Firstfeeding coalition focuses on enriching Indigenous lives

Heidi Abed, Executive Director Ayllu Community Network, gave birth 20 years apart. With this spacing, Abed saw firsthand how mothers are treated according to their age and perceived experiences.

Photo Courtesy of IFCC

As a 17-year-old, medical professionals doubted her when she told them she was in labor. When she was sent away from the hospital, Abed almost gave birth at home alone.

“I had to call an ambulance,” she recollects.

At 37, Abed desired a water birth, but her insurance denied coverage for this natural option.

“Even 20 years later, I have not seen enough improvement in maternal support provided for any natural options during birth, postpartum and especially with lactation,” Abed shares.

What’s more, she says it was like pulling teeth to try to gain access to a lactation care provider in the hospital.

“They told me that they had lactation consultants, but a couple of days later, they never got the chance [to come see me.]”

Once she and her baby were discharged, it was hard to find lactation care too. When she did connect with one, the lactation specialist used language Abed didn’t understand, and she says she had to look it up on Google to try to make sense of it.

Established in 2018, Abed joined the Indigenous Firstfeeding Coalition Colorado (IFCC)– a coalition created to combat extremely low lactation rates in Indigenous communities due to generational and historical trauma— a few years after its launch. [More on addressing historical trauma here.]

“I am doing what I can to fill a gaping void for far too many,” Abed shares.

Abed’s comrade at IFCC, LJ, has been invested in supporting and educating parents about lactation since having a child in 2013. Being Native, enriching Native lives stays a priority for LJ.

Abed and LJ  have grown in their knowledge and ability to help support others by completing the Indigenous Lactation Counselor Training and Cornerstone Full Spectrum Doula Training.

The team has also embraced inclusivity leading to their name change from Indigenous Breastfeeding Coalition Colorado to its current name, along with their handle across social media: NativeNipples.

The coalition networks with many other community organizations promoting and engaging with their events. This summer has been full of opportunities to connect and more to come like the Breastival, the Indigenous Mind Body Gathering, the Healing Hoop veteran honoring event, Elephant Circle video contest, and the second part of Tewa Women United’s Lactation After Loss.

“Interconnectedness and networking is really everything since we are volunteers with no funding,” Abed begins. “Our aforementioned training was made available through other partnerships at no cost to us. Also, our communities are relatively small and spread out, so pooling together knowledge and resources across social media helps bridge geographic gaps. Bringing light to each other’s efforts makes us more effective, supported, and [helps] avoid redundancy.”

IFCC at the 9 Health Fair in 2019.

Abed also points out the links between Black maternal health and Indigenous maternal health and how they are working together with allied organizations to dismantle many shared experiences that impact maternal infant health.

With the 3rd Annual Indigenous Milk Medicine Week this week, honoring the theme “Strengthening Our Traditions From Birth and Beyond”, IFCC will host an Instagram Live event. Follow them on social media and stay tuned for more information throughout the week.

Knowing that Indigenous cultures are diverse and complex, the learning and honoring never ends! Check out the following to learn more and support these important efforts.

Father holds son born prematurely skin-to-skin, facilitates bonding and steps up for breastfeeding

Eight years ago, Dennis Gaynor Jr.’s son Samuel was born at 28 weeks gestation weighing 1 lb. 6 oz. Mr. Gaynor was encouraged to hold his baby skin-to-skin during their hospital stay to help improve his baby’s blood oxygen levels, sleep, temperature, breastfeeding and weight gain. Kangaroo Care was a new concept for Mr. Gaynor.

Photo courtesy of the Gaynor family

“[I] didn’t realize that this is such a great way to bond with Sam. But I did it with no hesitation and I’m enjoying every minute, second, and hour,” Mr. Gaynor shared. “The thought of my heart beat going into my sons’ ears brings a melody to my heart.”

Samuel’s mother also held him skin-to-skin and provided her milk which helped them endure several surgeries throughout his first few years of life. 

Mr. Gaynor says that he continued to hold Sam skin-to-skin after they were discharged from the hospital. “He was so small, I was scared to hold him, but that was the only other method,” he explains. “To this day, he lays on my chest; everyone else gives me a normal hug, but this is what we’ve always done.”

Photo courtesy of the Gaynor family

Mr. Gaynor and his wife run a 501(C)3 nonprofit organization called Young Men on a Mission: YMOM (pronounced why mom) established in the inner city of Milwaukee, Wis.  Their programming includes mentoring, sports and work training intended to help young men “gain hope in themselves to create goals that extend beyond their daily existence; retain hope when it appears that the odds are stacked against them; and dare to be somebody.” Find out more about YMOM here: https://www.youngmenonamission.org/about-us  

Check out Healthy Children Project’s Kajsa Brimdyr’s The 9 Stages of Premature Infants film which shows the nine stages demonstrated by premature infants. Find more here.

