Celebrating Infant Mental Health Awareness Week

This summer, we are revisiting some of our previous publications as they relate to various national celebrations. 

This week is Infant Mental Health Awareness Week, so we are re-sharing “Breastfeeding is…” a 2014 piece. Based on an interview with Barb O’Connor, this piece describes how breastfeeding is so much more than nutrition, including establishing secure attachments which are fundamental to infant mental health. 

——

With a gentle pulsing of the sand, a baby sea turtle emerges from her hatching place. She breathes the salty ocean air and immediately begins her race to the rushing tide. She dodges stealthy crabs and gulls, mounts beach debris and endures what seems like an endless journey. Programmed for survival, she plunges into the abounding ocean, her lifeline.

Worldwide, there are over 70 conservation laws and regulations that protect sea turtles.

Not far from the briny ocean breeze, a mother hears her infant cry as she enters the world outside of the womb for the first time. Placed on her mother’s abdomen, the baby relaxes for several minutes until she begins to awaken. Soon, she makes mouthing and sucking movements signaling her interest in her mother’s breast. She leaps and crawls upward with intermittent periods of rest. When she reaches the breast, her hands become increasingly active and she familiarizes herself with her mother’s nipple. She suckles enjoying her first few sips of thick colostrum. After the first feed, she will rest again in the arms of her mother, her lifeline. [For more information about the 9 Stages visit: http://www.magicalhour.com/aboutus.html]

When a newborn is given the opportunity to practice early survival skills, amazing things happen.

But all too often, the newborn’s programming is interfered with by well-meaning health care professionals and popular, although non evidence-based health care practices.

“Our culture really discredits the importance of early beginnings,” Healthy Children faculty Barb O’Connor, RN, BSN, IBCLC, ANLC says. “If we protect and nurture mothers and infants, that’s going to impact future outcomes.”

Barb O’Connor (back left) pictured with colleagues from HCP and ALPP.

She goes on,  “Mothers and infants really have a synergistic recuperation from birth and if breastfeeding is supported and not interfered with, both parties are able to develop in a manner that leads to positive health outcomes.”

O’Connor discusses several cultural components that make establishing normal, healthy beginnings nearly impossible for families.

Our culture urges independence. Mother and baby are expected to properly function away from one another immediately after birth. Most birthing facilities don’t encourage or appropriately support the important practices of skin to skin contact or even rooming in.

Moreover, mothers are often expected to return to work or school while they are still bleeding from childbirth.

“There are other cultures that really value moms and babies and you can see it in the legislation,” O’Connor says.

Differently, our country provides mothers with zero paid maternity leave.

To be fair, there have been strides made in terms of promoting, protecting and supporting breastfeeding families in our nation. The Baby-Friendly Initiative (BFI) offers more and more families the opportunity to successfully breastfeed for instance. Particularly, BFI advocates for babies by requiring the facilities to provide the healthiest practices for mom and baby. O’Connor calls skin to skin contact and rooming in essential practices for all babies regardless of feeding method.

Still we have a lot to grasp, especially when it comes to older breastfeeding babies and children.

“Because we focus so much on breastfeeding being nutrition, our culture doesn’t really understand what breastfeeding really is for infants over one,” O’Connor says.  “We don’t understand as a population that nursing becomes a source of joy and communication and a way of life that should only be discontinued as mother and child mutually desire.”

O’Connor is particularly interested in the value of breastfeeding beyond nutrition.

“The delight I witness in the eyes of a baby who is nursing is indescribable; it is pure, unadulterated joy,” she says. “Every baby deserves the right to experience this loveliness.”

And skin to skin and breastfeeding are lovely in so many ways.

Breastfeeding is a stabilizer.

When a mother holds her baby skin to skin to breastfeed, she regulates her baby’s body temperature, heart and breathing rates, stress and glucose levels just to name a few. [For more information see these publications on skin to skin contact.]

O’Connor is fascinated by the findings of Dr. Nils Bergman and KH Nyqvist. Bergman, Nyqvist and colleagues have discovered that if the mothers of low birth weight babies practice Kangaroo Mother Care (KMC), they learn to breastfeed at incredibly young gestational ages. KMC also supports increased brain development and decreased mortality for low birth weight babies.

