Breastfeeding is collaborative.

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

Breastfeeding is collaborative.

A breastfeeding dyad is a beautiful, fascinating, complex organism. Mother and bab(ies) attend and respond to one another facilitating nourishment, the flow of hormones, immunity, learning and bonding, comfort, fun, an all-encompassing sensory experience that has generational impacts on social, emotional and physical health.

Photo by Luiza Braun

In this intimate depiction of a breastfeeding dyad, a world of collaborative intricacies occur: the undulation of baby’s tongue to help with milk removal, the contraction of myoepithelial cells thanks to oxytocin elicited by baby, the removal of milk to signal mother’s body to produce more, to name a few.

It’s clear that breastfeeding is so much more than “the healthiest feeding choice” nutritionally speaking. Take the following anecdotes for example.

Nikki Lee offers her commentary to this case report on infant botulism in an exclusively breastfed baby explaining how interactive feeding can save a baby’s life.

https://unsplash.com/@luizabraun

“One doesn’t have to ingest honey to contract botulism. Exclusively breastfed babies can get botulism. Some parts of the continental US have c.botulinum in the soil; construction stirs up the soil, and the germ floats in the air. The breastfeeding mother is the one to notice that the baby’s suck isn’t as strong. This is a reason that breastfed babies survive botulism, because they get diagnosed and treated sooner than bottle-fed babies.”

In this case, breastfeeding offered early detection of breast cancer in the mother because of her baby’s refusal to nurse from one side. This phenomenon is known as Goldsmith’s Sign.

To demonstrate the importance of  the relationship that breastfeeding affords, we might consider the implications of separation. Lee again offers insight on the implications of mother baby separation in this piece.

Zooming out to view breastfeeding less individualistically and instead as a global food security system, we must recognize the collaboration necessary to support the breastfeeding dyad and abandon the idea that breastfeeding is a solitary act, a “one-woman job”.

https://unsplash.com/@luizabraun

In Breastfeeding as a ‘Resilient’ Food Security System: Celebrating…. And Problematizing Women’s Resilience in the face of chronic deprivation as well as emergencies, Dr. Vandana Prasad, MBBS, MRCP (Ped) UK, MPH describes breastfeeding as “wholly community-based”. Dr. Prasad continues that breastfeeding is potentially universally accessible and sustainable because it  “depends wholly upon the status of time, energy, health, nutrition and general availability of women”. This achievement, breastfeeding as definitely universally accessible and sustainable,  would require collaborative efforts by “governments, decision-makers, development partners, professional bodies, academia, media, advocates, and other stakeholders” working together, as Dr. Tedros Adhanom Ghebreyesus writes.

In the U.S., WIC has created an interactive resource “to help reinforce the important role that family and friends play in supporting breastfeeding moms.” The resource invites WIC staff to “click through the prompts with parents, grandparents, and others discussing when and how to offer helpful support so that mom and baby continue to thrive.”

At an organizational level, the United States Breastfeeding Committee (USBC) uses a collective impact approach to manage multi-sectoral collaborations, working to protect, promote, and support breastfeeding and human milk feeding.

Source: United States Breastfeeding Committee.

Internationally, the Global Breastfeeding Collective calls on donors, policy makers and civil society to increase investment in breastfeeding worldwide.

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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, tell us: Who is your s/hero in the field of maternal child health?

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.

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

The lactation care provider glanced at her breasts and claimed, “You’re not going to be able to produce much milk.” Glenis Decuir, CBS, a young mother at the time, had just given birth to her first baby (now 17 years old), and while she intended to breastfeed her daughter, without explanation, without proper consultation and counseling, without a shred of compassion, the lactation consultant disparaged her intentions so tragically that Decuir not only did not breastfeed her daughter, she remained discouraged through the birth of her second child (now 14 years old) and did not breastfeed him either.

Decuir eventually learned that she has Insufficient Glandular Tissue (IGT) disorder.

