How do breastfeeding benches, lactation pods, “Breastfeeding Welcome Here” window clings signify a culture’s acceptance of breastfeeding in the wild? 

Ambling around my step-dad’s deceased brother’s home, a red canvas book caught my attention. “The Great Cars” its title. I thumbed through its musty pages without expectation of finding any passages of interest, but to my delight, a print of an early 20th century De Dion-Bouton cars advertisement depicting a breastfeeding dyad! Two other passengers look on attentively and lovingly. There’s nothing jarring about the scene (well, except no car seat or seat belts); instead, the mother and baby are seamlessly woven into the imagery, part of the motion of the moment captured.

A snapshot from the book

As I studied the page, a wistfulness washed over me; a longing for breastfeeding to (once again) be effortlessly infused into our existence. 

Instead, when I encounter a breastfeeding dyad in public, an awkwardness washes over me. I am thrilled and want to throw confetti, because this should be celebrated, and I am thrilled, draw my gaze away so not to gawk, because this is how babies are (almost always) intended to be fed and cared for. 

In the States, it seems we have been sitting at this cumbersome crossroad for quite some time, where breastfeeding is recognized as a good thing, and yet, we shame the act in public and design our lives in a way that makes breastfeeding impossible: no paid parental leave, harmful birthing practices, the unrestricted advertising of commercial formulas… 

For those of you who drive, have you ever been caught at a congested intersection, red traffic lights flash, each vehicle lurches forward just a few inches at a time and so you’re left to guess whose turn it is? When I encounter lactation pods, discreet breastfeeding benches and “Breastfeeding Welcome Here” window clings, this same uncertainty, an abruptness, hits me. 

Lactation pods now pepper public spaces, a gauge of living in Pump Nation (I think credit for this term goes to Kimberly Seals Allers.) The pods have been extolled for good for nursing the distractible, though as many have argued, “creating an object specifically to conceal breastfeeding, surely justifies the stigma” of breasts in public.   

This discreet breastfeeding bench was designed with this sentiment in mind, though it has also been criticized for divorcing dyads from full integration into society. The bench has also been criticized for its pink hue, which for some might seem a silly thing to focus on, and for others may be justified for colors’ sometimes incredible power.  

But as Natashah Hitti writes:  “‘Instead of isolating mums, Heer allows them to stay in the environment they want to be in and keep control of it,’ said [the designer]. ‘If mum has company, they can sit next to her. This is especially important for mothers with another child.’”

Photo by Luiza Braun

Breastfeeding benches installed in the Southwest are an emblem of celebrating breastfeeding in public and are coupled with other initiatives like accompanying QR codes with the Kansas Breastfeeding Coalition directory so that families can find the support they need based on their zip code and billboards. 

On various establishments’ windows– libraries, shops and cafes for instance– clings read “Breastfeeding Welcome Here” perhaps inadvertently reinforcing the reality that breastfeeding is not encouraged everywhere.  (Remember, it wasn’t until 2018 that breastfeeding became legal across all 50 states.)

The Australian Breastfeeding Association baby care room initiative circumvents this predicament in a way as it strives to enhance breastfeeding journeys through identification of venues equipped with proper feeding and care amenities in order to foster inclusive and supportive environments. These spaces are designated by a “Breastfeeding is Welcome Everywhere” sticker. That simple tweak in language seems to make a difference. 

In her final year as an Industrial Design student, Alanna Bamber was challenged to design a comfortable breastfeeding seat for the Canada Science and Technology Museum in Ottawa. Bamber shares her process on the Ingenium Channel and writes: 

While lactation rooms are wonderful and provide a necessary function, they may embolden people who disapprove of breastfeeding in shared public spaces to say, ‘There is a place for that, why do it in the view of others? Cover up!’ I wanted to create a piece of furniture that acts as an invitation for mothers to breastfeed in a shared space, and in some small way contribute to a more positive perception of public breastfeeding.”

