Infusing work-life balance in medicine: reflections from Katrina B. Mitchell, MD, IBCLC, PMH-C, FACS

— “…Breastfeeding isn’t about ‘success’ or ‘goals’ — it’s a human experience.” —
Mitchell’s son captures her on the job. Used with permission: https://www.instagram.com/p/CuN_G35Rc0h/

Katrina B. Mitchell, MD, IBCLC, PMH-C, FACS, a breast surgeon, lactation consultant, and perinatal mental health provider in Santa Barbara, Cali., went back to work at five weeks postpartum.

“Looking back…I have no idea how I did this,” she reflects.  “I know this is still far better than migrant workers on the central coast of California, who may not even have a week to recover.”

In part, Dr. Mitchell recognizes the support she received from a pediatrician; he counseled her on bed sharing during the time she was breastfeeding as a single parent in surgical training.

“This literally saved mine and my son’s physical and emotional health (as well as allowed me to exclusively breastfeed for six months and then onward for years),” Dr. Mitchell explains. “Sure, it was still terrible to have to pump milk in a bathroom by the OR and lug my pump all over the hospital, but I really believe I stayed on a postpartum high because I got to sleep and nurse my baby at night when I got home.”

She continues: “[Bedsharing] saved every possible complication we could have experienced with me being back at work operating 14 plus hours a day at that point in time…. I am forever grateful to this pediatrician…”

Dr. Mitchell captured these early experiences in a book she wrote for her son about being a surgeon mom.

In her practice today, Dr. Mitchell tells her patients who are going back to work that the ounces in a bottle during the day are not nearly as important as feeding baby at the breast when the dyad is together and feeding overnight on cue.

“Safe bedsharing is what facilitates this and results in continuation of breastfeeding far longer than separate surface bedsharing, sleep training, and feeding a pump rather than the baby,” she explains.

In particular, physicians have long struggled with “pouring from an empty cup” alongside being influenced by insidious industry tactics, mechanical culture and inadequate education. Nikki Lee and I wrote about these forces in Physicians as parents: How can one pour from an empty cup? and Physicians as breastfeeding supporters.

In New study calls for greater access, equity for breastfeeding surgeons author Hilary Brown reports on “A new vanguard of physicians… determined to make the field more hospitable to working mothers by establishing dedicated pumping spaces and allotting time for pumping without fear of retribution or punishment.”

Brown goes on, “… No one should be denied professional opportunities just for choosing to have a work-life balance. For too long, surgeons were lauded for not having families, or prioritizing their work over a personal life. To be a martyr to the field was considered the highest level of dedication. But ultimately, such devotion has proven to be a detriment. Excellent patient care, London-Bounds says, starts with self-care.”

Dr. Mitchell acknowledges that “..the surgical world is becoming more attune to this topic.”

In 2020, the Association of Women in Surgery released a position statement on supporting physicians and trainees who are breastfeeding.

In regard to lactation accommodations in the workplace though, Dr. Mitchell says she often thinks of something Kimberly Seals Allers pointed out many years ago when she said something along the lines of: “We are a pump nation — we shouldn’t be celebrating being gifted a pump from our medical insurance.  We should be demanding adequate paid maternity leave.”

“Accommodations should really be focusing on this governmental-level change,” Dr. Mitchell elucidates.  “Not only is it the right thing to do for human beings, but it reflects one of the fundamental principles of economics 101:  opportunity cost.  You lose some productivity up front by giving mom a longer maternity leave, but you exponentially recoup this cost when moms breastfeed rather than wean and have good mental and physical health when they return to work.”

In this landscape without paid leave, there can be a layer of tension that brews between colleagues.

“A  lot of the hostility towards lactation and lactating patients does stem from physician personal experience with lactation (which was unfortunately largely negative in the past, and can persist today no matter what accommodations we provide),” Dr. Mitchell begins.

