A story of lactation and breastfeeding as a ‘Tummy Mummy’

Apryl Yearout, a school psychologist in Washington state, uses her body in powerful ways. For one, Yearout, known as Ariel Pain on the roller derby track, competes as a full contact skater excelling as both a jammer and a blocker.

Used with permission.

Yearout was drawn to roller derby well over a decade ago because of the “incredible community” it offered her.

“I heard ‘I’m proud of you’ and ‘good job’ more than I ever had,” she reflects. “It’s physically demanding and makes you feel strong and capable.”

In another manifestation of her power, Yearout birthed and breastfed her two daughters. Yearout’s eager body produced so much milk that she was also able to donate about 1,000 ounces of milk to local families.

Beyond this, Yearout helped create a family as a gestational carrier, or “tummy mummy” as the intended parents refer to her.

The idea of surrogacy came to her as a few realities collided. She’d anticipated having many more children of her own, but she and her husband divorced when their youngest child was 18 months old. As her children grew and without a new partner, she didn’t feel she was in the position to “start over” again with a baby.

Yearout watched her sister struggle to carry a pregnancy to term for some time, but ultimately, she was able to birth her own baby, so Yearout pursued the services of an agency and matched with a couple in need.

In April 2023, Yearout gave birth to the couple’s son. The baby and her youngest daughter wound up sharing a birth date, fulfilling her daughter’s birthday wish.

As discussed during her pregnancy, Yearout breastfed her surrobaby on occasion, for a few days after the birth while spending time with the new family.

“Overall, it felt like the natural completion of the pregnancy,” she shares. She also predicts it’s why she recovered so well from pregnancy.

Though she and the indented parents had already discussed direct breastfeeding as their plan while possible, Yearout expressed colostrum in the event that the intended parents felt strongly about being the ones to feed their baby first.

Unlike some surrogates, Yearout didn’t struggle with the idea that breastfeeding would create an unhealthy bond with the surrobabe.

She shares: “I was already very connected to this baby. I approached the surrogacy with a mindset that I need to make sure I have the right couple, I need to fall in love with them becasue I know I’m going to fall in love with this baby… physically and emotionally…everything is tied up… he’s not mine, I never felt like he was my child but I still love him… For me, not nursing, not having any breastfeeding experiences would have felt a little incomplete. I think it also would have put a physical strain on my body that could have pulled on those emotions and made it harder. I didn’t like the idea of forcing my body to stop [producing milk].”

The intended parents were not interested in managing the shipment of her milk after they returned home, so Yearout sought out a local family to donate to.

“And I get to see that little one grow up,” she says.

Yearout completed pumping and donating her milk in the autumn of 2023.

“Pumping alone is really hard,” she reports. In contrast, Yearout after a workday pumping for her keepers, she would come home to breastfeed through the night, and her body responded to this interaction much differently.

“When I was just pumping, [production] tapered off a lot faster,” she shares.

Thinking back on her experience as a tummy mummy, Yearout articulates her discomfort with the perception that gestational carriers are compelled solely by financial compensation.

She says in a somewhat joking manner, “I feel like I could sell pictures of my feet for more money.” (Let us note that this is not to diminish the financial burden that surrogacy can cause for many couples looking to create a family.)

“The thing that always bothered me was that people assumed that I did this for the money,” she goes on. “I had other motivations. [The arrangement]  helped me take my kids on a trip we would have never gone on before, but it wasn’t my reason…Money wasn’t a primary motivator but it did come up so often [with others].”

Instead, Yearout sought and found connection.

She comments, “This is what my body is good at and I’m going to use it to benefit other people.”

Yearout and her mom recorded an interview with StoryCorps. Unrelated to surrogacy, it’s a conversation about Native American roots, racism, white privilege, and their relationships with their extended family, and it’s worth a listen. You can find it here.