O’Connor’s daughter Brandy, mother and full-time caregiver of a special needs son who, born at 25 weeks gestation (now 5 years old), spent 110 days in the NICU, will speak at Healthy Children’s upcoming International Breastfeeding Conference about her experience with KMC and breastfeeding. She will share her perspective of the emotional turmoil, hospital practices, and challenges experienced by mothers of infants in the NICU.

“It has taken her a long time to come to a place where she could talk about this,” O’Connor says of Brandy’s experience. “I am extremely excited for my colleagues who work in the NICU to hear her perspective on how the experience affects new mothers”.

Breastfeeding is empowering.

The symbiotic relationship between breastfeeding mother and child and the infant’s programming for survival has a profound impact on the mother’s physical and mental well-being, O’Connor explains.

She continues that a child’s desire to breastfeed for comfort can be empowering. No one else but the mother has the capacity to console an upset child the way she does.

In Breastfeeding: A Feminist Issue, author Penny Van Esterik explains the many other ways breastfeeding is empowering including:  “breastfeeding confirms a woman’s power to control her own body, and challenges the male-dominated medical model and business interests that promote bottle feeding” and ”breastfeeding requires a new definition of women’s work – one that more realistically integrates women’s productive activities.”

Breastfeeding is immunity.

Maternal body flora and milk prime an infant’s immune system in a way that cannot currently be replicated and offers beneficial lifelong effects. O’Connor cites Lars Hanson’s immunology of breast milk research.

“A fully breast-fed infant receives as much as 0.5-1 g of secretory immunoglobulin A (SIgA) antibodies daily, the predominant antibody of human milk,” authors of Breast feeding: Overview and breast milk immunology write. “This can be compared to the production of some 2.5 g of SIgA per day for a 60 kg adult. These SIgA antibodies have been shown to protect against Vibrio cholerae, ETEC, Campylobacter, Shigella and Giardia.”

Breastfeeding is communication.

“If I see a baby who looks anxious or isn’t taking the breast well, it’s an immediate sign that something isn’t right in baby’s life,” O’Connor says.

As stated babies seek the breast for survival, so if baby refuses to breastfeed, they are communicating in a non-verbal way, she continues. Perhaps baby is ill or injured. When circumstances like these arise, it is important that the dyad receive help from a lactation professional who can assist with investigating the problem.

O’Connor reminds lactation professionals that it is always important to practice from a current, evidence-based perspective and to possess appropriate counseling skills.

“Most moms want to breastfeed,” she says. “It’s a matter of figuring out how to fit it in her life.”

Breastfeeding is regulatory.

A breastfed baby is offered control over the amount of milk she ingests whereas a bottle-fed infant’s intake is usually dictated by the amount of milk in its artificial container.

Consequently bottle feeding, regardless of the type of milk, may have future implications on obesity.

“Infants who are bottle-fed in early infancy are more likely to empty the bottle or cup in late infancy than those who are fed directly at the breast,” authors of Do infants fed from bottles lack self-regulation of milk intake compared with directly breastfed infants? conclude.

Breastfeeding is survival.

O’Connor suggests we reevaluate our definition of survival. Survival goes beyond the performance of simple body functions.

“We have to look beyond that at a more encompassing definition,” she says. “Babies who are breastfed have a different potential for intellectual and interpersonal relationships.”

In fact, authors of Breast feeding and intergenerational social mobility: what are the mechanisms? conclude that “Breast feeding increased the odds of upward social mobility and decreased the odds of downward mobility.”

The effect was mediated in part due to stress mechanisms,” O’Connor comments.  “This is really fascinating.”

Breastfeeding has become of international concern because it offers protection against infant mortality. The World Health Organization’s Millenium Development Goals include breastfeeding as a strategy to combat child malnutrition and reduce child mortality.

In “Breastfeeding and Infant-Parent Co-Sleeping as Adaptive Strategies: Are They Protective against SIDS?” included in Breastfeeding: Biocultural Perspectives, James J. McKenna and Nicole J. Bernshaw explore the epidemiological studies that suggest that breastfeeding may be protective against SIDS.

What does breastfeeding mean to you? How else is breastfeeding more than nutrition? Please share your thoughts in the thread below.

