Breastfeeding is not binary.

–This post is part of our 10-year anniversary series “Breastfeeding is…” When we initially curated this series, we planned for 10 weeks, but breastfeeding is so many things that we just couldn’t fit it all in.  Thus, two bonus weeks in our anniversary series! — 

Breastfeeding is not binary.

There’s solid evidence that direct breastfeeding offers the most protective and beneficial effects to mothers, babies and ultimately society.

Photo by Luiza Braun on Unsplash

When breastfeeding, a baby’s saliva transfers chemicals to their mother’s body that causes her milk to adjust to meet the changing needs of the baby. [Al-Shehri, et al 2015]

Even more fascinating, the combination of baby saliva and fresh breastmilk generates enough hydrogen peroxide to inhibit growth of Staphylococcus and Salmonella. Read about the science behind it all here.

Breastfeeding encourages proper mouth and jaw development and promotes oral health. 

When babies breastfeed, they are less likely to become obese for reasons like self-regulation of milk intake and seeding of their gut microbiomes. [Pérez-Escamilla, 2016] 

Infants at the breast, compared to bottle-fed infants, have better heart and respiratory rates and higher oxygen saturation rates because breastfeeding consumes less energy.

Photo by Zach Vessels on Unsplash

Breastfeeding has implications on mother-infant bonding and children’s future behavior. One study found that “compared to children whose mothers breastfed them, children who were not breastfed showed an increased number of internalizing behavioral problems, particularly anxious/depressed and somatic symptoms… A duration effect (dosage effect) appeared such that breastfeeding for 10 months or longer had the strongest impact on reducing anxious/depressed and somatic symptoms in children.”

Direct breastfeeding does not require feeding paraphernalia that may be vectors for disease. 

Even if the contents of a bottle contain human milk, the effects achieved through direct breastfeeding may not be possible.  

However, the reality of families’ lives, and sometimes choice, mean that most babies in the U.S. will not exclusively breastfeed or go on to breastfeed in conjunction with appropriate complementary feeding as recommended.

Photo by Lucas Margoni on Unsplash

The most recent CDC Breastfeeding Report Card acknowledges, “Numerous barriers to breastfeeding remain, and disparities persist in breastfeeding duration and exclusivity rates by race, ethnicity, and socioeconomic status. Policy, systems, and environmental changes that address breastfeeding barriers, such as better maternity care practices, paid leave policies, and supportive ECE centers, can help to improve breastfeeding rates and reduce disparities.” 

For these reasons and others, infant feeding often takes many forms. Infant feeding in America is not either/or, it’s both/and

Fiona Jardine and Aiden Farrow present experiences that do not fit into how we often generalize the infant feeding experience. 

Universal pumping icon by Fiona Jardine

Jardine’s work follows those who exclusively pump human milk. Farrow too pumped milk for their child born with cleft complications and then went on to directly chestfeed their baby.

Farrow has explained: “Feeding methods are not mutually exclusive. There are always windows and doors.” 

Lactation care providers, other care providers, health policies and procedures must all acknowledge the incredibly diverse experiences of families while honoring the very ubiquitous human desire that we all want what’s best for our babies.   

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Our 10-year anniversary giveaway has ended. Thank you to everyone who participated!

Hispanic Health Council’s Breastfeeding Heritage and Pride (BHP) Program heals, empowers and celebrates through peer counseling model

Photo by Luiza Braun

Over half of the Hispanic Health Council’s Breastfeeding Heritage and Pride (BHP) Program peer counselors were once served by the program as mothers enduring mastitis or going back to work early or other barriers to healthy infant feeding. Yet, some of these mothers still managed to breastfeed into toddlerhood.

“They took the knowledge to not only be able to succeed but [brought] it back into their community,”  BHP program manager and lactation consultant Cody Cuni, IBCLC, BS says. “This is a success story.”

BHP is a person-centered, peer support counseling program intended to increase breastfeeding initiation, duration, and exclusivity among low-income, minority women in the greater Hartford, Connecticut area. For over 20 years, the program has existed in some form. In 2000, an official review of the program was completed and solidified the peer-counseling model.

The program’s name was born out of community feedback, mainly from Puerto Rican families. Cuni explains that as community Puerto Ricans were heavily targeted by formula marketing,  the name ‘Breastfeeding Heritage and Pride’ grew from the idea of reclaiming breastfeeding as part of their heritage.

Photo credit: United States Breastfeeding Committee (USBC)

Often, the lactation model of care is rooted in colonization, but Cuni says that their program  strives to respect and celebrate diversity.

