‘Full pandemic mama’ becomes full spectrum doula

Allysa Singer was, as she describes, a “full pandemic mama.” Singer became pregnant with her first child in the winter of 2019. As she became aware of the threats and the consequences of COVID-19, she started researching her options and her rights in the delivery room she’d find herself in August 2020.

What started as personal preparation– How many support people would she be allowed? Would she be allowed a support person at all? What restrictions would she encounter? How could she advocate for herself? What were her options?–  propelled her into a world of birth support and autonomy advocacy.

“I was just dumbfounded by the disparities that exist in maternal health,” Singer begins.

In 2020, Alabama, where Singer and her family live, had the third-highest Maternal Mortality Rate in the nation, at 36.4 per 100,000 live births.

BIPOC families suffer from massive disparities in maternal and infant deaths. In a recent piece, Childbirth Is Deadlier for Black Families Even When They’re Rich, Expansive Study Finds, Tiffany L. Green, an economist focused on public health and obstetrics at the University of Wisconsin-Madison is quoted: “It’s not race, it’s racism…The data are quite clear that this isn’t about biology. This is about the environments where we live, where we work, where we play, where we sleep.”

Still, unlike so many of her peers, Singer reports having had an amazing birth experience.

Inundated by birth horror stories, she decided to change care at 27 weeks in hopes that she would be better supported in her choices at a different institution.

Here, she was allowed a doula and support person to accompany her during her birth.

“Not a lot of women had that luxury,” Singer comments.

Knowing well that birth support is a right and not a luxury, she started her own doula practice in December 2021. 

Singer shares that she experienced severe postpartum depression, but she was able to divert and ultimately reshape this energy into her doula work.

“My doula training was the lifeboat that saved me from drowning in my PPD,” she says.

And now her practice, Faith to Fruition, has become the lifeboat for many of the birthing people Singer supports.

She shares: “I don’t believe that a birther’s desire to have more children should be dictated by their birthing experience. I have heard so many stories from people who had one kid but say, ‘I would never do this again because my experience was so traumatic.’ One of my biggest missions and goals is to support birthers to feel empowered in their process; not as bystanders of their process.”

Singer also holds a full time position as an industrial psychologist where she channels her advocacy work, pushing for organizational change and understanding of proper maternal support.

In fact, as part of a public speaking course for a training curriculum, Singer presented on why it’s important to support breastfeeding. She reports that her audience of roughly 25 was engaged, especially as she pointed out the absurdities of infant feeding culture in our country: How would you feel if I asked you to eat your meal in the bathroom? How would you like to eat with a blanket tossed over your head? for instance.

Singer also points out the “insanely amazing public health outcomes” breastfeeding affords.

If 90 percent of U.S. babies were exclusively breastfed for six months, the United States would save $13 billion per year and prevent an excess 911 deaths, nearly all of which would be in infants ($10.5 billion and 741 deaths at 80% compliance). [Bartick, Reinhold, 2010]

“Not only is there a personal investment, there is a public investment and value to understanding the larger implications,” Singer comments. “As a taxpayer, [breastfeeding] impacts you; as someone who utilizes our healthcare system, [breastfeeding] impacts you.”

With the recent passing of the PUMP Act and the Pregnant Workers Fairness Act coming soon, Singer says “We still have a long way to go.”

Organizational policy doesn’t support motherhood; instead it fuels detached parenting which goes against nature, Singer goes on.

“Mothers feel the brunt of that more than ever,” she says.  “[We aren’t] supported to be able to care for our children the way that we want to.”

Singer says she sees it as her mission as an organizational psychologist to encourage change that supports parenthood, so that women don’t feel threatened to care for their children the way that they want to. This means ensuring that women are provided with ample space to pump their milk while away from their babies and empowering them to approach HR when there aren’t appropriate accommodations.

“Outside forces shouldn’t be able to dictate how you care for and feed your child. The end of one’s breastfeeding journey should be a personal decision.”

She continues, “It’s amazing that legislation is catching up. The thing that I fear with any law, there are still people behind those laws that have to enforce them and carry them out. Education and garnishing an understanding of what this looks like is a key component to implementation. The people behind those policies have to make them successful, but this is  moving things into a very good direction, and I hope that more changes to legislation follow suit, especially with paid parental leave. It’s a catalyst for change; I am hopeful but cautiously optimistic.”