“And these negative experiences are a direct result of the medical patriarchy, which provides little to no education on the breast and lactation in medical school, residency, or fellowship training.  Because of this, just like all other patients, physicians themselves are at risk for not receiving appropriate evidence-based support and education surrounding lactation and breastfeeding.”

She continues, “As we all know, the postpartum time period is one of great vulnerability, and a person’s experience with breastfeeding can play a central role in how they navigate early motherhood.”

Juxtaposing the way that we look at lactation and breast cancer care, Dr. Mitchell says that we would never tolerate breast cancer care as being reflective of personal experience, but this often happens with lactation.

“With breastfeeding, there’s the dismissive comments of ‘oh, it didn’t work for me, so it’s fine it doesn’t work for you.’  We would never say ‘that chemotherapy didn’t work for me, so it’s ok if it doesn’t work for you,’” she explains.

Clear to recognize that this is not the fault of the individual, Dr. Mitchell says it’s instead a reaction to “the fact that the patriarchy didn’t support them, either.”

And so, to influence real change, we have to start at a systems level in medical education, she says.

Training needs to include education about things like safe bedsharing, how formula feeding and breastfeeding are vastly different in terms of volume and infant behavior (e.g. the normal distraction of a breastfed infant at four months old versus a bottle fed infant taking a bottle on schedule), Dr. Mitchell explains.

“…This should be standard education for all of us.”

Physicians from less traditional backgrounds have great power to drive change too, Dr. Mitchell suggests, sharing her personal experience:  “I am the only person in my generation on one side of my family to go to college, much less medical school.  Three quarters of medical school matriculants come from the top two household-income quintiles — I was not one of them.  Since I was a teenager, I worked my way through school.  I had a liberal arts background and undergraduate degree, and I think all of this made me see things from a different perspective than other medical students and physicians.  I was also lucky that my mom pushed back against the tide of formula feeding in the late 1970s, and I was a breastfeed infant myself because of this.”

In a powerful Instagram post, a photo snapped by her seven-year-old son is captioned “I love this moment because it’s the ultimate rebellion against corporate medicine. No one can take away the power of human connection.”

The post is commentary on a simpler, more connected way of caring for patients.

“Instead of a patient having to login to the EMR or deal with a centralized scheduling call center to make an appointment, [the post] reflected the way we used to care for people in medicine and what I try to preserve as much as possible:  a patient needing help, contacting me directly on a weekend, us all going in with casual clothes and me just doing my job as a doctor,” Dr. Mitchell explains. “ No electronic medical record, no ‘15 minutes with each patient’ corporate mandates, no ‘you can’t do this or that’ by the administration.”

Ironically, Dr. Mitchell continues, she’s noticed that corporate medicine has made certain aspects of lactation accommodations better.

“The one positive aspect …is oversight and standardization and human resource departments,” she says.   “If there’s a law for accommodations, there is someone enforcing them (along with all the other not-so-helpful ‘enforcements’ like clicking through countless screens in the EMR simply to write a quick note on a patient).”

During the 2020 COVID-19 pandemic, Dr. Mitchell created the Physician Guide to Breastfeeding, a hub where she’s committed to sharing openly and advocating for improvements in broader maternal child health education. You can explore her collection here.

Where are they now? Checking in with Stephanie Hutchinson of the Appalachian Breastfeeding Network (ABN)

In May 2016, Stephanie Hutchinson (then Carroll), MBA, BS, IBCLC  and a few of her colleagues launched the Appalachian Breastfeeding Network (ABN), “dreaming that one day [Appalachian] parents would have the access to lactation care that they deserve.”

In just one year, the network grew to 11 states and 250 members. By the time the organization was five years-old, the network  grew “to over 600 members across all 13 states in Appalachia – and beyond!” Today, ABM “continues to grow in its membership, its capacity, and its visibility.” [Retrieved from: https://www.appalachianbreastfeedingnetwork.org/abn-board.html

 

Then

When Our Milky Way first featured Hutchinson in 2017, she said that the exponential growth was not expected, but also not surprising. 