Brenda Hwang’s, MA, CCC-SLP, CLC, CDP light bulb moment: “My colostrum is in fact enough…”

[Photo by Andrea Piacquadio]
We consider ourselves life-long learners here at Healthy Children Project. Sometimes learning occurs gradually, and sometimes there are the ‘light bulb’ moments.

We put a call out to our followers to share “Aha!” moments with us. Maybe it was a myth busted during the Lactation Counselor Training Course (LCTC) or maybe it happened during a visit with a dyad.

We also called for stories about your babies’ and children’s ‘light bulb’ moments. When have you seen your little ones’ faces light up in discovery and understanding?

The call for stories is still open! Please send your reflections to info@ourmilkyway.org with “Light Bulb” in the subject line. 

This is Brenda L. Hwang’s, MA, CCC-SLP, CLC, CDP illuminating moment. 

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Myth – You have to feed formula in the beginning until your milk “comes in.”

FACT – You do not have to feed formula if you do not want to and your colostrum IS ENOUGH. 

I had an incredible breastfeeding journey with my first born that lasted a little over two years. It was difficult for me to think about other moms not having a positive breastfeeding experience. 

That is when I decided to become a lactation counselor. During my training, I remember learning about helping mothers feel confident about their milk supply (when there are no medical reasons to be concerned about). I remember being fascinated with the Baby-Friendly Hospital Initiative and researching if there were any near me for when I deliver again or to recommend my patients to go to for the most pro-breastfeeding support. Unfortunately, there wasn’t one. 

When I gave birth to my second born, I remember feeling overwhelmed by so many emotions following childbirth. I remember trying to remind myself that this was typical as our hormones are off the charts after experiencing what the amazing body just went through to bring new life into the world. I felt like there were so many things that I had little or no control over, but what I did have control over was advocating for immediate skin-to-skin and the opportunity to breastfeed my daughter. That made me feel grounded and confident. 

However, that night came and my daughter wouldn’t stop crying. The nurse would come in and out of our room always looking angry, telling me that my supply was not enough, and that I needed to give my daughter formula for her to stop crying. I kept advocating for myself and reminded my husband that –

  1. Formula was not what we planned for or want, 
  2. I have colostrum and,
  3. My colostrum is in fact enough and the best thing that we can give to our daughter right now. 

Although I knew this was true, the sad little cries broke my heart and the nurse’s comments and facial expressions made me feel uneasy. 

Even with the breastfeeding education that I had, she eventually made me believe that perhaps I was wrong and what I had was not enough for my daughter. I dozed off crying quietly to myself, feeling like a failure as a mom. This was my Ah-Ha moment. I thought, “Wow, that was terrible and unfortunately too common of an event that mothers often experience in the hospital.” I would never wish for any mom to feel that way – to feel like she is not enough, or a failure as a mom.

I am now dedicated to providing breastfeeding education during pregnancy… to help moms feel prepared for the first few moments after baby is born. I strive to find a role in the hospital in order to advocate for parents who wish to breastfeed and to provide timely interventions so that they too can have a positive breastfeeding experience. 

Thank you for reading my story.



Breastfeeding is part of a continuum. 

–This post is part of our 10-year anniversary series “Breastfeeding is…”

Breastfeeding is part of a continuum.

It has been hypothesized that starting around nine weeks of fetal development, the pattern and sequence of intrauterine movements of the fetus seem to be a survival mechanism, which is implemented by the newborn’s patterns of movement during the first hour after birth  (described as the 9 stages)  when skin-to-skin with the mother to facilitate breastfeeding.

Photo credit United States Breastfeeding Committee

This very behavior refutes the idea that breastfeeding is “an adjunct to birth” as it is generally viewed in maternity care settings in America.

Not only are human babies hardwired to progress through 9 stages and self attach to the breast, mammalian bodies are hardwired to produce milk too.

