Speech is great, but silence is greater

I’d be willing to bet you’ve never thought to compare a circus clown to a nursing mother and her infant. I certainly hadn’t until I had the pleasure of speaking with Healthy Children faculty Kristin Stewart, BS, CLC.

Jay and Kristin pose in the middle of Clown Alley.
Jay and Kristin pose in the middle of Clown Alley.

“With circus clowning, you can’t speak,” Kristin explains to me. “Someone in the top row of the arena isn’t going to hear you.”

Instead, circus clowns resort to non-verbal communication.

“If you’re good at what you do, the people in the back will know exactly what you’re doing and why it’s funny.”

Somewhat recently, the stars aligned in such a way that Kristin ran into childhood friend and Healthy Children faculty Kajsa Brimdyr. Shortly after, Kristin began working with HCP.

Having nursed both of her children, Kristin tells me that she has always been interested in lactation on a personal level.

“But once you start really learning, you become more and more passionate,” she says. Kristin is inspired by the idea that something so personal has sweeping influences on “the big picture.”

Since working with HCP, Kristin has also become fascinated by the unspoken communication between the breastfeeding pair, similar to clown and audience.

“There are all sorts of unspoken language,” Kristin explains.

For instance, infants display a wealth of feeding cues other than crying. For more information about infant feeding cues visit: http://www.amazon.com/Pocket-Guide-For-Lactation-Management/dp/1449687784/ref=sr_1_1?ie=UTF8&qid=1360015618&sr=8-1&keywords=pocket+guide+lactation and http://www.nal.usda.gov/wicworks/WIC_Learning_Online/support/job_aids/cues.pdf.

The more time a mother spends with her child, the better she will understand those cues. Kristin explains that this learning of infant body language is not a conscious process. She refers to it as a “subconscious soaking in.”

Health care providers’ disinterest

Kristin describes another non-verbal, subconscious experience.

“I’m sure it’s happened to you,” she tells me. And she’s right.

“You go in to see your [healthcare] provider and you are clearly not what they are thinking about,” she describes the familiar situation. “It’s a subconscious feeling that ‘I’m not important to this person.’”

Because of this scenario she offers this advice to lactation professionals: Really listen, listen to mom and listen to baby.

Kristin knows lactation care workers face unique challenges. She asks us to remember that we’re not alone and to seek support when needed. Getting the support you need will only enhance your ability to encourage mom and baby.

Not your average herstory

After graduating with an Ivy League liberal arts degree, Kristin decided to attend Ringling Bros. and Barnum & Bailey®’s Clown College in the early 90s.

Kristin married her husband and fellow clown, Jay, a few years after graduation. Two years later, they welcomed their first born Karen into the world.

The Stewarts pose with daughter Karen for a Good Housekeeping article.
The Stewarts pose with daughter Karen for a Good Housekeeping article.

When Karen was just eight months old, the Stewarts made a brave choice to leave their vinyl flooring jobs behind and journey to Japan where Jay had been offered a clown position.

“It was terrifying and exciting and all of those things,” Kristin says.

After spending about a year in Japan, the Stewarts were offered a place in the Ringling’s Red Unit where Jay served as Boss Clown.

Currently, Jay performs with Big Apple Circus’ Clown Care a signature community outreach program that offers classical circus entertainment to hospitalized children at 16 leading pediatric facilities across the United States. [Retrived from: http://bigapplecircus.org/clown-care]


Circus life, a life defined by its commitment to family and community, allowed Kristin time to develop the delicate, non-verbal relationship she’s fascinated by with her second born, Nicholas.

He was only three weeks old when Kristin hit the road with the circus again. She wasn’t performing at that time, but she worked in the circus’ nursery. This allowed Kristin and Nicholas to be with one another very often.

“The time that the circus gave me as a mother was hugely instrumental in my breastfeeding success,” Kristin says. “There was never any pressure to go back to [performing.]”

Kristin’s nursing experience with Karen was more of a struggle.

She tells me Karen was born in a huge facility in Atlanta where locating a lactation consultant was a chore.

