During Black History Month and beyond, celebrate positive stories of Black people’s ongoing legacy

I received an email from my fourth grader’s teachers updating parents on some of the topics they’ve been covering in class: World War II and Black History. In the message was a heads-up that students may be coming home with “big questions” about some of the sometimes difficult details they’d discussed. 

My grade school memories fade, but I can say with near certainty that none of the history lessons covered in my elementary education (and beyond) required any kind of warning from my teachers. The history that we covered was diluted to become palatable, white-washed, white-centered, and one-dimensional. 

At the same time, there was little to no celebration of the Black individuals who have shaped American history and propelled us forward. 

Photo by Prince Akachi on Unsplash

The National Institute for Children’s Health Quality (NICHQ) Black History Month Celebration statement puts it this way: “Too often, the mainstream narrative around the Black experience is one of violence, heartbreak, and pain. The importance of understanding our nation’s exploitative history and its impact on modern-day inequities cannot be overstated.”

It goes on,  “However, leaning into collective learning about the contributions of Black thinkers, doers, and visionaries is imperative to creating a world equitable for all. As journalist John Blake and countless others highlight the need for more ‘trauma-free Blackness,’ NICHQ joins the call to highlight and share positive stories and messages about Black people’s ongoing legacy. ” 

Nichelle Clark’s piece  Breastfeeding As An Act Of Resistance For The Black Mother seconds this sentiment.

“Black History Month in the breastfeeding community is normally littered with posts and articles about the dark history of African American Breastfeeding in this country,” Clark writes. “I firmly believe that in order to understand where you are going, you must first understand where you have been. However, Black Mothers in today’s society face a very different dilemma: actually being Black History.”

Photo by Kiana Bosman on Unsplash

And again, Jamarah Amani, LM, executive producer of the documentary Legacy•Power•Voice— a three-part documentary that explores the evolution of Black birthing traditions in America–advises, “You have to look back to go forward.” 

As a white woman with white children educated by white people, in honor of  Black History Month– but of course extending beyond the month of February– I’m looking back on my education (and looking inward) in an effort to evolve my learning and re-learn with my kids.  

We have subscribed to the idea that “If Black children are ‘old enough’ to experience racism then white children are ‘old enough’ to learn about it” as educator Blair Amadeus Imani has said. This is a piece of the critical process of dismantling systemic racism in America.

Thanks to Kimberly Seals Allers’ (KSA) Irth Wind & Fire Facebook episodes, I’ve started digging into the rich history of Black midwifery in my effort to relearn and gain new perspective. 

Black midwifery is part of history that has been hijacked by white men who thought birth should be medicalized and white women who turned it into something “crunchy,” KSA explains.  These influences eventually led to the criminalization of midwives and ultimately influenced low breastfeeding rates and high maternal infant mortality rates in BIPOC.

Photo by Mustafa Omar on Unsplash

Midwifery worked before these forces disturbed the process. Actually, midwifery still works, and KSA shouts out the Black organizations and individuals who are helping families birth safely: 

National Black Midwives Alliance, Southern Birth Justice Network, the Granny Midwives, and community-centered missions and birth centers like those in Detroit and New Jersey for example.     

KSA urges us to honor the systems that have worked for generations, rather than grasping for flimsy and phony solutions. Speak up about midwifery care and to find ways to put time, money and energy into the solutions that we know work, she says in her Irth Wind & Fire episode.

Reflecting on NICHQ’s statement, I realized that Our Milky Way is in part, a collection of “positive stories and messages about Black people’s ongoing legacy.” 

The people we’ve featured– Anihhya Trumbo, Tytina Sanders-Bey, Crystal Lovett, Brittany Isler, Rose Hurd, Kayla Bitten, Evelyn Rhodes, Monica Haywood, Joy R. Gibson, Tangela L. Boyd, Dr. Carolyn Turner, Chanel Porchia-Albert, Dr. Byron Whyte, Tammy Thompson, Ngozi Walker-Tibbs, Acquanda Stanford, Ravae Sinclair, Sering A.L. Sosseh, Charles Clayton Daniels, Jr., Shirley Payne, Patricia Officer, Ashley Albright, and many others–  are the changemakers, the “Black thinkers, doers, and visionaries… creating a world equitable for all.”

Photo by Humphrey Muleba on Unsplash

Racial discrimination is morally wrong and often deadly to Black Indigenous People of Color (BIPOC). If that’s not enough to inspire people with privilege to create positive change, Sum of Us Author Heather McGhee draws “on a wealth of economic data… [and] argues that when laws and practices have discriminated against African Americans, whites have also been harmed… thus we all have an interest in fighting…”  [Read more or listen about the cost of racism for everyone here.]