For a collection of research on skin-to-skin contact visit: https://www.unicef.org.uk/babyfriendly/news-and-research/baby-friendly-research/research-supporting-breastfeeding/skin-to-skin-contact/ 

You can read Facilitating the bond between children and fathers or male-identifying partners which covers the positive effects of skin-to skin contact on paternal attachment here.

It’s World Breastfeeding Week! Celebrating how Nurturing Care Centers of Excellence step up for breastfeeding

Tomorrow we kick off World Breastfeeding Week (WBW) 2022! As always, WBW is a time to focus, reflect, galvanize and forge forward protecting, promoting and supporting breastfeeding to address inequalities that stand in the way of achieving Sustainable Development Goals in commemoration of the 1990 Innocenti Declaration.

Coordinated by the World Alliance for Breastfeeding Action (WABA), this year’s theme, Step Up for Breastfeeding: Educate and Support, focuses on strengthening the capacity of actors at different levels of society to protect maternal child health and ultimately global health. Target audiences including governments, health systems, workplaces and communities make up the warm chain of support for breastfeeding and must be informed, educated and empowered to strengthen their capacity to provide and sustain breastfeeding-friendly environments for families in the post pandemic world. [https://worldbreastfeedingweek.org/

The following story is an example of multi-level engagement– from community members to the Ministry of Health– working toward the shared goal of ensuring food security and reducing inequalities.   

 

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Photo by Trevar Skillicorn-Chilver

There’s a sliver on the globe, a place called Timor Leste, one of the newest countries in the world. It gained independence from Indonesia in 2002.

In the spring of 2021, the small island country of about 1.3 million people endured major flooding, killing 44 people and affecting over 30,000 households. [More figures about this tragedy can be found in the OCHA situation report here.]  

Prior to the flooding, families in Timor Leste were already challenged by extreme child malnutrition. One in 24 children under five years old will not survive to celebrate their fifth birthday. [UNICEF 2018]

Nearly 2,000 people were displaced during the flooding, seeking safety at evacuation centers and camps. As is often the case during emergencies, those in Timor Leste dealt with the subsequent flooding of infant formula, baby cereals and feeding material donations. Artificial feeding methods can be dangerous especially during emergency situations and undermine breastfeeding.  

Dr. Magdalena Whoolery reported in Strategies for Infant and Young Child Feeding in Climate-Related Emergencies that the Indonesian Bank donated 180 kgs of infant formula during this emergency. The conditions in the camps are dire, she said. The situation did not welcome a safe environment for artificial feeding. Dr. Whoolery went on to show photos of children eating artificial milk powder from packages. 

In an effort to properly serve those facing disasters and emergencies, Whoolery and her colleagues developed the first “Nurturing Care Centers of Excellence (NCCE) for Emergencies and Beyond”, a cost-effective and innovative package of care for rapid integration of MCH-IYCF recommended practices. The centers were developed based on WHO’s five components of nurturing care

Whoolery proudly reported that over 1,000 families were supported through NCCE; 571 children under 5 and over 600 lactating and pregnant women.

The initiative included strategies like emphasizing the importance of skin-to-skin.  While skin-to-skin is often overlooked during emergencies, it helps mothers continue producing milk, offers calming effects to both mother and child and limits child trafficking because there is zero separation of the dyad. 

The program offers instruction on relactation and bottle amnesty where caregivers are made aware of the risks of bottle feeding and offered cups in exchange for their bottles. 

NCCE places an emphasis on cooking traditional foods to uphold a sustainable food system. 

Community members are also trained to manage and intercept artificial baby milk and other ultra-processed food product donations. 

Following the successful pilot of NCCE at an evacuation center, and improved outcomes of maternal, child and infant health and nutrition, the Ministry of Health requested UNICEF support in replicating the program in all 20 evacuation centers. NCCE is now integrated as part of the National Mother Support Group under the Alola Foundation’s directive. [https://www.globalbreastfeedingcollective.org/strategies-infant-and-young-child-feeding-climate-related-emergencies

Whoolery offers a higher understanding of these numbers and successes. Behind the statistics are children, she reminded us. Juxtaposed photos– the first of a 2 year old depicted with his arm measurement in the red (a danger sign for risk of death) and the next of him thriving, held by his smiling mother after she was able to feed him her expressed milk– demonstrate the power of human milk and the importance of supporting efforts like those of Whoolery and her colleagues.