“I knew my breasts looked different, but my mom’s looked the same as mine; I didn’t think anything was abnormal,” Decuir explains. “ I was young and wasn’t resourceful; no one explained anything.”

Though Decuir’s introduction to infant feeding was shrouded in the unknown and total neglect from care providers, her story takes a turn, epitomizing self-determination, advocacy and education, perseverance, resilience and empowerment.

In 2018, Decuir’s wife became pregnant with their third child. Because she would not grow and birth this baby, Decuir wondered how she would form a bond with him.

“It was very difficult for me to wrap my head around that,” Decuir shares.

Plunging into self-guided research, Decuir landed on the potential to induce lactation.

When she decided to embark on this path, Decuir reached out for guidance, but found herself in a void.

“Unfortunately, I received the most pushback from doctors, many of whom didn’t even know that inducing lactation was possible,” Decuir documents her road to co-breastfeeding. “I had to see four different doctors before I could find one willing to work with me. Being under the doctor’s care was very important because I had never done this before, and I knew I would be taking medications. After exploring several options, we chose the Newman Goldfarb Protocol as our method of induced lactation.”

For well over 20 weeks, Decuir delved into the protocol.

“Because I had really poor experiences with my first two and poor experiences with seeking help with breastfeeding professionals… I became an advocate… I had overcome so much adversity,” Decuir begins.

Laws state that we can pump anywhere, Decuir continues. And that’s what she did.

“I was pumping in every location imaginable! At my desk, in the car, the movie theater, Six Flags, and much more!” she writes.

Decuir goes on, “I decided to be very public about my entire journey on Instagram. One, I have the right to and I exercise every right, but it also opened a gateway to educating others.”

Prior to inducing lactation, Decuir reports that her children had never been exposed to anyone breastfeeding, “not even at a playground or anything,” she elucidates.

“This is how behind closed doors moms are with breastfeeding,” she says.

But Decuir and her wife’s approach is different; they are open-books with their children, she explains.

“They were old enough to understand scientifically, biologically, physically what my body was going to go through,” Decuir starts. “I educated them through a scientific standpoint, but also talked about normalizing breastfeeding. We talked about my daughter breastfeeding in the future, and my son and his role as a man in a household and how he can support his future wife to breastfeed.”

Decuir recalls the emotional and practical support her older children offered: “I cried in front of them, I pumped in front of them, I laughed in front of them; they helped wash bottles and Spectra parts…”

In sharing her journey with others though, Decuir wasn’t always met with such maturity and acceptance.

“I got everything under the sun,” Decuir remembers. Some told her it was disgusting, some found it weird, and some even went as far as to claim it child abuse.

Orion was born on September 2, 2018. At the time of his birth, Decuir was producing 16 ounces a day– quite close to what is considered full production– and had stored over 1,000 of her milk in a deep freezer.

Decuir says that she didn’t set forth focusing on the quantity though. “I wasn’t thinking about achieving full supply; I was thinking about producing anything. Even if it was only five ounces a day, I thought, I can at least do one feeding a day and that to me was worth it on its own.”

She continues: “Every time that I would latch Orion on, I just thanked Mother Nature and how amazing our bodies are. Maybe if I had birthed Orion, if I  had just latched him on, it wouldn’t have been a second thought, but because of what I went through–I worked real, real hard– every time I was able to latch my son, I literally thanked the universe. I was so grateful.”

Decuir and her wife went on to co-breastfeed Orion until he was two-and-a-half.

Throughout her breastfeeding relationship, Decuir remained visible in her efforts. “Having the power to go through that experience breastfeeding anywhere and everywhere in public, it became almost liberating and very freeing to be able to exercise my right, and in doing so I came across a lot of people. I took them as opportunities to talk more about breastfeeding and breastfeeding in public.”

At the start of her journey, in order to create her village, Decuir started a private Facebook support group. Today it has over two and a half thousand members.

Locally, Decuir serves as a breastfeeding support person through ZipMilk and is a ROSE Community Transformer, all on a volunteer basis. She has presented at the ROSE Summit in years’ past and is currently working on a book.

