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.