Project’s executive director. 

Since social distancing and safer-at-home policies have been implemented, Healthy Children Project (HCP) was propelled to use this as an opportunity to offer the Lactation Counselor Training Course (LCTC) completely online for the first time ever. 

“While we still strongly believe that the experience of being together for the LCTC course has provided wonderful opportunities for meeting new friends and colleagues and networking, the changing times have propelled us to revisit the course delivery options,” Cadwell says. 

ALPP will offer an online, remotely-proctored CLC exam starting this week

The LCTC course combines up-to-date high level evidence, counseling training, policy and practice.

“I have learned so much already that medical school, 20 years of practicing and nursing four babies never taught me. (I am only in the second section!)” one participant shares. 

Another participant shares: “I was extremely happy with this course, as it was taught in a way that was inclusive, free of bias, and with much knowledge. In addition, the evidence that was provided was exceptional. Though I was not able to do this course in person, the instructors created a course that was not only highly educational, but also enjoyable. Thank you again to all that made this course happen.”

Photo by Charles Deluvio on Unsplash

The online LCTC is a self-paced online course presented in an engaging and energetic format through videos, self-check questions and competency verification and twice-weekly office hours with faculty to answer additional questions for online participants. 

“I am truly enjoying the format of this course and it definitely helps that you are all so entertaining and fun! I feel like I am sitting in your living room and you are telling me everything you know and it is quite lovely!” on participant exclaims.

The course should take 52 hours to complete (just like the in-person version).

“I’m so impressed with our participants. They are working on the course when they get back from a long day working in the hospital or in between their kids online school zoom meetings. They are finding ways to grow and learn, even with this new ‘normal’ we are all experiencing,” according to Healthy Children Project faculty Kajsa Brimdyr.

Offering the LCTC online has produced some unexpected benefits like accessibility. 

“I love that we are able to offer this to those who need the flexibility of online learning, those who may not be able to get five days off in a row can take this course on their own time, in a way that works for busy lives and schedules,” says Brimdyr.

“I enjoyed the teaching methods utilized and enjoyed the ability to work on training while having the ability to pause and do other duties for my employment as well,” another participant attests.

What’s more, faculty has gotten creative about how to best replicate the face-to-face experience. 

“The office hours are a popular aspect of the new online class,” says Healthy Children Project’s Anna Blair. “Karin and I have had a great time getting to know the participants and help them think about how to integrate the new information into their practice. It’s really fun. My dog, Sandy, occasionally joins us and I love seeing all the faces (and participants’ babies and dogs) on the screen during the office hours.” 

Blair continues, “It is so nice to connect with the participants who are going through this journey.” 

Participants have also shared that one of their favorite parts of the course is  the virtual office hours with faculty. 

“It is really helpful hearing some of the questions and answers people are asking/getting,” one explains. 

Participants can email questions in advance or ask questions during the office hours in the chat feature of the program. In the absence of in-person learning, this feature replicates the value of hearing others’ questions. Each office hour section is logged and labeled by topic so that students can revisit and review the questions at their convenience. 

Photo by Richard Jaimes on Unsplash

“We kept thinking about the phrase ‘Laurus crescit in arduis’ –Laurel grows in steep and difficult places,” Cadwell begins. “Not only have we seen amazing stories of resilience in the news and with our friends, our team at Healthy Children has been focused on making a difference in the world. We all have, and need, the opportunity to bloom. Learning together, we can share our experiences and knowledge. We have loved hearing from our participants during the course – their ideas, experiences and future plans. We all can work together to make a difference for breastfeeding families.”


To register for the Online Lactation Counselor Training, please click here.