Photo credit: WIC Image Gallery

Bamber’s rendering features one armrest to “allow people of any body size to use the seat and prevent it from being an obstruction when nursing bigger children.” 

Further south, a Brazilian team creates an urban design to normalize breastfeeding. For me, their design evokes the same feelings of integration that the painting did, where accommodation does not sacrifice assimilation. 

 

 

“Mama’s got milk. Educate. Normalize. Nurse in Public!”

Their work is situated in the Proximity of Care Design Guide developed by Arup and the Bernard van Leer Foundation which helps urban planners, designers, developers, city leaders and early childhood development practitioners embed child and family-friendly design principles into their work.

In a final example, an example of how “all roads lead to breastfeeding”, Wanda Lau covers how architects, namely Kim Holden, AIA, CABC, CLC  founder of Doula X Design can transform birth and postpartum experiences in the U.S. through the built world.

For more, check out  Our Milky Way’s Empathy in architecture and ‘Being in a womb’ or ‘playing musical chairs’: the impact of place and space on infant feeding in NICUs by Renée Flacking and Fiona Dykes. 

Music in perinatal care and education

Her arms rested over the edge of the birthing tub, her laboring body buoyant in the water. Breathing through a contraction, her eyebrows furrowed slightly. Warm, dim light hummed throughout the room. A midwife, an assistant, her partner, and I floated through the suite offering her encouragement and support as she worked to bring her baby earthside. 

Photo by Rebekah Vos on Unsplash

Another wave of intensity swelled throughout her body. The “rhythmic sound of blood coursing through the uterine artery” was her baby’s surround sound. Simultaneously, the escalation of energetic strings on her playlist interrupted her concentration. She laughed. Something about the sound of this music struck her as funny, and she asked her husband to please advance the playlist. I sometimes think back to this little moment as evidence of how powerful music can be.

Then as her labor progressed, she produced her own music, a sound deep within that reverberated through the room, the vibrations of an ancient song.  

Elena Mannes, author of The Power of Music, has shown that “music stimulates more parts of the brain than any other human function.” 

Music can be used as a relatively low-cost, low-intervention tool in perinatal care. Though its use may seem innocuous, as with any tool, it should be used intentionally.  

 

Early on 

Photo by Greta Hoffman

Mannes points out that the “human relationship to sound starts early… The fetus begins to develop an auditory system between seventeen and nineteen weeks. Already, we are in a world of sound, of breath and heartbeat, of rhythm and vibration.”

She also highlights Dr. Sheila Woodward’s work which looked at the transmission of music into the human uterus and the human fetus and newborn response to music and found that a “fetus responds to a music stimulus from at least the 32nd week of gestation; and that the neonate alters the normal sucking pattern to activate longer periods of a music stimulus which has been repeatedly presented during the intrauterine stage and shorter periods of a novel music stimulus.”

Healthy Children Project’s Karin Cadwell shares a fond memory:  “I learned to play the guitar when pregnant with one kid. I wouldn’t exactly call what I was doing ‘music’ but it was probably rhythmic against my belly. She was only a few days old and I was mixing bread with a dough hook in my mixer and she was pushing her legs up and down exactly to the beat!” 

What’s more, the authors of Prenatal Music Exposure Induces Long-Term Neural Effects conclude that “prenatal exposure to music can have long-term plastic effects on the developing brain and enhance neural responsiveness to the sounds used in the prenatal training…Furthermore, we found that these plastic changes are long lasting, as the effect of prenatal exposure persists for at least four months without any additional stimulation.”

The authors declare some practical implications:  “… since the prenatal auditory environment modulates the neural responsiveness of fetuses, it seems plausible that the adverse prenatal sound environment may also have long-lasting detrimental effects. 

Such environments may be, for example, noisy workplaces and, in case of preterm infants, neonatal intensive care units. 

Furthermore, as prenatal exposure still affected the [event-related potentials (ERPs)] responses months after birth, additional fetal exposure to structured sound environments might be beneficial for supporting the auditory processing of, for example, infants at risk for dyslexia in whom basic auditory processing was shown to be impaired.”

