Where are they now? Catching up with Lucy Ellen Towbin, LCSW

Towbin admires her grandchild in this recent photo.

Many of Lucy Ellen Towbin’s, LCSW endeavors are defined by nourishment. By the time she was two, Towbin was producing art and as she has continued to make multimedia art into her 70s, she nourishes her Self. As the eldest of four children, Towbin helped provide for her
younger siblings in their childhood. In her 30s, as a new mother,  she nourished her children.  As a social worker and lactation care provider, she supported other dyads in their infant feeding efforts. Later, Towbin started a business (which has since been sold) that offers clean, dehydrated parrot pellets, so that she and other parrot-owners could escape reliance on industry-produced pet food which usually contains additives and food coloring that parrots are particularly sensitive to.

During the first wave of the COVID-19 pandemic, Towbin retired from the
Arkansas Health Department, and while she no longer holds her IBCLC
credential, she continues to assist new mothers informally. Towbin now
practices as a part-time therapist for a psychotherapy clinic in
Arkansas.

The last time Towbin graced Our Milky Way was back in 2017 when we
featured the breastfeeding art contest she facilitated through the
Arkansas Breastfeeding Coalition.

We’re pleased to have chatted with Towbin as part of our Where are they
now? series. Responses have been edited for brevity.

 

Towbin poses with Ruth Lawrence roughly a decade ago.

How did you become interested in maternal child health? 

The first job I had at the Department of Health was as the refugee health program coordinator. We worked with mostly refugees from Southeast Asia.  I was really interested in and intrigued  by the difference in how
they were taking care of their children. They slept with their babies, which I’m sure plenty of people in the U.S. still did quietly, but back then, no one was talking about it.
During a panel discussion we once held, a speaker from Laos shared
that his six children born in Laos were breastfed, and the five children
born in the States were bottle-fed. This is when I really became
interested in the cultural aspects that affect infant feeding, and I started
to try to figure out what was going on.

Is there a current trend, project or organization that excites you?

I’m really not that up-to-date about trends in lactation, but what does
excite me are the portable pumps that working moms can wear. A close
friend of my daughter’s is a nurse practitioner and she showed me her
pump that she wears under her white jacket as she walks around seeing
patients. It makes almost no noise and it’s amazing because you don’t
even know that it’s under there. That would’ve been so incredible for me
to have as a working breastfeeding mom.

When I was working outside of the home, it was really difficult; even La
Leche League wasn’t very supportive of working moms at the time. With
my first child, I had a manual pump and my own office, but the pump was
miserable.  It hurt and wasn’t that effective. With my second child, I
stayed home longer with him and then he wouldn’t take a bottle, so I
didn’t do that much pumping. When I went back to work, my mother took
care of him and she lived close to where I was working, so I would nurse
him before work, and then drive back and forth to her house to feed him
about every two hours. It was a lot of back and forth.

What is the most significant change you’ve noticed within maternal child
health?

I have a very small sample size to talk about significant changes. All I
know is from my daughter and her friends. I’ve noticed that there seems
to be less unmedicated births happening in the hospital. I know there are
still a lot of people choosing home birth. But of those having babies in
the hospital, I haven’t heard about anyone doing what I did and having
mine in the hospital, but with no pain medicine or IV or anything.   I was
lucky to find the physicians that I did who went along with my wishes.  I
would expect there would be more supportive physicians now and instead, I don’t hear about any. I do want to reiterate that my observations are based on just a small group.

What is your best piece of advice for the next generation of lactation
care providers?

The most helpful lesson combines my training as both a therapist and
lactation consultant. New mothers need so much emotional support.
They don’t need people to take care of the baby. Bringing food and running errands for them is helpful. But I think what gets overlooked is
how much they need to be told that they’re going to make it, that they will
survive this early period of no sleep, and not knowing if they are doing a
good job. They need reassurance that this difficult time is normal and
they need to be told they will get through this.

My best piece of advice for the next generation is to take a holistic
approach, don’t just emphasize the physical exam. Equally important is
how much sleep the mother is getting,  what she is eating, if she is
getting exercise, if she has family and friends supporting her, if she has a
plan for if she’s going to be working outside of the home. It’s important to
equip new moms with coping strategies like easy breathing exercises or
something when she is feeling stressed that are doable in short time
frames and at home.

Where do you envision yourself in the next decade?

Asking someone my age where I see myself in the next ten years is
basically just hoping I’m still healthy and active! I do all the right things
and have good genes, so I’m on the pathway to that, but you never
know. Appreciate good health and youthful energy if you still have it.

Involution

*This piece contains curse words.