 

Other relevant pieces

Field of lactation gains child psychologist

Cheap medicine: laughter

Implications of mother baby separation

Nutrition and facial development

When I was a freshman in high school, I had these tiny little ramp-like structures fused to the back of my upper incisors so that my overbite wouldn’t interfere with my bottom braces. I called them “rabbit teeth”, because that’s what they resembled: prominent, cartoon-like rabbit teeth. They were so embarrassing, though I was lucky I didn’t need to contend with headgear or what I’m about to share next.

Photo by Kenny Eliason on Unsplash

A friend recently described her son’s orthodontia as a “medieval torture device.”  Every night, she has to insert a key into the expander across the roof of his mouth and crank it multiple times in an effort to widen the canal. He’s also endured multiple tooth extractions, multiple phases of metal braces, a retainer, and his parents have forked over thousands of dollars for these treatments. 

I’m forking over thousands of dollars too, for my oldest daughter’s orthodontia. About every six weeks, we haul over for adjustments. Currently, she’s in the rubber band phase. Tiny little bands hook diagonally onto her braces in order to train her jaw into proper positioning. 

Though my own orthodontic care wrapped up about two decades ago, I’ve discovered these hilarious facial exercises– face yoga– regimens marketed at those of us who aren’t pleased with our face sculpture. 

Torture devices, face toning, what have you, these interventions have come to rise in modern times to address our changing faces and it’s not just vanity at stake. Jaw and other facial development, dental occlusion, tooth spacing have all been affected by how and what we eat and they have real effects on our overall health and function. 

“…The problem we face is that we have entered a space age world with Stone Age genes—genes that evolved to produce jaws adapted to a hunter-gatherer diet. Today’s jaws epidemic is concealed behind the commonplace. Its most obvious symptoms are oral and facial: crooked teeth (and the accompanying very common use of braces), receding jaws, a smile that shows lots of gums, mouth breathing, and interrupted breathing during sleep…” Sandra Kahn and Paul R. Ehrlich write in Why Cavemen Needed No Braces.  

The authors go on to explain: “The epidemic’s roots lie in cultural shifts in important daily actions we seldom think about; things like chewing, breathing, or the position of our jaws at rest, and these changes have in turn been brought about by much bigger sociohistorical developments—namely, industrialization.”

Photo by Etienne Girardet on Unsplash

More specifically, Americans’ diets have become saturated by ultra processed foods (UPFs). According to the documentary Food Inc. 2, on average, UPFs make up 58 percent of Americans’ total energy intake, compared to 17 percent in Italy. 

While we might think of UPFs contributing to things like obesity, diabetes, and heart disease, Daniel E Lieberman, et al conclude in Effects of food processing on masticatory strain and craniofacial growth in a retrognathic face that “…food processing techniques have led to decreased facial growth in the mandibular and maxillary arches in recent human populations.” This shifting development of our facial structures comes with its own set of health concerns.

 Weston A. Price delves into the relationship between diet, the development of teeth and bones and overall health in his book Nutrition and Physical Degeneration.  

Starting in utero, researchers have suggested that the amount of protein consumed by pregnant women can impact the facial development of their offspring. 

It is well established that infant feeding and the introduction of complementary foods impacts facial development.

Photo by Helena Lopes on Unsplash

“Breastfeeding is not mere nutrition and can be considered as a natural orthopedic appliance for the harmonious development of face,” as the authors of Validation of Association between Breastfeeding Duration, Facial Profile, Occlusion, and Spacing: A Cross-sectional Study put it. 

In Relationship between Nutrition and Development of the Jaws in Children, a small pilot study, the authors reference a study conducted in Beijing by Chen, et al that “revealed that children who either did not receive breastfeeding or breastfed for less than six months were more susceptible to subsequent crossbite, which is directly linked to the position of the terminal plane.” 

The authors also write that “initiating [complementary] feeding with solid foods [as opposed to porridges] may lead to a lower tendency for crowding. Primate spaces and interincisive diastemas are considered essential and important as they facilitate the proper alignment of permanent teeth by occupying the necessary space for a harmonious occlusion.” 

Alas, the packet apocalypse is upon us. The convenience of “ready-to-feed-super-glops and slops” have largely replaced the art of dining and sharing meals and chewing our food. Stocked shelves offer an overwhelming array of mostly highly processed snacks and meals in a pouch that generally lack texture diversity.