 

Language learning 

Photo by Mălina Sîrbu

A more recent study looked at the language learning implications of prenatal music exposure. Sonia Arenillas-Alcón, et al conclude that their “findings support the idea that daily musical exposure during the last trimester of pregnancy is associated with enhanced encoding of low-frequency sound components, such as those typical of the fundamental frequency of human speech, that relate to pitch perception.” 

Matthew J. Traxler writes about prosodic (the rhythm and intonation of language)  features of language learning in Introduction to Psycholinguistics: Understanding Language Science. “Infants … appear to be endowed with perceptual and representational skills that enable them to tell the difference between different speech sounds from the moment they are born (or at most, within the first 24-48 hours),” Traxler writes. 

 

Music in therapy 

There’s compelling evidence that shows the importance of music as a therapeutic tool, like during labor and in other environments like the NICU.

Photo by Raul Angel on Unsplash

Marissa Rivera Bolaños recounts her experience with the didgeridoo during labor on the Womb Revolution blog: “…It resonates through your body as a non-touch massage…. During the birth, I just remember the sound was very grounding…. My husband played it directly into my belly while I circled my hips and sang my birth song. I felt like the vibrations were helping soften every cell of my body.” 

Andrea M. Cevasco , PhD, MT-BC, NICU-MT quotes a mother in The Effects of Mothers’ Singing on Full-term and Preterm Infants and Maternal Emotional Responses who said that knowing her infant listened to her singing helped her to cope with the baby’s stay in the NICU.

Jayamala AK, et al notes that their study results “suggest that music therapy has a positive effect in reducing stress in mothers of hospitalized premature neonates thereby increasing the amount of expressed breast milk. A relative increase in the amount of breast milk expressed is a boon to the premature baby for its growth and development as it requires additional nutrition. Music therapy being a non invasive method; can easily be used clinically as a method to increase breast milk secretion.” 

And the results of Caine’s work suggest that “music stimulation may have significantly reduced initial weight loss, increased daily average weight, increased formula and caloric intake, significantly reduced length of the NBICU and total hospital stays, and significantly reduced the daily group mean of stress behaviors for the experimental group.”

MUSIC AND HEALTH CARE: A Paper Commissioned by the Musical Connections Program of Carnegie Hall’s Weill Music Institute by Lea Wolf, MSW and Dr. Thomas Wolf details how music enjoyed by patients can reduce staff stress too.  (p .13)  

Annie Jameson plays alchemy crystal singing bowls which produce resonance and help people de-stress, release anxiety and relax deeply, she says. Her music can be used alongside most therapies to induce tranquility, she adds. 

“Because the brain of each individual patient has absorbed musical building blocks of his or her local sonic environment in infancy and developed expectations and preferences based on this experience, choosing appropriate musical selections is an important challenge,” Wolf and Wolf write. 

This is particularly evident in the anecdote I share up top as I sat alongside my laboring friend. The same sounds conjured comedy in her brain, whereas I was unaffected. 

The authors go on to offer a strategy for music choice in health care. 

Music in perinatal education and normalization 

Song can serve as a way to share stories and lessons and influence popular culture. 

If you’ve completed the Lactation Counselor Training Course (LCTC), you’ll be familiar with the jaunty  When you counsel tune which serves as a reminder to honor the mother as the expert of her baby(ies) and the agent of her decision-making. It  goes to the tune of Frère Jacques:

When you counsel
When you counsel 
Never judge 
Never judge 
Praise mother and baby 
Praise mother and baby 
Don’t command 
Do suggest 

If you’ve never heard T’Amentanefer Lumukanda Camara (TaNefer)’s viral “Teach Me How to Breastfeed” video, you’ll want to drop everything else to acquaint yourself. 

Equally entertaining is Sparrow Folk’s Ruin Your Day song, commentary on breastfeeding in public. 

On our Weird Findings installation, we shared a beautiful video from the Pokot community in Kenya which uses song to deliver a PSA about infant feeding. 

