Lives and legacies of late maternal child health advocates: Dr. Audrey Naylor

Photo by Alex Guillaume on Unsplash

The evening darkens early this time of year. There’s a crunch of blanketed autumn leaves when I walk the neighborhood trails; dormant, woody branches loom overhead. 

In my son’s school, student-made ofrendas welcome admiration and an opportunity to study Día de Muertos and the monarchs’ arrival.   

In my podcast feed– up next– a Bay Curious episode called “A Final Resting Spot for Furry Friends.”

In another, Wild Card, the host asks her contestant, “How often do you think about death?” 

I reflect on this myself. 

It’s been four years since I watched my grandma die, I realize. 

My step-dad, diagnosed with stage IV colorectal cancer in 2013 and then hit with two major strokes the following summer, announced last week that he will cease the invasive treatment he’s endured all of these years. All of these years, I have been bracing myself for his death.  We call him– in the most loving way– The Cockroach. This season, his death feels more present than ever. 

In the headlines, death tolls are also ever-present. 

So, how often do I think about death? It’s bombarding me as of late. 

I’m reminded of the saying: “Grief is a reminder of the depth of our love.” 

This month, that’s where Our Milky Way will take us. Each week, a commemoration revisiting publications about late maternal child health advocates. The World Alliance for Breastfeeding Action (WABA) houses a tribute page where you can learn about the lives and legacies of other advocates who we didn’t have the honor of featuring here. 

If you knew a maternal child health advocate you’d like to honor, please email us at info@ourmilkyway.org. 

We begin this series honoring Dr. Audrey Naylor. We featured Dr. Naylor’s work in 2013. 

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Dr. Naylor receives coin for her protection, promotion and support of breastfeeding at US Breastfeeding Committee meeting in August of 2010.

There are an estimated 300 billion stars in our galaxy. The collective twinkle of the thousands of stars visible to the human eye makes the night sky magnificent. But in a seemingly infinite galaxy, there are stars that always stand out. Polaris for example is famous for virtually standing still in the night sky. It serves as a celestial navigator in our endless sky.

Our Milky Way is made up of thousands of luminous stars working to promote, protect and support breastfeeding.  Like our night sky, the beauty of Our Milky Way is the collective, brilliant energy of all lactation professionals working toward a common goal. However, like Polaris our celestial guide, there are certain lactation professionals that serve to inspire upcoming lactation stars.

Dr. Audrey J. Naylor, MD is Clinical Professor of Pediatrics at the University of Vermont. Her distinguished career and humorist approach are both something to look up to.

While studying in San Diego, Naylor completed a clowning course with the local clown club.

“Somehow, when you get into clown make-up with a red nose it changes who you are!” she exclaims. “I have always carried a red nose with me. You never know when it will be useful.”

That clown nose is something remembered by lactivists everywhere, like Ryan Comfort of Milk for Thought.

With a lifetime interest in illness prevention, Naylor says she was quickly convinced of the power of breastfeeding after only attending a few hours of a breastfeeding seminar in 1976.

“Neither medical school nor pediatric residency taught me anything about breastfeeding,” Naylor says. Since then, Naylor has completed Healthy Children’s Certified Lactation Counselor training and agrees that there is always something more to learn.

On a mission to educate physicians and maternity care facilities around the world improve breastfeeding practice, Naylor and her colleague Ruth Wester founded Wellstart International in the 1980s.

In 15 years, Wellstart has educated 655 professionals from 55 countries including the U.S.

“They all did something significant,” Naylor says of the Wellstart Associates.

Colonel Roseanne Warner, US Air Force presents Dr. Naylor with medal.

Stressing the importance of collaboration between professionals, Naylor explains that the Wellstart program’s design brings multidisciplinary teams of healthcare providers together including obstetricians, pediatricians, family practitioners, nurses, nurse midwives and nutritionists.

While collaboration isn’t always easy, it’s essential when it comes to serving mothers and babies.

Naylor offers this advice to beginning lactation professionals on how to work with medical clinicians in the care of breastfeeding moms and babies: “Know that the medical clinicians are very interested in the wellbeing of the patient,” she says. “Many know nothing about lactation and breastfeeding but can’t admit it.”

Naylor suggests staff review Wellstart International Self-Study Modules Level I. She says this approach does not offend the medical clinician’s lack of basic knowledge.

Through its trainings and other involvement in the medical community, Wellstart has “changed the care given to mother-baby pairs in hundreds of hospitals, modified curriculum in a significant number of professional training programs, contributed to hundreds of thousands of secondary training events and contributed to the global expertise regarding lactation management.” [Retrieved from:http://www.wellstart.org/about.html]

Naylor’s activity in many groundbreaking breastfeeding events is equally inspiring.

She was present at the Innocenti Declaration, a WHO/UNICEF policymakers’ meeting that declared specific actions to be taken to protect, promote and support breastfeeding around the world.