Lack of and inconvenient lactation care access remains a huge barrier to mothers’ breastfeeding success everywhere. Measurable steps have been taken by the Affordable Care Act to make services more reasonable for mothers.

Not only did Karen face insufficient access to lactation care, she was afraid to ask for help. Why is it that many women feel like they have to do everything alone? Is it the pressure society puts on us to be flawless in every aspect? Is it because we don’t know where to ask for help? Is it because we’ve lost a sense of sisterly community?

“It’s such a cliche but the circus is such a family-centered place to be,” Kristin says comparing her nursing experiences. “Babies in the circus are everyone’s babies.”

Kristin says she felt embraced by this sense of togetherness while nursing Nicholas.

“There are so many great people,” she says.

The Stewarts became especially close to the 12 to 16 performing clowns.

“They became our extended family,” says Kristin.

When Karen was about 20 months old, Lisa, a family friend came to visit the Stewarts on the road. While Lisa carried Karen around backstage during Kristin and Jay’s performance, she recalls at least six people stopping her wondering, “What are you doing with the Stewart baby?”

“She was so happy to know that we were so safe with the circus,” Kristin says.

Consistent prenatal care

The stories of the Stewart family adventures only get wilder.SFE Family shot

A typical week looked like this: Arrive in a given city on Tuesday or Wednesday, load in, perform Wednesday and Thursday night, perform two shows on Friday, three on Saturday and two on Sunday. Sunday night the crew hit the road for the next city which could be anywhere between six and 20 hours away.

Imagine going on an extended road trip for the duration of your pregnancy!

Kristin explains that obstetricians many times refused to see her for prenatal care only once while she passed through the city. Luckily, Kristin’s theatrical talent served her well.

“Often I would have to call and say ‘I’m moving to the area…’”

Kristin simply carried her medical records with her. As a second-time pregnant mom, she says she was confident about her pregnancy even without traditional prenatal care.

“The circus provides outstanding health insurance,” she adds.

Several weeks before Nicholas was due, Kristin traveled to her home on the Cape.

“I wasn’t willing to just go to any hospital,” she explains. “It wasn’t a comfortable option for me.”

Once again, the stars aligned in such a way that Jay happened to be performing only a few hours away when she went into labor. He attended the birth.

“The timing was unbelievable,” Kristin laughs.

To read more about responsive parenting and infant self-regulation click here, here, and here.

Please note: it is vital for moms to have access to all lactation care workers. CLCs, advocate for your services by contacting insurance companies and let them know what a difference you make for moms, babies, families and communities.

Coming soon… The Milky Way Movie: Nursing a Galactic Revolution

I have a lot of faith in the future of breastfeeding. Lactation professionals like Jennifer Davidson RN, BSN, IBCLC and Chantal Molnar RN, MA, IBCLC dedicate every cell in their bodies to breastfeeding advocacy.

I recently had the opportunity to speak with them about their feature length documentary The Milky Way Movie: Nursing a Galactic Revolution formerly known as  Bottled Up!. It is scheduled for release in June 2013.

65540_434360679972649_1441959782_nThe nursing mother has disappeared from our cultural landscape; the sexual breast usurped the mothering breast. I’m sure you’ve noticed. The Milky Way Movie is an exposé about breastfeeding in America and intends to restore the Phenomenon of the Nursing Mother to our culture. [Retrieved from: http://www.bottledupthefilm.com/bottled-up-the-film/]

Even though the bottle has become the “most recognizable symbol of infancy,” there’s some good news: Eventually, thanks to projects like The Milky Way Movie, the tides will turn and nursing dyads will flood the streets once again. Ideally, an infant will consume artificial baby milk only when medically indicated.

The less than ideal news: breastfeeding is a crucial public health issue. We don’t have time for the eventual, the pending, the future. Changes within our maternal infant care model need to happen now.

Even so, there’s more good news: The Milky Way Movie is going to have monumental impact. It’s release date couldn’t come any sooner.

We cannot be what we cannot see

The Milky Way Movie has serious potential when it comes to normalizing breastfeeding in our culture through the power of images.