“There was absolutely no organization that grouped Appalachia as a culture, together, to make an impact for change,” she said.

 

 

and now.

Almost a decade later, Hutchinson serves as the President of ABN and Administrator of their 24-Hour Breastfeeding Hotline. She also works in private practice as the owner of Rainbow Mountain Lactation, is an instructor and administrative assistant/media manager for Lactation Education Consultants

This year, ABN will host its first cohort of Appalachian LATCH (Lactation at the Center of Healthcare) Leaders which is their train-the trainer program. With grant funding provided by Gallia American Community Fund of the Foundation for Appalachian Ohio (FAO) and the I’m a Child of Appalachia Fund®, they will offer 20 scholarships for registration to the course. 

Many years ago, before the birth of her daughters, Hutchinson shared that she never anticipated doing the work she’s been engaged in, but as we often say, “All roads lead to breastfeeding.” Now, reflecting on the most significant change she’s noticed in maternal child health in the last decade, Hutchinson says, “As a member of the LGBTQ+ community, I have noticed more inclusivity in education and support for all families. I am happy to see such wonderful changes to include everyone who is lactating.” 

And the most helpful lesson she has learned along the way is to say ‘no’. 

“This has probably been my hardest lesson learned, but there is only one of me and I know I cannot do all the things,” she reflects. “It’s okay to refer out to someone else, say no to a speaking gig, not go to every conference possible, and take care of myself. Once I learned this hard lesson, I noticed I am able to give more to my clients and my own family…I know that I am not the lactation consultant for every person and humbling yourself to collaborate with others will help your practice tremendously.”

Photo by Elijah Mears on Unsplash

Looking forward, Hutchinson says: “In 10 years, I hope Appalachian Breastfeeding Network has been able to grow enough to fit more into our budget and reach more parents, especially in those areas with little to no lactation support. It is my vision to duplicate our hotline and make it sustainable and available to anyone, anytime, for as long as possible. On a personal front, I hope to see my kids happy and thriving as adults and live out our empty nester lives.” 



Full spectrum doula facilitates multilateral programming to support BIPOC breastfeeding

When Meah El, SFW, TCP, CBE, a Full-Spectrum Doula, Education Specialist, Doula Team Leader and Cribs for Kids Coordinator at The Foundation for Delaware County, was just eight years old, she landed her first job. On summer trips to New England, El would help her aunt in her in-home daycare.  When her aunt gave birth to a premature baby in her late forties, El was the only one her aunt trusted in helping out with the baby.

“I always say that my career found me,” El reflects.

She stayed on this early education career path, later working with Maternity Care Coalition as an Early Head Start advocate. Through this work, she became trained as the first doula at their site.

“I loved it ever since,” she says. “Birth work is the crème de la crème.”

El remembers one of her first clients, a 15-year-old mother, and struggles to put into words just how amazing it felt to help a birthing mother.

To enhance her ability to support lactating and breastfeeding clients, El took a breastfeeding course with Nikki Lee  and now, she is one of the latest recipients to earn the Accessing the Milky Way scholarship which covers the Lactation Counselor Training Course (LCTC). A colleague of hers is also working through the LCTC, so they have scheduled a weekly meet up to review the course material together.

El is dedicated to helping BIPOC families reach their breastfeeding goals and dedicated to improving overall health within BIPOC communities through healthy infant feeding.

While Chester and Delaware counties have relatively high breastfeeding initiation rates, the overall infant feeding culture “hushes” breastfeeding, and BIPOC families are up against barriers to breastfeeding like lack of education, familial support, and skilled lactation care, as El explains.

During Black Breastfeeding Week (BBW) 2023, El facilitated a celebration complete with henna artists, reiki sessions, infant foot massage, aromatouch hand massages for parents, brunch and a breastfeeding photo shoot. El will curate the images from the photo shoot into an art installation during next year’s BBW celebration.