Image by Nadezhda Moryak

It’s early in the New Year. Every evening, I work out on my beloved stationary bike, not because of some expected resolution or disillusioned intentions, but because it’s where I am forced to breathe, and therefore it’s become a necessary part of my existence. After each workout, I move through a ritual, so absurd, before stepping into the shower.

Confronting my naked self in the mirror, my head cocks slightly, my eyes narrow, and I admire the tone I’ve achieved in my upper abs and the muscles that grip my ribs.

Simultaneously, I grimace at the places I obsess over sculpting but that which won’t respond to calorie deficits, macro-calculating, crunches, four minute planks, cardio, endurance training, barre, yoga, weight-lifting, mindfulness, willing myself into a satisfying form.

In an exasperated sigh, I roll my shoulders back, scowling at the beefy traps I’ve acquired.  The scowl accentuates the crease between my eyes, a fissure carved by contemplation.

I “draw my navel to my spine.” This is the more sensitive version I’ve learned to replace “suck it in.”

I squint at the flakey, smudged mascara under my eyes, the substance I brush on my blonde eyelashes each morning to avoid people thinking I’m sick. (A former co-worker once insisted I must be sick when I arrived at work without it. “No, really, you do not look good,” she said, recoiling as if it were painful to look at me.)

I prop my hands on my hips, smoothing out the bulge so that it’s easier to envision myself at least one pant size smaller, just out of reach of kid sizing, a disgusting delusion I recognize.

When I prop my hands this way, it also makes my arms look thinner by avoiding the offensive spread when they’re at rest.

And then I clench my fingers around my waist, squeezing enough to whiten my knuckles, wishing there were somewhere else for my organs to go, wondering if maybe they are the reason I appear so wide.

My scrutiny moves next to the sinewy dangles suspended from my chest wall. They’re pruned, though more full than the year my husband begged me to see a doctor for the weight I had (intentionally) lost.

Shiny stretch marks radiate from auburn areolas punctuated by cylindrical nipples topped with depleted pigment, like tiny little snow-capped mountains.  They’re cock-eyed yet knowing and they hold my attention offering me something like: “‘Fuck the patriarchy and boob idolatry!…’”

They demand respect.

I cup my hands around them. The flesh spills into the spaces between my fingers. They’re soft, not like how my former boyfriends would express; soft, not like how they felt after my babies had fed; soft, more like the powdery skin that hung from my grandmother’s triceps.

I pull them up toward my face, and the stretch marks wrinkle into themselves. A fold forms under my thick collarbones. I lift my arms above my head and my boobs fall to gravity. The muscle near my armpits lift the edges of my breasts into a mischievous smile. The bottoms hang pendulous. Each breast morphs into an elongated structure, like the way an octopus maneuvers and slips gracefully, awe-inducingly into secret crevices and caves.

My breasts don’t respond to the tricks I experiment with on other parts of my body: the pressing, sucking, tensing, flexing, tucking.

They’re rebellious.

Still needing a shower, I cup my breasts again as if hand expressing milk.  On other nights, I’ve envisioned thick, golden colostrum beading at my pores or milk like that that nourished my children sprinkling onto the bathroom floor, but as biology would have it, these substances don’t come.

When I draw my fingers down toward the nipples on this night, in a festive but discreet explosion, like the poof of a dainty flatulent, confetti detonates from my nipples. Beautiful colors and sparkle blast toward the mirror in a nebulous, celebratory swirl toward my reflection which distorts into an expression of utter disbelief.

The remnants drift gracefully onto the counter, into the sink, onto the tiled floor littered with my sweaty clothing. The confetti speckles the tile where I birthed my son, catching him with my own hands in a triumphant act that propelled me into my next evolution of motherhood.

I gather some confetti into a pile and examine the sheen of some pieces, the crepey texture of others, the dusty glitter that I dread will take me forever to clean.

Then I peek out of the bathroom door into my bedroom where my husband still lay asleep, undisrupted by this commotion. His gentle snore reverberates from under the sheets.

I tend to the remaining mess of confetti and dispose of the projectiles in the trash next to our toilet.

“What the fuck,” I mutter, finally stepping into the shower.

I wash myself, dry myself and settle into bed like any other night.

The clock nears midnight. I toss and turn. I sleep some. Numbness in my extremities wakes me to moonlight, mostly snuffed out by thick winter clouds, glowing just enough though to reveal a panorama of slouching silhouettes, snow-laden willows, pines, junipers and oaks that surround me.