Timor Leste’s “Country Profile for Early Childhood Development”, developed by UNICEF in collaboration with Countdown to 2030 Women’s, Children’s and Adolescent’s Health is available here

For more stories like this, read the Global Breastfeeding Collective’s Compendium of Skilled Breastfeeding Counselling Case Studies

#WBW2022

#WABA

#breastfeeding

#SDGs

#worldbreastfeedingweek2022

#buildingbackbetter

#stepupforbreastfeeding

#educateandsupport

#WarmChain

USBC Deputy Director Amelia Psmythe Seger’s ‘The Four Pillars of Infant Nutrition Security in the United States’

Our headlines are overloaded with tragedy, perversion, inequities, the unthinkable yet preventable.

Journalist Mary Pilon says in Throughline’s Do Not Pass Go episode “It’s a shame to waste a crisis. A crisis can also be a moment when you look at things and make changes and improvements.”   

And so, from that vantage point, we are honored to be republishing United States Breastfeeding Committee Amelia Psmythe Seger’s piece The Four Pillars of Infant Nutrition Security in the United States originally published here last month. 

“We will get through this because we must. Together we must ensure we build an infant nutrition security system worthy of parent’s trust,” she writes. 

In celebration of World Breastfeeding Week and National Breastfeeding Month on the horizon, there’s no better time than now to take action.  #TogetherWeDoGreatThings

 

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The Four Pillars of Infant Nutrition Security in the United States by Amelia Psmythe Seger, Deputy Director USBC

Throughout its 22-year history, the U.S. Breastfeeding Committee has been working towards the policy, systems, and environmental changes that build a landscape of breastfeeding support.

The catastrophic infant formula shortage demonstrates the value of this work and the need to build a robust infrastructure for infant nutrition security in the U.S. that holds all families in care.

This infrastructure includes four pillars: Parents, Programs, Policies, and a Plan for emergencies.

Parents:

Parents are critical stakeholders in infant nutrition security. The Parents pillar includes people of all races, genders, caregiving roles, routes to parenthood, immigration status, religious or political views, and infant feeding methods. Everyone who loves and cares for a young child belongs. Welcome.

Parents deserve the full support of a robust national infant nutrition security infrastructure. Without it, many are forced onto painful and difficult paths of infant feeding and care. The U.S. needs equitable programs, policies, and a plan for emergencies that centers on the most impacted.Parents and caregivers whose infants rely on formula are the highest priority right now. They need help finding formula, advice on switching between formulas, reassurance that reliable supplies are on the way, and an answer to the question: what should I feed my baby if I cannot find formula?  With appropriate caution, the American Academy of Pediatrics (AAP) published an article on what to feed babies of different ages and situations in an extreme emergency (such as this). Babies under six months should truly only consume human milk or infant formula. In considering very short-term alternatives, the stakes are so high that a physician should monitor the baby.

Parents who are breastfeeding or feeding human milk are in anguish right now, too. Many are feeling pressure to share their milk without acknowledgment of how hard this society has made it to establish and maintain milk supply. Few families have access to lactation support providers, paid family leave, and workplace accommodations to pump breast milk during the workday. In this context, many turn to formula as their backup plan, and it is very scary for them to see that their safety net is in tatters. To answer questions related to human milk, the Academy of Breastfeeding Medicine (ABM) published a guide. This ABM guide addresses pregnancy, low milk supply, re-lactation, options for donation or safe milk sharing, and healthcare guidance and training.

Additional burdens or blame should never be placed on the families and caregivers whose hands are literally full of babies and toddlersWhen capacity allows, however, the collective potential power of parents is significant. Consider if parents insisted on being at the table with the commercial milk formula industry, playing a role in ensuring industry quality, safety, and ethics. They are key stakeholders, after all, so this should be encouraged. Parents could also insist the U.S. enhance our nonprofit milk banking system to ensure an affordable, plentiful donor milk supply for medically fragile infants and those whose parents cannot or do not wish to breastfeed. This would diversify the infant food supply and provide parents with more options.

Programs:

Federal programmatic funding needs to be expanded considering setbacks caused by the pandemic, including the current infant formula shortage.

Federal funding supports quality improvement investments to implement maternity care best practices in hospitals, especially while recovering from pandemic-induced breakdowns in those settings.

Expansion of this funding supports state and community efforts to advance care coordination and strengthen lactation support through policy, systems, and environmental change interventions to reduce or eliminate breastfeeding disparities along the fault lines of income and race.