Finally, we prefer this version of Dua Lipa’s original: I’m Lac-a-tating.

Empathy in architecture

A friend of mine works in a healthcare building; her office, windowless. Stark white walls frame the shiny tiled floors in the also windowless laboratory that surrounds her office. Rectangular fluorescent lighting looms eerily overhead. Working in this space for the majority of her waking hours amounts to constant longing for sunshine and an overall agitated demeanor. I imagine the architect of this space wasn’t much of an empath.

Photo by Robert Katzki on Unsplash

This effect is being documented in a growing body of research demonstrating how color, texture and patterns affect human emotions.

Generally, humans are quite robot-like, performing our daily duties without a great deal of attention paid to the building structures, layouts or designs that we move through. 

“When we don’t notice the built environment, it’s silently affirming our right to be there, our value to society. When we do, too often it is because it’s telling us we don’t belong. Those messages can be so subtle that we don’t recognize them for what they are,” Kim Tingley writes, later quoting architect Joel Sanders: “‘We sleepwalk our way through the world…Unless a building interior is strikingly different or lavish or unusual, we are unaware of it.’” 

The first time I saw a lactation pod at an airport– unusual at the time– I had mixed emotions. Part of me became excited that this was an option for traveling, lactating, pumping, and breastfeeding people, but most of me scoffed, annoyed, thinking something along the lines of: “Of course breastfeeding moms would be given this messaging to go hide themselves away from the public eye.” 

What Tingley wrote, that our built environment affirms our right to be in a space, affirms our value to society, is certainly a powerful concept. 

The COVID pandemic has forced us to think more about the built spaces we move through, adding layers to this idea of how and what and who we value.  

In a recent episode of Uniquely Milwaukee Salam Fatayer of 88Nine Radio Milwaukee poses the question: “What could our city, neighborhoods and community spaces look like if they were created based on people’s emotional, psychological and social needs?”

Photo by Coasted Media on Unsplash

Local architects and scholars answer with ideas about how they’re supporting the users of the spaces they create, with the goal of making sure people feel safe, at peace and nurtured by those built environments. 

On Our Milky Way, we’ve had the honor of highlighting the work of those thinking about how built spaces affect birth, lactation and beyond. 

For example, in conjunction with the Institute of Patient-Centered Design, Inc., The MomFriendly Network created The Lactation Design program which consists of research and outreach projects to enable the Institute to contribute design resources that  improve accommodations to support breastfeeding. Read more about this project here: https://www.ourmilkyway.org/physical-environment-influences-breastfeeding-outcomes/ 

Renée Flacking and her colleagues’ work, Closeness and separation in neonatal intensive care, explores how architecture influences outcomes in neonatal units. Single-family room designs are increasingly replacing traditional open-bay units for reasons documented in their paper.

Source: United States Breastfeeding Committee (USBC)

“This architectural structure provides the family with an opportunity to be with their child in the neonatal intensive care unit day and night providing facilities for parents’ basic needs including the need for privacy. This design has been suggested to be associated with a lower rate of hospital-acquired infections, similar to single patient rooms in adult intensive care (48), earlier full enteral nutrition, higher breastfeeding rates and a more soothing environment with, for example, lower ambient sound levels (49). As this design has been shown to reduce the length of stay in hospital significantly, for example, by 10 days in preterm infant below 30 weeks of gestation in a Swedish study (50), it shortens the time of separation for the infant from the home and family. Parents have reported that they felt that a single family room design in a NICU facilitated their presence with their infant (51), but the increase in parent–infant closeness gained by a single family room model during hospital care is not well documented in scientific literature.”

Read Our Milky Way’s coverage on this concept here

In stark contrast, attorney Leah Margulies recently shared in Protecting Breastfeeding in the United States: Time for Action on The Code that formula companies provide architectural designs to maternity care facilities in a deliberate attempt to separate dyads, making bonding and breastfeeding difficult and consequently,  families more likely to become reliant on their artificial products. It’s a sickening example of how the industry saturates our systems, down to the skeletons of our buildings.