You can read Decuir’s former publications about her co-breastfeeding journey at https://aeroflowbreastpumps.com/blog/the-road-to-co-breastfeeding

https://www.baby-chick.com/what-is-co-breastfeeding/ and

https://www.huffpost.com/entry/co-breastfeeding_n_5c13eaf8e4b049efa75213e6.

For many, grandmothers are the village

Reflecting on her experience as a first-time grandmother, one of my colleagues and mentors expressed that, for most of us, “grandmothers are the closest thing to a village that we have.”

This colleague, a lactation care provider herself,  described the intricacies, sweetness and sacredness of watching her daughter step into motherhood. My colleague’s notes described her thoughtful presence without overbearance, leaving space for her daughter and her new family to learn and to bond. For instance, she cleans the house, prepares their bed with sun-dried sheets, and sits at the foot of the bed while her daughter and granddaughter nurse. In this dreamy scenario, grandma, baby and parents are all met with challenges, however those challenges haven’t become insurmountable thanks in part to this level of grandmotherly support and care.

This week we bring to you some work that details grandmothers’ powerful influence on the perinatal experience and beyond. A 2016 systematic review found that “a grandmother’s positive breastfeeding opinion had the potential to influence a mother up to 12 % more likely to initiate breastfeeding. Conversely a negative opinion has the capacity to decrease the likelihood of breastfeeding by up to 70 %.”

Healthy Children Project’s own Barbara O’Connor, RN, BSN, IBCLC, ANLC – Faculty Emerita designed and authored the Grandmothers’ Tea Project for the Illinois State Breastfeeding Task Force (2011).

Through O’Connor’s interactive curriculum, grandmothers are invited to learn about breastfeeding through three activities that pose breastfeeding scenarios:

“The Grandmothers’ Apron activity updates grandmothers’ knowledge about the importance of breastfeeding.

During the Grandmothers’ Cell Phone activity, grandmothers talk about breastfeeding myths and barriers.

In the Grandmothers’ Necklace activity, participants create a beaded necklace to remind them of ways they can offer support through loving encouragement, updating their breastfeeding knowledge, and being helpful.” (As described in A Grandmothers’ Tea: Evaluation of a Breastfeeding Support Intervention)

Source: United States Breastfeeding Committee.

Author Jane S. Grassley, RN, PhD, IBCLC and colleagues encourage perinatal educators to explore the curriculum for A Grandmothers’ Tea as they found that grandmothers and mothers who attended the teas in their study enjoyed their interactions with one another and with the class content.

Their work also unearthed a phenomenon of defensiveness in grandmothers who did not breastfeed their own children. The authors explain  “Grandmothers who did not breastfeed may feel defensive about their infant-feeding decisions because of the current emphasis on the health benefits of breastfeeding (Grassley & Eschiti, 2007)”  and advise that “perinatal educators can invite grandmothers to share their experiences and validate the cultural context in which these experiences took place.”

In this realm of validation and healing, Midwife Andrea Ruizquez of Partera Midwifery explores the implications of the Mother Wound. On Partera Midwifery’s Instagram page, Ruizquez writes:

“Props to all the people navigating complicated mother child relationships as adults. Now that I am in my 40’s I find myself reconnecting with my own mother in a deeper way. There was a time when we were estranged from each other. I learned how to recognize that I needed boundaries and practiced maintaining them. I am learning not to get triggered by my mother’s ways, and have compassion for her reasons behind them. I extend this sentiment to all of my grandmas ancestors who are in my lineage.

I am having more compassion for myself, and the ways I am like her my mom. I am learning to love myself deeper and become a more conscious mama to my children. I am still learning to love my child self that did not get all of her needs met, and I reparent myself with love. I feel myself heal.”

Source: United States Breastfeeding Committee.