She attended the 1984 Surgeon General’s Workshop on Breastfeeding and Human Lactation which described several infant feeding recommendations for our nation and resulted in various breastfeeding promotion activities.

Service women from Aviano Air Force Base (a US base in Italy) who breastfeed exclusively for a specified time period also receive this coin for their commitment.

She was also involved in the founding of the United States Breastfeeding Committee. After conducting an intensive needs assessment of breastfeeding activities in the U.S., the National Alliance for Breastfeeding Advocacy (NABA) and Healthy Children Project convened to satisfy one of the four operational targets set by the Innocenti Declaration “to establish a multi-sectoral national breastfeeding committee composed of representatives from relevant government departments, non-governmental organizations, and health professional associations in every country.” [Retreived from:http://www.usbreastfeeding.org/AboutUs/History/tabid/62/Default.aspx]

At the August 2010 meeting of the US Breastfeeding Committee, Colonel Roseanne Warner of the US Air Force awarded a coin to Dr. Naylor on behalf of Aviano Air Force Base in Italy in recognition of her ceaseless efforts to protect, promote and support of breastfeeding.

Among the many landmark events Naylor has been involved in, she’s unable to pinpoint one in which has influenced her most deeply.

“They have all had their place in the work that I have done,” she says.



Happy World Breastfeeding Week and National Breastfeeding Month!

It’s World Breastfeeding Week (WBW) and National Breastfeeding Month (NBM)! This time of year, we come together to celebrate our successes, reflect on the challenges we’ve overcome and those that are still ahead, to continue our momentum and reignite passion and purpose.

The 2024 World Breastfeeding Week campaign’s focus is on survival, health and wellbeing. It showcases the need to improve breastfeeding support to reduce inequalities that exist in our society with a special focus on breastfeeding in times of emergencies and crises. There are so many ways to engage. Check out this interactive map here. 

And this year’s NBM theme, Nourish, Sustain, Thrive, shines a light on why protecting, promoting, and supporting lactation is so important for the human life cycle. This summer, we honor the incredible work that organizations are doing to make the world a little more friendly for new parents and families, and highlight how individuals, funders, and policymakers can contribute to a strong and sustainable lactation field. 

We are excited to kick off NBM sharing a short Q&A with U.S. Breastfeeding Committee’s Senior Collective Impact Coordinator  Erin Fortuna, IBCLC. Among her many amazing achievements, Fortuna designed the beautiful NBM logo.

Fortuna’s personal, adverse experiences with birth and breastfeeding in 2017 led her down the path of wanting to make a difference for people in her community, particularly in service to LGBTQIA+ families. As a queer parent, she became a peer-to-peer lactation counselor because she says she wanted to better support those who wished to feed their babies human milk. This ultimately led her to her journey toward becoming an IBCLC.  In 2022, when she came to the USBC, she was newly postpartum with her second child and “knee-deep in the throes of [on-cue] nursing a 3-month-old, constant diaper changes, and all the challenges that come along with new parenthood…at the same time navigating a career change.”

“The USBC was so incredibly accommodating, which enabled me to nurse on demand for an additional two-and-a-half years,” Fortuna continues. “I knew that my ‘luck’ in having this flexibility shouldn’t be luck at all – this should be the standard! From paid leave to equitable lactation support compensation, this journey is a long and winding road toward change, and I am grateful to be a part of such a hardworking team dedicated to a vision for thriving families and communities.” 

Q: What else makes you proud to be a part of USBC?

A: Honestly, so much work happens behind the scenes at the USBC, and this is exciting for me! I get to see organizations come together to collaboratively work on a common goal and knock down barriers that previously separated them. I get to learn from those in the field who are breaking barriers to get the work done and carving their own path to progress. I get to be there to support and celebrate legislative wins and learn how to navigate the disappointment when efforts become derailed or stalled. It’s pretty incredible to watch these building blocks get stacked at the USBC and built as a collective! 

Q: What are you most looking forward to this NBM?

A: I love seeing how many organizations and community-led initiatives create events and celebrations for National Breastfeeding Month. From cultural weekly celebrations to milk banks to hospitals to lactation support programs, every year, I look forward to seeing photos of celebrations and achievements shared with the USBC! It’s a really exciting time, and the momentum from all the awareness generated and the actions taken in support and celebration of NBM-related activities can continue to have an impact year-round.

 Q: You created the NBM logo to reflect “a special harmony and peace that aligns when a nursing dyad’s needs are met.”  Can you please describe your approach to creating the design? 

A: I have been exploring the possibilities of AI generation as it relates to people and faces. We have such limited access to stock images that it becomes challenging to not use the same parent-and-baby or breastfeeding-baby photo that the rest of the field is using. The USBC does have a photo gallery that organizations can use for non-commercial, educational purposes, but I was looking for a new face!  With the help of AI tools, I was able to generate a generic likeness of a dyad that harnessed feelings of harmony and togetherness. From that image, I creatively styled it to reflect a more illustrated and colorful feel. I really wanted it to feel vibrant and lively but also “close to home” for those partners and organizations that would ultimately use it. My hope is that even if the likeness of the dyad doesn’t resonate with folks, the warm embrace between the parent and baby will.

