Celebrating Father’s Day

This summer, we are revisiting some of our previous publications as they relate to various national celebrations.  This week, we’re celebrating fathers with our 2017 piece “Fathers profoundly influence breastfeeding outcomes”, a piece highlighting Muswamba Mwamba’s, MS, MPH, IBCLC, RLC work with families.

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At a WIC clinic a few miles north of Dallas in an immigrant community, a pregnant woman confided in a male peer counselor–part of the WIC Peer Dads Program— that she wanted to breastfeed her baby. Her boyfriend wasn’t at all interested in supporting this journey though. The counselor offered to speak to the father; the mother agreed, so the counselor called him just then. Ring, ring, ring. After introductions, this conversation ensued:

Counselor: We heard you have an issue with breastfeeding.

Father: So you are calling me to convince me that breastmilk is better?

Counselor: No, I just want to give you some information.

Father: I will come to your office. You prove to me that breastfeeding is better.

The next morning, the father arrived at the clinic before it opened.

Source: United States Breastfeeding Committee

“Tell me why she should breastfeed,” the father demanded of the counselor, who was feeling rather intimidated.

The counselor replied: Forty-five years down the road, your unborn son is guaranteed to be the president of the United States. What are you going to do today?

The father looked at him perplexed and laughed.

“You tell me,” his retort.

The counselor handed him a sheet of paper instructing him to write these letters: B-R-E-A-S-T-F-E-E-D, providing corresponding ‘benefits’ to breastfeeding with each letter. (B is for bonding and so on.)

“Dude! You’re good,” the father exclaimed, changing his demeanor. “Ok, you got me,” he agreed to open his mind to breastfeeding.

Mwamba demonstrates ways to hold baby during a class for parents .

Muswamba Mwamba, MS, MPH, IBCLC, RLC, a public health nutritionist, told me this story during a fascinating interview for Our Milky Way. Having worked in nutrition for nearly three decades, Mwamba has acquired a brilliance for carefully interpreting and reflecting on the stories of the people he encounters.

“The guy was bold,” Mwamba remembers of the father. In fact, the father planned to dump his pregnant girlfriend after she became pregnant.

“A lot of men may know how to change diapers, know how to carry the baby,” Mwamba begins. “But something they don’t know is how to befriend the woman. When they don’t know, they run away.”

This couple’s story took a happy turn. Mwamba reports that they married with their peer counselor as their witness.

“You saved my relationship,” the father heartfully expressed his gratitude to the counselor.

After serving nearly 10 years as the City of Dallas WIC Peer Dads Program Coordinator, Mwamba is currently Director to Reaching Our Brothers Everywhere (ROBE), a descendant of Reaching Our Sisters Everywhere (ROSE). ROSE and ROBE are dedicated to reducing breastfeeding disparities among African Americans.

But Mwamba’s career goals didn’t always point specifically to breastfeeding. Always fascinated by nutrition as the foundation of health, Mwamba found himself in a microbiology lab in Belgium completing two master’s degrees in Food Science and Technology and Agricultural Engineering & Human Nutrition.

He quickly realized that he “prefers people to mice.”  So when Mwamba, a Congolese native, came to the States in 1997, he searched for a doctoral program that might better fit his passion for behavioral science. Mwamba made his way to Columbia University in 1999 where he studied Nutrition Education, exploring the intersections between science and behavior, environment and genes.

At the time, Mwamba remembers being happy to be in the U.S. but in retrospect, he says he realizes he was naive about racial disparities in health care. It wasn’t until later that he learned about the historical forces in the United States that make health disparities a reality.

Mwamba pictured with colleagues Brenda Reyes and Mona Liza Hamlin.

“Thinking backward, I didn’t see anyone in my class who was local; they were all caucasian female,” Mwamba recalls.

Except for himself of course, the only Black man, and an immigrant at that. Institutions have policies written to encourage diversity, Mwamba begins.

“When they see Black, they see diversity,” he says. These policies ignore the heterogeneity of Black culture.

“As an immigrant, I was privileged when I got the scholarship,” he explains. Mwamba already held two master’s degrees and had seen the world. His experience was vastly different from those of the People of Color living in the community he was to serve.

“We have the same color of skin, but not the same stories, not the same backgrounds,” he reiterates.