Cultural beliefs held by grandmothers have the potential to influence healthy infant feeding practices. In Grace Yee, Retired IBCLC and Tonya Lang’s, MPH, CHES, IBCLC  Cultural Dimensions in Promoting, Protecting, and Supporting Lactation in East Asian Communities, they explained the prominent roles of aunties and grandmothers in the early postpartum. One example includes how colostrum is sometimes regarded in older generations as impure or unhealthy. Yee and Lang suggest that instead of positioning tradition and culture as a hindrance, to reframe barriers to breastfeeding into potential strengths. Respect of elders’ traditions and cultural practices will establish trust and foster positive relationships, as noted in Monique Sims-Harper, DrPH, MPH, RD, IBCLC, Jeanette Panchula, RN PHN, BA-SW, and Patt Young’s, Health Educator, CLE work entitled It Takes A Village: Empowering Grandmothers as Breastfeeding Supporters.

The physiological imprint of breastfeeding withstands generations and the sensations of milk production may surface decades later as mothers become grandmothers. Grandmothers who have previously breastfed have reported the tingling sensation of a phantom milk release when holding their grandchildren.

In South Sudan, grandmothers are relactating to help manage severe acute malnutrition. This practice has been documented elsewhere like Natal, South Africa and Vietnam for example.

Barry Hewlett and Steve Winn’s study on allomaternal nursing indicates that while this practice occurs in many cultures, “it is normative in relatively few cultures; biological kin, especially grandmothers, frequently provide allomaternal nursing and that infant age, mother’s condition, and culture (e.g., cultural models about if and when women other than the mother can nurse an infant or colostrum taboos) impact the nature and frequency of allomaternal nursing.”

Photo by Наталия Игоревна from Pexels

For an illuminating anthropological perspective, read A Biocultural Study of Grandmothering During the Perinatal Period by Brooke A. Scelza and  Katie Hinde. Their “findings reveal three domains in which grandmothers contribute: learning to mother, breastfeeding support, and postnatal health and well-being” and “show that informational, emotional, and instrumental support provided to new mothers and their neonates during the perinatal period can aid in the establishment of the mother-infant bond, buffer maternal energy balance, and improve nutritional outcomes for infants.”

We would love to learn about your perinatal and infant feeding experiences as grandmothers or with grandmothers. If you’d like to share, please email us at info@ourmilkyway.org.

Facilitating the bond between children and fathers or male-identifying partners

 There’s quite a bit of literature on why it is important for fathers to support breastfeeding, and robust recommendations on how fathers can be good support people.

Photo by Anna Shvets: https://www.pexels.com/photo/a-man-in-blue-long-sleeves-playing-with-his-baby-11369399/

Specifically in Black communities though, there’s a “lack of resources for men to learn about and advocate for breastfeeding.”  George W. Bugg, Jr, et al. write in Breastfeeding Communities for Fatherhood: Laying the Groundwork for the Black Fatherhood, Brotherhood, and Manhood Movement  that “Black men deserve to be educated in culturally competent ways about prenatal and postpartum care to advocate for their partners. This is not happening in a systematic way in the Black community. In the Reproductive Justice space, Black men are basically being treated as if they are invisible.” 

As a whole, our nation lacks support for fathers and male identifying partners to bond with their babies. The father–infant relationship should be honored “in its own framework rather than as an alternative to mother–infant theory.” (Cheng 2011

Author Carolynn Darrell Cheng, et al points out in Supporting Fathering Through Infant Massage that “fathers may feel dissatisfied with their ability to form a close attachment with their infants in the early postpartum period, which, in turn, may increase their parent-related stress.”

Photo by Caroline Hernandez on Unsplash

Infant massage is such a neglected modality, especially in the NICU, where it reduces both the risk of sepsis and bilirubin levels, and gets babies home sooner because their brains mature more quickly and they gain weight faster,” Nikki Lee points out. 