The next day happens, and soon I’m brined in sweat standing in front of my mirror again. On this evening, I skip the self-loathing and move straight to the breast-fondling, because if my breasts can produce confetti, the possibilities seem endless. Perhaps tonight it’ll be that beautiful new mixing bowl I’ve had my eye on… a fancy pair of boots…all of the words of the Croatian language I’ve been trying to learn… assurance that my kids will enjoy a well-adjusted life… world peace.

There’s a lurching in my stomach, the one that comes with anticipation as I attempt to express the unknown. Then, lights.

My breasts are projectors beaming stories in some sort of visual diary of my memories. The picture is dream-like, bleeding and blended around the edges. At first the shapes sway like shadows in dappled sunlight.

Then there’s focus. I watch my seven-year-old self walking around my childhood home in soccer shorts, otherwise topless. I ask my mom if I look like a boy, and she tells me no. I ask her again and she confirms that no, she does not think I look like a boy.

I watch my fifth grade self sporting my new three quarter-length, hot pink top. It has glitter embedded in its purely synthetic fabric, and I absolutely love it. Walking to my desk, a boy shouts, “Put a bra on!” My cheeks ignite into a shade that’s between red and purple. I relive the combustion of embarrassment, shame and anger. I try to keep this potion from seeping out, but I hate this boy for a good portion of my life. It’s when I realize that he is someone’s misguided son that hatred dissipates, and then I pity him.

The clips keep playing.

I watch myself in ballet class. I’m “sucking it in” and constantly adjusting my leotard so that what little fabric is there will cover up as much of my growing breasts as possible. I see myself wishing that they were detachable, so that I’d be flat-chested in ballet class, but have the option to use them to my benefit outside of the studio.

The next clip shows my dear friend and I during our study abroad on a long train ride in Morocco. My eyes scan, hardly keeping up with the passing landscape, tumbling plastic bags, dusty cracked soil, and as we slow to a stop I notice a woman draped in textiles but her face and her breast. An older baby is positioned to feed, his lower body dangles on a diagonal. She holds his weight in one cradled arm. She’s striking. I’m saddened when the train’s speed picks up again, pulling me away from her captivating strength.

In another flicker, I’m approaching my grandma’s house. She greets me with her beautiful, comforting face. She embraces me and kisses me many, many times like she’s going to devour me, and then attempts to wipe off the lipstick she’s smudged on my skin. She holds my shoulders, looks directly at me, and tells me, “I just love you!” and while I was once perplexed by her unending-enthusiasm to see me, I now understand since becoming a mother. Now I kiss my children, devouring them, the way she used to kiss me. The clip continues to the part where my grandma tells me that she’s going to get breast implants. She says she wants others to feel what she feels when she hugs me. She’s felt insecure about her breasts for as long as she knows, I learn, and so at 70-something, she does something about it.

The reel transitions to depict me discovering colostrum leaking from my breasts while pregnant with my first daughter. My mind is absolutely blown. I call to my then fiance to share my fascination, but he’s seemingly less entertained by my body’s ability.

The reel reveals me riding this wave of fascination.  My areolas have darkened and expanded after the birth of my first child, a target intended to guide her to survival outside of my body,  and I show them to my friends, because seriously, how crazy is this?! My breasts have ballooned to a size much bigger than my baby’s head. Tingly let downs spray milk in spectacular fountains soaking my infant and all of our surroundings.

The projection pans to my toes curled. Like clenching fists, they channel discomfort as I breastfeed through a pregnancy, and then the overwhelm of breastfeeding a toddler and a newborn and ultimately the fatigue of having breastfed for a combined nine and a half years.

There’s a clip that shows the blossoming of one of my most treasured friendships. I am watching her breastfeed her young infant in the middle of a mom-and-me music class, and my face brightens for I feel instant connection and admiration.

Another clip of the woman who flashes me a smile and a thumbs up while I breastfeed my baby in a restaurant. I smile back and it’s a beautiful, unspoken exchange of understanding and pride.

The projections remind me of each of my children’s darling little bodies weighted across my lap feeding from my left breast, where my heart beat is most detectable. My rhythm and nourishment pulsing into them; their energy surges back into me.

In a final clip, I watch my husband administer a syringe of Lupron into my lower abdomen, the artificial hormone that will propel me into a menopausal state. The drug is part of the protocol that will attempt to trick my body into welcoming a frozen embryo, so that I can gestate and birth another couple’s baby. I look forward to lactating again and I visualize abundance, enough to express for their baby, enough to donate to others. The clip starts to fade, but of course I already know what happens. I do not birth their baby, and I do not make milk anymore.

There is a part of this story where I am supposed to be a gestational carrier that feels unresolved. A section of my heart withers into little bits of confetti, just like the other stuff, and drifts to the floor like snowflakes tumbling through the slow-moving molecules of a bitterly cold night.

