Breastfeeding is food sovereignty. Breastfeeding is health equity. Breastfeeding is healing.

–This post is part of our 10-year anniversary series “Breastfeeding is…”

Breastfeeding is food sovereignty. Breastfeeding is health equity. Breastfeeding is healing.

Breastfeeding is a “weapon of mass construction”, a phrase coined by Camie Jae Goldhammer, MSW, LICSW, IBCLC, (Sisseton-Wahpeton).

In her Reclaiming the Tradition of Breastfeeding: the Foundation of a Nation webinar, Goldhammer describes how breastfeeding has the power to heal those suffering the effects of generational trauma, specifically through the release of oxytocin, subsequently allowing mothers and their babies to feel empowered and independent.

Photo by Luiza Braun

Kathleen Kendall Tackett’s work also illuminates how breastfeeding can heal trauma. Her videos, How Birth Trauma Affects Breastfeeding and Breastfeeding Can Heal Birth Trauma and Breastfeeding’s Healing Impact on Sexual Assault Trauma discuss the mechanisms behind why and how breastfeeding can be helpful for trauma survivors. Essentially, breastfeeding allows for the down regulation of stress responses, specifically adrenocorticotropic hormone (ACTH) and cortisol, and similar to exercise, improves maternal mood, decreases the risk of depression, decreases hostility, and improves the mother infant bond.

Jennie Toland, BSN, RN, CLC offers commentary on the role lactation care providers play in offering trauma-informed care in this piece.

This Invisibila episode, Therapy Ghostbusters, shares the incredible story of how a Cambodian practitioner worked to help heal an entire community from generational trauma. It took him over a year to simply earn individuals’ trust.

“…That’s pretty unique,” the podcast hosts point out and offers insight into how our nation approaches care for individuals with specific mental health needs and cultural considerations.

Goldhammer quotes Round Rock elder Annie Kahn:  “When a mother nurses her baby, she is giving that child her name, her story and her life’s song. A nursed baby will grow to be strong in body, mind and spirit.”

This connection to the past that Kahn refers to, also offers a form of healing. Breastfeeding is an example of Indigenous food sovereignty, “a part of living culture” and facilitates the revitalization of traditional knowledge. (Cidro, et al 2018)

The revitalization of breastfeeding spans the Black Indigenous People of Color (BIPOC) experience and is a channel to champion equity.

Ifeyinwa V. Asiodu,  Kimarie Bugg,  and Aunchalee E.L. Palmquist write in Achieving Breastfeeding Equity and Justice in Black Communities: Past, Present, and Future:

“Breastfeeding is an especially important public health issue in Black communities, particularly given that Black families and communities continue to experience the highest burden related to poor maternal and infant health outcomes, including higher incidence of preterm birth, low birth weight, maternal mortality and morbidity, infant mortality, and lower breastfeeding rates. Owing to lifetime exposure of racism, bias, and stress, Black women experience higher rates of cardiovascular disease, type 2 diabetes, and aggressive breast cancer. Given that cardiovascular disease and postpartum hemorrhage are leading causes of maternal mortality and morbidity, increasing breastfeeding rates among Black women can potentially save lives.”

Photo by Emily Finch

More specifically, studies show that the experience of racial discrimination accelerates the shortening of telomeres (the repetitive sequences of DNA at the ends of chromosomes that protect the cell) and ultimately contributes to an increase in people’s risks of developing diseases.

It has been found that higher anxiety scores and inflammation are associated with shorter telomere length.

Because physical and psychological stressors trigger the inflammatory response system, one way to counter this reaction is by supporting ongoing breastfeeding relationships; when breastfeeding is going well, it protects mothers from stress. (Kendall-Tackett, 2007)

Another study found that early exclusive breastfeeding is associated with longer telomeres in children.

Photo by Luiza Braun

The authors of Achieving Breastfeeding Equity and Justice in Black Communities: Past, Present, and Future continue, “Yet breastfeeding is rarely seen as a women’s health, reproductive health, or a public health strategy to address or reduce maternal mortality and morbidity in the U.S. Inequities in lactation support and breastfeeding education exacerbate health inequities experienced by Black women, specifically maternal mortality and morbidity, and thus a greater investment in perinatal lactation and breastfeeding education and resources is warranted. Breastfeeding is an essential part of women’s reproductive health.”

Journalist and maternal child health advocate Kimberly Seals Allers’ approach is one “For Black people, from Black people.”

“…The call to revive, restore and reclaim Black breastfeeding is an internal call to action,” Kimberly Seals Allers begins in Black Breastfeeding Is a Racial Equity Issue.  “… Breastfeeding is our social justice movement as we declare the health and vitality of our infants as critical to the health and vitality of our communities.”

Specifically through her work with Narrative Nation, Seals Allers and colleagues are promoting health equity “by democratizing how the story of health disparities is told,” centering BIPOC voices. Additionally, through her Birthright podcast, KSA uplifts stories of  joy and healing in Black birth.

Especially after the deaths of George Floyd, Breonna Taylor and Ahmaud Arbery, organizations made statements about their commitments to dismantling structural racism and focusing efforts on equity.