Photo credit: Henrico County Public Library

Venturing beyond the very early postpartum period, it’s exciting to explore how community spaces are supporting young families. The Henrico County Public Library – Fairfield Area Library is accommodating families with their Computer Work + Play Stations which were conceptualized by library staff and materialized by architects at Quinn Evans and TMC Furniture staff. Read more about that inspiration and process here

Supporting lactation and breastfeeding in the workplace is a vital part of ensuring that lactating individuals feel valued. Setting up lactation spaces sometimes calls for innovation and creativity. You can explore our collection of stories about workplace accommodations in the stories below: 

CLC advances breastfeeding protection and support in the workplace

Workplace supports breastfeeding mother of triplets

Making Breastfeeding the Norm through The Breastfeeding Family-Friendly Community Designation (BFCD)

Alameda sergeant improves lactation space and support in county

Artist celebrates working mothers with ‘Liquid Gold’ project

Worksite program caters to nursing moms

Photo credit: Meredith W. Gonçalves

 

Pulling back the lens further, the architecture of communities themselves influences well-being too. One of the effects of redlining is poor health outcomes. Part of this equation involves the placement of industrial buildings and factories. Vann R. Newkirk II points out in Trump’s EPA Concludes Environmental Racism Is Real that The National Center for Environmental Assessment released a study indicating that BIPOC are much more likely to live near polluters and breathe polluted air. “Specifically, the study finds that people in poverty are exposed to more fine particulate matter than people living above poverty,” he writes.  

NICHQ hosts a webinar The Residual Impact of Historical Structural Inequities: Connecting Residential Segregation and Mortgage Discrimination to Current Infant Mortality and Breastfeeding Rates where maternal child health experts including speakers Jaye Clement, MPH, MPP, Brittney Francis, MPH, Kiddada Green, MAT, Arthur James, MD and Jessica Roach, LPN, BA, MPH share examples for supporting efforts to reduce infant mortality and improve maternal and infant health. 

Circling back to Tingley’s piece, the article raises the concern that although we’re equipped with knowledge about how under-resourced populations are being affected by current structures and practices,  “funding earmarked for expanding inclusivity [may] be diverted toward making existing facilities safer for those they already privilege.” 

Drawing on Sanders’ work, Tingley writes,  “Throughout history… the built environment has reflected and reinforced inequality by physically separating one group from another, often in the presumed interests of health or safety. Women-only bathrooms, so designated by men, supposedly preserved their innocence and chastity; white-only bathrooms separated their users from supposedly less ‘clean’ black people. It’s no coincidence that Covid-19 has disproportionately sickened and killed members of demographic groups — people who are black, Indigenous and Latino; who are homeless; who are immigrants — that have been targets of systemic segregation that increased their vulnerability. It’s also not hard to imagine the pandemic, and a person’s relative risk of infection, being used to justify new versions of these discriminatory practices.”

Art by Liz Richter, Photo by Leslie Rodriguez
Find more of Richter’s art here: https://www.lizrichterart.com/public-art

In this vein, Glenn Gamboa details where some funding gets funneled in a piece published this spring. 

“Twelve national environmental grant makers awarded $1.34 billion to organizations in the Gulf and Midwest regions in 2016 and 2017, according to a 2020 study by The New School’s Tishman Environment and Design Center. But only about 1% of it — roughly $18 million — was awarded to groups that are dedicated to environmental justice.” 

The climate crisis is an accelerating threat that is both affected by and affects architecture. 

“Architecture has to mediate between the perceived needs of the moment versus the unknowable needs of the future; between the immediate needs of our bodies and the desire to create something that will outlast generations,” Tingley goes on to write. 

Across the globe, architects push to be “mindful of their projects’ environmental impacts and resilience, including an emphasis on upcycling, the use of solar power, better building practices, and, of course, structural longevity,” Alyssa Giacobbe writes.  [More on ecological design here.] 