Mwamba adds that African immigrants are the fastest growing and most educated group of immigrants in the U.S. From 2000 to 2004, four percent of immigrants in the U.S. were African. Today, African immigrants account for 8 to 10 percent, he reports.

Mwamba stresses, money needs to be properly allocated to serve those in need.

“The gap is increasing within the [Black] community,” he says of health disparities. “…Diversity is not the solution for the disparity.”

Little did he know, his opportunity to work to close this gap and to give a voice to “the folks who think they have nothing to say because nobody ever listened to them” was just around the corner.

Discussing a course’s simplicity with his professor at Columbia one day, a woman from Ghana happened to be listening in on their conversation. She was the director of a WIC clinic and recruited Mwamba as a nutritionist one year later.

Mwamba was instantly fascinated by the components of artificial baby milk, inspired by the questions his clients asked, and curious about the effects of clients’ infant feeding experiences.

He noticed that mothers who fed their babies formula often came to the clinic with various complaints.

Then there was a woman he remembers who exclusively breastfed her baby for one year. When she came in, she seemed happy and had only one concern: Why hadn’t her period returned yet?

Mwamba needed to do some research. He read everything he could. He worked to develop appropriate language to discuss infant feeding with his clients.

He began to grasp delicate intricacies like the sexualization of breasts in America. One client in particular expressed concern about her baby touching her “boobs.” (As a self-taught Anglophone, Mwamba never encountered “boobs” in his literature.)

As he discovered more and more about breastfeeding, he shared the information with his team. Mwamba became a breastfeeding champion.

In 2003, Mwamba moved to a WIC clinic in Dallas. Here, he received structured training through breastfeeding modules.

In 2005 he and his wife, an OB/GYN, welcomed their first babies to the world, a three pound baby girl and a four pound baby boy. Over the next couple of years, they added three more children to their family. Mwamba spent several months at home with their infants.

Source: United States Breastfeeding Committee

Aware that a primary reason a mother chooses not to breastfeed is her perception of the father’s attitude toward infant feeding, Mwamba launched the City of Dallas WIC Peer Dad program. The program was promptly a success.

Perhaps most importantly, the clinic was already breastfeeding-friendly. Secondly, there were several men already working in the clinic– including Mwamba who understood rich, complex immigrant culture. As Kimberly Seals Allers puts it, “The experience of being interpreted is different from the experience of being understood.”

Mwamba and his team worked by the motto Prepare, Equip and Empower.

They validated men in their role as a father and gave them tools like how to speak up and say, “Hello, I’m here!” when others failed to recognize their presence.

“Equip the father with tools they can use today,” Mwamba begins. “If you start talking about the future, they won’t get the information. Meet people where they are.”

Mwamba started conversations with his clients in an attempt to get fathers to connect with their relationships with their fathers; Emotion is more valuable than hard science.

For instance Mwamba describes one client, the father of five children, who “was over six feet tall with dreadlocks and his underwear showing.” He remembers this client had an air about him: I’m the dude here.

Mwamba discussed with him his role to protect and provide for his family. He asked, “Is there a man you look up to?” The father reported that he had a close relationship with his big brother. Mwamba wondered if he looked to his own father as a hero, or if he would change his relationship with his father. At that, the father’s voice cracked. He began to sob. This father was in the position to reflect on his role as a father and accept the influence he would have on his family.  And a father’s role is profound. When he is indifferent about breastfeeding, mothers will breastfeed 26 percent of the time; if he is pro-breastfeeding, mothers will breastfeed 98 percent of the time.

Tapping into the generalization that “men like the brag,” Mwamba and his colleagues encouraged their clients to spread forth their infant feeding experiences into their communities.

In his years working with the peer counselor program, Mwamba listened to stories that seriously question one’s capacity to have hope in humanity. In these moments, he didn’t have a script. Whatever rage he felt, whatever sympathy he bestowed, he couldn’t find a book or a module to learn how to accept the rawness, the vulnerability of his clients. Instead, Mwamba offered his presence and his willingness to listen, learn and understand.

Check out the rest of Our Milky Way‘s collection celebrating dads here.

School Age Parenting Program nurses complete Lactation Counselor Training Course enhancing support for students

Spring can be an especially busy time for pregnant and parenting teens. There’s prom, Easter egg hunts, Eid al-Fitr, Holi, Passover and other festivities,  the summer school enrollment process, all alongside their typical school responsibilities. Then there’s the excitement of pending graduation for some. 