Along with an understanding of our nation’s exploitative history and acknowledgement of the systemic racism embedded in our country, let’s also celebrate that “… Black lives should matter outside of trauma.”

John Blake writes, “Any true racial reckoning should acknowledge all of our humanity — not just when we’re dying.”

Photo by Eye for Ebony on Unsplash

More resources to consider:

  • The International Confederation of Midwives (ICM) and Council of International Neonatal Nurses (COINN) are surveying nurses and midwives asking for what they might need to better support breastfeeding. The UNICEF-WHO Global Breastfeeding Collective will incorporate the results into an Advocacy brief that highlights the important role of nurses and midwives in supporting, protecting and promoting breastfeeding. Nursing and midwifery organizations and individual nurses and midwives are encouraged to participate in this survey before the end of February. 
  • Teasers and behind the scenes footage of Legacy•Power•Voice here
  • Celebrate BHM with NICHQ’s Weekly Social Media Themes and follow them on Facebook, Twitter, and LinkedIn for posts and resources.
  • Tune into KSA’s Irth, Wind and Fire episodes.
  • Get free access to Breastfeeding Medicine research and articles about Black experiences. 

Tailoring infant feeding support to better serve Chinese American families

On Friday evening, many Chinese American families’ tables were filled with Kao Nian Gao, Tang Yuan, Jiaozi, Jujube, fish, noodles, oranges and other traditional dishes in celebration of the Lunar New Year. 

Asian culture is incredibly diverse, encompassing approximately 52 different countries with about 800 different languages and dialects. The Asian and Pacific Islander (API) population is also the fastest growing group of people, yet they are often overgeneralized or overlooked in health messaging and support.

Jeanne Kettles, MA, IBCLC, Tonya Lang, MPH, Grace Yee IBCLC, presenters of Effective Collaborations and Breastfeeding Promotion Strategies for Asian, Southeast Asian and Pacific Islander Communities, part of the USBC Racial Equity webinar series, point out that on an aggregate level, the API community looks like they’re doing very well in terms of breastfeeding initiation and duration rates.

But the statistics don’t cover the full story, they add, stating that “there are stark disparities within these population groups.”   

Photo by Taiying Lu on Unsplash

Heading into the Year of the Ox, let’s celebrate Chinese American culture– the largest Asian American group– by looking at some of the ways maternal child health advocates can better serve new families by building on cultural practices and by uplifting the organizations that are designed to serve these families. 

Discovered in part through their work with the Asian Southeast Asian Pacific Islander (ASAP!) Taskforce,  Alameda County Breastfeeding Coalition and other community engagement,  Kettles, Lang and Yee outline some strategies for tailoring infant feeding support in the Chinese American population. 

  • Include grandmothers in breastfeeding education and infant feeding plans. Grandmothers are influential elders that often assume responsibility of care for the new mother and infant during the postpartum period.  
  • Incorporate peer counseling into the traditional postpartum confinement period. Whether  mothers stay in the home or in a confinement center during this period, they should have access to proper lactation care. This study shows the importance of targeted training to support better breastfeeding outcomes. 
  • Establish a referral system for appropriate lactation care. 
  • Educate employers on lactation space provisions. 
  • Increase representation of Asian mothers in breastfeeding promotion. 
  • Increase representation of Asian lactation care providers. 
  • Ensure counseling strategies align with cultural practices. 

A major barrier to Chinese American families’ healthy infant feeding practices is linguistic isolation. ASAP! collaborated with Global Health Media to translate some of their videos into Chinese.  La Leche League Canada provides some of their information sheets in simplified Chinese and traditional Chinese. To-wen Tseng’s blog And I’d rather be breastfeeding is available in English and Chinese.  

Photo by Reynardo Etenia Wongso on Unsplash

Moving into a new year, the Asian & Pacific Islander Breastfeeding Task Force celebrates some of their accomplishments as shared on their Facebook page

Photo by Macau Photo Agency on Unsplash

“The ox, in Chinese culture, is a hardworking zodiac sign. It usually signifies movements so, hopefully, the world will be less static than last year and get moving again in the second half of the year,” Thierry Chow, a Hong Kong-based feng shui master is quoted in this article offering predictions on the year ahead.

For more on API culture, resources and materials, visit USBC’s page here

‘Accessing the Milky Way’ scholarship recipient advances equitable care

 

Lovett nurses her 4 month old at a family reunion.