Singer says she owes her personal success continuing to breastfeed her two-and-a-half year old to Chocolate Milk Mommies, where she now serves as a board member.

Through Chocolate Milk Mommies, Singer started a subcommittee to focus on education for individuals within the breastfeeder’s support system.

“The people in the village need to be supportive. When you don’t know better, you can’t do better,” she explains.

Singer recently completed the Lactation Counselor Training Course (LCTC) as part of Chocolate Milk Mommies’ mission to best support their constituents and as a way to benefit her doula clients with more well-rounded support.

“I really loved the training because I already thought that our bodies are amazing, but learning more science was great. I would text my friends the ‘Boobie Fact of the Day’,” Singer shares. “[The science] allows me to really appreciate my journey that much more and how impactful I’m being with my daughter.”

You can follow Singer’s work here and here.

Prioritizing infant and young child feeding in emergencies during National Preparedness Month and beyond

September is National Preparedness Month. We’ve spent a lot of bandwidth covering our country’s deficiencies in handling healthy infant feeding in emergency situations. There was National Preparedness Month: the U.S.’s deficit in Infant and Young Child Feeding preparedness during emergencies, Guiding resources for infant and young child feeding during emergencies, Spotlight on Infant and Young Child Feeding in Emergencies during National Breastfeeding Month, Toxic Stress, Resilience Building, COVID-19 and Breastfeeding, and Underdeveloped plans for infant and young child feeding during emergencies.

In preparation for Hurricane Katrina– which the Federal Emergency Management Agency (FEMA) called “the single most catastrophic natural disaster in US history”– the government organized an alternate site for the Super Bowl but failed to employ an infant feeding in emergencies (IFE) plan. In the aftermath of the catastrophe, pets and exotic animals were accounted for, but mothers and infants were separated from one another as hospitals were evacuated. If you haven’t the time to sift through our coverage on emergency preparedness and response, those accounts pretty much sum up where our priorities lie.

Photo by João Henrique do Carmo: https://www.pexels.com/photo/child-breastfeeds-from-her-mother-5839104/

With the deficit clearly illuminated, we’re glad to report solutions and resources for infant and young child feeding in emergencies (IYCF-E) that have begun to emerge as emergent situations increase in frequency and severity.

During World Breastfeeding Week, we shared work being done in Timor Leste as reported by Dr. Magdalena Whoolery in Strategies for Infant and Young Child Feeding in Climate-Related Emergencies.

We covered Doula and Program Coordinator at Birthmark Doula Collective & New Orleans Breastfeeding Center Malaika Ludman’s, MPH, CLC work in Infant and Young Child Feeding in Emergencies in Louisiana: Lessons Learned from a Post-Hurricane Laura Response During the COVID-19 Pandemic.

Julia-Lorraine Mercedez Moore, a WIC peer counselor in Pickens County, S.C., talks about supporting breastfeeding through the pandemic in South Carolina WIC peer counselors help families through COVID and beyond.  

In New Mexico Breastfeeding Task Force’s efforts to support human milk feeding in alternative housing environments, task force members describe how to best support families in crisis.

Beyond Our Milky Way coverage, there’s fantastic work and opportunities for action to amplify.

CHEERing is an ISO certified, Greek-registered NGO dedicated to improving maternal child health and promoting preventive health in refugee populations. They provide direct support in refugee camps and shelters; training for agencies, including medical professionals and volunteers who work daily with refugee populations, and evaluation and monitoring.

The Global Breastfeeding Collective created an advocacy brief, Breastfeeding in Emergency Situations, which details a call to action that focuses on establishing proactive versus reactive feeding systems.

Photo by Mehmet Turgut Kirkgoz : https://www.pexels.com/photo/a-woman-breastfeeding-her-child-11779231/

The IFE Core Group by the Johns Hopkins Center for Humanitarian Health at Johns Hopkins Bloomberg School of Public Health, the Friedman School of Nutrition Science and Policy at Tufts University and the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill has compiled a repository that provides peer-reviewed journal articles that cover emerging evidence in emergency settings such as natural disasters, conflicts, displacement including refugee settings. Access the repository here.

This summer, the CDC’s Division of Nutrition, Physical Activity, and Obesity (DNPAO) released a toolkit with information and resources for emergency preparedness and response personnel, families, and the public to ensure that children are fed safely when disaster strikes. You can access the toolkit here.

