‘Strong. Resilient. Latched.’ Celebrating Native Breastfeeding Week

Just short of a decade ago, the United States Breastfeeding Committee (USBC) declared August National Breastfeeding Month. National Breastfeeding Month kicks off with the World Alliance for Breastfeeding Action’s (WABA) World Breastfeeding Week (WBW) and continues to celebrate each subsequent week:

Week 2 (August 9-15): Native Breastfeeding Week: Strong. Resilient. Latched.  

Week 3 (August 16-24): Spotlight on Infant and Young Child Feeding in Emergencies 

Week 4 (August 25-31): Black Breastfeeding Week: Revive. Restore. Reclaim.

This week, we honor the very diverse experiences of Indigenous families and “address the inequity and injustice of Indigenous parents and their abilities to practice their roles in accordance to the tribal communities they descend from.”  [https://www.facebook.com/NativeBreastfeedingWeek/

There are so many ways to celebrate, to uplift, to support, and as white lactation care providers and maternal child health advocates, ways to learn, humble ourselves, and do better.

The official Native Breastfeeding Week Facebook page actively includes ways to engage in Native Breastfeeding Week. There are sunrise honor prayers, a Virtual 5K Move, Q&A sessions, platforms for sharing personal accounts, and much more.

On Tuesday, the American Indian Cancer Foundation will host an #IndigenousMilkIsMedicine webinar, where Indigenous midwife Hope Mayotte (Bad River Tribe) presents on the importance of Indigenous birth and breastfeeding. 

“For generations, our families have known that breastfeeding nourishes baby’s mind, body, and spirit, and also reduces the risk of cancer and cancer risk factors for birthing people,” American Indian Cancer Foundation’s Communications Specialist Tina MacDonald, BA (Leech Lake Ojibwe) shares.  “During Indigenous Milk Is Medicine, we aim to educate and support Native families across the nation by providing them with culturally-tailored breastfeeding webinars and resources.”

Register here

The Indigenous Birth and Breastfeeding Collective of North Dakota will host the Indigenous Breastfeeding Counselor Training in Standing Rock August 26 to 30. The course is taught by Camie Jae Goldhammer, MSW, LICSW, IBCLC (Sisseton-Wahpeton) and Kimberly Moore-Salas, IBCLC (Navajo) and covers topics like historical trauma, the impact of birth on breastfeeding, water rights and its relation to breastfeeding, food sovereignty, maternal mood disorders and much more. The course is open to those who self-identify as Indigenous. Find more information here

Indigenous Women Rising is facilitating the delivery of Covid-19 care packages, and while the deadline to apply has passed, individuals may still donate to the cause

Bold Futures shared An open letter: Seeking justice and systemic change for Native Families harmed by structural racism, a response to a “secretive policy [at a prominent women’s hospital]…to conduct special coronavirus screenings for pregnant women, based on whether they appeared to be Native American, even if they had no symptoms or were otherwise at low risk for the disease, according to clinicians.” [https://www.propublica.org/article/a-hospitals-secret-coronavirus-policy-separated-native-american-mothers-from-their-newborns

The letter details how maternal child health advocates can help move forward; for example:

* “Centering BIPOC midwives, birth workers and birth advocates in leadership and decision making,” 

* “Significant investment through the state Department of Health and public health funds in out-of-hospital birth models led by Native, Black and People of color,”

* “Defunding and criminalizing of medical institutions and providers that are, or have, engaged in hate crimes under the guise of medical care.”

Last year, four out of 10 Indian Health Service (IHS) hospitals achieved Baby-Friendly re-designation. Baby-Friendly hospitals support exclusive breastfeeding which “protects against obesity and type II diabetes, conditions that American Indians and Alaska Natives are particularly prone,” Tina Tah, IHS Senior Nurse Consultant writes.  

Learn more about IHS and the American Indian and Alaska Native Communities and Hospitals Advancing Maternity Practices (AI/AN CHAMPS) project’s successes here.

 For more on Native American experiences in birth, infant feeding and beyond, read Generational trauma among Native American cultures affects infant feeding and Honoring the diversity of Indigenous breastfeeding experiences.

#NativeBreastfeedingWeek

#StrongResilientLatched

#IndigenousParenting

#IndigenousMilk

#Bodyfeeding

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.

A call to reinvigorate the International Code Of Marketing Of Breastmilk Substitutes

Last month marked the 39th anniversary of the World Health Organization (WHO) International Code Of Marketing Of Breastmilk Substitutes. As the World Alliance for Breastfeeding Action (WABA) reminds us,  “Following the adoption of the Code in 1981, governments have been called upon by the World Health Assembly to give effect to the provisions in the Code through national legislation. So far, UNICEF/ World Health Organization (WHO)/ #IBFAN have identified 136 countries as having Code regulations in place.”

Photo by Andre Adjahoe on Unsplash

You might know that the U.S. is not one of these nations. 

In a timely offering– when formula companies use the crises of the pandemic to prey on mothers and babies– The Network for Global Monitoring and Support for Implementation of the International Code of Marketing of Breastmilk Substitutes and subsequent relevant World Health Assembly Resolutions (#NetCode) has developed a toolkit to reinvigorate and reinforce ongoing monitoring and periodic assessment of the Code and national laws. The toolkit offers health advocates an opportunity to connect with governments to establish a sustainable system that will monitor, detect and report violations of national laws. Find it here: https://waba.org.my/netcode-toolkit-for-ongoing-monitoring-and-periodic-assessment-of-the-code/?fbclid=IwAR2PzeROMctrsCJ3ZiG8gah07IXQMhI-3eSn6EqLDhV3-TdGhhmk-IxDzt4

“Formula manufacturers are exploiting the panic and fears of contagion to intensify their aggressive marketing practices,” Patti Rundall writes in the Baby Milk Action policy blog. “In this context, government action to regulate the marketing of breast-milk substitutes has never been greater.”

