Breastfeeding is food sovereignty. Breastfeeding is health equity. Breastfeeding is healing.

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

Breastfeeding is food sovereignty. Breastfeeding is health equity. Breastfeeding is healing.

Breastfeeding is a “weapon of mass construction”, a phrase coined by Camie Jae Goldhammer, MSW, LICSW, IBCLC, (Sisseton-Wahpeton).

In her Reclaiming the Tradition of Breastfeeding: the Foundation of a Nation webinar, Goldhammer describes how breastfeeding has the power to heal those suffering the effects of generational trauma, specifically through the release of oxytocin, subsequently allowing mothers and their babies to feel empowered and independent.

Photo by Luiza Braun

Kathleen Kendall Tackett’s work also illuminates how breastfeeding can heal trauma. Her videos, How Birth Trauma Affects Breastfeeding and Breastfeeding Can Heal Birth Trauma and Breastfeeding’s Healing Impact on Sexual Assault Trauma discuss the mechanisms behind why and how breastfeeding can be helpful for trauma survivors. Essentially, breastfeeding allows for the down regulation of stress responses, specifically adrenocorticotropic hormone (ACTH) and cortisol, and similar to exercise, improves maternal mood, decreases the risk of depression, decreases hostility, and improves the mother infant bond.

Jennie Toland, BSN, RN, CLC offers commentary on the role lactation care providers play in offering trauma-informed care in this piece.

This Invisibila episode, Therapy Ghostbusters, shares the incredible story of how a Cambodian practitioner worked to help heal an entire community from generational trauma. It took him over a year to simply earn individuals’ trust.

“…That’s pretty unique,” the podcast hosts point out and offers insight into how our nation approaches care for individuals with specific mental health needs and cultural considerations.

Goldhammer quotes Round Rock elder Annie Kahn:  “When a mother nurses her baby, she is giving that child her name, her story and her life’s song. A nursed baby will grow to be strong in body, mind and spirit.”

This connection to the past that Kahn refers to, also offers a form of healing. Breastfeeding is an example of Indigenous food sovereignty, “a part of living culture” and facilitates the revitalization of traditional knowledge. (Cidro, et al 2018)

The revitalization of breastfeeding spans the Black Indigenous People of Color (BIPOC) experience and is a channel to champion equity.

Ifeyinwa V. Asiodu,  Kimarie Bugg,  and Aunchalee E.L. Palmquist write in Achieving Breastfeeding Equity and Justice in Black Communities: Past, Present, and Future:

“Breastfeeding is an especially important public health issue in Black communities, particularly given that Black families and communities continue to experience the highest burden related to poor maternal and infant health outcomes, including higher incidence of preterm birth, low birth weight, maternal mortality and morbidity, infant mortality, and lower breastfeeding rates. Owing to lifetime exposure of racism, bias, and stress, Black women experience higher rates of cardiovascular disease, type 2 diabetes, and aggressive breast cancer. Given that cardiovascular disease and postpartum hemorrhage are leading causes of maternal mortality and morbidity, increasing breastfeeding rates among Black women can potentially save lives.”

Photo by Emily Finch

More specifically, studies show that the experience of racial discrimination accelerates the shortening of telomeres (the repetitive sequences of DNA at the ends of chromosomes that protect the cell) and ultimately contributes to an increase in people’s risks of developing diseases.

It has been found that higher anxiety scores and inflammation are associated with shorter telomere length.

Because physical and psychological stressors trigger the inflammatory response system, one way to counter this reaction is by supporting ongoing breastfeeding relationships; when breastfeeding is going well, it protects mothers from stress. (Kendall-Tackett, 2007)

Another study found that early exclusive breastfeeding is associated with longer telomeres in children.

Photo by Luiza Braun

The authors of Achieving Breastfeeding Equity and Justice in Black Communities: Past, Present, and Future continue, “Yet breastfeeding is rarely seen as a women’s health, reproductive health, or a public health strategy to address or reduce maternal mortality and morbidity in the U.S. Inequities in lactation support and breastfeeding education exacerbate health inequities experienced by Black women, specifically maternal mortality and morbidity, and thus a greater investment in perinatal lactation and breastfeeding education and resources is warranted. Breastfeeding is an essential part of women’s reproductive health.”

Journalist and maternal child health advocate Kimberly Seals Allers’ approach is one “For Black people, from Black people.”

“…The call to revive, restore and reclaim Black breastfeeding is an internal call to action,” Kimberly Seals Allers begins in Black Breastfeeding Is a Racial Equity Issue.  “… Breastfeeding is our social justice movement as we declare the health and vitality of our infants as critical to the health and vitality of our communities.”

Specifically through her work with Narrative Nation, Seals Allers and colleagues are promoting health equity “by democratizing how the story of health disparities is told,” centering BIPOC voices. Additionally, through her Birthright podcast, KSA uplifts stories of  joy and healing in Black birth.

Especially after the deaths of George Floyd, Breonna Taylor and Ahmaud Arbery, organizations made statements about their commitments to dismantling structural racism and focusing efforts on equity.

Equity has become a buzzword; in fact, one author brands the sentiment “Fakequity”. This year, United States Breastfeeding Committee (USBC) National Conference and Convening presenters expressed their fatigue with the word.

“We want to see action,” they said.

Nikki & Nikki LIVE offer their Allies, Advocates and Activists Equity in Lactation webinar which covers the meaning of equitable in lactation care, how to show up for the marginalized and how to make a lasting impact.