Nurse Michelle and Nurse Ashlee

Michelle Alkinburgh, BSN, RN and Ashlee Anzalone, RN, health care coordinators at the Racine Unified School District’s School Age Parenting Program (SAPAR), recently completed the Lactation Counselor Training Course (LCTC) in an effort to further support their students who are managing the multiplicity of being pregnant or parenting in high school. 

The duo is proud to report that many of their young parents choose to breastfeed even while juggling all of their other demands.

“We have many moms who breastfeed the first few weeks and have had three moms who breastfed for a year!” they exclaim.  

In the U.S., one estimation suggests that of the  “approximately 425,000 infants born to adolescents… only 43 percent will initiate breastfeeding, in contrast to 75 percent of mothers of adult age…” [Kanhadilok, et al, 2015]

Over 30 years ago, the state of Wisconsin required school districts to provide programming and services to school-age parents. As such, SAPAR  programming has been in place since the requirement was established.  

SAPAR is intended to retain pregnant and parenting students in school, promote academic progress, increase knowledge of child development and parenting skills, improve, decision-making regarding healthy choices, prevent subsequent teen pregnancies and child abuse and neglect, including that of the teen mother, and assist in post-secondary education and/or employment.  The program is open to all students under the age of 21 years who are not high school graduates and are parents, expectant parents or have been pregnant during the last 120 days. [Retrieved from https://rusd.org/academics/alternative-programs/pregnant-parenting-teens

Alkinburgh and Anzalone report that they average around 100 enrolled students each year.  During the 2022/23 school year, they served 104 students.

Healthy Children Project’s Carin Richter notes that programs like SAPAR aren’t often sustained for as long as Racine’s programming; instead,  they’re often met with a lot of opposition and are frequently cut from school budgets, she observes.

“I am impressed with the school district that promotes her program and the school board, PTA, and school staff that encourage this type of program,” Richter offers. 

The team comments on their strength and sustainability: 

“[Our program] has two nurse case managers with extensive knowledge and experience in maternal and child health, allowing us to help when medical issues arise, not just for our parents but also their children.  We provide health education, childbirth and parenting classes, and assist with community resources and academic needs.  We work together as a team with our students, families, school staff, medical providers and community partners.  

The national average graduation rate for teen parents is about 50 percent,  but our program changes that!  Last year 94 percent  of our eligible Seniors graduated providing more job opportunities, financial stability and college or apprenticeship options. Teens 15 to 19 years old also have higher rates of infant mortality and maternal complications. We had zero percent.”

Students Anika Moreno and Gregory Sanders Jr. pictured with their child.

Each work day is different for the duo. There are no defined hours and they often work with students for several years.  

“Our work requires a lot of flexibility and patience, but it is so rewarding to see our students succeed,” they begin. “We provide school visits throughout the district, and also phone, virtual, home and community visits to meet the individual needs. You may find us busy helping students get health insurance, find a medical provider, manage pregnancy symptoms to stay in school, check a blood pressure, obtain a medical excuse, meet with support staff, talk to a parent, help enroll in community programs, get a crib or car seat, find diapers, etc.  We may be assisting with childcare, nutrition, housing, employment or transportation needs.  We also do a lot of health teaching and use evidenced-based curriculum specifically designed for young parents to help them learn and have an opportunity to earn additional credit toward graduation. Our goal is that our students stay in school, graduate high school and have healthy babies.”

Teenage dads can get a bad rap, but Alkinburgh and Anzalone note that “they really want to be great dads.” The nurses offer individual, joint and group meetings for young fathers and cover topics like infant care, co-parenting, child support, etc.  

“We try to make learning fun and engaging,” the duo says. “For example, we may have a diaper changing race or have them practice giving a baby a bath with our infant model and newborn care kit.” 

To add to their skill-base, the team needed to do some unlearning about breastfeeding myths through the LCTC.  

“Now that we know the newest research-based facts, we can best educate our students,” they say. “We already started using the awesome counseling skills they taught us in the training and it has really helped us ask more open- ended questions to address students’ concerns and goals.” 

Overall, the nurses have experienced a positive attitude for breastfeeding in their community at large. For instance, the district offers private lactation rooms in each of their schools for staff and students to use when needed. 