Moreover, El is working to establish a lactation cafe, a peer breastfeeding support group run by breastfeeding champions in the community, and mini trainings for staff at The Foundation.

Logo by Meah El

In order to combat breastfeeding misinformation on social media, El will create social media “shorts” with practical breastfeeding information that will be disseminated through the organizations channels. El is also in the process of working with the Pennsylvania Chapter of the American Academy of Pediatrics (AAP) to recognize breastfeeding-friendly businesses.

All of these efforts are part of El’s goal to create a supportive environment around breastfeeding.

“If there’s no community support and no support at home, [the system] is built to fail,” El begins. “I want everyone to win.”

El encourages Our Milky Way readers to share their breastfeeding photos on social media and tag #delcobreastfeeds in order to normalize breastfeeding. She also reminds readers to explore the multitude of programs available at The Foundation for Delaware County. You can contact El directly for direction.

Reflections from a volunteer CLC working on naval base

Many of our Our Milky Way interviewees launch into their advocacy for
healthy infant feeding after they’ve endured personal situations with their
own babies. This is not Crystal Grask’s, CLC origin story into the world
of breastfeeding though.  Now the mother of a darling little one, Grask
serves as a Red Cross volunteer lactation counselor at Naval Base Rota
in Spain, but her road to breastfeeding started before becoming a
mother.

We’re pumped to feature this interview with Grask this week on Our
Milky Way.

On discovering her passion for maternal child health…

I had really no insight into maternal child health until I found myself
interviewing for the Communications Coordinator position with the Rocky
Mountain Children’s Health Foundation and Mothers’ Milk Bank. Once I
obtained the role, I started working directly with Laraine Lockhart-
Borman, the then director of the milk bank…her staff… Donor Relations
Coordinators, Certified Lactation Educators, Doulas and more. I found
myself immersed in a totally new world and was soaking up the
knowledge like a sponge. Everyday I learned something new about
breastfeeding, donating human milk, or lactation and the impact these
things have on the mother-baby dyads and the families we served.
As I learned…I found myself becoming more and more passionate about
helping moms, babies and families have successful happy starts in life.
Through the RMCHF and MMB I learned about the the Lactation
Counselor Training Course (LCTC), learned about the importance of
breastfeeding, saw firsthand the impact donating and receiving donor
human milk had on mother-baby dyads and families, and was able to
observe and glean insight into dozens of parents’ feeding journeys
through the Foundation’s  programming and milk bank’s weekly Baby
Cafe pregnancy and postpartum moms groups.

On completing the LCTC…

… Life happened, and I was unable to take the course during my tenure
at the [RMCHF], but the passion didn’t go away. It continued to blossom. I moved to Washington State where the course wasn’t offered,
but I remained passionate and steadfast in my desires using my
previous knowledge about breastfeeding/lactation to help providers (OBs
and Pediatricians) communicate with their patients about breastfeeding. I
knew I still wanted to work in this realm, and decided that once I was
able to obtain my CLC certification, I would like to pursue a private
practice.

In 2020, the course became virtual, which allowed me to start my
training! I started in December of 2020, and soon after, we moved to
Spain with the Navy. It was there I finished my training, in June of 2021. I
loved the virtual nature of the training and found – even when I was an
ocean away – I could tune in, interact during office hours, and complete
the course with ease. I really appreciated that!

On her own breastfeeding journey…

Flash forward five years… I found myself breastfeeding my daughter,
Julieanne, and having a rough journey. We started off feeding well,
resolving minor latch issues right off the bat. However, despite having a
small but adequate supply, she struggled to gain weight. Our pediatrician
immediately suggested formula supplementation, and I struggled with
that suggestion. My husband was a huge supporter of breastfeeding,
and also felt like there wasn’t a huge need to supplement. I was able to
reach out to prior colleagues… for observations, but neither of them
could find anything truly amiss. My daughter latches well and has always
been very healthy, but didn’t gain weight well no matter how much or
what we were feeding her. We discovered she has a very high
metabolism and strong passion for eating, so I found myself feeding
round the clock, triple feeding for a few weeks, and eventually settling
into a combo-feeding routine. While it wasn’t my picture perfect image of
how our breastfeeding journey would go, I am proud to say we’re still
largely breastfeeding and she’s gained a significant amount of weight.