The projections dim with a final flicker.

So I step into the shower again. I sleep again. I wake again. I sweat again. And this happens over and over.

And every night, there’s something oozing, spewing, dribbling, emitting from my breasts.

One night, a substance I can best describe as lava.  Another it’s spider silk, then soil, the wafting scent of cedar.

“Each week on our program, we choose a theme….” It’s Ira Glass broadcasting not from WBEZ Chicago, but from my breasts.

Throughout this inconceivable sorcery, I question my sanity, but I’ve been worried about being crazy long before my breasts started blasting party paraphernalia and sound and other things.

Mostly, I am amused by the unpredictability.

There is no purpose to these substances I’m producing. It’s completely unlike the milk I made for my children. And it’s not like the perceived uselessness of say, foreskin, which holds a cultural misconception of being futile.

My breasts now truly perform no other function than amusement, dynamic works of art, in all their expressions, like eroding sea glass tumbled by the elements.

Where are they now? Checking in with Stephanie Hutchinson of the Appalachian Breastfeeding Network (ABN)

In May 2016, Stephanie Hutchinson (then Carroll), MBA, BS, IBCLC  and a few of her colleagues launched the Appalachian Breastfeeding Network (ABN), “dreaming that one day [Appalachian] parents would have the access to lactation care that they deserve.”

In just one year, the network grew to 11 states and 250 members. By the time the organization was five years-old, the network  grew “to over 600 members across all 13 states in Appalachia – and beyond!” Today, ABM “continues to grow in its membership, its capacity, and its visibility.” [Retrieved from: https://www.appalachianbreastfeedingnetwork.org/abn-board.html

 

Then

When Our Milky Way first featured Hutchinson in 2017, she said that the exponential growth was not expected, but also not surprising. 

“There was absolutely no organization that grouped Appalachia as a culture, together, to make an impact for change,” she said.

 

 

and now.

Almost a decade later, Hutchinson serves as the President of ABN and Administrator of their 24-Hour Breastfeeding Hotline. She also works in private practice as the owner of Rainbow Mountain Lactation, is an instructor and administrative assistant/media manager for Lactation Education Consultants

This year, ABN will host its first cohort of Appalachian LATCH (Lactation at the Center of Healthcare) Leaders which is their train-the trainer program. With grant funding provided by Gallia American Community Fund of the Foundation for Appalachian Ohio (FAO) and the I’m a Child of Appalachia Fund®, they will offer 20 scholarships for registration to the course. 

Many years ago, before the birth of her daughters, Hutchinson shared that she never anticipated doing the work she’s been engaged in, but as we often say, “All roads lead to breastfeeding.” Now, reflecting on the most significant change she’s noticed in maternal child health in the last decade, Hutchinson says, “As a member of the LGBTQ+ community, I have noticed more inclusivity in education and support for all families. I am happy to see such wonderful changes to include everyone who is lactating.” 

And the most helpful lesson she has learned along the way is to say ‘no’. 

“This has probably been my hardest lesson learned, but there is only one of me and I know I cannot do all the things,” she reflects. “It’s okay to refer out to someone else, say no to a speaking gig, not go to every conference possible, and take care of myself. Once I learned this hard lesson, I noticed I am able to give more to my clients and my own family…I know that I am not the lactation consultant for every person and humbling yourself to collaborate with others will help your practice tremendously.”

Photo by Elijah Mears on Unsplash

Looking forward, Hutchinson says: “In 10 years, I hope Appalachian Breastfeeding Network has been able to grow enough to fit more into our budget and reach more parents, especially in those areas with little to no lactation support. It is my vision to duplicate our hotline and make it sustainable and available to anyone, anytime, for as long as possible. On a personal front, I hope to see my kids happy and thriving as adults and live out our empty nester lives.” 



Behavioral Safe Sleep Training (BeSST) teaches caregivers how to arrange infant sleeping spaces

Whereas bedsharing was once denounced entirely, it is becoming increasingly recognized as a behavior that many parents will engage in, especially when breastfeeding. So, health advocates are shifting focus to how to do so safely. For some examples see ABM, NCEMCH, and NAPPSS-IIN.

Image courtesy of the Safe to Sleep® campaign, for educational purposes only; Eunice Kennedy Shriver National Institute of Child Health and Human Development, http://www.nichd.nih.gov/sids; Safe to Sleep® is a registered trademark of the U.S. Department of Health and Human Services.

The CDC reports that there are about 3,400 sleep-related deaths among babies in the US each year. 