Photo by Derek Owens on Unsplash

Yvonne Luxford’s Was the Tooth Fairy Breast Fed? The Politics of Infant Tooth Decay is a fascinating doctoral thesis that teases out the flaws in 1970s research that linked breastfeeding to tooth decay (and has stuck around in many spaces.) 

In one section, Luxford cites Babu Jose and Nigel M King’s research which found that “the  [addition of sugar in local snack food preparations and the increasing frequency of snacking] may have been a factor that has affected data from other studies where breast-feeding was high; in other words, this may serve as a warning to communities that the good practice of breast-feeding may be counteracted by adverse factors that are not reported by caregivers, and these factors may be cultural or social in nature.” 

This bit nods to snack culture and industry influence where multinational corporations work to influence infants’ and young children’s diets in order to increase their profits.    

During this research, I came across a device shaped like a mouthguard intended to promote chewing. How incredibly bizarre, I thought. When I shared the device with one of my mentors, she pointed out that humans who are tube fed or those living with other medical complexities might benefit from a device like this, but for those of us who can chew regular, whole foods… we both cocked our heads– our heads formed with great influence by the foods we eat– in bewilderment at this silicone product. 

 

Further reading 

Global human mandibular variation reflects differences in agricultural and hunter-gatherer subsistence strategies

Malocclusion: Disease of Civilization

Ultra-Processed People

Evolution of Diet 

How the Western Diet Has Changed the Human Face



From Africa to Appalachia, improved relationships and communication through nutrition research

 From Africa to Appalachia, Stephanie L. Martin’s, PhD, CLC research on nutrition during pregnancy, lactation, and childhood, has gone beyond nutrition alone.

In a world where infant feeding is commonly reduced to input and output, “perfect” latches and weighted feeds, Martin’s work illuminates the added benefit of improved relationships and communication. 

In Zambia for instance, Martin and her colleagues have looked at how to engage family members to support nutrition in women living with HIV and their children. 

Twenty years ago, when antiretroviral therapy (ART) was less accessible, the risk of transmitting HIV through breastfeeding was high. Today though, with an increase in availability and access to ART, the World Health Organization (WHO) recommends the use of antiretroviral drugs as a safe way to prevent postnatal transmission of HIV through breastfeeding. 

Still, Martin has found that mothers talk about their fears of transmitting HIV to their infants the same way they did two decades ago. Mothers often use unfounded strategies like breastfeeding for shorter durations, breastfeeding less often or offering other liquids in an effort to limit the risk of transmission. So, Martin and her team have counseled mothers not to cut feedings short. Martin shares that her most recent Lactation Counselor Training has offered new insight.

“I’m going to change things in our counseling materials based on what we learned in the CLC training [in regard to] how we phrase things about breastfeeding for longer periods of time; if there is efficient milk transfer, we don’t need to focus on this longer length of time,” she explains.   

Additionally, in an effort to reduce caregivers offering infants under six months food or drink other than breastmilk, alternative soothing recommendations were offered. Martin remembers one mother who tried the suggestions to calm her crying baby. The mother reported that propping her infant onto a specific shoulder alleviated the baby’s discontent. “I don’t know what it was about that shoulder, but she stopped crying,” Martin quotes the mother, noting the importance of empowering mothers and caregivers through counseling. 

In Tanzania, Martin and partners at Kilimanjaro Christian Medical University College sought to identify  facilitators and barriers to exclusive breastfeeding among women working in the informal sector. And in Kenya, Martin and colleagues have worked to improve adolescent nutrition in informal settlements.

Martin pictured with colleagues from Kilimanjaro Christian Medical University College and Better Health for the African Mother and Child organization

Throughout all of her work in East and Southern Africa, Martin says they are reliant on community health workers to roll out their programs. 

“It’s so important to understand their experiences,” Martin says of hearing out the helpers. 

Through her research , Martin has explored the experiences of peer educators, community health workers, WIC breastfeeding peer counselors, health care providers, and program implementers.

Surveying global health professionals provides an opportunity to learn from their experiences and fill gaps in the peer-reviewed literature to strengthen intervention design and implementation as concluded in Martin, et al’s Experiences Engaging Family Members in Maternal, Child, and Adolescent Nutrition: A Survey of Global Health Professionals

Through Facilitators and Barriers to Providing Breastfeeding and Lactation Support to Families in Appalachia: A Mixed-Methods Study With Lactation Professionals and Supporters, Martin draws parallels in the challenges lactation care providers in Africa and Appalachia face, including compensation and availability of services. 