Photo by Taylor Marie Photography

I hope to help moms receive the support I lacked in the immediate
postpartum. With consistent help and follow-up observations, perhaps
we wouldn’t have needed to supplement. I want to be that resource for other moms, to help them feel validated, encouraged to meet their goals,
and support them no matter what their feeding choices are.

On landing her volunteer CLC position at the naval base…

One of the first things I noticed after arriving at Naval Base Rota was the
multitude of pregnant women around. We were still living in COVID
times, and I quickly learned while there was support for moms to
breastfeed from a command standpoint, there were not many staff or
programs available to support the station’s breastfeeding dyads either in
hospital or at home postpartum. I knew I could help bridge this gap.
After exploring a few different avenues, I found I was able to sign up with
the Red Cross as a volunteer CLC at the Navy Medicine Readiness and
Training Command Rota (Naval Hospital Rota) Maternal Child Infant
ward! This role gives me the unique opportunity to help moms within
hours after delivering her baby, and help these dyads and families start
their feeding journeys feeling confident and supported.

On a typical day in this role…

I come in, check in with the nurse on duty or head nurse for a rundown
of our patients to learn about their delivery(ies), their baby, their current
health situation, and how feeding has been going thus far. I also ask if
mom/family has presented them with any concerns/questions about
feeding thus far, so I can be as prepared as possible when I first meet
with a mom.
After ensuring I have all the information/resources ready, I go meet with
the mom/baby dyad/ family. While in their room, we talk about how mom
is doing, I meet their new little one, and we go over how their feeling
about feeding thus far. I often provide latch assessments, and observe
feedings while in the room as well. Sometimes, during this, we’ll be in a
more relaxed setting, and mom will ask questions about any concerns
she has for when she goes home, which I answer or refer her to her
provider or the base’s Visiting Nurse if it’s a subject outside of my scope.

Once my initial visit is over, I will make a follow up plan with mom if
desired, then input notes and do any supplemental research for her. At
my follow up visit (usually that day or the next) I will give her any
resources we discussed and provide answers to her questions.
In the LCTC, we focused a lot on listening to mom, hearing her story and
using that, her experience and her health history to guide our
counseling. I think I use that often to meet moms where they are and
give them the care they deserve. I also find I’m teaching the asymmetric
latch often, even to second and third time moms! I also cover hand
expression and storage guidelines often. We get a lot of questions
around pumping and building a stash of milk for returning to work,
especially for active duty moms.

I have also started seeing postpartum patients in the hospital’s OBGYN clinic.

On unique challenges…
Grask at Rota Breastfeeding Week 2023 presenting topics like skin-to-skin and hand expression 

I think there is a strong desire to help breastfeeding moms here, but
there is an apparent lack of resources, especially for postpartum moms.
The community has one Visiting Nurse who is a rockstar seeing many
moms daily, but she’s unfortunately the only one able to do so at the
moment. To help bridge this gap, I’ve gained approval to have a small
business, Asbury Breastfeeding Counseling, and am offering my
services to moms in the community in addition to my work as a
volunteer. I’m also working with the Visiting Nurse and hospital MCI
leads to host monthly breastfeeding courses at the hospital, promote the
existing pregnancy and postpartum support groups, and soon will be
offering a BYOBB (Bring Your Own Baby and Breastfeed) class at the
hospital for new moms to learn the various positions they can breastfeed
their babies in and be available to answer any questions/troubleshoot
any feeding/latch issues in person.
We also hosted Rota Breastfeeding Week helping educate the
community here on what is available for new moms and showcasing the
various lactation spaces. We also had a latch on nursing event.