Image credit: United States Breastfeeding Committee

The United States Breastfeeding Committee (USBC) is a leader in helping pass legislation that would better protect young families in emergencies. USBC’s Take Action Center offers an easy way to engage in formalizing legislation. You can contact your legislators about the DEMAND Act (S. 3601/H.R. 6555) here.

Read other USBC coverage on IYCF-E in Disasters Don’t Wait: We Must Make Babies a Priority in Emergencies and The Four Pillars of Infant Nutrition Security in the United States.

22 more actions in 2022

 In our third installment of 22 in 2022, we bring you 22 MORE Actions in 2022, because there is always work to do. 

Source: United States Breastfeeding Committee

22 in 2022 was inspired by Life Kit’s 22 Tips for 2022, and we hope it provides inspiration for you to forge forward with this important work.

  1. Learn about the Girls’ Bill of Rights. Empowered women start with empowered girls. 
  2. Watch a film centered around maternal child health like  A Doula Story, The Milky Way breastfeeding documentary, Chocolate Milk, Zero Weeks, Legacy Power Voice: Movements in Black Midwifery or register to play Factuality
  3. Identify and network with an individual or organization with a mission that intersects with maternal child health. This shouldn’t be a challenge… “All roads lead to breastfeeding!” (A popular adage at Healthy Children Project.)  Often, we find ourselves preaching to the choir, shouting in an echo chamber, whatever you want to call it. It’s time to reach beyond our normal audience. 
  4. Follow Dr. Magdelena Whoolery on social media to stay up to date on strategies that combat the multi-billion dollar artificial baby milk industry. 
  5. Sign on to USBC’s organizational letter in support of the DEMAND Act of 2022.
  6. Congratulate, encourage or simply smile at a mother. 
  7. Explore White Ribbon Alliance’s work around respectful care. You can start by watching this poignant webinar Healthcare Professionals Honoring Women’s Demands for Respectful Care
  8. Read The First Food System: The importance of breastfeeding in global food systems discussions.
  9. Read Lactation in quarantine: The (in)visibility of human milk feeding during the COVID-19 pandemic in the United States
  10. Sign this petition to stop unethical formula research on babies. 
  11. Check out the updated Center for WorkLife Law’s Winning New Rights for Lactating Workers: An Advocate’s Toolkit
  12. Register for a free PQI Innovation webinar.
  13. Read the revised Academy of Breastfeeding Medicine (ABM) Clinical Protocol #2: Guidelines for Birth Hospitalization Discharge of Breastfeeding Dyads here
  14. Gear up for World Breastfeeding Week 2022 and National Breastfeeding Month. 
  15. Check out this NIH project Breastmilk Ecology: Genesis of Infant Nutrition (BEGIN) Project which seeks a deeper understanding of human milk biology to address ongoing and emerging questions about infant feeding practices.  
  16. Learn about the Melanated Mammary Atlas.
  17. Consider becoming a ROSE community transformer or share the opportunity with someone who may be interested. 
  18. Get familiar with WHO’s recent report How the marketing of formula milk influences our decisions on infant feeding and disseminate the corresponding infographics
  19. Sensitize journalists and the media to stimulate public debate on the links between breastfeeding and the climate crisis as suggested by the World Alliance for Breastfeeding Action (WABA).
  20. Get to know how breastfeeding and proper nutrition fits into the Sustainable Development Goals (SDGs)
  21. Access one of the National Institute for Children’s Health Quality’s (NICHQ) webinars on breastfeeding, infant health, early childhood or health equity here
  22. Engage with the PUMP Act Toolkit! This is crucial, time-sensitive work that will make a huge difference for families across our nation.

Read our original list of 22 Actions here and our celebration of unsung sheroes/heroes here

Spotlight on Infant and Young Child Feeding in Emergencies during National Breastfeeding Month

It’s Week Three (August 16-24) of National Breastfeeding Month, recognized as Spotlight on Infant and Young Child Feeding in Emergencies by the United States Breastfeeding Committee (USBC). 

Among the many effects of the novel coronavirus, the pandemic has truly exposed our nation’s deficiencies; one of them being emergency unpreparedness. 

Years ago, Federal Emergency Management Agency (FEMA) called Hurricane Katrina “the single most catastrophic natural disaster in US history.”

In preparation for the storm, the government organized an alternate site for the Super Bowl but failed to employ an infant feeding in emergencies (IFE) plan, Healthy Children Project Executive Director Karin Cadwell reports. In the aftermath of the catastrophe, pets and exotic animals were accounted for, but mothers and infants were separated from one another as hospitals were evacuated.