In other efforts, the CDC has identified breastfeeding as a priority area to address health inequities.

Photo by Luiza Braun

NICHQ’s Achieving Breastfeeding Equity campaign also focuses on closing breastfeeding disparity gaps, viewing their efforts through an equity lens.

Director of policy and partnerships at the National Women’s Health Network Denys Symonette Mitchell offers commentary on a way forward with key policies that will ensure investment in breastfeeding to ultimately advance health equity.

Watch Racism and the Colonial Roots of Gendered Language in Public Health and Biomedicine with Dr. Aunchalee Palmquist, PhD, IBCLC for more on these issues.  

 

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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, tell us about how you are contributing to working toward healthy equity.

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.

Self-care strategies for lactation care providers

Tomorrow is World Mental Health Day. Read on about self-care strategies for lactation care providers.

Image credit: WHO

When a gas-powered vehicle is low on fuel, it’ll often show signs of fuel starvation like a sputtering engine and intermittent power surges. Eventually, when the engine dies completely, the hydraulic power to the brakes and steering lose power too. Steering and stopping is still possible at this point, but it requires greater effort.

Perinatal professional Sara BhaduriHauck, CLC of Mandala Motherhood analogizes the vehicle and the human body and how self-care and nurturing mental health is crucial to providing sustainable care.

“It feels good to give,” she begins, speaking from the perspective of lactation care provider. “But you can only give so much.”

Learning to sense the feelings and sensations that warn us of burnout, is like filling up the gas tank when it hits a quarter tank.

“Keep an eye on your gas tank,” BhaduriHauck advises.

This wisdom of self-discipline, knowing when to stop giving to others so that one can give to themselves, allows for a healthy care provider/client relationship.

Liba Chaya Golman, CLC with lev lactation shared her struggle after a particular session: “I just met with a dyad dealing with weight loss and low supply and while we have a short term plan and pediatrician involvement, I am feeling so emotionally spent after the consultation. I’m empathetic by nature and became a CLC after my own difficult breastfeeding experience. I feel capable of managing the situation and have people to refer to and rely on, but came home and cried after the visit.” Soliciting tips for lactation provider self-care, BhaduriHauck offered up some suggestions.

“I find therapy to be an amazing self-care tool, especially when client situations trigger my own traumas,” she shared. “The situations that hit us the hardest shed light on the areas inside of ourselves that need some tender attention.”

BhaduriHauck endured traumatic birth experiences herself, like so many maternal child health care providers who are drawn to this work because of personal challenges that they endured.

After slogging through our mental health system,  BhaduriHauck eventually connected with a trauma-informed therapist specializing in EMDR and a perinatal mental health specialist. Later, BhaduriHauck pursued training as a postpartum doula.

“Doing that work and learning how to help other people also helped me help myself,” she explains. “You have to have healed enough of your own emotional stuff to put it down and to pick up someone else’s, but in learning to help others, I was also learning how to support myself.”

She continues that journaling allows care providers to give their feelings space and “attention to be seen and articulated.”

“Sometimes I just need the space to express them before I can let them go,” she shares.

Affirmations are another avenue of self-care for care providers to explore.

BhaduriHauck uses this one most often: This work isn’t about its outcomes. It’s about making a difference.

“Over-giving/over-investing is something I fall into naturally, and I have to work at creating distance between a client’s situation and my responsibility to it,” she explains. “Reminding myself that me just doing my job, makes a world of difference to the client [and]  helps me release some of the big feelings I’m holding onto about the client’s situation.”

BhaduriHauck acknowledges two types of processing: active and passive.

Going to therapy, having someone who is trained in validating and providing empathy, is an example of active processing. When our feelings are “infused with empathy,” as BhaduriHauck puts it, “we can put them away inside ourselves softer.” The opposite of this can happen if we have not chosen the listener appropriately, she warns.

Passive processing sometimes comes in the form of slowing our pace and down regulating our nervous systems. For BhaduriHauck, she finds a calmer state of being by going for a walk, snuggling her dog, or taking a hot bath. In these scenarios, she might not be actively processing trauma or emotions, but she’s giving her body space.

Intentionality in practice can help preserve mental health, and allow a care provider to be a more effective support person too. BhaduriHauck suggests checking in with oneself, “Am I doing this in service of the client, or in service to myself?” If it’s the latter, there are better avenues to pursue the boost of “feeling good by doing good” and/or getting the assurance that “my knowledge is valuable”.

BhaduriHauck shares some final thoughts on mental health as a lactation care provider. “The emotional learning I’ve done in becoming a care provider and overcoming my own struggles, they’ve gone hand in hand.  My experiences help other people and others’ experiences have helped me in learning emotional management techniques. When I talk to parents… I can listen without it triggering past traumas.”

Photo by Madison Inouye

She goes on, effective care requires the provider to have trained themselves to embrace the emotional component of the work in ways that are in service to their clients.

In 2021, the CDC issued a call to action to protect health care workers’ mental health. You can find that  information here.

The National Alliance on Mental Illness (NAMI) offers resources for Health Care Professionals including peer and professional support options. Find those resources listed here.

Praeclarus Press offers Burnout, Secondary Traumatic Stress, and Moral Injury in Maternity Care Providers, an opportunity to learn about the stresses of maternity care and how to care for yourself on the job. Learn about the course here.