We were only two months into the pandemic when our nation’s deficiencies were exposed like never before. Emergency unpreparedness, racial health disparities, our “highly polarized, fragmented, and individualistic society…”, and the failure of capitalism to name some big ones. Now nearly two years into the pandemic, those burdens continue to amplify especially in marginalized populations.
Limiting human contact in order to limit COVID-19 infections has left underserved populations underserved.
In 2020, 172,000 families experienced homelessness with single moms being the biggest sub category. For folks living in alternative housing environments, an already overlooked population, efforts to support healthy human milk feeding have been stalled.
For instance, work by Nikki Lee, Alexandra Ernst, Vanesa Karamanian and colleagues– 10 Steps to a Breastfeeding Friendly Shelter in Philadelphia– has been put on hold because of the pandemic.
In New Mexico, a home visitor with Northwest New Mexico First Born Jessica Chandler, Siboney Rodriguez-Gallegos, LMSW, CLC of the New Mexico Breastfeeding Task Force (NMBTF) and colleagues collaborated to create Best Practices for Supporting Human Milk Feeding in Alternative Housing Environments despite the limitations of a pandemic. But they haven’t been able to advance their work to the level that’s necessary to best serve New Mexico’s unhoused population.
NMBTF, under the leadership of Monica Esparza, is the funding sponsor behind the work being done.
Rodriguez-Gallegos shares that a big part of her interest in maternal child health advocacy comes from her experience growing up as a Latina woman in New Mexico and becoming a mother at 18. After working for several years with the NMBTF helping to establish the Baby-Friendly Hospital Initiative (BFHI) and on other projects, Rodriguez-Gallegos says she started to see some gaps in the work they were doing.
“How much do we reach families that are facing barriers that would destroy breastfeeding relationships?” she wondered.
Simultaneously, Chandler, having also been working alongside NMBTF for many years, started thinking about safe infant feeding in emergency situations after attending a conference. She explored the well-intentioned but detrimental effects of artificial baby milk donations during emergencies.
In April 2021, the policy was released.
The document states:
- Have a written policy that is communicated to all staff and residents and train all staff in implementation of this policy.
- Identify lactating families when they arrive and provide them with education, assurance and support to sustain their milk supply.
- Protect the rights of babies to breastfeed in dining and public areas.
- Provide a clean, comfortable and safe space (not a bathroom) for breastfeeding / pumping. Private is not necessary, but implementing curtains or dividers on preference.
- Encourage peer support that empowers families feeding choices.
- Permit breastfeeding residents to bring their infants with them to any classes or groups within the facility.
- Develop a relationship with lactation resources in the community. Keep an updated guide of community breastfeeding resources, train all staff in its use, and give residents referrals as needed.
“When we created the document we wanted to keep it open to the bottom line,” Rodriguez-Gallegos comments.
That is, New Mexico already has public lactation laws in place, so they didn’t want to convolute the fact that babies can be breastfed any place they are otherwise allowed to be.
The team also wanted to be sure that extra pressure wasn’t put on shelter staff. Rodriguez-Gallegos says she and her team have questioned the best approach for tapping into shelter staff during a time when they are “just trying to keep their heads afloat.”
“We don’t expect them to be experts, but we do expect them to create a safe environment [for breastfeeding],” Rodriguez-Gallegos adds.
The overall infant feeding culture worries Chandler.
“Unfortunately, people have the mindset that formula feeding is easier,” she explains.
Until she and her colleagues are in a position to be able to sit down, connect with and educate staff, Chandler remains uneasy that breastfeeding mothers in precarious housing situations will continue to be discriminated against.
Rodriguez-Gallegos pulls back the lens even further.
“We face unique barriers here because New Mexico has very limited resources in general,” she begins. “A lot of our shelters are for just men or just women or just women who have experienced violence or just women experiencing substance abuse. All of these categories you have to fit into limit access to resources.”
Looking forward, the team hopes to continue to disseminate the policy to institutions that work with unhoused populations as well as other maternal child health advocates.
Chandler is in the process of completing the Lactation Counselor Training Course (LCTC) in an effort to enhance her ability to support families.
In order to grow the number of lactation care providers in New Mexico overall, the NMBTF provides full scholarships for eligible New Mexico residents to complete the LCTC.
Rodriguez-Gallegos and Chandler both express the hope to help reshape how their communities think about infant feeding.
Chandler points out human milk’s preventative effects on disease which is of course especially important during a pandemic and especially important when people are living in close quarters like is often the case in shelters.
Rodriguez-Gallegos thinks about the impact of breastfeeding on health, bonding and perinatal mood disorders.
“If we can come back to that and recognize that [breastfeeding] provides a different level of security and safety for families, it would be more of a priority.”