Proximity and profit

The red bud in my yard is bursting with magenta. The remnants of nighttime thunderstorms, gems of rain dangle from its branches glistening under late morning sun. There’s a lot of anticipation in our backyard woods; a buzzing of green that will soon become too dense to see the railroad tracks that curve through the neighborhood. 

When I open the grill on one of these beautiful spring days, I’m confronted by a mother mouse perched in her nest. Her black, beady eyes send me shrieking, foolishly and frantically flailing into my house. 

My partner, much less ruffled by the tiny animal, uses the grill utensils to relocate the mother mouse and her nest. Upon removal, he notices that her tiny, pink babies, nearly translucent, are attached to her teats. 

“Oh my god!” he exclaims. “Oh my god, they’re nursing! They’re just hanging on!” And then, minus the flailing, proceeds to freak out, because he is so affected by the fact that he has disturbed a nursing mother and her babies. Despite the assault of grill tongs and  humans giant relative to their size, the mother and her babies remain together, in an act of survival. 

A few days later, at my daughters’ soccer game, my son finds an empty field to kick around his soccer ball. His location and the girls’ game are separated by a small parking lot. I want to finish watching the girls’ game, so my son and I establish a meeting spot. When I go to check on him the first and second time, he is happily occupied, working on what looks like some fancy footwork and big boots. The next time I go to check on him, I scan the landscape, but he is not there. There’s a berm, so I swiftly walk over to see if he’s hidden behind the mound. Still, I don’t see him, so I panic, shouting for him, over and over with no response. 

Perhaps I will reveal too much about my character here…I start to conjure up all of the possibilities: he’s been abducted by a stranger, driven away in a van and I’ll never see him again; he’s been swallowed by the marsh on the other side of the road; he’s wandered off into the woods on the perimeter of the field and wolves will eat him; he’s been coerced by someone in the stands and they’ve snuck off with him somewhere. 

At this point, my heart is beating in my forehead. Blood drains from my arms and legs and they begin to tingle. It feels like I could be staggering from light-headedness, but I manage to make my way over to recheck our meeting spot; he is not there either. I walk up into the bleachers and ask a familiar face if she has seen my son.

“Yep, he’s right there; I’ve been keeping my eye on him,” she points to the other end of the bleachers… not our meeting spot. 

I exhale, thank her quickly, rush to him, embrace him, scold him through trembles. He holds my hand as we make our way to the top of the bleacher seating. He curls his arm around my waist and we sit side-by-side this way watching the reminder of the game together. 

My son is no longer a nursling, but my point in sharing these vignettes is that the connection we have to our children, the instinct to be with them, near them, is mammalian, primal. It’s beautiful and powerful. 

From the start, our infants’ survival depends on proximity. Of the many things that Karin Cadwell and Kajsa Brimdyr have taught me and that have stuck with me is how babies instinctively crawl to the breast, so even when infant feeding hasn’t been a part of the prenatal conversation, or even if a mom has been on the fence about “committing” to breastfeeding, the baby often makes that initial decision, questing to the breast when given the opportunity in uninterrupted skin-to-skin contact after birth. 

“[Babies] are 10,000 years old when they are born,” Nikki Lee has said. “If they’re not next to a heart beat, they are saber-toothed tiger lunch.”

As well as being ancient, breastfeeding is a natural progression in a continuum. Linda Smith once remarked at an International Breastfeeding Conference: “We don’t ask women if they want to deliver their placenta. Why are we asking about breastfeeding?” Smith was not making a point about the removal of choice; instead she was commenting on the fact that breastfeeding is biological

Yet, we find ourselves in a culture that has stripped us of these sacred experiences through marketing and medicalization. We have been acculturated to believe that separation is normal, acculturated to believe that tending to our babies’ basic needs will spoil them, acculturated to believe the only way we can be rested and sane is by separation from our babies, acculturated to believe that we require gadgets to properly raise our children, because somewhere along the line, we started to believe the marketing that nature must be flawed. We fell into the corporate trap, succumbed to their greed, allowed it to dim our instincts. 

Now, the language we use refers to the “benefits” of our mammalian behavior: the benefits of physiological birth, the benefits of skin-to-skin contact, the benefits of breastfeeding. Max Ramirez of IBFAN & MOH Panama has said that “Talking about the advantages of breastfeeding versus the risks of not breastfeeding is like talking about the advantages of breathing instead of the consequences of smoking.”

The idea that without breastfeeding, a baby is significantly disadvantaged, is not in our vernacular. 

As commentator Frn Ange wrote on a The Natural Parent Magazine post “…Proximity is not profitable…” and so we have been forced away from the power of the dyad, the power of our innate abilities as babies and parents. Marketing propaganda created the breast versus bottle wars because it drives profits, further dismantling our power. 

In this Leadership Pittsburgh presentation about “Milk Money,” Todd Wolynn goes as far as to say, “Economics dismantled us as a species.” (He’s referring to formula companies.) 

All is not lost. In fact, Camie Jae Golhammer has said of Indigenous traditions, that they’ve gone dormant rather than have completely died off. 

 

Like the boasting red bud in my yard, these sacred moments during our reproductive years will not always lay dormant and there are bright spots to celebrate. 

Programs like the Baby-Friendly Hospital Initiative empower families with practices and messaging like: “Every mother has the right to evidence-based information, free from commercial interests to help her decide how to feed her baby and should be equally supported and treated with dignity and respect for her infant feeding decision.” 