Alongside resilience and sustainability, there must be a focus on design that specifically serves mothers and their children. Mothers are too often left out, unseen, underserved despite there being about two billion of us worldwide, with an increasing likelihood of women becoming mothers

Photo by Dimitry Anikin on Unsplash

Lisa Wong Macabasco puts it this way: “Although the experience of human reproduction touches all of us at least once in our lives, its effects remain taboo, under-researched and excluded from exhibitions and publications covering architecture and design history and practice. In these spheres, maternity is treated furtively or as unimportant, even as it defines the everyday experiences of many – some 6 million Americans are pregnant at any given time.” 

It isn’t surprising that “design for children, design for healthy spaces, design for those with disabilities, care of and for their colleagues – these discussions and follow through are happening largely through female-led firms and initiatives,”  Julia Gamolina comments in The Unspoken Burden on Women in Architecture

In an exciting development, Wong Macabasco describes design historians Amber Winick and Michelle Millar Fisher’s Designing Motherhood, “a first-of-its-kind exploration of the arc of human reproduction through the lens of design. Their endeavor encompasses a book, a series of exhibitions and public programs in Philadelphia, and a design curriculum taught at the University of Pennsylvania.” 

This is exciting, and it’s progress. But as Wong Macabasco quotes Juliana Rowen Barton– architecture and design historian and curator who also helped organize Designing Motherhood– “Progress is not the fact that this show happened – progress is these conversations continuing to happen.” 

Designing Motherhood is on view at the Mutter Museum in Philadelphia through this month of May 2022.

Progress through podcast: Care provider supports families through relevant lactation education

When Tangela L. Boyd, MA, IBCLC, CLC, CLE, CCCE, CPD, a Union Institute & University affiliated faculty member and owner of Mommy Milk  & Me, Inc., had her twin boys 14 years ago becoming a mother of four, she simultaneously entered a space of advocacy.

“I had a very adventurous time with those guys in the NICU,” Boyd remembers. “It changed the way I thought about breastfeeding.” 

As a young Black mother, Boyd says she feels fortunate to have had support from hospital staff to feed her twins (which she went on to do for three years), acknowledging that this is not often the case for BIPOC families

“That support in turn gave me the desire to help other mommies,” she says.

Boyd’s passion lies in uplifting underserved communities, particularly families living in the rural regions of the Southeast U.S. where she lived for nearly 20 years. 

Now located in Florida, Boyd’s newly released podcast, The Early Postpartum Period, offers a way to stay connected and reach underserved mothers with basic, relevant breastfeeding information. 

Boyd admits that the technology was something new to her and it required much patience to bring the project to fruition. Still, she says, it’s something that she wants to commit to for a long time to come, connecting with families especially in the time after they’ve left the hospital. Boyd hopes to soon host focus groups to get a better understanding of what kind of information families would like her to cover in the episodes. 

In the meantime, she plans to release more episodes over the summer. Her practice emphasizes the importance of organization, so she’s planning a podcast featuring organizational skills and time management tips. 

“There is a lot of lactation education out there and I don’t want to be repetitive,” Boyd begins. “I want to hit areas that will really be relevant and give [parents] something they can use, not just something they can listen to.”  

Boyd explains that learning organizational skills can bring a sense of calmness which allows parents the energy to move forward with daily tasks, rather than getting engulfed by an often chaotic world. She suggests things like preparation, avoiding procrastination and working up endurance through taking a breath and stepping away when necessary. 

Especially as our country examines our foundations and current events have brought race to the forefront, Boyd emphasizes the urgency to address high Black maternal mortality rates.

The pandemic has illuminated ways in which to address these rates, Boyd explains, like out of hospital birth and doula support. 

“We have to move forward,” Boyd encourages. 

You can connect with Boyd on Twitter here and find her website here

Boyd has been featured on Ifeyinwa Asiodu’s PhD, RN, IBCLC Blacktation Diaires for her work on increasing breastfeeding and perinatal education rates among BIPOC. She has also written for Kimberly Seals Aller’s Mocha Manual.