Beyond its benefits to infants, Cheng and colleagues have found that “infant massage appears to be a viable option for teaching fathers caregiving sensitivity.” Their work showed that “fathers were helped by increasing their feelings of competence, role acceptance, spousal support, attachment, and health and by decreasing feelings of isolation and depression. Although not all fathers saw the direct benefit of infant massage instruction, they did note they enjoyed participating in an activity that gave them special time with their infants and appreciated the opportunity to meet other fathers.” 

More broadly, skin-to-skin contact has a positive effect on paternal attachment.  

The results from Effects of Father-Neonate Skin-to-Skin Contact on Attachment: A Randomized Controlled Trial identified touching as the highest-scoring Father-Child Attachment Scale (FCAS) subscale. 

Ontario artist Lindsay Foster’s viral image of fathers BJ Barone and Frankie Nelson meeting Baby Milo captures perfectly the flood of oxytocin that skin-to-skin affords fathers and male-identifying parents.

Fathers BJ (left) and Frankie (right) embrace their seconds-old-newborn boy Milo. Milo’s umbilical cord is still attached to the surrogate in this image.
Photo by Ontario artist Lindsay Foster.
Formerly published in: http://www.ourmilkyway.org/skin-to-skin-image-goes-viral/

The World Alliance for Breastfeeding Action (WABA) identifies other ways in which fathers can be “empowered by a whole-of-society approach to fulfill their fathering capacity.” 

WABA suggests that fathers should be engaged and involved throughout the 1,000 days and health systems and care providers can provide knowledge on breastfeeding through antenatal visits, other breastfeeding classes and enabling their participation during labor and delivery and postnatally. 

Sufficient paternity or parental leave is vital to allow time to care for and bond with their new family. 

There is also “a need for greater vigilance against promotion and unethical marketing of breastmilk substitutes targeting fathers to ensure that they also get unbiased information.” [More here.] 

In our national sphere of advocacy, last month, Foundations of Fatherhood Summit hosted Wide World of Fathering  with a mission to advance fatherhood and families in Michigan communities and beyond. The speaker lineup was full of individuals passionate about fatherhood and working to shift the way we view males as parents. 

Presenter Reginald Day, CLC for instance, hosts a podcast called Get At Me Dad which reveals the true narrative of BIPOC fathers–”present, connected and raising strong families.”

Father-son duo Mark and Corey Perlman host another podcast called Nurturing Fathers based on the Nurturing Fathers Program

Last week, New Mexico Breastfeeding Task Force Board Member Francisco J. Ronquillo hosted a Hearing our Voices virtual roundtable for fathers and male-identifying partners. 

Reaching Our Brothers Everywhere (ROBE), an organization which seeks to educate, equip, and empower men to impact an increase in breastfeeding rates and a decrease in infant mortality rates within the African-American communities, hosts a monthly virtual call where males can discuss maternal child health related topics.   

In partnership with Reaching Our Sisters Everywhere (ROSE), ROBE will host the 11th Annual Breastfeeding and Equity Summit in New Orleans from August 25  to 27, 2022 where presentations center on equity in breastfeeding, maternal health, fathers and partners, and infant health initiatives.

 

Our Milky Way past coverage on fathers

Photo by PNW Production: https://www.pexels.com/photo/a-family-walking-together-on-a-boardwalk-8576210/

New CLC engages fathers, supports breastfeeding, heals communities

Fathers profoundly influence breastfeeding outcomes

Founder of Fathers’ Uplift adopted into breastfeeding movement

The Institute of Family & Community Impact hosts event to boost paternal mental health

Paternal mental health and engagement

Robert A. Lee, MA answers the call

A lasting bond 

Skin to skin image goes viral

Changing families demand changing policies

Physicians as parents: How can one pour from an empty cup?

A medical student once told Nikki Lee, RN, BSN, MS, Mother of 2, IBCLC,RLC, CCE, CIMI, CST (cert.appl.), ANLC, RYT500  about an obstetrician who loved to pump while she was catching babies because she collected more milk than usual. Lee theorizes that perhaps it was due to the high levels of oxytocin in the atmosphere during childbirth. 