Around 16 weeks of pregnancy, the body starts to prepare for breastfeeding. This phase, called Lactogenesis I is when colostrum begins to be created. During Lactogenesis II, the secretion of copious milk follows the hormonal shift triggered by birth and the placenta delivery. After this phase, milk production must be maintained through a supply-and-demand-like system. [Neville 2001]

Even before a pregnancy is achieved, individuals are being influenced by the infant feeding culture that surrounds them, consciously or subconsciously laying a foundation for how they feel about feeding their own babies.

Pat Hoddinott’s, et al study found that women who had seen successful breastfeeding regularly and perceived this as a positive experience were more likely to initiate breastfeeding.

Exposure to prenatal breastfeeding education also affects breastfeeding outcomes. Irene M. Rosen and colleagues found that women who attended prenatal breastfeeding classes had significantly increased breastfeeding at 6 months when compared to controls.

Photo by Luiza Brain

Mode of birth and birth experiences influence infant feeding too, for both members of the dyad.

A growing body of evidence shows that birth by cesarean section is associated with early breastfeeding cessation.

Intrapartum exposure to the drugs fentanyl and synOT is associated with altered newborn infant behavior, including suckling, while in skin-to-skin contact with mother during the first hour after birth. [Brimdyr, et al 2019]

What’s more, the authors of Intrapartum Administration of Synthetic Oxytocin and Downstream Effects on Breastfeeding: Elucidating Physiologic Pathways found “No positive relationships between the administration of synthetic oxytocin and breastfeeding.” They comment, “Practices that could diminish the nearly ubiquitous practice of inducing and accelerating labor with the use of synthetic oxytocin should be considered when evaluating interventions that affect breastfeeding outcomes.”

Photo by Olivia Anne Snyder on Unsplash

In Transdisciplinary breastfeeding support: Creating program and policy synergy across the reproductive continuum, author Miriam Labbok takes a detailed look at “the power and potential of synergy between and among organizations and individuals supporting breastfeeding, the mother-child dyad, and reproductive health to increase sustainable breastfeeding support.”

Labbok points out that a paradigm shift on the issues in the reproductive continuum – family planning, pregnancy and birthing and breastfeeding– is needed.

“These are issues that are intimately, biologically, gender linked in women’s lives, and yet ones that are generally divided up to be addressed by a variety of different professional disciplines,” Labbok begins.  “Despite the impact of child spacing on birthing success, of birthing practices on breastfeeding success, and of breastfeeding on child spacing, we are offered family planning services by a gynecologist, birth attendance by an obstetrician or midwife, and baby care by a pediatrician. Having these ‘silos’ of care, each with its own paradigm and priorities, may lead to conflicting messages, and hence, may undermine the search for mutuality in goals, and collaboration.”

One such initiative looking to deconstruct siloed care is the Baby-Friendly Hospital Initiative which includes standards and goals for birthing practices, for breastfeeding-friendly communities, and guidance for birth spacing, in addition to reconfirming the original Ten Steps to Successful Breastfeeding, in recognition that breastfeeding occurs along a continuum.

Source: United States Breastfeeding Committee

1,000 Days emphasizes how breastfeeding fits within the global picture as a crucial part of a whole.

In the U.S. context, the 1,000 Days initiative recognizes comprehensive health coverage, comprehensive guidelines on nutrition during pregnancy, lactation, and early childhood for women in the first 1,000 days, paid family  and medical leave policy for all workers, and investments to ensure parents and caregivers can access good nutrition as solutions to a well nation and a well world.

 

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As part of our celebration, we are giving away an online learning module with contact hours each week. Here’s how to enter into the drawings:

Email info@ourmilkyway.org with your name and “OMW is 10” in the subject line.

This week, in the body of the email, please share with us some or all of your birth stor(ies).

Subsequent weeks will have a different prompt in the blog post.

We will conduct a new drawing each week over the 10-week period.  Please email separately each week to be entered in the drawing. You may only win once. If your name is drawn, we will email a link with access to the learning module. The winner of the final week will score a grand finale swag bag.