Jennifer Davidson RN, BSN, IBCLC
Jennifer Davidson RN, BSN, IBCLC

Davidson cites the film Miss Representation as inspiration for The Milky Way Movie’s imagery.

“You cannot be what you cannot see,” she quotes. “For us, the imagery is to show mothers and babies doing this amazing thing.”

The duo tells me about their experience filming a medical facility where very tiny, less than 1,000 gram babies, go skin to skin with their mothers, a method often referred to as Kangaroo Mother Care.

The facility accommodates families in big rooms equipped with incubators for each baby and even beds for dads. Babies live on their mothers’ chests almost always..

“She’s with that baby wrapped and skin to skin no matter how many tubes there are,” Davidson explains.

Most infants are discharged once they reach 1500 grams… that’s just over three pounds. Incredible!!

When I ask in amazement, Where is this place you speak of?!, the duo and I half-heartedly joke, Obviously not in America.

While rules vary, most low birth weight (LBW) babies aren’t discharged from hospitals in the U.S. until they reach about five pounds.

Please note, I am not bashing our extraordinary country. The problem is that what Davidson and Molnar filmed should be happening everywhere; it saves lives with minimal resources but for whatever reason(s), we aren’t advancing maternal infant health even when the solutions are quite simple.

Chantal Molnar RN, MA, IBCLC
Chantal Molnar RN, MA, IBCLC

“When you go to Europe, you see imagery… it’s up and around and honored,” Molnar says of breastfeeding iconography. “People can see it and it is a part of their culture.”

By photographing or painting an image, not only are you creating normal imagery, but you are putting it on a higher pedestal, Davidson says.

“We don’t have iconography that elevates us into that place of honor. It’s amazing what our culture has done to the nursing mother,” Davidson adds.

(By amazing, she means deplorable.)

In places like Norway and Sweden, around 90 percent of infants exclusively breastfeed in their first week of life.

In the U.S., about 75 percent of babies initially breastfeed and those rates plummet once the infant reaches six months .

A chance to get involved

529356_420650754676975_694487862_nThe Madonna Mosaic serves to raise money for the film and to further Davidson and Molnar’s goal to glorify nursing mother imagery.

The Mosaic image will be used in the marketing campaign for The Milky Way Movie.

Here is how it works:
1. Contribute $20.00 to this fundraising campaign in support of the movement.
2. Send your nursing photograph to mosaic@bottledupthefilm.com (please limit the image file size to 2Mb).
3. Images will be collected and the mosaic will be created.

The film’s team offers these incentives:
1. You’ll receive a digital download of the final Madonna Mosaic poster image.
2. You’ll also receive a complimentary digital download of the film upon its release.
3. Your name will appear on our Mosaic Participants page (or you can choose to remain anonymous).
4. Sincere gratitude for supporting Bottled Up! and the movement.

Normal, not super-duper

The Milky Way Movie’s imagery is coupled with important adherence to language advice given by Diane Wiessinger in her article Watch Your Language.

“When you say ‘breastfeeding decreases,’ you are using formula as the norm,” Molnar explains. Instead, breastfeeding normalizes our risk for diseases like breast cancer.

“It is not this special, super-duper thing that is like a vitamin pill,” she continues.

Molnar’s realism is something to appreciate. I have conflicting thoughts about the glorification of breastmilk. On one hand, we need to realize that it really is an incredible, remedial, living substance but on the other, breastmilk’s veneration doesn’t make it normal. Instead, it makes breastfeeding seem unachievable when that’s simply not the case.

It’s increasingly important to use similar language around birthing practices. For instance, natural birth is normal birth. We should be focusing on the harm certain hospital practices do rather than defending midwifery and out of hospital births.

A call for action

As excited as I am about this film, in all honesty, I would prefer that it never needed making in the first place.

The reality: After years of working with mothers and babies at the unique and progressive practice of Dr. Jay Gordon, Davidson recognized a consistent need to provide her clients with essential tools to enable them to trust their bodies, trust their babies, and trust themselves. [Retrieved from: http://www.bottledupthefilm.com/bottled-up-the-team/]

Davidson and Molnar visit a client.
Davidson and Molnar visit a client.