Crystal Lovett, RN, CLS loves telling her breastfeeding stories. The first one goes like this:

My breastfeeding story began February 13, 2006, the day my son was born at WomenCare BirthCenter in Hurricane, W.Va.  Due to possible aspiration of meconium in my amniotic fluid, he was transferred to the hospital where he spent his first week of life.  I expressed breast milk using a hospital-grade breast pump in addition to attempting to feed him at the breast.  After spending the first couple of nights in the hospital with him, the staff urged me to go home and rest.  Though leaving the hospital without him is one of the most difficult things I have ever done, I went home, rested, and continued pumping around the clock to provide him with as much breast milk as possible.  We had some difficulty getting a good latch during his hospital stay and thankfully had the opportunity to work with a lactation professional before he was discharged home.  We ended up having a 15-month breastfeeding journey!

Years later, on March 22, 2019, Lovett gave birth to her daughter at 35 weeks by an unplanned cesarean section. She continues recounting her journey: 

The evening of her birth remains a blur as it took several hours for the medications I received during surgery to wear off.  Though she weighed 4 lbs 15 oz, had an initial low blood sugar, and low body temperature, she did not require a stay in the NICU and we were able to room together the majority of our time there.  I attempted nursing for each feeding before supplementing with formula and pumped after each feeding.  We had some difficulty with latching in the beginning resulting in lots of pain on my end.  We were fortunate to see the lactation consultant before discharge and she showed us some helpful techniques, including how to use a supplemental nursing system (SNS), so that my daughter could receive her supplement while nursing at the breast.  The lactation consultant was the first person to identify a possible tongue restriction, which was diagnosed and revised, along with an upper lip tie, at two weeks of age.  We went back to see the lactation consultant for three outpatient visits.  Eventually, with much work and continuous support, my daughter and I got the hang of breastfeeding.  We were able to stop supplementing around day five and she was back to birth weight by one week!  Now here we are at 22 months still going strong.

Lovett takes a work selfie on dress down day, 3 months postpartum.

From a young age, Lovett says she knew she wanted to make her career in maternal child health, but it was after receiving “such amazing support” from hospital lactation specialists that she zeroed in on wanting to help families navigate new parenthood. 

COVID-19 has challenged Lovett’s newest role as a WIC Peer Counselor, but she says she’s part of a supportive team that has helped her learn the ropes. While the majority of their work is currently done remotely, Lovett reports that they have been able to see some clients in-person with proper PPE and cleaning and sanitizing procedures to ensure a safe experience for everyone. WIC clients have been encouraged to use a lactation support app which offers 24/7 support complete with video chat capabilities.

“I love talking with participants, listening to their stories, providing prenatal breastfeeding education, and counseling for concerns and questions,” Lovett says.   

Her accomplishments have been honored in her feature in the Future of Nursing WV’s Courage to Care Campaign.  She plans to participate as an Ambassador RN and work with the Diversity Team at Future of Nursing West Virginia. 

As an Accessing the Milky Way Scholarship recipient, Lovett completed the Lactation Counselor Training Course (LCTC) last month. 

Not only [will] this help broaden my knowledge base and in turn better equip me to help families, but it…also provide[d] me with a portion of the 90 lactation specific education hours required to become an International Board Certified Lactation Consultant,” Lovett explains. 

Lovett will sit for the September 2021 IBCLC exam.

Mocha Milk in the Mountains, Lovett’s developing business, was born out of her passion to help families and focuses on families of color through pregnancy, birth, breastfeeding/chestfeeding, and beyond. 

Lovett poses in celebration of Black Breastfeeding Week 2020.

“My hope for our community is that all families, regardless or race, ethnicity, or gender, will receive the equitable care and support needed to have healthy and safe pregnancies, deliveries, and parenting experiences,” Lovett says.  

She continues,  “This care includes not only the medical aspect, but also the mental, emotional, and spiritual well-being of the families.  Our need for this support does not go away in the midst of a pandemic; therefore, now more than ever it is important to reach our communities…Our communities need us and I look forward to being one of hopefully many that help normalize breastfeeding in our culture and lead us to better outcomes for families.”

Southern Oregon cohort of maternal child health professionals complete LCTC

Photo by Raj Rana on Unsplash

While families, communities and nations continue to suffer through the COVID-19 pandemic, good things occasionally glimmer amidst the devastation and tragedy. Early in the pandemic, we reported on the positive environmental impact of decreased transportation. In Fostering connection through technology, we touched on the creation of new technology to foster meaningful connection while we physically distance from other humans. We also learned that charitable human milk donations have increased dramatically during the pandemic.

Now, there’s more good news out of Oregon. A group of 24 maternal child health advocates have completed the Lactation Counselor Training Course (LCTC) on scholarship made possible by Health Care Coalition of Southern Oregon (HCCSO)

The organization had initially intended to send a limited-sized group to the in-person LCTC in Springfield, Ore. which required travel costs, HCCSO Healthy Start Program Manager Lee Ann Grogan, CLC reports.

