Finding missing puzzle pieces in maternal support

Creighton University School of Pharmacy and Health Professions Assistant Professor Kailey Snyder, PhD noticed early in her career that the experience and needs of mothers are often missing from conversations when developing health messaging and policy, and this is leading to substantial gaps in support.

For instance, during her graduate work focusing on early childhood physical activity, she realized that a focus on the mother’s physical activity could lead to an increase in her child’s activity, rather than solely focusing on enhancing the child’s experience. Only one in five pregnant/postpartum mothers meet physical activity recommendations however. Snyder states this is due, in large part, to a lack of effective education, resources, and support to help mothers know how to safely engage in prenatal/postpartum physical activity.

“If we can provide a mother with the tools to engage in healthy behaviors, like physical activity, during pregnancy and postpartum, we can enhance the health of her child,” Snyder begins. “A healthy mother is not only a role model, but a primary proponent of her child’s health behaviors. I [hold] strongly to the belief that if we can support mom during that pivotal transition to motherhood, we can make really substantial change…To improve the next generations’ health and well-being, it starts with mom.”  

Until recently, Snyder says she has focused a lot of her work on identifying maternal needs, specifically in Nebraska.  

Some of her most recent publications related to breastfeeding include Social Support During COVID-19: Perspectives of Breastfeeding Mothers, Healthy eating and physical activity among breastfeeding women: the role of misinformation, Workplace Breastfeeding Support Varies by Employment Type: The Service Workplace Disadvantage and Perceptions of Physical Activity While Breastfeeding Using the Self-determination Theory

Through this work, she and her colleagues came to conclusions such as:

  • “Mother’s ability to obtain breastfeeding support has been negatively impacted by the pandemic due to the inability to engage with individuals in-person and the lack of access to childcare.
  • Women need greater access to education and resources regarding healthy eating and physical activity while breastfeeding… [and] breastfeeding women may need additional support for engaging in physical activity…
  • There is a need for more breastfeeding support programs to be developed that target specific workplace characteristics.”

Snyder and her colleagues are currently working on a project to improve self-management of pelvic health among mothers living in rural Nebraska in conjunction with breastfeeding education.

One in four women suffer from pelvic floor dysfunction (PFD). It’s estimated that surgery related to PFD will increase by 47 percent by 2050, driving up health care spending and suffering, Snyder reports. She reminds us that just because a condition is common, it doesn’t make it normal (think nipple pain during breastfeeding). 

Older theories blamed common breastfeeding issues like engorgement and other breast discomfort for high rates of inactivity among mothers, but Snyder says that her new research to be published this spring shows that a large population of mothers are experiencing urinary incontinence too. Because breastfeeding is a low estrogen state, breastfeeding parents are at risk for incontinence. 

“This is a piece of the puzzle that hasn’t gotten a lot of attention,” Snyder comments.  

Because PFD is a risk factor for postpartum depression (PPD) and PPD is a risk factor for early cessation of breastfeeding, it is Snyder and her colleagues’ hope to help moms better self-manage their pelvic health. Not only this, but educating mothers to safely engage in pelvic floor muscle exercises, identify distressing symptoms, and seek additional care that may reduce PFD, all of which can positively influence a mother’s health and well-being.  

In her effort to move beyond identifying the problems that new parents are up against, Snyder completed the Lactation Counselor Training Course (LCTC) to enhance her breastfeeding knowledge and broaden her scope, she explains. 

“For someone in the weeds of maternal/child health research, it can be easy to get tunnel vision, and I think it’s crucial to continue to find ways to increase your knowledge and understanding of the population you are working with,” Snyder says.   

She goes on, “Where we are in 2021, people know that breastfeeding is a good thing. However, despite the consistent and widespread evidence on the benefits of breastfeeding, we continue to have suboptimal breastfeeding durations. Our interventions need to go beyond just breastfeeding education and support and also consider the mother’s mental and physical health.  Considering factors such as pelvic health and physical activity equips a mom with additional tools to support her own health in her breastfeeding journey.” 

The next phase of Snyder and her colleague’s work hones in on which health education models are most cost-effective and sustainable. They’ll pilot different education pieces like offering mothers a webinar coupled with weekly follow up text messages or a follow-up appointment with a specialist, for example. With time, she and her colleagues will be able to assess which models and services mothers can access and utilize best.  

“We are taking things piece by piece when we go to develop these interventions and using the voices of moms to guide us,” Snyder explains. “…We want everything we do to not only be evidence-based but to resonate with moms. There’s an old saying, The best medication is the one the patient will take. It’s not just about having the right information but disseminating it in the right way as well.” 

You can find an exhaustive list of Snyder’s publications here

To learn more about emerging research on PFD, click here

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