“People that go there are part of a rather elite crowd,” Molnar says of Dr. Gordon’s practice. “Even that select group of people is getting the cultural message that our bodies aren’t good enough.”

Molnar calls her background odd in that she has worked both in the home birth setting and as a labor and delivery nurse.

“When you’ve seen the extent of the influence of the medical system and how women are viewed in our medical world, it’s not a very pretty picture,” Molnar says.

Molnar worked at Irvine Medical Center for over 20 years.

“Doctors are not taught to question, to analyze or to think critically,” she says. “They are taught to be better than the next guy.”

She calls it an ugly, ugly system.

“I’m finally out of it.”

Not unscathed though. Molnar says she feels a sort of PTSD from her work as an L&D nurse.

She is currently writing a book called Failure to Progress which contrasts her experience within a homebirthing model and the formal healthcare setting.

Even now, Davidson and Molnar face challenges as professionals within the lactation field. They both agree that being considered Nipple Nazis can be rather hindering to their intentions. But name calling won’t stop them from helping mothers to trust themselves and their babies, which is what they say is the most important piece of advice out of many.

“We are so excited to make a difference,” Davidson says. “We know that the more you look at the important role of the nursing mother, you realize that it influences every aspect of life.”

For more information, to watch The Milky Way Movie’s trailer and to find out more about how you can get involved in the film, visit http://www.bottledupthefilm.com/ and Like them on Facebook.

Women don’t breastfeed, cultures do

Explore your community. Do nursing mothers have a safe place to feed their children in grocery stores, airports, places of worship, medical facilities? Are obstetric and pediatric offices void of infant formula marketing? Do your community’s billboards and bus stop advertisements feature breastfeeding mothers over images of bottles and artificial baby milk? Does common public sentiment support breastfeeding mothers and babies?


IMocha fabulous, breast feeding awareness.f you answered no to these questions, you’re living in a First Food (Breastmilk) Desert. 
Leading commentators and breastfeeding advocates Kimberly Seals Allers and Isabel Barillas, MPH recently launched the Be First Food Friendly Movement in several southeastern, predominantly African American cities with some of the lowest breastfeeding rates in the nation. The project aims to define and designate “first food deserts,” or under-resourced communities lacking breastfeeding support mechanisms. [Retrieved from http://befirstfoodfriendly.org/about-us/] Be First Food Friendly will eventually expand to become a national campaign.Seals Allers explains that it’s time to realize that what we have been doing has not gotten us to the goal of normalizing breastfeeding.

“This is the next frontier for helping mothers and babies,” she says of the Be First Food Friendly Movement.

Seals Allers is asking members from all communities to take action. The project features three key suggestions: Share Your Story, Spread the Word, and Sign the Petition.

Seals Allers is creating a story bank of community experiences about breastfeeding as participants share their accounts.

In her interactions, Seals Allers has found that people struggle to remember the last time they saw a woman nursing in public. (Perhaps because most nursing mothers are discreet and contrary to popular belief, we don’t whip our breasts around.) More seriously, a lack of community stories means a lack of breastfeeding. To reach more mothers, Seals Allers has extended the Share Your Story portion to social media platforms.

10/2/2012 Mocha fabulousThe Be First Food Friendly Petition requests the governors of Mississippi, Louisiana and Alabama take immediate action to transform key communities in their states into First Food Friendly environments. The goal is to collect 2,000 signatures by the end of Black History Month. Seals Allers makes clear that the petition is for everybody, not just the starting point areas. Click here to sign the petition.

Seals Allers has been engaging in the breastfeeding conversation for years.
She says she realized that women know the facts about breastfeeding, but they can’t figure out “how to fit it into the reality of everyday life.”

Through her exchanges, Seals Allers says she became increasingly aware that women feel burdened by providing healthy feeding options for their infants. Some women anticipate being restricted to their homes and that breastfeeding will minimize their life to the size of a teaspoon, as Seals Allers puts it. Others report concern that people will look at them strangely when they nurse in public and others worry about going back to work.