Federal investments enhance and deepen partnerships to integrate infant feeding and lactation support services into emergency response systems and food security programs during acute disasters and prolonged public health crises.

This funding supports critical national monitoring and public reporting activities, including annual analysis of the National Immunization Survey (NIS), administration of the bi-annual Maternity Practices in Infant Nutrition and Care (mPINC) Survey, bi-annual production of the National Breastfeeding Report Card, and administration of the longitudinal Infant Feeding Practices Study. All of which is especially needed in light of recent updates to the Dietary Guidelines for Americans, which, for the first time, provides nutritional guidance for infants and toddlers.

Policies:

Due to major policy gaps, families face obstacles that make it difficult or impossible to start or continue breastfeeding. Policymakers must choose to prioritize the policies and investments for infant food security so that we never find ourselves in this situation again.

Critically needed policy solutions are waiting for Congressional action:

  • Establish a national paid family and medical leave program. The FAMILY Act (S. 248/H.R. 804) would ensure that families have time to recover from childbirth and establish a strong breastfeeding relationship before returning to work.
  • Ensure all breastfeeding workers have time and space to pump during the workday. The Providing Urgent Maternal Protections (PUMP) Act (S. 1658/H.R. 3110) would close gaps in the Break Time for Nursing Mothers Law, giving 9 million more workers time and space to pump. Contact your legislators about the PUMP Act!
  • Invest in the CDC Hospitals Promoting Breastfeeding program by increasing funding to $20M in FY2023This funding helps families start and continue breastfeeding through maternity care practice improvements and community and workplace support programs.
  • Create a formal plan for infant and young child feeding in emergencies. The DEMAND Act (S. 3601/H.R. 6555) would ensure the Federal Emergency Management Agency can better support access to lactation support and supplies during disasters. Contact your legislators about the DEMAND Act!

Additional areas for policy development

The U.S. has not regulated the marketing practices of the commercial milk formula industry, unlike 70% of the world, which has implemented at least some part of the WHO’s International Code of Marketing of Breast-Milk Substitutes. In the absence of regulation, these marketing practices are predatory.

Diversify the nation’s production of infant formula. Plainly it is a mistake to allow 42% of the infant formula in this country to be produced not only by one company but by one factory of that company. Infant formula companies are part of an infant food security system, but we don’t have to be so dependent on that industry.Enhance the national network of nonprofit donor milk banks. Support innovative partnerships across existing structures, taking a cue from a national model such as what exists in Brazil. Consider: Red Cross has the infrastructure to support donor screening; WIC offices or community health clinics could be donor drop-off sites; more hospitals could provide space and equipment for donor milk processing and distribution, as some have done. Models exist to create an affordable and plentiful alternative to commercial milk formula when a parent’s own milk is not available.

Plan:

All nations should have a robust plan for infant and young child feeding in emergencies that includes three phases: preparedness, response, and resiliency. The USBC-Affiliated Infant & Young Child Feeding Constellation has published a Joint Statement on Infant & Young Child Feeding in Emergencies (IYCF-E) in the U.S. context.
Emergency preparedness includes building a lactation support provider directory and a system to track the inventory of national resources such as infant formula.Emergency response for infants, young children, and their families must include priority shelter, trauma-informed care, lactation support providers in every community; access to breast pumps, and milk storage and cleaning supplies; non-branded infant formula, clean water, bottles, and cleaning supplies.

Emergency resilience includes trauma-informed care that centers on the needs of communities that have been historically undersupported, and disproportionately impacted in emergencies.

Every system is perfectly designed to get the results it gets. The insufficient system we’ve had, led to this crisis. It was predictable, and thus it was preventable.

Now that there’s a mass mobilization of activity – from neighbors driving many miles to find spare formula tins, to the President invoking the defense production act – we must collectively build the resiliency to support a community during a flood, a region during a power outage, or a nation during a pandemic and supply chain crisis. We will get through this because we must. Together we must ensure we build an infant nutrition security system worthy of parent’s trust.

Facilitating the bond between children and fathers or male-identifying partners

 There’s quite a bit of literature on why it is important for fathers to support breastfeeding, and robust recommendations on how fathers can be good support people.

Photo by Anna Shvets: https://www.pexels.com/photo/a-man-in-blue-long-sleeves-playing-with-his-baby-11369399/

Specifically in Black communities though, there’s a “lack of resources for men to learn about and advocate for breastfeeding.”  George W. Bugg, Jr, et al. write in Breastfeeding Communities for Fatherhood: Laying the Groundwork for the Black Fatherhood, Brotherhood, and Manhood Movement  that “Black men deserve to be educated in culturally competent ways about prenatal and postpartum care to advocate for their partners. This is not happening in a systematic way in the Black community. In the Reproductive Justice space, Black men are basically being treated as if they are invisible.” 

