Our Milky Way

March 19, 2023March 19, 2023

‘Full pandemic mama’ becomes full spectrum doula

Allysa Singer was, as she describes, a “full pandemic mama.” Singer became pregnant with her first child in the winter of 2019. As she became aware of the threats and the consequences of COVID-19, she started researching her options and her rights in the delivery room she’d find herself in August 2020.

What started as personal preparation– How many support people would she be allowed? Would she be allowed a support person at all? What restrictions would she encounter? How could she advocate for herself? What were her options?– propelled her into a world of birth support and autonomy advocacy.

“I was just dumbfounded by the disparities that exist in maternal health,” Singer begins.

In 2020, Alabama, where Singer and her family live, had the third-highest Maternal Mortality Rate in the nation, at 36.4 per 100,000 live births.

BIPOC families suffer from massive disparities in maternal and infant deaths. In a recent piece, Childbirth Is Deadlier for Black Families Even When They’re Rich, Expansive Study Finds, Tiffany L. Green, an economist focused on public health and obstetrics at the University of Wisconsin-Madison is quoted: “It’s not race, it’s racism…The data are quite clear that this isn’t about biology. This is about the environments where we live, where we work, where we play, where we sleep.”

Still, unlike so many of her peers, Singer reports having had an amazing birth experience.

Inundated by birth horror stories, she decided to change care at 27 weeks in hopes that she would be better supported in her choices at a different institution.

Here, she was allowed a doula and support person to accompany her during her birth.

“Not a lot of women had that luxury,” Singer comments.

Knowing well that birth support is a right and not a luxury, she started her own doula practice in December 2021.

Singer shares that she experienced severe postpartum depression, but she was able to divert and ultimately reshape this energy into her doula work.

“My doula training was the lifeboat that saved me from drowning in my PPD,” she says.

And now her practice, Faith to Fruition, has become the lifeboat for many of the birthing people Singer supports.

She shares: “I don’t believe that a birther’s desire to have more children should be dictated by their birthing experience. I have heard so many stories from people who had one kid but say, ‘I would never do this again because my experience was so traumatic.’ One of my biggest missions and goals is to support birthers to feel empowered in their process; not as bystanders of their process.”

Singer also holds a full time position as an industrial psychologist where she channels her advocacy work, pushing for organizational change and understanding of proper maternal support.

In fact, as part of a public speaking course for a training curriculum, Singer presented on why it’s important to support breastfeeding. She reports that her audience of roughly 25 was engaged, especially as she pointed out the absurdities of infant feeding culture in our country: How would you feel if I asked you to eat your meal in the bathroom? How would you like to eat with a blanket tossed over your head? for instance.

Singer also points out the “insanely amazing public health outcomes” breastfeeding affords.

If 90 percent of U.S. babies were exclusively breastfed for six months, the United States would save $13 billion per year and prevent an excess 911 deaths, nearly all of which would be in infants ($10.5 billion and 741 deaths at 80% compliance). [Bartick, Reinhold, 2010]

“Not only is there a personal investment, there is a public investment and value to understanding the larger implications,” Singer comments. “As a taxpayer, [breastfeeding] impacts you; as someone who utilizes our healthcare system, [breastfeeding] impacts you.”

With the recent passing of the PUMP Act and the Pregnant Workers Fairness Act coming soon, Singer says “We still have a long way to go.”

Organizational policy doesn’t support motherhood; instead it fuels detached parenting which goes against nature, Singer goes on.

“Mothers feel the brunt of that more than ever,” she says. “[We aren’t] supported to be able to care for our children the way that we want to.”

Singer says she sees it as her mission as an organizational psychologist to encourage change that supports parenthood, so that women don’t feel threatened to care for their children the way that they want to. This means ensuring that women are provided with ample space to pump their milk while away from their babies and empowering them to approach HR when there aren’t appropriate accommodations.

“Outside forces shouldn’t be able to dictate how you care for and feed your child. The end of one’s breastfeeding journey should be a personal decision.”

She continues, “It’s amazing that legislation is catching up. The thing that I fear with any law, there are still people behind those laws that have to enforce them and carry them out. Education and garnishing an understanding of what this looks like is a key component to implementation. The people behind those policies have to make them successful, but this is moving things into a very good direction, and I hope that more changes to legislation follow suit, especially with paid parental leave. It’s a catalyst for change; I am hopeful but cautiously optimistic.”

Singer says she owes her personal success continuing to breastfeed her two-and-a-half year old to Chocolate Milk Mommies, where she now serves as a board member.

Through Chocolate Milk Mommies, Singer started a subcommittee to focus on education for individuals within the breastfeeder’s support system.