In 2016, Healthy Children Project, Inc. (HCP)  convened an Expert Panel to complete the World Breastfeeding Trends Initiative (WBTi), an international tracking, assessment and monitoring system for national implementation of the Global Strategy on Infant and Young Child Feeding, as originally reported in Underdeveloped plans for infant and young child feeding during emergencies

WBTi Panel Members

The USA scored 0 out of 10 points on WBTi Indicator 9, which measures implementation of actions to protect infant and young child feeding (IYCF) during emergencies.

WBTi originator Dr. Arun Gupta challenged HCP to conduct a state-by-state review of WBTi indicators that can be measured on a state level. 

The US Expert Panel reconvened in 2017 to complete the United States of America and U.S. Territories 2017 Assessment Report. Results further show the absence of state policies ensuring babies and young children are safely fed during emergencies.

HCP’s Cindy Turner-Maffei says that the lack of well-developed plans for protecting IYCF during emergencies was one of the most worrisome findings of the U.S. WBTi Assessment.

She explains: “Scores above two points were rare, and most of the points scored regarded funding allocation for emergencies, not for specific inclusion of the needs of infants and young children in emergency plans.”

Puerto Rico and Texas scored 0 out of 10. New Jersey and Mississippi scored 2 out of 10. Oklahoma 3 out of 10. Connecticut took the lead at 6 out of 10.

“Panel members were struck by the fact that few of the states and territories that had recently experienced significant disasters were among those with significant scores for Indicator 9,” Turner-Maffei continues. “Ironically, some states and territories have well-elaborated plans for the care and feeding of household pets in shelters, but none for infants and young children.”

Photo by Luiza Braun on Unsplash

Although there are always crises occurring, since being thrust into a global pandemic, our nation has had to reevaluate how we care for families with babies and young children. Especially in marginalized populations, poverty, health inequities, and other burdens are amplified during an outbreak or other emergency. 

Carolina Global Breastfeeding Institute states,  “Any crisis presents an opportunity for positive, sustainable change and coordinated involvement of all. #COVID19 taught us that we are all affected and an immediate societal response is required.” 

In an effort to increase awareness and preparation, 1,000 Days— a non-profit working to improve nutrition and ensure women and children have the healthiest first 1,000 days–compiled a list of five things we need to know about breastfeeding in emergencies in a 2018 blog post:

1. Breastfeeding is the safest, most nutritious and reliable food source for infants under the age of six months.

2. Breastfeeding decreases the risk of infection and disease, which is vital to survival in emergency settings.

3. Breastfeeding mothers need (even more!) support during emergencies.

4. When breastfeeding is not possible, immediate support is necessary to explore feeding options and protect the health of vulnerable infants.

5. Preparedness is key to ensure babies everywhere have the best opportunity to survive and thrive. 

Parents and care providers can consult Global Health Media’s video How to Express Breastmilk in situations where hand expression is warranted. 

More recently, USBC has compiled a comprehensive resource page for Infant and Young Child Feeding in Emergencies, including COVID-19.

USBC calls on us to take action by urging policymakers to take three actions to integrate infant and young child feeding into emergency preparedness and response efforts:

  • Expand the Federal Interagency Breastfeeding Task Force to include emergency and infectious disease experts
  • Direct the Federal Emergency Management Agency to ensure breast/chestfeeding people have appropriate services and supplies during a disaster or pandemic
  • Enact World Health Assembly Resolution 12.6 related to infant and young child feeding in emergencies

The CDC offers their guide to disaster planning here

CGBI’s Dr. Aunchalee Palmquist leads Lactation and Infant Feeding in Emergencies (L.I.F.E.) Amid the Pandemic Initiative, an active hub of research, policy advocacy, and technical support with recommendations relating to current emergency situations.

The World Alliance for Breastfeeding Action (WABA) has made available an interview between Dr. Felicity Savage and Dr. Amal Omer Salim which touches on proper breastfeeding support during normal and crisis situations. 