“Our program seeks to empower…” she begins. “[Breastfeeding] is something that is yours, and something that has always been yours,” she says, speaking to the people they serve.

As program manager, Cuni trains the peer counselors through a 40-hour comprehensive lactation training. She approaches the training through a lens of diversity and cultural competence, helping peer counselors learn to have respectful conversations and teaching them how to be an advocate.

She explains, “Our peer counselors are working with mothers who do face a lot of bias in their health care and in lactation, so we have whole trainings on how to communicate with a provider, how to approach hospital staff who say things like ‘Don’t waste your time on that mother…’”

Peer counselors embark on visits with senior peer counselors and other lactation care providers as part of their mentorship model.

Photo by Felipe Balduino

The program also provides continuing education to stay relevant and weekly meetings to complete case reviews.

As part of their grant funding, BHP is required to track their breastfeeding rates, but Cuni says that what she finds more compelling than these numbers, is the documentation of the lactating person’s individual goals.

Empowering mothers to seek their own goals is our ultimate goal, Cuni says.

BHP is nestled in the Hispanic Health Council’s Parent and Family Learning department which offers other supports throughout the “cycle of learning throughout a family’s lifespan”.

Photo by Omar Lopez

“A holistic approach of care is vital especially for maternal child health care,” Cuni explains. “The first 1,000 days of life are critical to laying a healthy foundation.”

Practicing on a continuum of care gives Cuni and her colleagues the ability to gain a deep understanding of the families they serve, she says.

“Because we work so closely with the families, we establish trust and are able to refer in a way that they might not be open with [other providers].”

The clients that BHP serves are up against every breastfeeding challenge that every family faces in our country, but the issues are compounded and amplified by the stress of living in communities steeped in systemic racism and lack of resources, Cuni explains.

Their clients are managing intergenerational trauma and all of the symptoms associated with trauma, at a cellular level and beyond. For instance, BHP clients have a higher propensity of birthing babies with complex medical needs because of higher rates of preterm labor, gestational diabetes and other health concerns.

Cuni points out other challenges like those associated with being an undoumented immigrant. Gaining access to basic tools like breast pumps can be nearly impossible. Some of their clients return to work at two weeks postpartum after a cesarean section, not by choice of course, but for fear of losing their work as part-time employees.

And although Connecticut has workplace lactation laws in place, mothers will find that if they make noise about those protections, they might not see their name on the schedule any longer.

Photo source: United States Breastfeeding Committee (USBC)

Yet, despite all of these obstacles, Cuni says, “There is a sense of resiliency. They’re overcoming so much and they’re not even sitting in that; they’re just living their lives and wanting to do the best for their baby. That resiliency is really inspiring.”

Cuni shares about a mother who lost her baby late in her pregnancy and decided to pump and donate her milk for six months.

“This mom, her experience, her unimaginable tragedy…she still wanted to do something with her milk, and it was really a privilege for our peer counselors to support her.”

Another client they served, after struggling to assert her workplace lactation rights, had a position created for her by their HR department as “breastfeeding liaison”. Now, she is an advocate for any breastfeeding or lactating mother at her workplace.

“Not only did she win for herself, she left it better,” Cuni comments.

Cuni came to this work as a stay-at-home mom with ten years of breastfeeding experience. She was a single mother, returning to the workforce after leaving an abusive marriage.

“My breastfeeding experience was valued as an asset,” Cuni remembers. “My lived experience counted.”

She goes on, “As women, and especially as mothers, we’re always caring for someone else. The pressures that we face make wellness difficult. Our society needs to do more to recognize the value that women have and the support they need to succeed. I want to …. amplify the voices, because if we listen, the answers that we need to solve the maternal mortality crisis, the answers are there if we listen to the women and families we are working with.”

For those interested in supporting the work of the Hispanic Health Council’s BHP, they are looking for donated breastfeeding supplies. You can get in touch at  codyc@hispanichealthcouncil.org.

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.

Wives co-breastfeed son for two-and-a-half years

The lactation care provider glanced at her breasts and claimed, “You’re not going to be able to produce much milk.” Glenis Decuir, CBS, a young mother at the time, had just given birth to her first baby (now 17 years old), and while she intended to breastfeed her daughter, without explanation, without proper consultation and counseling, without a shred of compassion, the lactation consultant disparaged her intentions so tragically that Decuir not only did not breastfeed her daughter, she remained discouraged through the birth of her second child (now 14 years old) and did not breastfeed him either.