It’s a fascinating concept, and quite unusual considering physicians often find themselves in a terrible paradox. As Lee puts it, they are supposed to take care of everybody else, and no one takes care of them. They’re expected to be experts on everything;  as childbirth educators and lactation care providers, we often disclaim “this information is not meant as a substitute for medical advice.”

In this two-part series, Lee and I set out to explore the forces that surround infant feeding, ones that physicians must muscle through as parents themselves and as professionals. We explore emerging themes inspired by the article Medical training taught this Philadelphia doctor about breast feeding. But the real lessons came from her twins. In Part One, we offer thoughts on physicians functioning as parents themselves. Part Two covers physicians as professionals trying to support breastfeeding most often with inadequate education and training.

Source: United States Breastfeeding Committee

With insufficient support in their personal infant feeding goals, physicians’ struggles sometimes seem to spur advocacy and a “do-better-for-my patients” attitude. Just the same, these experiences can lead individuals to harbor resentment, despair, resignation and defeat, and might unintentionally influence the breastfeeding support they are able to offer their patients. 

When physicians’ basic needs aren’t met, we can’t expect them to meet the needs of their patients. How can one pour from an empty cup?  Kathleen Kendall Tackett offers Burnout, Compassion Fatigue, and Self Care for Members of the Perinatal Team which presents insights on the effects of little institutional support and specific strategies for integrating self-care into care for others. 

Self-care is sustainable only when everyone can do it. 

Before physicians are done with their decade or more of training, they are challenged by inadequate support in their efforts to feed their own children. 

“In a survey of 412 medical trainees with children, more than 80% of women reported feeling stressed about breastfeeding, and one-third did not meet their breastfeeding goal,” Gaelen Dwyer points out in Pumping up support: Making breastfeeding easier for med students

What’s more, a  recent research letter, American Board of Medical Specialties Board Examination Lactation Accommodation, evaluates the American Board of Medical Specialties (ABMS) member boards’ lactation-specific board examination accommodation policies highlighting that a minority of female physicians (42%) achieve the recommendation that infants receive mother’s milk at least until age one. 

Source: United States Breastfeeding Committee

“Board examinations are a key aspect of medical training,” the authors begin. “With up to 22% of female trainees delivering a child during postgraduate training, and nearly 59, 000 female physicians in residency and fellowship in the US, there is a large group potentially affected by board examination lactation accommodations.”

About a decade ago, ​​in a landmark case that has implications for all testing organizations in Massachusetts, a unanimous Massachusetts Supreme Judicial Court ruled that breastfeeding mothers are entitled to special accommodations to allow them sufficient time to pump milk during lengthy testing for medical licensure. [https://www.wbur.org/news/2012/04/13/breastfeeding-doctor-ruling ] 

The elephant in the room is the issue of parental leave. Honestly, it’s hard to stomach that we are still arguing that there are medical and psychosocial benefits of protected parental leave for both parents and children. The U.S. is the only Organisation for Economic Co-operation and Development (OECD) member country—and one of only six countries in the world—without a national paid parental leave policy. The U.S. is also one of the few high-income countries without a national family caregiving or medical leave policy. [https://bipartisanpolicy.org/explainer/paid-family-leave-across-oecd-countries/

Women don’t breastfeed; societies do. The societal burden on the mother is magnified when the mother is a physician and is compelled to take care of everyone else, with no support for their own breastfeeding. Breastfeeding is blamed for being difficult, instead of us all getting furious that we don’t have paid maternity leave.

In the current U.S. healthcare system, physicians find themselves paid in Relative Value Units (RVUs), which bluntly put, is a pretty mechanical way to value providing care to other humans. In short, the more RVUs a physician racks up, the more they’re paid. Often that leaves lactating physicians forgoing pumping to spend more time with patients. The Providing Urgent Maternal Protections (PUMP) for Nursing Mothers Act would close the loopholes that force physicians to choose income or feeding their babies. The PUMP Act advanced out of the Senate HELP Committee with unanimous bipartisan support in May 2021 and then passed with significant bipartisan support (267-149) in the House last October. Despite this strong bipartisan support, the bill has languished in the Senate for almost a year. Get updates on progress here

In February 2021, the American Academy of Pediatrics (AAP) issued a policy statement on Parental Leave for Residents and Pediatric Training Programs.