Dr. Savage points out that one of the biggest concerns about breastfeeding counseling during emergent situations is actually getting the counseling to parents. Specifically during the Covid-19 pandemic, Drs. Savage and Salim emphasize that separating mother and baby is not necessary to prevent the spread of the infection from mother to child, and make clear that care providers should follow WHO and UNICEF guidelines

#NBM20 

#IYCFE 

#ManyVoicesUnited

‘Strong. Resilient. Latched.’ Celebrating Native Breastfeeding Week

Just short of a decade ago, the United States Breastfeeding Committee (USBC) declared August National Breastfeeding Month. National Breastfeeding Month kicks off with the World Alliance for Breastfeeding Action’s (WABA) World Breastfeeding Week (WBW) and continues to celebrate each subsequent week:

Week 2 (August 9-15): Native Breastfeeding Week: Strong. Resilient. Latched.  

Week 3 (August 16-24): Spotlight on Infant and Young Child Feeding in Emergencies 

Week 4 (August 25-31): Black Breastfeeding Week: Revive. Restore. Reclaim.

This week, we honor the very diverse experiences of Indigenous families and “address the inequity and injustice of Indigenous parents and their abilities to practice their roles in accordance to the tribal communities they descend from.”  [https://www.facebook.com/NativeBreastfeedingWeek/

There are so many ways to celebrate, to uplift, to support, and as white lactation care providers and maternal child health advocates, ways to learn, humble ourselves, and do better.

The official Native Breastfeeding Week Facebook page actively includes ways to engage in Native Breastfeeding Week. There are sunrise honor prayers, a Virtual 5K Move, Q&A sessions, platforms for sharing personal accounts, and much more.

On Tuesday, the American Indian Cancer Foundation will host an #IndigenousMilkIsMedicine webinar, where Indigenous midwife Hope Mayotte (Bad River Tribe) presents on the importance of Indigenous birth and breastfeeding. 

“For generations, our families have known that breastfeeding nourishes baby’s mind, body, and spirit, and also reduces the risk of cancer and cancer risk factors for birthing people,” American Indian Cancer Foundation’s Communications Specialist Tina MacDonald, BA (Leech Lake Ojibwe) shares.  “During Indigenous Milk Is Medicine, we aim to educate and support Native families across the nation by providing them with culturally-tailored breastfeeding webinars and resources.”

Register here

The Indigenous Birth and Breastfeeding Collective of North Dakota will host the Indigenous Breastfeeding Counselor Training in Standing Rock August 26 to 30. The course is taught by Camie Jae Goldhammer, MSW, LICSW, IBCLC (Sisseton-Wahpeton) and Kimberly Moore-Salas, IBCLC (Navajo) and covers topics like historical trauma, the impact of birth on breastfeeding, water rights and its relation to breastfeeding, food sovereignty, maternal mood disorders and much more. The course is open to those who self-identify as Indigenous. Find more information here

Indigenous Women Rising is facilitating the delivery of Covid-19 care packages, and while the deadline to apply has passed, individuals may still donate to the cause

Bold Futures shared An open letter: Seeking justice and systemic change for Native Families harmed by structural racism, a response to a “secretive policy [at a prominent women’s hospital]…to conduct special coronavirus screenings for pregnant women, based on whether they appeared to be Native American, even if they had no symptoms or were otherwise at low risk for the disease, according to clinicians.” [https://www.propublica.org/article/a-hospitals-secret-coronavirus-policy-separated-native-american-mothers-from-their-newborns

The letter details how maternal child health advocates can help move forward; for example:

* “Centering BIPOC midwives, birth workers and birth advocates in leadership and decision making,” 

* “Significant investment through the state Department of Health and public health funds in out-of-hospital birth models led by Native, Black and People of color,”

* “Defunding and criminalizing of medical institutions and providers that are, or have, engaged in hate crimes under the guise of medical care.”

Last year, four out of 10 Indian Health Service (IHS) hospitals achieved Baby-Friendly re-designation. Baby-Friendly hospitals support exclusive breastfeeding which “protects against obesity and type II diabetes, conditions that American Indians and Alaska Natives are particularly prone,” Tina Tah, IHS Senior Nurse Consultant writes.  

Learn more about IHS and the American Indian and Alaska Native Communities and Hospitals Advancing Maternity Practices (AI/AN CHAMPS) project’s successes here.

 For more on Native American experiences in birth, infant feeding and beyond, read Generational trauma among Native American cultures affects infant feeding and Honoring the diversity of Indigenous breastfeeding experiences.

#NativeBreastfeedingWeek

#StrongResilientLatched

#IndigenousParenting

#IndigenousMilk

#Bodyfeeding