Specifically in Appalachia, the authors heard lactation care providers expressing the desire for additional training for providing support around mental health, chest feeding, drug use, etc. 

Martin says that she found the Lactation Counselor Training Course (LCTC) covered many of these topics. 

“[The course] seemed very intentional in all of the right ways,” she says. 

The Appalachian Breastfeeding Network (ABN) also offers an Advanced Current Concepts in Lactation Course which covers these desired topics with scholarship opportunities. 

When asked if she’s optimistic about the future of maternal child health, Martin answers with a slightly tense laugh: “I feel like I have to say yes.” Martin goes on to explain the inspiring work of ABN and all of the lactation care providers she’s interacted with.

“If they were in charge of the world, it would be such a better place,” she begins. 

“When I think about them, I feel optimistic. I’d like to see different laws that are supportive of women’s health and families. We have all the right people to make positive changes.”

Centering and celebrating cultures in health: Dietary Guidelines for infants and toddlers for Chinese and Vietnamese communities

During the first week of April each year, the American Public Health Association (APHA) brings together communities to observe National Public Health Week. This year’s theme  is Centering and Celebrating Cultures in Health and highlights the importance of fostering cultural connections to health and quality of life. 

Last month, we celebrated National Nutrition Month, an annual campaign by the Academy of Nutrition and Dietetics which highlights the importance of making informed food choices across the lifespan.

Photo by Angela Roma

A beautiful example of the convergence of these two themes is work being done by the Asian Pacific Islander Breastfeeding Task Force (APIBTF) a part of  Breastfeed LA, tailoring the Dietary Guidelines for infants and toddlers for Chinese and Vietnamese communities. This project augments APIBTF’s sister organization Alameda County’s Asian, Southeast Asian, Pacific Islander (ASAP!) Breastfeeding Taskforce’s Continuity of Care (CoC) Blueprint Project Prenatal Toolkit for AANHPI families. The prenatal toolkit was adapted from an existing toolkit in Alameda County, and is available in English, traditional Chinese, and Vietnamese.

The initiative is supported by the Centers for Disease Control and Prevention, Division of Nutrition, Physical Activity, and Obesity (CDC/DNPAO). NACCHO selected seven communities to strengthen community lactation support through the implementation of the Continuity of Care in Breastfeeding Support: A Blueprint for Communities from November 2022 to July 2023. The purpose of this project is to support the implementation of CoC strategies by local-level organizations among oppressed communities with historically low rates of chest/breastfeeding. [https://www.naccho.org/programs/community-health/maternal-child-adolescent-health/breastfeeding-support#early-childhood-nutrition]

Photo by Roderick Salatan

 

The dietary resources which include an Educational Handout from Dietary Guidelines, Nutrition Resource Directory, and social media posts can be found here, available in English, Chinese and Vietnamese. The materials include a dietary guidelines hand out with two toddler-friendly recipes (with a fun suggestion to use green onion to decorate steamed eggs), three social media messages with a timeline for infant feeding, human milk recommendations, and complementary food recommendations, all commonly eaten in Asian communities. The deliverables are full of color and easy to navigate. 

Judy Li and Cindy Young presented their work during NACCHO’s The First 1,000 Days Nutrition: Improving Nutrition Security for Infants and Toddlers in Communities of Color where the Improving Infant and Young Child Nutrition during the first 1,000 days in Communities of Color summary report was introduced. 

Li, Young and their team’s work was community-informed, standing by the sentiment, “Nothing about us, without us.” The team spoke with community members about eating habits and learned that families do not eat according to the MyPlate graphic. Instead, they enjoy their meals in family-style servings from bowls. Recipes developed were tested by community members with children and tailored according to their suggestions; for example, the addition of different dipping sauces.

Participants also offered feedback stating that they appreciated the accessibility of the ingredients. 

 

Helpful links

ASAP!’s Asian American, Native Hawaiian, and Pacific Islander (AANHPI) Social Media Toolkit 

National Public Health Week’s shareables and toolkit (available in Spanish)  

USDA’s Dietary Guidelines for Americans (2020-2025)

The Association of State Public Health Nutritionists (ASPHN) brief on Transition Feeding 

Public Health Nutrition Deserves More Attention

Undernourished and Overlooked

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.