Equity has become a buzzword; in fact, one author brands the sentiment “Fakequity”. This year, United States Breastfeeding Committee (USBC) National Conference and Convening presenters expressed their fatigue with the word.

“We want to see action,” they said.

Nikki & Nikki LIVE offer their Allies, Advocates and Activists Equity in Lactation webinar which covers the meaning of equitable in lactation care, how to show up for the marginalized and how to make a lasting impact.

In other efforts, the CDC has identified breastfeeding as a priority area to address health inequities.

Photo by Luiza Braun

NICHQ’s Achieving Breastfeeding Equity campaign also focuses on closing breastfeeding disparity gaps, viewing their efforts through an equity lens.

Director of policy and partnerships at the National Women’s Health Network Denys Symonette Mitchell offers commentary on a way forward with key policies that will ensure investment in breastfeeding to ultimately advance health equity.

Watch Racism and the Colonial Roots of Gendered Language in Public Health and Biomedicine with Dr. Aunchalee Palmquist, PhD, IBCLC for more on these issues.  

 

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As part of our celebration, we are giving away an online learning module with contact hours each week. Here’s how to enter into the drawings:

Email info@ourmilkyway.org with your name and “OMW is 10” in the subject line.

This week, in the body of the email, tell us about how you are contributing to working toward healthy equity.

Subsequent weeks will have a different prompt in the blog post.

We will conduct a new drawing each week over the 10-week period.  Please email separately each week to be entered in the drawing. You may only win once. If your name is drawn, we will email a link with access to the learning module. The winner of the final week will score a grand finale swag bag.

Paternal mental health and engagement

Humans are born connected. Separation is a learned behavior and in Western society, is often an accelerated process beginning just moments after birth

Photo by Kreated Media on Unsplash

If we can learn to separate, then we can unlearn those practices too. We can learn to reconnect. 

In recent time, skin-to-skin contact immediately after birth and beyond has been widely embraced as a tool to keep mothers and babies connected and to promote bonding. Skin-to-skin contact is encouraged to facilitate bonding between baby and father and other care providers too. 

As NICHQ President and CEO Scott D. Berns, MD, MPH, FAAP points out in Fathers: Powerful Allies for Maternal and Child Health, “father engagement and involvement is a critical opportunity to improve children’s health outcomes in the decades to come”… beginning in the prenatal period. 

Despite overwhelming evidence demonstrating the importance of paternal involvement, fathers are up against significant barriers “including systemic obstacles related to employment, and a lack of confidence stemming from social stereotypes about the expected role of a father—namely that their role is somehow secondary to the mother’s.” [https://www.nichq.org/insight/fathers-powerful-allies-maternal-and-child-health

Fathers BJ (left) and Frankie (right) embrace their seconds-old-newborn boy Milo. Milo’s umbilical cord is still attached to the surrogate in this image. Photo by Ontario artist Lindsay Foster. Formerly published in: http://www.ourmilkyway.org/skin-to-skin-image-goes-viral/

In an effort to address paternal mental health, Healthy Children Project faculty Eira Yates in partnership with OhioGuidestone developed the Yates Paternal Depression Screening Tool for male fathers, a first of its kind measurement. 

The tool is reminiscent of the Edinburgh Postpartum Depression Scale (EPDS) developed to screen for depression in women during and after pregnancy and childbirth, but different in that it is sensitive to fatherhood and “not retrofitted and adapted from tools developed to capture unique characteristics of depression in women and mothers.” 

Photo by Kelly Sikkema on Unsplash

The Yates tool can screen male fathers during the perinatal period (prenatal or before birth up to 12 months after birth) for signs of depression with questions related to Mood/Loss of Interest and Motivation, Aggression/Irritability, Self-Concept/Feelings of Worth, Social System Deficits and Drug/alcohol use.  

“We believe that a culturally sensitive, carefully designed tool can give insight into the particular ways depression manifests in male fathers, identify men at risk for perinatal depression, and highlight the need to tailor treatment and services to the unique experiences of male fathers,” Brittany Pope, M.S., Director of Applied Clinical Sciences and Research at OhioGuidestone explains. “Furthermore, we hope to spur opportunities to explore potential programming, treatment and policy changes, both to raise awareness of the need to screen male fathers and to offer efficient and effective services and programs to meet their clinical and parenting needs.” 

The tool isn’t yet published and due to COVID-19,  research activity has been suspended, however the team plans to reopen the study using remote telehealth videoconferencing in August/September. This method will allow for even higher recruitment and screening. 

You can learn more about the screening tool at The Institute of Family & Community Impact’s website here

Photo by Chris on unsplash

In another effort to include fathers in the conversation around birth practice, separation and support,  Lactation Specialist Lydia O. Boyd, CLE is conducting a survey to capture the experiences of Black males through the Covid-19 pandemic. The survey can be found here

Reaching Our Brothers Everywhere (ROBE), an organization dedicated to educating, equipping, and empowering men to impact an increase in breastfeeding rates and a decrease infant mortality rates within the African-American communities, is hosting its 2020 Virtual Summit June 23 & 25 featuring speakers Dr. Saturu Ned, former Black Panther, Dr. Brian McGregor, Dr. Torian Easterling, Kenn Harris from National Healthy Start and the entire ROBE team. Register here.