As a whole, our nation lacks support for fathers and male identifying partners to bond with their babies. The father–infant relationship should be honored “in its own framework rather than as an alternative to mother–infant theory.” (Cheng 2011

Author Carolynn Darrell Cheng, et al points out in Supporting Fathering Through Infant Massage that “fathers may feel dissatisfied with their ability to form a close attachment with their infants in the early postpartum period, which, in turn, may increase their parent-related stress.”

Photo by Caroline Hernandez on Unsplash

Infant massage is such a neglected modality, especially in the NICU, where it reduces both the risk of sepsis and bilirubin levels, and gets babies home sooner because their brains mature more quickly and they gain weight faster,” Nikki Lee points out. 

Beyond its benefits to infants, Cheng and colleagues have found that “infant massage appears to be a viable option for teaching fathers caregiving sensitivity.” Their work showed that “fathers were helped by increasing their feelings of competence, role acceptance, spousal support, attachment, and health and by decreasing feelings of isolation and depression. Although not all fathers saw the direct benefit of infant massage instruction, they did note they enjoyed participating in an activity that gave them special time with their infants and appreciated the opportunity to meet other fathers.” 

More broadly, skin-to-skin contact has a positive effect on paternal attachment.  

The results from Effects of Father-Neonate Skin-to-Skin Contact on Attachment: A Randomized Controlled Trial identified touching as the highest-scoring Father-Child Attachment Scale (FCAS) subscale. 

Ontario artist Lindsay Foster’s viral image of fathers BJ Barone and Frankie Nelson meeting Baby Milo captures perfectly the flood of oxytocin that skin-to-skin affords fathers and male-identifying parents.

Fathers BJ (left) and Frankie (right) embrace their seconds-old-newborn boy Milo. Milo’s umbilical cord is still attached to the surrogate in this image.
Photo by Ontario artist Lindsay Foster.
Formerly published in: http://www.ourmilkyway.org/skin-to-skin-image-goes-viral/

The World Alliance for Breastfeeding Action (WABA) identifies other ways in which fathers can be “empowered by a whole-of-society approach to fulfill their fathering capacity.” 

WABA suggests that fathers should be engaged and involved throughout the 1,000 days and health systems and care providers can provide knowledge on breastfeeding through antenatal visits, other breastfeeding classes and enabling their participation during labor and delivery and postnatally. 

Sufficient paternity or parental leave is vital to allow time to care for and bond with their new family. 

There is also “a need for greater vigilance against promotion and unethical marketing of breastmilk substitutes targeting fathers to ensure that they also get unbiased information.” [More here.] 

In our national sphere of advocacy, last month, Foundations of Fatherhood Summit hosted Wide World of Fathering  with a mission to advance fatherhood and families in Michigan communities and beyond. The speaker lineup was full of individuals passionate about fatherhood and working to shift the way we view males as parents. 

Presenter Reginald Day, CLC for instance, hosts a podcast called Get At Me Dad which reveals the true narrative of BIPOC fathers–”present, connected and raising strong families.”

Father-son duo Mark and Corey Perlman host another podcast called Nurturing Fathers based on the Nurturing Fathers Program

Last week, New Mexico Breastfeeding Task Force Board Member Francisco J. Ronquillo hosted a Hearing our Voices virtual roundtable for fathers and male-identifying partners. 

Reaching Our Brothers Everywhere (ROBE), an organization which seeks to educate, equip, and empower men to impact an increase in breastfeeding rates and a decrease in infant mortality rates within the African-American communities, hosts a monthly virtual call where males can discuss maternal child health related topics.   

In partnership with Reaching Our Sisters Everywhere (ROSE), ROBE will host the 11th Annual Breastfeeding and Equity Summit in New Orleans from August 25  to 27, 2022 where presentations center on equity in breastfeeding, maternal health, fathers and partners, and infant health initiatives.

 

Our Milky Way past coverage on fathers

Photo by PNW Production: https://www.pexels.com/photo/a-family-walking-together-on-a-boardwalk-8576210/

New CLC engages fathers, supports breastfeeding, heals communities

Fathers profoundly influence breastfeeding outcomes

Founder of Fathers’ Uplift adopted into breastfeeding movement

The Institute of Family & Community Impact hosts event to boost paternal mental health

Paternal mental health and engagement

Robert A. Lee, MA answers the call

A lasting bond 

Skin to skin image goes viral

Changing families demand changing policies