Seals Allers says she was inspired to bring others into the conversation to lessen mothers’ burdens.

“Women don’t breastfeed, cultures do,” she says powerfully. “Once we can capture the cultural shift around breastfeeding, that’s the next piece.”

The Be First Food Friendly Movement is innovative and exciting. Seals Allers is brilliant, energetic and influential. But the issue at hand is depressing and dark.

Seals Allers explains in a video featured on the project’s website that “culturally relevant” lactation professionals are hard to come by.

She further explains the problem in Lactation Consultants Need to Diversify Yesterday.

How can a mother in need succeed at breastfeeding when she doesn’t have access to lactation professionals who understand her culturally?

Seals Allers tells me this: If African American women have positive experiences with breastfeeding, they will become champions for other mothers. This is the bottom up approach. But she adds that there are also barriers like access to and cost of lactation professional training.

“There needs to be a change in thinking from the people that are leading the movement,” Seals Allers says. She suggests these groups become more welcoming, open and accessible.

“There really needs to be an effort. It’s not going to change itself.”

10/2/2012 Mocha fabulousLactation professionals of all backgrounds and colors play a crucial role in a landscape where women have been taught to mistrust our breasts. Seals Allers says that our ability to breastfeed is more socially than biologically influenced.

We don’t wake up thinking, “Oh, I don’t know if my liver is going to work today…” Seals Allers role plays. We certainly do second guess our breasts’ function though.

What happens when mistrust of our breasts is muddled with other cultural nuances?

Seals Allers writes a beautiful recollection of her thoughts about receiving support from a white lactation consultant in Lactation Consultants Need to Diversify Yesterday.

Breastfeeding can be an intimate and profound experience between mother and baby and mother and herself. At the same time, we need public supports to nurture our motherhood journeys.

“When we start engaging other people in the process, we are a much stronger force to do the work we want to do,” Seals Allers says. “The community is powerful.”

Photos taken from http://befirstfoodfriendly.org/ with Kimberly Seals Allers’ permission. 

Support group targets military specific challenges

2012 CLC Course at Landstuhl Regional Medical Center, Germany.  Course hosted by Mom2Mom of KMC, taught by Healthy Children’s Center for Breastfeeding.  Photos courtesy of Public Affairs, Landstuhl Regional Medical Center.
2012 CLC Course at Landstuhl Regional Medical Center, Germany. Course hosted by Mom2Mom of KMC, taught by Healthy Children’s Center for Breastfeeding. Photos courtesy of Public Affairs, Landstuhl Regional Medical Center.

Lactation didn’t become interesting to me until I became pregnant with my now 18 month old daughter. My mom exclusively breastfed both my brother and I, otherwise I had never had exposure to milk-producing breasts in my adult life. I may have witnessed nursing moms and babes in my adventures, but I’d never taken the time to stop and notice. Now lactation is all I can think about and I’m not afraid to admit it. Human milk is fascinating. Women are incredible and babies are little bundles of brilliance.

A while back, I was in touch with Amy Smolinski, CLC and Community Outreach Director of
Mom2Mom of Kaiserslautern Military Community (M2M of KMC) in Germany,  a network of breastfeeding families that helps new mothers overcome the difficulties of living far from family support to reach their personal breastfeeding goals. [Retrieved from: http://www.facebook.com/M2MofKMC/info] She, in conjunction with M2M of KMC’s four other board members, shed light upon the unique challenges military families face when it comes to breastfeeding their children.

I was so excited to learn about such a unique community and the breastfeeding services M2M provides.

Mentor influence

M2M is mainly comprised of peer mentors all of whom volunteer their time. Smolinski calls them the backbone of the organization.

M2M mentors must have breastfed for at least six months and have considered it a positive experience. Mentors must also complete a six hour, free training course offered through the organization.

“Mothers learn best from other mothers who have been through similar circumstances, or are going through them together,” Smolinski says. “Mom2Mom is about building a community network of support for breastfeeding families, and the most effective way to do that is to build one-on-one relationships.”