Global recognition of the importance of midwifery care came to the forefront late last year when midwifery was inscribed on the Representative List of the Intangible Cultural Heritage of Humanity. This recognition is not only well-deserved by the many, many generations of midwives who have supported and continue to support healthy families, but essential in order to safeguard those in the practice of protecting fundamental human rights and these sacred moments. 

 

Another ray shines as the people at the United States Breastfeeding Committee (USBC) do lots and lots of hard work to advance policies that actually allow people to be with their babies. The organization offers a hub for policy action that makes it incredibly simple for citizens to engage and influence change. 

 

Further reading 

Interrupting the mother-child dyad is not the answer to infant safety

Ancient bodies in a modern world 

Mothers matter 

Nuturescience and Kangaroo Mother Care 

The Hidden Pregnancy Experiment which explores anxieties around surveillance.   “As a general rule, these devices don’t lead to better outcomes for the babies they monitor. More often—like social media, which promises connection as a salve for the loneliness created by social media—parenting tech exacerbates, even calls into existence, the parental anxieties that it pledges to soothe.”

Exploring language among gender nonconforming individuals and nontraditional partners

 June is notoriously known as Pride Month, but October features other observances that bring awareness to a variety of health issues and topics that impact LGBTQIA youth. October 11 was National Coming Out Day, October 20 was International Pronouns Day and last week, individuals and organizations recognized Intersex Awareness Day

In Breastfeeding Priorities: Safe Sleep, Bias, Gender Equitable Norms, and Paid Leave— Q&A with Internationally and Nationally Recognized Breastfeeding Expert, Lori Feldman Winter, MD, MPH, NICHQ poses the questions: How can we acknowledge the need to be inclusive of all types of parents and caregivers?  How do we promote gender-equitable social norms to better support breastfeeding?”

Photo by Karolina Grabowska

Feldman Winter offers, “… We need to ask, ‘how do we better support breastfeeding among gender nonconforming individuals and nontraditional partners?’ so we don’t alienate anyone when it comes to breastfeeding. It starts with being more inclusive and acknowledging that the benefits of breastfeeding aren’t all tied to the concept of the ‘breast’ itself. Breastfeeding is a complex compilation of systems including biological benefits from skin-to-skin touching and nurturing; nutrients from human milk that can be breast- or bottle-fed; and benefits that come directly from the flora on a lactating/nursing breast.

There are multiple ways to look at breastfeeding and understand its benefits, Feldman Winter continues. 

For instance “a chest that may not be able to produce milk can still nurture babies through the benefits of skin-to-skin contact,” she’s quoted in the NICHQ piece. “People who don’t produce breastmilk can still provide human milk through donor milk and bottle feeding. Transgender men and gender nonconforming parents and caregivers may still breastfeed safely if they choose to, and may prefer the term chestfeeding over breastfeeding because it respects their identity. All kinds of arrangements can be made to truly provide an equitable support system. As clinicians and scientists, we need to keep an open mind as we look at breastfeeding and explore how to optimize the health and well-being of all babies and families.” 

The authors of Effective Communication About Pregnancy, Birth, Lactation, Breastfeeding and Newborn Care: The Importance of Sexed Language present their thoughts about the risks of using desexed language in perinatal care.

Photo credit: PNW Production

The authors acknowledge that “Desexing the language of female reproduction has been done with a view to being sensitive to individual needs and as beneficial, kind, and inclusive.” 

They go on, “Yet, this kindness has delivered unintended consequences that have serious implications for women and children. These include: decreasing overall inclusivity; dehumanizing; including people who should be excluded; being imprecise, inaccurate or misleading; and disembodying and undermining breastfeeding. In addition, avoidance of the term ‘mother’ in its sexed sense, risks reducing recognition and the right to protection of the mother-infant dyad.”  

As part of this discussion, NICHQ has released statements in regard to the use of its language.

Photo by Mikhail Nilov

Heidi Brooks, Chief Operating Officer at NICHQ writes,  “NICHQ is not abandoning the traditional use of the terms ‘mother’ and ‘maternal.’ We are embracing the inclusive language of ‘birthing person/people’ across our work. A move toward inclusive language does not force us to stop using language that so many people identify with; at its core, inclusion is about creating more space for one another. We are taking care to expand the use of these terms in our communications, on our website, in our resources, and eventually, in all our projects. This evolution is another aspect of NICHQ’s commitment to equity in all forms, including race, nationality, gender identity, sexual orientation, and ability.” 

The Academy of Breastfeeding Medicine (ABM) put out its Clinical Protocol #33: Lactation Care for Lesbian, Gay, Bisexual, Transgender, Queer, Questioning, Plus Patients in May 2020 to help guide lactation care providers through items like language, creating a respectful health care environment, through the effects of transition-related health care on pregnancy and breast/chestfeeding, fertility options, induced lactation and colactation and milk sharing, as well as put out a call out for future research to better inform practice.

Photo courtesy of Glenis Decuir

Check out past Our Milky Way coverage on LGBTQIA health

Uplifting transgender and non binary parents 

On becoming transliterate 

Working to close the gaps in LGBTQ care 

Blurring the binary 

Skin to skin image goes viral 

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

Explore youth.gov’s page for other past and upcoming events celebrating Sexual Orientation and Gender Identity, Expression, and Well-Being.

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.