Source: United States Breastfeeding Committee

The policy reports that the Institutional Requirements of the Accreditation Council for Graduate Medical Education require training programs to provide written policies regarding leaves of absence, including parental leave, and these policies must comply with current legislation such as the Family Medical Leave Act (FMLA), but that the length of leave has considerable variability among residency programs. The statement outlines the challenges of parental leave policies in training programs and gives recommendations to protect trainees and their families. One challenge is that education calendars are set long before a person enters a medical program, but labor, delivery, and the establishment of breastfeeding don’t fit into a predetermined calendar. 

Despite this dismal landscape, the medical world is changing and there are stories and models to celebrate. 

Catherine Wagner, a cardiothoracic surgery resident at Michigan Medicine, managed to breastfeed and pump for a year during her residency with a network of support. 

A committee at the University of Michigan is calling on pediatricians to support their fellow physicians.  Pediatricians Advocating Breastfeeding: Let’s Start with Supporting our Fellow Pediatricians First describes the efforts to support lactation within the department. The committee collected university policies, state and federal laws, identified the needs of breastfeeding mothers and then created a policy to support lactating individuals as well as a handout to help supervisors and colleagues support lactating women in the healthcare setting. (Supplemental material; available at www.jpeds.com).

Got Milk? Design and Implementation of a Lactation Support Program for Surgeons describes an initiative where “Multiple faculty members offered to offload resident workload before starting cases to provide time for a lactating resident to express milk… The University of Wisconsin adopted a ‘cross-cover’ model encouraging lactating residents to have other residents assist in the operating room during non-critical portions of the case if the primary operating resident needed to express milk that has been very well received and easily implemented.”

Source: United States Breastfeeding Committee

There’s attention being paid to lactation accommodation information in urology residency programs too. 

In this study, “Of 145 urology residency programs, 72.4% included information about lactation accommodations anywhere on the institution’s website.” The authors conclude that “efforts to recruit and retain female urologists should include making [lactation accommodation]  information more easily accessible.”

Authors Annery G Garcia-Marcinkiewicz and Sarah S Titler call on  anesthesiology as a workforce and specialty, to support the unique need of lactating and breastfeeding anesthesiologists in Lactation and Anesthesiology

This study offers the first comprehensive scoping review of the literature on breastfeeding policies pertaining to surgical residents in Canada.

The authors write: “…We aim to use these data to advocate for breast feeding for surgical resident physicians through the creation and improvement of current breastfeeding policies as applicable. This work aims to help change surgical culture to be more inclusive, which is vital in creating a breast feeding-friendly environment. This would include leadership endorsement of the policy, a culture shift (for example, no repercussions to resident for coming back on a modified schedule or taking breaks for expressing milk), visible educational notices throughout the workplace (ie, ‘breast feeding-friendly workplace’ notices, common in Canadian public settings), and creation of a network of ‘new moms’ within the surgical resident programme to ensure there is support and mentorship for new moms returning back to work. ”

While we wait for policies to catch up to the needs of lactating physicians, wearable pumps are helping them reach their infant feeding goals.  The Impact of Wearable Breast Pumps on Physicians’ Breastfeeding Experience and Success found that “those who had used a wearable pump reported statistically significant shorter lactation breaks (p < 0.00001) and were more likely to be able to provide breast milk to their infants for their entire intended duration (p = 0.005) compared to the traditional pump group.” 

The support network Dr. MILK (Mothers Interested in Lactation Knowledge) has been successful at helping physicians mothers reach their infant feeding goals. 

Where else are you seeing physician parents being supported in their infant feeding journeys? Email us at info@ourmilkyway.org