On goals for next year…

 

Over the next year, I hope to reach more moms and families to help
them feed successfully… I know this community’s resources are slim. I hope to establish these classes and have imparted education to staff so
when I ultimately transition out of this station, I know I am leaving moms
with supportive providers who can help her achieve her goals.

Some favorite breastfeeding stories…

While working at the Mothers’ Milk Bank, I was able to sit in on several
Baby Cafe postpartum support groups. During a few of these groups, I
met a parenting duo and their little one. No matter what they did, this
mom struggled to make enough for her little one, but desperately wanted
to make breastfeeding work. I listened and observed them for weeks,
learning from their interactions as a couple, parents and individuals and
gleaning insights from the [lactation care provider]  helping them.
Ultimately, I believe they began to feed with donor milk and formula, but
it was their journey and the persevering passion to help their baby and
family thrive that left an impression on me.
Here in Rota, I have been lucky enough to see a few of the moms I’ve
helped in early days several months postpartum. Two such dyads come
to mind. One was a new mom, baby born a couple weeks early had had
an ample supply of milk. Due to her baby’s early arrival, the baby was
transferred to a Spanish hospital where they received formula instead of
her breast milk. I saw her about five days postpartum and her milk
supply had fully come in but the baby was fussy and struggled to latch.
We worked on several techniques, including skin-to-skin care, cross-
cradle and football holds, asymmetric latch and also discussed ways to
pump/store milk. I was worried as this mom seemed to be ready to give
up quickly, but I ran into her six months postpartum and her once small
baby was now thriving on breast milk! It was a beautiful thing to see and
she is still breastfeeding.
In January, I served the family who had the first baby of the year. The
parents were first time parents, and had no idea what to expect or how
to navigate breastfeeding now their arrival had made her debut. Mom
and I worked on recognizing feeding cues, latching, promoting skin-to-
skin care, using dad for support, and discussed various ways to pump– hand express, manual, double-electric, wearables, to help her build a
supply later on. Soon after I had my own baby, I ran into this mom at a
moms group and found breastfeeding was going well for her! Her little
one was steadily gaining weight and she felt confident in her feeding
routine and encouraged by the support she had received early on. I was
elated at this update and so happy to see them thrive.
Personally, breastfeeding hasn’t been as easy as I’d like, but when I feed
it is the most wonderful, almost indescribable feeling. One of my favorite
stories I have is from my early postpartum days. I had been hanging out
skin-to-skin with her on the couch and accidentally fallen asleep. A little
while later I awoke — to a baby suckling on my breast! I had heard and
known about a baby’s natural instinct to find the breast, but I hadn’t expected her to seek it out and find it on her own when she was so new
to the world. Now she giggles whenever she sees my breast and is
especially excited for boob food time!

‘Full pandemic mama’ becomes full spectrum doula

Allysa Singer was, as she describes, a “full pandemic mama.” Singer became pregnant with her first child in the winter of 2019. As she became aware of the threats and the consequences of COVID-19, she started researching her options and her rights in the delivery room she’d find herself in August 2020.

What started as personal preparation– How many support people would she be allowed? Would she be allowed a support person at all? What restrictions would she encounter? How could she advocate for herself? What were her options?–  propelled her into a world of birth support and autonomy advocacy.

“I was just dumbfounded by the disparities that exist in maternal health,” Singer begins.

In 2020, Alabama, where Singer and her family live, had the third-highest Maternal Mortality Rate in the nation, at 36.4 per 100,000 live births.

BIPOC families suffer from massive disparities in maternal and infant deaths. In a recent piece, Childbirth Is Deadlier for Black Families Even When They’re Rich, Expansive Study Finds, Tiffany L. Green, an economist focused on public health and obstetrics at the University of Wisconsin-Madison is quoted: “It’s not race, it’s racism…The data are quite clear that this isn’t about biology. This is about the environments where we live, where we work, where we play, where we sleep.”

Still, unlike so many of her peers, Singer reports having had an amazing birth experience.