For those interested in supporting the program’s mission, the team offers: “Be kind, supportive and share with others how truly valuable a program like ours really is!” They also suggest donating, volunteering or partnering with community organizations that help support their students  like the Racine Diaper Ministry, Salvation Army, Cribs for Kids, Parent Life, Halo, and United Way. 

Find the program on Facebook here.

Where are they now? Checking in with Stephanie Hutchinson of the Appalachian Breastfeeding Network (ABN)

In May 2016, Stephanie Hutchinson (then Carroll), MBA, BS, IBCLC  and a few of her colleagues launched the Appalachian Breastfeeding Network (ABN), “dreaming that one day [Appalachian] parents would have the access to lactation care that they deserve.”

In just one year, the network grew to 11 states and 250 members. By the time the organization was five years-old, the network  grew “to over 600 members across all 13 states in Appalachia – and beyond!” Today, ABM “continues to grow in its membership, its capacity, and its visibility.” [Retrieved from: https://www.appalachianbreastfeedingnetwork.org/abn-board.html

 

Then

When Our Milky Way first featured Hutchinson in 2017, she said that the exponential growth was not expected, but also not surprising. 

“There was absolutely no organization that grouped Appalachia as a culture, together, to make an impact for change,” she said.

 

 

and now.

Almost a decade later, Hutchinson serves as the President of ABN and Administrator of their 24-Hour Breastfeeding Hotline. She also works in private practice as the owner of Rainbow Mountain Lactation, is an instructor and administrative assistant/media manager for Lactation Education Consultants

This year, ABN will host its first cohort of Appalachian LATCH (Lactation at the Center of Healthcare) Leaders which is their train-the trainer program. With grant funding provided by Gallia American Community Fund of the Foundation for Appalachian Ohio (FAO) and the I’m a Child of Appalachia Fund®, they will offer 20 scholarships for registration to the course. 

Many years ago, before the birth of her daughters, Hutchinson shared that she never anticipated doing the work she’s been engaged in, but as we often say, “All roads lead to breastfeeding.” Now, reflecting on the most significant change she’s noticed in maternal child health in the last decade, Hutchinson says, “As a member of the LGBTQ+ community, I have noticed more inclusivity in education and support for all families. I am happy to see such wonderful changes to include everyone who is lactating.” 

And the most helpful lesson she has learned along the way is to say ‘no’. 

“This has probably been my hardest lesson learned, but there is only one of me and I know I cannot do all the things,” she reflects. “It’s okay to refer out to someone else, say no to a speaking gig, not go to every conference possible, and take care of myself. Once I learned this hard lesson, I noticed I am able to give more to my clients and my own family…I know that I am not the lactation consultant for every person and humbling yourself to collaborate with others will help your practice tremendously.”

Photo by Elijah Mears on Unsplash

Looking forward, Hutchinson says: “In 10 years, I hope Appalachian Breastfeeding Network has been able to grow enough to fit more into our budget and reach more parents, especially in those areas with little to no lactation support. It is my vision to duplicate our hotline and make it sustainable and available to anyone, anytime, for as long as possible. On a personal front, I hope to see my kids happy and thriving as adults and live out our empty nester lives.” 



The breastfeeding-friendly baby shower

My oldest daughter was perusing through her baby book the other night and discovered an exhaustive list of the gifts we’d received at my baby showers. Without dismissing how incredibly generous our guests were, looking back, I’d deem 90 percent of the items we received (many of which I’d registered for) useless.

Then I remembered a dear friend of mine who participated in and later facilitated a wonderful, meaningful baby sprinkle activity.

Photo by Townsend Walton

The invitation’s poem read:

Bring two matching beads 

We’ll put them on a string

For Super Mom _____ to the hospital to bring (tweak for other birthing spaces)

Armed with our bead string, she’ll have our thoughts near 

When she brings forth a child…. So dear! 

One of the beads was strung onto a necklace for the mother and the other beads were strung onto bracelets for the guests to wear until the baby was born as a way to send prayers or manifest positivity during pregnancy, birth and beyond.

How I wish I had an artifact such as this to cherish in exchange for the heaps of plastic I’d acquired at my shower!