“The people in the village need to be supportive. When you don’t know better, you can’t do better,” she explains.

Singer recently completed the Lactation Counselor Training Course (LCTC) as part of Chocolate Milk Mommies’ mission to best support their constituents and as a way to benefit her doula clients with more well-rounded support.

“I really loved the training because I already thought that our bodies are amazing, but learning more science was great. I would text my friends the ‘Boobie Fact of the Day’,” Singer shares. “[The science] allows me to really appreciate my journey that much more and how impactful I’m being with my daughter.”

You can follow Singer’s work here and here.

March 12, 2023March 10, 2023

Human milk banks around the world

Of all the known approaches to saving infant lives, human milk has the greatest potential impact on child survival. (PATH) When direct breastfeeding or mother’s expressed milk is not available, donor human milk is the next best option.

As such, the 2018 WHO/UNICEF implementation guidance on the Baby-friendly Hospital Initiative stated that “Infants who cannot be fed their mother’s own milk, or who need to be supplemented, especially low-birthweight infants, including those with very low birth weight and other vulnerable infants, should be fed donor human milk.” The American Academy of Pediatrics, the European Society for Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition, and other national and global policy groups also call for use of donor human milk as the feeding of choice, if mother’s own milk is insufficient, unavailable or contraindicated. (WHO)

Now, WHO is in the process of developing guidelines on donor human milk banking.

The ISRHML Trainee Interest Group recently presented A Global View of Human Milk Banking with Kimberly Mansen (PATH), Dr. Victoria Nakibuuka (Nsambya Hospital), Debbie Stone (Rogers Hixon Ontario Human Milk Bank), and Dr. Maryanne Perrin (The University of North Carolina Greensboro) which brought to light several, wonderful resources and is the inspiration for this week’s post.

Let’s take a look at some human milk banks around the world.

This tableau map depicts publicly known human milk banks. If you know of a milk bank that is not shown on the map, you can fill out this form and/or email kamundson@path.org or humanmilkbankmap@gmail.com.

Brazil

Donor milk banking thrives in countries such as Brazil, where there has been a concerted effort at the Health Ministry level to incorporate milk banks into health policy. (Arnold, 2006)

Uganda

In commemoration of World Prematurity Day, Uganda introduced its first human milk bank at Nsambya Hospital on the 26th of November 2021 at Pope Square. [More here.]

Canada

The Rogers Hixon Ontario Human Milk Bank in Ontario has dispensed over 1 million ounces of human milk. The Rogers Hixon Ontario Human Milk Bank is a non-profit organization and a joint initiative of Mount Sinai Hospital, The Hospital for Sick Children (SickKids) and Sunnybrook Health Sciences Centre. It is a member of the Human Milk Banking Association of North America.

Ukraine

The first and currently only Ukrainian Human Milk Bank was established in Kiev at the Perinatal Centre where approximately 80 percent of all premature babies in the city are born.

South Africa

The South African Breastmilk Reserve (SABR) has set up a total of 44 in-hospital human milk banks in public and private hospitals across South Africa.

Vietnam

The first human milk bank in Vietnam was officially opened on February 17, 2017, at the Danang Hospital for Women and Children. This facility is supported by the Vietnam Ministry of Health and the Danang Provincial Department of Health, and is the first human milk bank in Vietnam to be operated within the public health system and to international standards. (PATH)

Take a virtual tour of the bank here.

Also consult:

March 5, 2023

Efforts to curtail dubious marketing practices of commercial milk formula industry

The commercial milk formula (CMF) industry uses marketing tactics similar to those of the tobacco, alcohol, and ultra-processed food industries.

Photo Credit: Boston Public Library
Date: ca. 1870–1900 https://ark.digitalcommonwealth.org/ark:/50959/3b591d51p Please visit Digital Commonwealth to view more images: https://www.digitalcommonwealth.org.

Earlier this winter, the Lancet published a three-paper series outlining the multifaceted and highly effective strategies used by commercial formula manufacturers to target parents, health-care professionals, and policy-makers.

“The industry’s dubious marketing practices—in breach of the breastfeeding Code—are compounded by lobbying of governments, often covertly via trade associations and front groups, against strengthening breastfeeding protection laws and challenging food standard regulations,” the Lancet summarizes.

Two new publications corroborate WHO findings on the digital marketing of commercial milk formulas in Mexico:

In another recent publication, Pediatricians’ Reports of Interaction with Infant Formula Companies, the authors found that: “Of 200 participants, the majority reported a formula company representative visit to their clinic (85.5%) and receiving free formula samples (90%). Representatives were more likely to visit areas with higher-income patients (median = $100K versus $60K, p < 0.001). They tended to visit and sponsor meals for pediatricians at private practices and in suburban areas. Most of the reported conferences attended (64%) were formula company-sponsored.”