Lee Ann Grogan

But when the course became available online, they reassessed costs and realized they could support more scholarships. 

“With the expansion, we have been able to support professionals from many different fields: pediatric providers, home visiting nurses, doulas, WIC staff, alcohol and drug counselors, homeless shelter staff, teen parent program staff, and all Healthy Start staff,” Grogan explains. “We are thrilled to support this network of professionals and know that having this level of knowledge and expertise in so many potential touch points will be a benefit to many families.” 

Rachel, one course participant, offers praise, “This course was inspiring in and of itself. I really enjoyed the course material and how the information was shared. It was one of my favorite training experiences to date. I also wanted to complete that course because I could see how the information that I was learning could be used in my everyday job and I could pass the knowledge to my patients.” 

Another participant, Kerri Anne, shares, “ The instructors are amazing and easy to follow… I am one who needs to see something multiple times before it really sinks in so having the ability to watch a module more than once before testing is extremely helpful. The quizzes after each module are also helpful. If I happen to misunderstand a question or get it wrong I love being able to see why my answer was incorrect.”

 

Course participants in the cohort are connected through a project management and team communication platform where they can build relationships with one another, share resources, and network with other lactation professionals.  

Along with ongoing lactation education training opportunities, the cohort will be invited to participate in a Perinatal Task Force panel discussion about their training, Grogan adds. 

She explains that the Perinatal Task Force is a collective impact group dedicated to overall community health, working together towards a shared goal, leveraging funds, and aligning priorities to be most effective.

Photo by Larry Crayton on Unsplash

“I would encourage other organizations interested in supporting wide-spread lactation education to do some dreaming and problem-solving with any organization that works with families,” Grogan advises. “We did not anticipate the interest from so many different fields of infant and family services, but are very pleased with the results!  Our organization was able to provide the financial support to our partner organizations for this opportunity, but we know that our partnerships are stronger and the investment will help ensure that the voices of lactation professionals are heard across our region. That will have a lasting impact when we look to future training needs, advocacy opportunities, and events.” 

While the circumstances brought forth by the pandemic have broadened some opportunities, a shift to remote support models for families has proven challenging.  

Southern Oregon is burdened by higher maternal infant mortality rates than the rest of the state. 

Grogan points out key areas of health challenges:

  • “Food Insecurity– Over 15 percent of all residents in Douglas and Josephine Counties are food insecure, but this rate is higher for children with one in four children in our region being food insecure. 
  • Unemployment– Our area’s unemployment rate continues to regularly exceed the state rate. 
  • Poverty Status– Both Douglas and Josephine counties have higher poverty rates than Oregon and the U.S. Over one in four children in the region live in poverty.
  • Maternal Smoking– Our region has alarmingly high rates of maternal tobacco use, with over 20 percent of women smoking during pregnancy.”

She goes on to explain, “Our rural communities lack access to reliable internet and cellphone services… The majority of our clients experience the crisis of poverty and do not have the financial means for smartphones, tablets, or computers.  Beyond access to the required technology, tech literacy is generally low for our population.”

Photo by Luiza Braun on Unsplash

Because of these limitations, Grogan says most of their services are provided over the phone.

Catrina, a cohort member, says that even telephone communication can be difficult because of poor reception in rural areas. Without being able to observe a feeding, she says she and her colleagues have had to tap into their listening skills.  

“We’ve been using our knowledge gained from our CLC training and  listening to what our parents are telling us to help them solve the challenges they have faced,” she says.   

For those with internet access, HCCSO transitioned their most recent Community Baby Shower to social media.  Lactation care providers addressed the importance of early literacy and gave out hundreds of books, addressed safe sleep education and gave away more than 50 cribettes and breastfeeding supplies like breast pads, easy-to-read breastfeeding guidebooks and hand pumps.

“We reached hundreds more families with our social media outreach than we had planned to with our in-person event, so that is definitely a silver lining!” Grogan exclaims.  

Kerri Anne and other LCTC participants in the cohort share that COVID-19 has presented the opportunity to change their perspective, embrace frequent change, and exercise flexibility.  

Photo by Juan Jose Porta on Unsplash

“Covid also accelerated our services and encouraged us to change what we do and how we offer assistance to meet the needs of our patients and their support systems and care teams,” Kerri Anne explains. “… We want them to feel supported and remind them that social distancing shouldn’t mean isolation. We want our families to lean on us … during these uncertain times. Covid has brought us closer to the families we work with and we now check in with them weekly just to see how they are doing rather than wait for them to contact us with a need or concern.” 

Follow HCCSO here, here and here

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