Now, as a baby shower guest, as tempting as darling baby outfits and beautifully printed blankets are, I generally opt for gifting some of my favorite breastfeeding books like Gill Rapley’s Baby-Led series. Knowledge is an incredible gift and it will never make its way to a landfill.

Pondering more about meaningful gifts for expecting parents and their babies, I got to thinking about how the baby shower is a microcosm of parenting culture. The avalanche of baby bottles, pacifiers, swaddling blankets and other gadgets and technology instigate detachment from baby rather than bonding. So, this week, we’ve compiled suggestions on how to make a baby shower breastfeeding-friendly along with ways to use this celebration as a source of education for parents and their guests.

 

Affirmation activity 

Provide seed paper or other stationary for guests to record birth and breastfeeding affirmations to be gifted to parents.

Photo by Ermias Tarekegn

Breastfeeding in pop culture game 

Show clips of breastfeeding and parenting in pop culture and ask participants to name that show. Some examples:  General Hospital, Sesame Street, Modern Family, Blackish, The Office, Rugrats, Mr. Rogers (around 3 minutes into video)

Feeding cues game

This feeding cues game can be adapted for baby shower guests. Not only is it important for new parents to recognize feeding cues, other caregivers need to understand when it’s ideal to feed the baby as well. If those attending the shower understand feeding cues, they’ll know just when to hand back the baby to be fed!

Help for parents sign up 

Use the baby shower gathering to post a meal train, house chores, or childcare for older siblings sign up sheet. You could also use this opportunity to gather other helpful postpartum resources.

Decorating and desserts

Swap baby bottles and other gadgets for breasts.  Please note, it is advised to exercise care when dealing with breast models in childbirth and breastfeeding education as the symbolic dismembering of the female body can carry powerful negative messages, and the same care should be considered in this case. That said, these colorful, cloth breasts could be used to decorate or given out as party favors!

Try making breast cupcakes in all shapes and sizes or these fun cookies for a special treat.

Breastfeeding bingo and other lactation games

These breastfeeding bingo sheets adapted by the Missouri Dept. of Health & Senior Services could be easily tweaked for a baby shower game. Many of the activities presented in Linda J. Smith’s Coach’s Notebook: Games and Strategies for Lactation Education can also be adapted.

Try this kahoot game here or create your own breastfeeding-friendly questions. Participants can play from their smartphones.

Phone tree game

The Grandmothers’ Tea curriculum has several interactive learning activities. The phone tree activity in particular can be adapted for a baby shower game with points and prizes.

Feed me game 

Similar to popular taste testing games at baby showers, this game was inspired by Gill Rapley’s activity at an International Breastfeeding Conference to bring attention to babies’ autonomy.

Ask participants to partner up. Set out several pureed baby food jars in front of each pair. Each partner takes a turn spoon-feeding the mush to their partner. Open up  a discussion about what it was like to be the feeder and what it was like to be fed. For more information about baby-led weaning visit https://www.ourmilkyway.org/the-baby-led-way/.

Books

It is becoming increasingly popular for books to be requested in lieu of cards.

The invitation poem often goes:

In lieu of a card, please bring

Your favorite childhood classic.

Let’s build a library for _____

That will be fantastic!

So instead of a card,

to baby and mother,

please give a book,

with your thoughts in the cover.

Photo by Helena Lopes

Consider purchasing a book that depicts and normalizes breastfeeding. Some options include Katie Morag, Noey Loves Nursing, A Mother’s Milk, The Creator’s Gift and First Sacred Food developed by Great Lakes Inter-Tribal Council, Inc. (GLITC), or check out this list.

Breastfeeding-friendly cards

If you are interested in sending a card, check out Dr. Tangela L. Boyd’s greeting cards which include text that reads:

“Wishing you all the best and hoping that mom will nourish you with the milk from her breasts.”

“Breastfeeding is a precious gift. Hoping you will receive all the love and nourishment that only mom can give!”

“Now that you are here, enjoy breastfeeding for as long as you and mom desire!”

Find Dr. Boyd’s cards here.

Labor as a labyrinth 

Denise Reynolds, a doula and Birthing From Within Mentor, wrote Labor as a Labyrinth inspired by a Birthing From Within concept developed by Pam England. Pass out or have participants design a labyrinth to follow along with mother’s journey.

Please tell us what other ideas you have for making a baby shower educational and meaningful. You can email us at info@ourmilkyway.org or write in the comments section below.