The authors write that “Seventy percent of countries follow the World Health Organization International Code of Marketing Breast Milk Substitutes that prohibits infant formula companies (IFC) from providing free products to health care facilities, providing gifts to health care staff, or sponsoring meetings. The United States rejects this code, which may impact breastfeeding rates in certain areas.”

The Lancet series authors provide recommendations to restrict the marketing of CMF to protect the health and wellness of mothers and babies, and ultimately society and the planet.

Curtail the power and political activities of the CMF industry

End state practices that do not uphold, or that violate, the rights of women and children

Recognise, resource, and redistribute women’s care work burdens in support of breastfeeding

Address structural deficiencies and commercial conflicts of interest in health systems

Increase public finance and correct the misalignment between private and public interests

Mobilise and resource advocacy coalitions to generate political commitment for breastfeeding

In Mexico, UNICEF and Instituto Nacional de Salud Pública have designed infographics for policymakers as well as parents and caregivers to educate on the impact of digital marketing.

The partners are also working on proposed modifications to current Mexican regulations that involve commercial formula milk and ultra processed food marketing to infants and young children. Further, development is underway for a mobile app tool for monitoring the Code in Mexico.

Legislation in El Salvador was recently passed–“Love Converted into Food Law, for the Promotion, Protection, and Support of Breastfeeding.”

PAHO is monitoring the implementation of the Baby-friendly Hospital Initiative in the Americas BFHI requires full compliance with the Code and subsequent WHA resolutions.

In other efforts to protect parents and babies, Breastfeeding Advocacy Australia released a video on how the organization monitors predatory marketing. Find it here. You can find their Facebook group here.

Learning self care through active practice

The same principles apply to supporting self care as the business case for breastfeeding: employees who are more satisfied and loyal and cost savings realized in the retention of experienced employees, the reduction in sick time taken, and lower health care and insurance costs.

Nearly a decade ago, Healthy Children Project’s Donna Walls, RN, BSN, ICCE, IBCLC, ANLC helped establish a meditation room in the maternity care wing of the hospital she worked at. With soft lighting, comfy chairs and the option for aromatherapy and calming music, the room was well-received, or necessary as Walls would argue.

Photo by Karolina Grabowska: https://www.pexels.com/photo/woman-kneeling-on-a-yoga-mat-4498216/

Now, Walls co-teaches an overview of holistic health as part of the Allied Health program at Sinclair College in Ohio.

Walls and colleague Jeri Layer recently presented a compressed version of the course, “Learning Self Care Through Active Practice”, to Sinclair faculty.

In their course, they ask participants to consider what they do on a daily basis to maintain physical and mental health. Participants are also asked to consider: what are their stress triggers and what are the sensations associated in those times of stress?

Typically, as a nation, we have been taught to be reactionary with our health, but Walls says that even before the COVID-19 pandemic struck, she started to notice people paying attention to mental health and self-care.

“The pandemic put a really bright light on it,” Walls says.

Walls and Layer have broken down self-care into very specific strategies and offer a variety of modalities for humans to promote emotional, mental and physical health.

Photo by Valeria Boltneva: https://www.pexels.com/photo/closeup-photo-of-white-petaled-flowers-965982/

For instance, aromatherapy can come in the form of simple awareness of the scents around us like freshly baked bread, the air after a rain, or the scent of roses. Essential oils can be used therapeutically as they have “a direct effect on the brain and trigger emotions and hormonal responses.”

The duo advise how to use essential oils along with methods of administering like steam inhalation, direct application to the skin with carrier oils, or used in diffusers like lamp rings or cotton balls for example. Oral ingestion is NOT recommended, they warn.

Tapping, or the Emotional Freedom Technique (EFT), is another modality proposed.

“Tapping is a self-help technique that involves tapping with fingertips on points of ‘energy meridians’ located around the body,” Walls explains. “It is based on the theory used for acupuncture, but without the use of needles, to stimulate energy points on the body which create a balance both emotionally and physically.”

Affirmations can be coupled with tapping.

Walls and Layer share these:

“Even though I feel this anxiety, I deeply and completely accept myself.”

“Even though I panic when I think about ______, I am strong enough to deal with this.”

“Even though I’m having pain, I can see myself relaxing and releasing this pain.”

Other self-care techniques include the Havening Technique which is a method that uses sensory input to alter thought, mood, and behavior through a process called synaptic depotentiation, mindful breathing, 4-7-8 breathing, box breathing, and three-part breathing, and mediation.