Decuir eventually learned that she has Insufficient Glandular Tissue (IGT) disorder.

“I knew my breasts looked different, but my mom’s looked the same as mine; I didn’t think anything was abnormal,” Decuir explains. “ I was young and wasn’t resourceful; no one explained anything.”

Though Decuir’s introduction to infant feeding was shrouded in the unknown and total neglect from care providers, her story takes a turn, epitomizing self-determination, advocacy and education, perseverance, resilience and empowerment.

In 2018, Decuir’s wife became pregnant with their third child. Because she would not grow and birth this baby, Decuir wondered how she would form a bond with him.

“It was very difficult for me to wrap my head around that,” Decuir shares.

Plunging into self-guided research, Decuir landed on the potential to induce lactation.

When she decided to embark on this path, Decuir reached out for guidance, but found herself in a void.

“Unfortunately, I received the most pushback from doctors, many of whom didn’t even know that inducing lactation was possible,” Decuir documents her road to co-breastfeeding. “I had to see four different doctors before I could find one willing to work with me. Being under the doctor’s care was very important because I had never done this before, and I knew I would be taking medications. After exploring several options, we chose the Newman Goldfarb Protocol as our method of induced lactation.”

For well over 20 weeks, Decuir delved into the protocol.

“Because I had really poor experiences with my first two and poor experiences with seeking help with breastfeeding professionals… I became an advocate… I had overcome so much adversity,” Decuir begins.

Laws state that we can pump anywhere, Decuir continues. And that’s what she did.

“I was pumping in every location imaginable! At my desk, in the car, the movie theater, Six Flags, and much more!” she writes.

Decuir goes on, “I decided to be very public about my entire journey on Instagram. One, I have the right to and I exercise every right, but it also opened a gateway to educating others.”

Prior to inducing lactation, Decuir reports that her children had never been exposed to anyone breastfeeding, “not even at a playground or anything,” she elucidates.

“This is how behind closed doors moms are with breastfeeding,” she says.

But Decuir and her wife’s approach is different; they are open-books with their children, she explains.

“They were old enough to understand scientifically, biologically, physically what my body was going to go through,” Decuir starts. “I educated them through a scientific standpoint, but also talked about normalizing breastfeeding. We talked about my daughter breastfeeding in the future, and my son and his role as a man in a household and how he can support his future wife to breastfeed.”

Decuir recalls the emotional and practical support her older children offered: “I cried in front of them, I pumped in front of them, I laughed in front of them; they helped wash bottles and Spectra parts…”

In sharing her journey with others though, Decuir wasn’t always met with such maturity and acceptance.

“I got everything under the sun,” Decuir remembers. Some told her it was disgusting, some found it weird, and some even went as far as to claim it child abuse.

Orion was born on September 2, 2018. At the time of his birth, Decuir was producing 16 ounces a day– quite close to what is considered full production– and had stored over 1,000 of her milk in a deep freezer.

Decuir says that she didn’t set forth focusing on the quantity though. “I wasn’t thinking about achieving full supply; I was thinking about producing anything. Even if it was only five ounces a day, I thought, I can at least do one feeding a day and that to me was worth it on its own.”

She continues: “Every time that I would latch Orion on, I just thanked Mother Nature and how amazing our bodies are. Maybe if I had birthed Orion, if I  had just latched him on, it wouldn’t have been a second thought, but because of what I went through–I worked real, real hard– every time I was able to latch my son, I literally thanked the universe. I was so grateful.”

Decuir and her wife went on to co-breastfeed Orion until he was two-and-a-half.

Throughout her breastfeeding relationship, Decuir remained visible in her efforts. “Having the power to go through that experience breastfeeding anywhere and everywhere in public, it became almost liberating and very freeing to be able to exercise my right, and in doing so I came across a lot of people. I took them as opportunities to talk more about breastfeeding and breastfeeding in public.”

At the start of her journey, in order to create her village, Decuir started a private Facebook support group. Today it has over two and a half thousand members.

Locally, Decuir serves as a breastfeeding support person through ZipMilk and is a ROSE Community Transformer, all on a volunteer basis. She has presented at the ROSE Summit in years’ past and is currently working on a book.

You can read Decuir’s former publications about her co-breastfeeding journey at https://aeroflowbreastpumps.com/blog/the-road-to-co-breastfeeding

https://www.baby-chick.com/what-is-co-breastfeeding/ and

https://www.huffpost.com/entry/co-breastfeeding_n_5c13eaf8e4b049efa75213e6.