Inundated by birth horror stories, she decided to change care at 27 weeks in hopes that she would be better supported in her choices at a different institution.

Here, she was allowed a doula and support person to accompany her during her birth.

“Not a lot of women had that luxury,” Singer comments.

Knowing well that birth support is a right and not a luxury, she started her own doula practice in December 2021. 

Singer shares that she experienced severe postpartum depression, but she was able to divert and ultimately reshape this energy into her doula work.

“My doula training was the lifeboat that saved me from drowning in my PPD,” she says.

And now her practice, Faith to Fruition, has become the lifeboat for many of the birthing people Singer supports.

She shares: “I don’t believe that a birther’s desire to have more children should be dictated by their birthing experience. I have heard so many stories from people who had one kid but say, ‘I would never do this again because my experience was so traumatic.’ One of my biggest missions and goals is to support birthers to feel empowered in their process; not as bystanders of their process.”

Singer also holds a full time position as an industrial psychologist where she channels her advocacy work, pushing for organizational change and understanding of proper maternal support.

In fact, as part of a public speaking course for a training curriculum, Singer presented on why it’s important to support breastfeeding. She reports that her audience of roughly 25 was engaged, especially as she pointed out the absurdities of infant feeding culture in our country: How would you feel if I asked you to eat your meal in the bathroom? How would you like to eat with a blanket tossed over your head? for instance.

Singer also points out the “insanely amazing public health outcomes” breastfeeding affords.

If 90 percent of U.S. babies were exclusively breastfed for six months, the United States would save $13 billion per year and prevent an excess 911 deaths, nearly all of which would be in infants ($10.5 billion and 741 deaths at 80% compliance). [Bartick, Reinhold, 2010]

“Not only is there a personal investment, there is a public investment and value to understanding the larger implications,” Singer comments. “As a taxpayer, [breastfeeding] impacts you; as someone who utilizes our healthcare system, [breastfeeding] impacts you.”

With the recent passing of the PUMP Act and the Pregnant Workers Fairness Act coming soon, Singer says “We still have a long way to go.”

Organizational policy doesn’t support motherhood; instead it fuels detached parenting which goes against nature, Singer goes on.

“Mothers feel the brunt of that more than ever,” she says.  “[We aren’t] supported to be able to care for our children the way that we want to.”

Singer says she sees it as her mission as an organizational psychologist to encourage change that supports parenthood, so that women don’t feel threatened to care for their children the way that they want to. This means ensuring that women are provided with ample space to pump their milk while away from their babies and empowering them to approach HR when there aren’t appropriate accommodations.

“Outside forces shouldn’t be able to dictate how you care for and feed your child. The end of one’s breastfeeding journey should be a personal decision.”

She continues, “It’s amazing that legislation is catching up. The thing that I fear with any law, there are still people behind those laws that have to enforce them and carry them out. Education and garnishing an understanding of what this looks like is a key component to implementation. The people behind those policies have to make them successful, but this is  moving things into a very good direction, and I hope that more changes to legislation follow suit, especially with paid parental leave. It’s a catalyst for change; I am hopeful but cautiously optimistic.”

Singer says she owes her personal success continuing to breastfeed her two-and-a-half year old to Chocolate Milk Mommies, where she now serves as a board member.

Through Chocolate Milk Mommies, Singer started a subcommittee to focus on education for individuals within the breastfeeder’s support system.

“The people in the village need to be supportive. When you don’t know better, you can’t do better,” she explains.

Singer recently completed the Lactation Counselor Training Course (LCTC) as part of Chocolate Milk Mommies’ mission to best support their constituents and as a way to benefit her doula clients with more well-rounded support.

“I really loved the training because I already thought that our bodies are amazing, but learning more science was great. I would text my friends the ‘Boobie Fact of the Day’,” Singer shares. “[The science] allows me to really appreciate my journey that much more and how impactful I’m being with my daughter.”

You can follow Singer’s work here and here.