On May 28, the World Health Organization (WHO), UNICEF, and the International Baby Food Action Network (IBFAN) launched the virtual 2020 Status Report which highlights which countries have implemented measures required by the Code. [The official launch event can be viewed here.]

Photo by Kelly Sikkema on Unsplash

“Given the important role of health workers in protecting pregnant women, mothers and their infants from inappropriate promotion of breast-milk substitutes, the 2020 report provides an extensive analysis of legal measures taken to prohibit promotion to health workers and in health facilities,” Thahira Shireen Mustafa, Department of Nutrition and Food Safety, writes. 

In the U.S. in late March, Baby-Friendly USA released a statement detailing access to adequate nutrition for babies born during the Covid-19 crisis with an announcement explaining that BFUSA  would relax one standard regarding the provision of small quantities of formula upon discharge to formula feeding families in communities experiencing shortages in retail outlets. 

“We did so to ensure that formula feeding families receive essential support during this global emergency,” BFUSA CEO Trish MacEnroe writes. “We did NOT loosen restrictions on interactions with formula companies.”

MacEnroe goes on to write, “Regrettably, some formula companies have interpreted our statement as a window of opportunity to reengage their aggressive marketing tactics with Baby-Friendly designated hospitals… 

“We at BFUSA are appalled that these companies would use the pandemic as an ‘opportunity’ to advance their business interests under the guise of an intent to support facilities during this difficult time.

So, please let us be perfectly clear: Our standards are still our standards. We have not ‘loosened’ our guidelines and we still expect Baby-Friendly designated facilities to shield health care workers, mothers and families from commercial influence, as outlined in the International Code of Marketing Breast-Milk Substitutes.”

Photo by Luiza Braun on Unsplash

In other parts of the world too, companies exploit the Covid-19 crisis. Baby Milk Action documents how one company violates Indian Law with their YouTube channel. Keep scrolling and scrolling and scrolling on Baby Milk Action’s page and you’ll find offense after offense after offense documented in multiple countries. 

In response, there are several documents cited offering guidance on how to navigate avoiding partnerships with these corporations.  Find them here

On an individual level, this is a great time to remind Certified Lactation Counselors (CLCs) of our Code of Ethics which states we must “Abide by the International Code of Marketing of Breast-Milk Substitutes and subsequent resolutions which pertain to health workers.”

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.

How to support world’s coordinating authority in setting global health norms

I have a friend who describes her experience wading through the pandemic as paralyzing. 

Photo by The New York Public Library on Unsplash

In the first few weeks of the social distancing orders, she says she found herself just standing there at times, staring off into the distance with an utter sense of loss. 

It’s a familiar feeling. Even with so much to be grateful for, there’s static that surrounds us– a heaviness that lingers around the edges, as my friend puts it. 

“It’s a pretty big presence to try to push away with positivity right now,” she counseled me. 

Amidst the stillness, what sometimes feels like paralyzation, there are actions taken, decisions made– like President Trump’s decision to halt funding to the World Health Organization (WHO) during a global pandemic— with sweeping consequences. 

Trump’s plan to defund WHO has been met with mobilization by the International Baby Food Action Network (IBFAN) and partner civil society organizations who are  joining forces to support WHO. You can read IBFAN’s full statement of support to WHO from April 11 here

Patti Rundall is the Policy Director Baby Milk Action, Global Advocacy IBFAN.  

“We have been one of the most outspoken NGOs, calling for WHO to adopt a sound conflict of interest policy to safeguard its independence and resist the unjustified influence of powerful interests, be they commercial or political,” she writes in an email to Our Milky Way.  “…All our criticisms are focused on supporting WHO in its unique role as the world’s coordinating authority in setting global health norms.” 

Specifically, WHO “is absolutely critical to the world’s efforts to win the war against COVID-19,” as U.N. Secretary-General António Guterres declares in a UN News story

Guterres goes on to say in that piece that it is “not the time to reduce the resources for the operations of the World Health Organization or any other humanitarian organization in the fight against the virus.”

Bill Gates on Twitter writes: “Halting funding for the World Health Organization during a world health crisis is as dangerous as it sounds. Their work is slowing the spread of COVID-19 and if that work is stopped no other organization can replace them. The world needs @WHO now more than ever.” The Bill & Melinda Gates Foundation’s voluntary contribution to WHO is second to the U.S.’s assessed and voluntary contributions. [More here.] 

Rundall adds: “WHO is needed to guide not only country responses to COVID-19 but also the host of other global threats that we face – not least global heating, new viruses, antimicrobial resistance and non-communicable diseases.” 

Rundall explains that “the U.S. is not the only nation to lobby against the much needed increases of Member States assessed contributions, but it is one of the most powerful.”

“For goodness sake, WHO’s total annual budget of $2.5bn is about the same as the budget of a large US hospital,” she puts the money into perspective.  

Even without defunding, WHO is already underfunded

Even as many of us are feeling debilitated to some degree, Rundall offers suggestions on how to take action for good. 

“We hope that US citizens– and especially anyone working in infant and young child health– will remember the critically important role that WHO has had in child survival,” she begins. “and do everything they can: write to politicians, media, social media, friends  and distance themselves from President Trump’s statements about health.”  [Link added.] 

Rundall directs us to the Society for International Development’s stance on Trump’s move which reiterates the G2H2 statement as well as an open letter of support to WHO and Dr. Tedros Adhanom Gebrheyesus in BMJ

Visit Rundall’s frequently updated policy blog here