2012 Big Latch On/World Breastfeeding Week Celebration, Ramstein Air Base, Germany.  Photos courtesy of Emily Karissa Photography
2012 Big Latch On/World Breastfeeding Week Celebration, Ramstein Air Base, Germany. Photos courtesy of Emily Karissa Photography

M2M mentors have breastfed preemies, twins, or tandem. Some have induced lactation for adopted children. Others breastfed while working at civilian jobs or on Active Duty.  Smolinski says the organization tries to ensure that its mentors can support each mom in her individual circumstance.

“We don’t tell mothers how to succeed in breastfeeding, we ask how they define breastfeeding success–and from there we offer support to help each mother succeed according to her own goals,” she explains.

Smolinski also says it’s typical for members to start as mentees when they are pregnant and eventually become mentors.  Many former members have gone on to start Mom2Mom organizations at other military installations.

CLC involvement

2012 CLC Course at Landstuhl Regional Medical Center, Germany.  Course hosted by Mom2Mom of KMC, taught by Healthy Children’s Center for Breastfeeding.  Photos courtesy of Public Affairs, Landstuhl Regional Medical Center.
2012 CLC Course at Landstuhl Regional Medical Center, Germany. Course hosted by Mom2Mom of KMC, taught by Healthy Children’s Center for Breastfeeding. Photos courtesy of Public Affairs, Landstuhl Regional Medical Center.

M2M of KMC hosted Healthy Children Project’s Certified Lactation Counselor (CLC) Training twice in recent years.

In fact, the organization includes a rolling subcommittee dedicated to bringing the CLC Training to their area about every 18 months.

Mom2Mom of KMC requires board members to be lactation counselor certified.

“We need to be able to provide adequate support not only for breastfeeding mothers with questions, but also for mentors who may encounter breastfeeding issues outside of the scope of a peer volunteer,” Smolinski says.

She says M2M includes a pledge to provide financial support to help any future new board members take the CLC training.

For mentors looking to become CLCs, the course is an approved licensure under the MyCAA program for military spouse tuition assistance.  Smolinski says the application process is rather lengthy, but eligible military spouses interested in using MyCAA to fund their CLC training should contact the appropriate continuing education office at their nearest military installation.

M2M is currently in the process of planning to host another CLC training in early 2014.

Community involvement

2012 Big Latch On, Photo courtesy of the Stars and Stripes
2012 Big Latch On, Photo courtesy of the Stars and Stripes

In addition to peer mentoring, M2M of KMC also offers a weekly Breastfeeding Cafe, an informal setting where moms and tots get together and socialize. Moms share their experiences over a loosely-guided discussion topic, Smolinski explains.

M2M offers a quarterly newsletter, community outreach events and open houses to reach new-to-the-area pregnant and breastfeeding moms.

“We are working to expand partnerships with other community and health organizations that work with breastfeeding families in our area,” Smolinski says.

Each August, M2M holds an event in conjunction with World Breastfeeding Week and National Breastfeeding Month.

The organization recently began participating in the Big Latch On.

M2M’s current projects include revamping and expanding Active Duty programs and pursuing Baby-Friendly Designation at Landstuhl Regional Medical Center (LRMC), the only U.S. military medical center in all of Europe and Africa.

Pursuing Baby-Friendly Designation

2012 Big Latch On/World Breastfeeding Week Celebration, Ramstein Air Base, Germany.  Photos courtesy of Emily Karissa Photography
2012 Big Latch On/World Breastfeeding Week Celebration, Ramstein Air Base, Germany. Photos courtesy of Emily Karissa Photography

KMC, which includes Ramstein Air Base, Landstuhl Regional Medical Center and several other smaller military installations, is home to the largest population of Americans outside of the U.S.

LRMC has a Level 3 NICU so high-risk pregnant mothers from other areas are frequently brought to LRMC until they deliver safely and mother and baby can travel home.  KMC’s  local population averages between 75 and 100 births per month.

With such a large population served, obtaining Baby Friendly Designation at LRMC would positively impact large numbers of families.

