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.   

___

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

Breastfeeding is mammalian.

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

Breastfeeding is mammalian.

(Okay, there are also the non-mammals who “produce nutrient-rich elixirs” to feed their young, including flamingos, cockroaches and male emperor penguins, and a species of jumping spider.)

A mammal is an animal of the class Mammalia, an animal that suckles its young. Mammal is the  1800’s Englished form of the Latin “Mammalia” (1773). Dissecting the word further, it was coined in 1758 by Linnaeus for the class of animals from the neuter (things that have no gender) plural of Late Latin mammalis “of the breast.” [https://www.etymonline.com/word/mammal]

Predating language, milk and lactation are ancient; in fact, the origins may date as far back as 300 million years ago, according to scientist Mike Power, who curates and maintains the Smithsonian’s National Zoo’s milk repository, as reported by Catherine Zuckerman. That makes mother’s milk older than dinosaurs!

Since those many, many million years ago, mother’s milk, the “magic potion”, has been shaped by natural selection and has diversified among the thousands of mammals that are living today, Katie Hinde has explained. Species specific milk has allowed mammals to live in environments in which the young could not otherwise survive and to cope with unreliable food sources.  This evolution to support infants while they’re developing has led to important mammalian adaptations like complex social relationships, Hinde goes on. The first social (and sometimes the only) encounter for mammals, is with their mothers.

Juan Brines and Claude Billeaud so graciously offer “a testimony of gratitude and respect to women who have assumed the responsibility of breastfeeding their infants because without them the human species would not have existed” in Breast-Feeding from an Evolutionary Perspective.

 

Additional resources

Healthy Child Manitoba put together “Mammals: Feeding their babies since the beginning of time” which can be used as a breastfeeding lesson in a variety of settings.

Check out Hinde’s March Mammal Madness inspired by the NCAA College Basketball March Madness Championship Tournament. This year’s fun and results can be found here.

——–

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: What is one of your earliest memories of infant feeding?

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, and this week we have made it to our tenth week celebrating Our Milky Way!

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.

 

——–

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.

Musings on unity beyond National Breastfeeding Month

This year’s National Breastfeeding Month (NBM) celebration has come to an end, but our momentum as maternal child health advocates– striving for equitable care for all– powers on. 

The 2020 NBM theme, Many Voices United, called on us to come together to identify and implement the policy and system changes that are needed to ensure that all families have the support and resources they need in order to feed their babies healthily. 

Photo by Tim Mossholder on Unsplash
Colorful Hands 1 of 3 / George Fox students Annabelle Wombacher, Jared Mar, Sierra Ratcliff and Benjamin Cahoon collaborated on the mural. / Article: https://www.orartswatch.org/painting-the-town-in-newberg/

Achieving this shared goal requires daily self-work and individual introspection so that our collective can be as effective as ever. No matter how socially-conscious, open-minded, anti-racist, (insert adjective), we think we may be, we still have learned biases and prejudices that require near constant attention. Much like I remind my children to brush their teeth every morning and every night, as a white, binary woman, I must remind myself to examine my biases and my privilege daily.  

With NBM’s theme of unity in mind, this Upworthy video features an art installation that demonstrates our society’s interconnectedness. With a piece of string, the installation shows an intricate, densely-woven web created by individuals wrapping thread around 32 poles with identifiers arranged in a circle. 

“You can see that even though we all have different experiences and we all identify in different ways…We are really one,” the project’s creator says in the video. 

The sentiment and the product are truly beautiful and fascinating. While appreciating the beauty of unity, it’s important to keep our critical thinking and progressive attitude sharp, refraining from slipping into too comfortable a space where change cannot happen.  

Recently, I’ve seen a few statements on unity circulating social media that I’d like to embrace with a “Yes!” Instead, I find myself reacting, “Yes! But…” 

My worry is that these well-intentioned mantras we live by– much like some might argue certain microaggressions are well-intentioned– are also dismissive. 

  1. We all bleed the same blood. 
  1. Children are not born racist.
  1. I will teach my child to love your child. Period. 

Let’s break those down starting with “We all bleed the same blood.”  Some things to consider:

First, Ashley May for The Thirbly writes,

“Black breasts do not exist separate from Black bodies and the situated existence we navigate in this world nor the racialized experience of motherhood. Racism and classism intertwine to act as a containment, working to make some of us feel as if we are walking in quicksand. Add to this the complexities of new motherhood and the needs of the postpartum body and now we have a cocktail for failure. Literal milk plugs. So, although her precious body may be able to produce milk, her situation prevents her and her baby from receiving it. Even the intention to breastfeed cannot save the milk of the mother who cannot find time for pump breaks as she works the night shift as a security guard. Or, perhaps she cannot figure out why pumping is not working, but she doesn’t have the time to seek the educational or financial resources to help her problem solve.” (underline added by OMW) 

Racism affects People of Color (POC) at a cellular level. 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’s epigenetics; the environments POC of are growing in affect their biology.  

Children are not born racist, but white children are born into a racist society that they will benefit from. 

From the very beginning, white children have a better chance of survival than Children of Color; African Americans have 2.3 times the infant mortality rate as non-Hispanic whites

What’s more, Black children are three times more likely to die when cared for by white doctors, while the mortality rate for white babies is largely unaffected by the doctor’s race, a recent study found. 

White children are born into being part of the problem and just the same, can be part of equitable solutions. 

I will teach my child to love your child. Period. 

Love is action, and even if it’s easier said than done, there are so many ways to teach our children about race, inequities and injustice. Afterall, “If Black children are ‘old enough’ to experience racism then white children are ‘old enough’ to learn about it.” – Blair Amadeus Imani

  • Be careful what you say. As a young girl on my way to ballet class one day, my mom, while locking the car doors,  pointed out the barred doors and boarded windows in the neighborhood we rolled through. 

“That’s how you know this is not a safe neighborhood,” my mom warned me. 

No questions asked, I noted the building facades, and then I noted the Black people. Because there wasn’t any further conversation, I made the connection that Black people must be “not safe” and ultimately, that there must be something wrong with Black people if they’re confined to neighborhoods “like this.” 

Imagine the impact we could make if we showed our children that there is nothing inherently wrong with Black people that ending racism can’t solve.

As a nation we are apathetic, made apparent by a recent poll. The survey shows that only 30 percent of white people have taken concrete action to better understand racial issues after George Floyd’s killing. 

The poll also shows that White Americans are also the least likely to support the Black Lives Matter movement, with 47 percent expressing support.

Is it because we don’t claim it as our problem? Is it because we misunderstand the problem? Is it because it’s easier to point fingers at others than ourselves? 

I’d like to leave you with this video of writer Kimberly Jones where she provides a brief history of the American economy told through an analogy using the board game Monopoly. I urge you to watch it, and then watch it again, and again, and again. 

There is no time for complacency within these truly abhorrent systems. When we start to lose sight of that, envision the tangle of yarn from the aforementioned unity art installation and remember that vastly different experiences are networked together.

‘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