The majority of these practices are inexpensive and accessible making them good options for whenever the need arises.

Walls and Layer emphasize the importance of building the immune system as a self-care tool. Part of building a healthy gut, a major component of the immune system, is minimizing the use of antibacterials and instead, washing hands with toxin-free soaps.

Using appropriate herbs, ensuring proper micronutrients through whole foods and prioritizing sleep are all vital components in caring for ourselves holistically, the duo teach in their course.

Photo by Nathan Cowley: https://www.pexels.com/photo/woman-slicing-gourd-1153369/

Walls acknowledges that it’s often most difficult to carve out time for self-care when we need it the most.

Reminiscing about when her children were young, Walls says, “I look back on those really busy times in my life and wonder ‘How did I get through those crazy times?’ I think I learned early on how to do a lot of these self care techniques… and I am really glad because I can see the benefits as the years have gone on… I am reaping the benefits now at my age from [practicing self-care] back then.”

When we practice self-care, we’re setting examples for the next generation, too. Walls points out that her adult daughter now uses many of techniques she observed as a child with her own children and with the children she works with at an elementary school.

Walls likens this to a concept Dalai Lama is credited with: “Just as ripples spread out when a single pebble is dropped into water, the actions of individuals can have far-reaching effects.”

Photo by Felix Mittermeier: https://www.pexels.com/photo/closeup-photography-of-water-drop-355724/

Check out another Our Milky Way piece Self-care strategies for lactation care providers for more thoughts on providing sustainable care.

February 19, 2023February 20, 2023

Breastfeeding is ours. Breastfeeding belongs to us.

–This post is part of our 10-year anniversary series “Breastfeeding is…” When we initially curated this series, we planned for 10 weeks, but breastfeeding is so many things that we just couldn’t fit it all in, which means we have two bonus weeks in our anniversary series.–

Breastfeeding is ours. Breastfeeding belongs to us.

Nicole Starr Photography Originally featured on Our Milky Way in ‘ Non-profit Julia’s Way proves babies with Down syndrome can breastfeed’

For decades, the 55 billion dollar formula milk industry has positioned itself as an ally to parents.

Through conniving tactics, like the distortion of science to legitimize their claims, the systematic targeting of health professionals to promote their products, and the undermining of parents’ confidence in breastfeeding, the industry impacts the survival, health and development of children and mothers, disrupts truthful information– an essential human right as noted by the Convention on the Rights of the Child, disregards the International Code of Marketing of Breast-milk Substitutes, and exploits the aspirations, vulnerabilities and fears at the birth and early years of our children solely for commercial gain. (WHO/UNICEF, 2022, p. x) [More at WHO report exposes formula milk marketing, offers steps forward]

Far before the advent of formula milks and their subsequent marketing campaigns, breastfeeding sustained the human species. When breastfeeding wasn’t possible, wet nursing was the primary alternative feeding option. [Stevens, et al 2009]

For generations, cultures across the globe have honored breastfeeding as a central part of their identities, and now they’re reclaiming these traditions after being challenged by the formula milk industry and other forces.

Photo by Mehmet Turgut Kirkgoz : https://www.pexels.com/photo/a-woman-breastfeeding-her-son-12359528/

HealthConnect One’s program manager Brenda Reyes, RN, CLC describes that reclamation of Latino/Hispanic birth and breastfeeding traditions in Reclaiming Latino/Hispanic birth and breastfeeding traditions for instance.

In It’s Asian American Native Hawaiian and Pacific Islander (AANHPI) Week: “Reclaiming Our Tradition”, To-Wen Tseng covers just what the title suggests.

Navajo Breastfeeding Coalition/Dine Doula Collective, Amanda Singer, CLC discusses the revitalization of Indigenous breastfeeding in Honoring Indigenous Milk Medicine Week: “Nourishing Our Futures”.

Hispanic Health Council’s Breastfeeding Heritage and Pride (BHP) Program manager and lactation consultant Cody Cuni, IBCLC, BS reminds us in Hispanic Health Council’s Breastfeeding Heritage and Pride (BHP) Program heals, empowers and celebrates through peer counseling model that breastfeeding has always belonged to the people.

Photo by willsantt: https://www.pexels.com/photo/woman-breastfeeding-her-toddler-under-the-tree-2714618/

Cuni offers commentary on her and her colleague’s responsibility to help facilitate breastfeeding without capitalizing, claiming and dominating. She sees her role as an empowerer.

Without diminishing the need for larger structural supports, let us also remember and celebrate the innate power we hold as individuals who can nourish and nurture our young and ourselves through breastfeeding.

___

Our 10-year anniversary giveaway has ended. Thank you to everyone who participated!

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