“Our goal in seeking Baby-Friendly Designation is to ensure that all hospital staff who work with breastfeeding mothers and children are adequately equipped with accurate information to support them,” Smolinski says.

Military hospital staff face unique challenges which directly impacts mothers’ breastfeeding success.

“Between moves, deployments, and clinical rotations, continuity of policies and training is very difficult to maintain,” Smolinski explains.  “Also, each provider, nurse, and technician comes to a military treatment facility with different training and ideas about breastfeeding.”

LRMC’s eventual Baby-Friendly Hospital Designation will provide a streamline, effective and beneficial system for staff members and families.

Unique challenges

2012 Big Latch On/World Breastfeeding Week Celebration, Ramstein Air Base, Germany.  Photos courtesy of Emily Karissa Photography
2012 Big Latch On/World Breastfeeding Week Celebration, Ramstein Air Base, Germany. Photos courtesy of Emily Karissa Photography

Military families face several unique challenges to breastfeeding.
“We all live far from family support,” Smolinski explains.  “We don’t have our mothers, aunts, sisters, or best friends down the street or across town to help out when a new baby arrives.”

She adds that because of frequent deployments, trainings, and other military career duties, mothers often times don’t even have their partners around when their babies are born.

Military families move frequently, so it’s not unusual for a woman to arrive in an unfamiliar place either pregnant or with a newborn.

“Military spouses learn quickly to seek out support from each other, and we are all willing to lend support to a newcomer,” Smolinski says.  “This is especially important for breastfeeding mothers, who are making these huge adjustments with young children.”

M2M has a large population of Active Duty servicewomen who require special support while breastfeeding. Smolinski says the organization strives to ensure that all breastfeeding Active Duty mothers have access to the support of an Active Duty peer mentor. M2M also aims to foster a community that understands breastfeeding Active Duty mothers’ exceptional challenges.

M2M’s correspondence with Robyn Roche-Paull, author and founder of Breastfeeding in Combat Boots, offers a special resource for Active Duty moms.

It’s overwhelmingly inspiring to hear the different stories, challenges and triumphs that breastfeeding mothers experience. It is vital that lactation professionals consider and understand the many contexts nursing mothers encounter so to better assist them in achieving their healthy children goals.

For more information about Mom2Mom of KMC, like them on Facebook.

Baby Steps

The Milky Way is off to a galactic start this year thanks to Progress in Increasing Breastfeeding and Reducing Racial/Ethnic Differences, a study recently released by the Centers for Disease Control and Prevention (CDC).
The study highlights that more women are breastfeeding for longer periods and that the gap between black and white breastfeeding initiation rates narrowed in recent years.

This is all great news. Celebrate!

But the study also found that only 23.4 percent of women breastfed for 12 months, the recommended duration. Twenty three point four percent is a miserable number.

Contributing author Jessica Allen, MPH, MSW
Contributing author Jessica Allen, MPH, MSW

“It depends on which way you look at,” Contributing author Jessica Allen, MPH, MSW says. She reminds me that trends are on the rise.

Still, there’s that enormous number of women not meeting recommended breastfeeding durations. Additionally, she says many mothers aren’t satisfying their personal breastfeeding goals.

That’s where support comes in.

The authors of the study place a huge emphasis on support in order to boost breastfeeding rates and duration and to further close the gap between black and white breastfeeding rates.

“We have to make sure women who want to breastfeed are receiving the support they need,” Allen says. “We need to continue to look at things that we know work.”

For instance, the CDC has compiled a Guide to Breastfeeding Interventions. The guide features information for state and local community members to choose a breastfeeding intervention strategy that best meets their needs.

“Hopefully people become familiar with [women’s] goals and the impact they have,” Allen says. She says she hopes all community sectors do their part to help women in whatever feeding choices they make.

CDC Director Tom Frieden, M.D., M.P.H. comments on Progress in Increasing Breastfeeding and Reducing Racial/Ethnic Differences in a clip featured on the CDC’s website: “Hospitals can make a big difference by becoming Baby Friendly and insuring that every woman has the best possible chance of starting breastfeeding.”