Jason C. Vladescu, Ph.D., BCBA-D, NCSP, LBA(NY) is a professor in the Department of Applied Behavior Analysis and Clinical Supervisor at the Center for Autism and Applied Behavior Analysis at Caldwell University, and he and his colleagues developed the Behavioral Safe Sleep Training (BeSST)—a practice-based approach—to teach caregivers to arrange the infant sleeping area. The BeSST team consists of researchers from three Mid-Atlantic Universities and has reached about 60 caregivers in Philadelphia since 2019.

Infant feeding is not a primary focus of their training, but Vladescu explains, “We recognize that this is an area that is not unrelated to safe infant sleep in that feeding of human milk (note here I intentionally didn’t specify breastfeeding, as work here has not always distinguished between feeding at the breast vs. expressed human milk) is recommended by the American Academy of Pediatrics (AAP) as it has been associated with a reduced risk of sudden infant death syndrome (SIDS).”   

He goes on to explain that BeSST training was designed to align with APP infant sleep environment recommendations: policy statement and  technical report.

The recommendation “includes supine positioning; use of a firm, noninclined sleep surface; room sharing without bed sharing; and avoidance of soft bedding and overheating.” 

Vladescu comments, “This recommendation is made because there is five times greater risk for infant death when bedsharing. The hope is that by room sharing (rather than bedsharing), caregivers can still feed and comfort their infant with relative ease, without increasing the risk of sleep-related death. By addressing the AAP recommendations in our work, we provide caregivers with information and training, as well as rationales for the recommendations provided in the training, with the end goal of minimizing risk and working to ensure caregiver needs and those of their infant are met.” 

The AAP recommendations differ from approaches like those of Durham University and the greater UK which acknowledges the reality that many babies will be in bed with parents and is against the ‘just say no’ approach, as Healthy Children Project’s Karin Cadwell points out. 

Currently, the BeSST team is deploying their training in a maternal residential substance use treatment program. 

“This is particularly exciting work given the emerging evidence that infants born to mothers with opioid use disorder are at increased risk of sleep-related deaths,” Vladescu begins.  “Some of the variables at play for this population of infants are unique (for example, healthcare personnel may utilize practices that do not align with the AAP recommendations to improve neonatal opioid withdrawal symptoms, which caregivers may imitate outside of the hospital). Such unique variables need to be considered when developing interventions to promote safe infant sleep with this population. In the context of this work,

we will be evaluating an initial attempt to evaluate the influence of a contingency management program based on caregiver responding across the night.” 

At the moment, the BeSST program is available in Philadelphia, Pa. through partnerships with community health centers, but Vladescu says he hopes by developing a network of partnerships with colleagues and professionals, they can increase the scale of their work. 

You can reach out to Vladescu directly at JVladescu@caldwell.edu  for more information or to engage with their programming. 

Check out these recent publications for more on the topic

LCTC participant fueled by daughter’s poor experiences

Shipley pictured with her grandchild.

As Tanya Shipley, a recent Accessing the Milky Way scholarship awardee, shares her experience working through the Lactation Counselor Training Course (LCTC) thus far, I sense both enthusiasm and relief.

“I love it!” Shipley exclaims. “I am learning so much stuff, oh my gosh, I love it. I  am just in awe.”

She goes on to explain that while she has always been interested in women’s health and wellness, she only became interested in maternal child health after her 35-year-old daughter’s pregnancy and birth this year.

Not unlike many women, and especially BIPOC women, Shipley’s daughter did not receive competent lactation care in the hospital.

“She was really bummed about it,” Shipley begins. “When she got home, she was having issues because she thought that she wasn’t producing enough milk. She felt like she let the baby down.”

Shipley blames some of what was lacking on her “own ignorance” as the grandmother.

At one point Shipley recalls suggesting: “Why don’t you just [give the baby] a little formula right now because she’s hungry.”

“It bothers me today because everything I am learning now,” Shipley reflects.  “It didn’t have to be that way.”

Shipley circles back to how much she is learning through the LCTC. This is where I hear a sense of relief in her tone; she is now well-equipped to share the knowledge she gains with not only new families but women her age, so that they can help their children, as she explains. It’s well-known that grandmothers have the capacity to influence exclusive breastfeeding. [More here and here.]

“After I finish a module,  I will call my daughter and I will share with her some of the things I am learning,” Shipley says.

Shipley recently left the entertainment industry and started volunteering for the Happy Mama Health Baby Alliance and Joy in Birthing Foundation. She also completed a birth doula workshop and finds herself exploring where she can make the biggest impact. She’s considering starting her own non-profit and providing lactation care in the hospital setting, fueled by the lack of care that her daughter received.

You can read more about grandmothers’ influence on infant feeding in For many, grandmothers are the village.