The Baby-Friendly Hospital Initiative backed by a government official. Incredible news for moms and babies everywhere.

Even more, the report cites the Surgeon General’s Call to Action to Support Breastfeeding which outlines a number of actions aimed at increasing support for breastfeeding women.

Best Fed Beginnings, a project supported by the CDC, provides support to close to 90 hospitals to improve maternity care practices that support breastfeeding. The project aims increase the number of Baby-Friendly hospitals in the U.S.

In an effort to establish better support systems for mothers, the CDC “awarded funds to six state health departments to develop community breastfeeding support systems in minority populations.”

Because African American women struggle with breastfeeding more so than other populations, the authors of the report suggest increasing the number of lactation consultants in these communities.

However, just because lactation services are available does not mean that they are accessible. Services need to be covered by insurance. The Affordable Care Act helps to make lactation services affordable for families.

Services also need to be physically accessible to mothers. That is, bring the help into the home like the efforts at Maternity Care Coalition.

Limiting credentials and/or “claiming that one set of credentials is worthy of health insurance reimbursement and not others will severely limit mothers’ and babies’ access to quality care,” as stated in Healthy Children Project’s A RENEWED CALL FOR COLLABORATION AMONG LACTATION PROFESSIONALS.

Award-winning journalist Kimberly Seals Allers recently launched the Be First Food Friendly Movement which serves to transform communities, especially those with extremely low breastfeeding rates, into First Food Friendly environments. Be First Food Friendly is a great example of increased support in all facets of the community so that moms and babies can be successful at breastfeeding.

Multifaceted support is especially important for African American mothers: “…Even when accounting for factors such as socioeconomic status and maternal education, racial/ethnic differences in breastfeeding persist. This persistent gap in breastfeeding rates between black women and women of other races…might indicate that black women are more likely to encounter unsupportive cultural norms, perceptions that breastfeeding is inferior to formula feeding, lack of partner support, and an unsupportive work environment,” the CDC report states.

While some communities suffer from depressingly low breastfeeding rates, initiation rates in the Hispanic population did not increase significantly from 2000 to 2008.

“They started so high,” Allen says. “It’s like taking an A student to an A+.”

My hope for the moms who aren’t meeting breastfeeding recommendations or personal feeding goals is that with increased recognition for support, national breastfeeding rates will continue to creep upward.

Even while we make baby steps, I remain skeptical.

In the study’s full report we learn that “Breastfeeding initiation was assessed by asking, ‘Was [the child] ever breastfed or fed breast milk ?’ Breastfeeding duration was assessed by asking, ‘How long was [the child] breastfed or fed breast milk ?’ The wording of the breastfeeding duration question changed slightly in 2006 to ‘How old was [the child] when [the child] completely stopped breastfeeding or being fed breast milk ?’”

This Pediatrics’ study discusses characteristics of breastfeeding practices among U.S. mothers: http://pediatrics.aappublications.org/content/122/Supplement_2/S50.full.pdf+html.

Allen says that Progress in Increasing Breastfeeding and Reducing Racial/Ethnic Differences’ questioning didn’t allow researchers to decipher whether baby consumed breast milk straight from the source or from another vehicle. The study includes baby’s consumption of breastmilk in any form. One may assume then that breastfeeding and breastmilk feeding are created as equal in the scope of the study.

We must remember though that breastfeeding and breastmilk feeding are not the same. For instance, babies fed from a bottle are less likely to self-regulate milk intake.

Will increased awareness for breastfeeding support help more mothers breastfeed or breastmilk feed?

We know that any amount of breastmilk given to baby is beneficial but nothing compares to the biological norm of mother feeding baby at the breast.

“We are really encouraged to see some of these increases, but at the same time there is a long road ahead of us,” Allen says.

For more information on how support affects breastfeeding rates please visit: http://summaries.cochrane.org/CD001141/support-for-breastfeeding-mothers

To hear more from CDC Director Tom Frieden, M.D., M.P.H. please visit http://www.cdc.gov/breastfeeding/resources/breastfeeding-trends.htm and scroll down to “MMWR News Synopsis.”