One of my favorite things about NBM is seeing the creativity behind each weekly observance logo and how each organization makes its celebration(s) unique. I like to collect things that support the efforts of these observances like stickers and t-shirts. I have a whole drawer full of them at home!

Q: What’s the best way for folks to get involved with USBC’s important work during NBM? 

A:  Be sure to subscribe to USBC communications! In each edition of our Weekly Wire newsletter, starting in mid-July and ending in mid-September, there is a special section related to National Breastfeeding Month activities. We have a searchable archive of past editions, a form to submit news and information for future issues, and an open call to the field asking for NBM-related activities that the USBC can amplify. Our team sends emails throughout NBM: offering opportunities to celebrate, learn, connect, and take action to help create a landscape of breastfeeding support for families across the U.S. We hope your readership will join us in making a difference this National Breastfeeding Month!

 

A few more suggestions from OMW on how to participate in WBW, NBM and beyond

Raise awareness by purchasing your NBM gear here. 

Healthy Children Project has released a new round of Accessing the Milky Way scholarships in celebration of WBW. Apply here.

Coffee and tea chats hosted by the Academy of Breastfeeding Medicine will be available throughout WBW.  

Watch the Global Breastfeeding Collective’s replay of Are we there yet? and register for Strength in Numbers. 

Acquaint yourself with corporate wrongdoing, the forces that seek to destroy the power of the mother baby dyad.  



Happy World Breastfeeding Week 2023: Making a difference for working parents

Logo by WABA

We’re abuzz with excitement for World Breastfeeding Week: Making a difference for working parents! This year’s theme is especially relevant in the U.S. with the recent passing of the PUMP for Nursing Mothers Act and Pregnant Workers Fairness Act. Yet, we remain one of the only countries with no paid family leave.

In celebration of the triumphs and in hopes of a better future paved by the hard work and passion of countless advocates, we’re looking back on Our Milky Way stories in the workplace.

  • The 2015 World Breastfeeding Week theme, Breastfeeding and Work Let’s Make it Work!, inspired Alyssa Sheedlo’s, RD LDN, CLC sharing of her story about providing milk for her triplets. Her story was originally published by the World Alliance for Breastfeeding Action (WABA). Read it here.
  • In a male dominated field, Alameda County Sergeant Misty Carausu blazed  trails for mothers working in law enforcement. Carausu was granted an initial three thousand dollar budget to renovate an existing lactation closet at the county jail. Read that story here.
  • Laura Westover PA-C, CLC, a provider at Castle Rock Pediatrics, dove into helping transform her office into a Breastfeeding-Friendly Employer and ultimate Breastfeeding- Friendly Medical Office.Westover worked alongside a  breastfeeding policy specialist to create their policies and lactation spaces through a six-point plan which includes policy, staff and provider training, patient education, environment, evaluation and sustainability, and continuity of care. Read the whole story here.
  • Learn about Zambian Investment Management and Banking Professional Musa Imakando-Mzumara’s perspective on breastfeeding and how it fits into the solution of national challenges here.
  • Look back on efforts by Scott Behson, PhD, creator of the Fathers, Work and Family (FWF) blog, to shape work policies here.
  • Passionate about breastfeeding support from both a personal and social standpoint, clinical researcher at the University of Colorado Dr. Bridget Young, PhD, CLC volunteered her time redesigning three lactation rooms and adding four newly designated lactation rooms at the University of Colorado Anschutz Medical Campus. Read about her efforts here.

 

We’d be honored to share your story about balancing employment and breastfeeding on Our Milky Way! Please email us at info@ourmilkyway.org with interest.

Cheers to a Happy World Breastfeeding Week and National Breastfeeding Month! Follow the WBW social media channels to stay up to date on all of the festivities @waba.wbw, @wabasecretariat, @waba_global and @wabasecr!

 

Helpful resources from A Better Balance and WorkLife Law:

Talking to your boss about your pump (Spanish)

Talking to your boss about your “bump”

 

It’s World Breastfeeding Week! Celebrating how Nurturing Care Centers of Excellence step up for breastfeeding

Tomorrow we kick off World Breastfeeding Week (WBW) 2022! As always, WBW is a time to focus, reflect, galvanize and forge forward protecting, promoting and supporting breastfeeding to address inequalities that stand in the way of achieving Sustainable Development Goals in commemoration of the 1990 Innocenti Declaration.

Coordinated by the World Alliance for Breastfeeding Action (WABA), this year’s theme, Step Up for Breastfeeding: Educate and Support, focuses on strengthening the capacity of actors at different levels of society to protect maternal child health and ultimately global health. Target audiences including governments, health systems, workplaces and communities make up the warm chain of support for breastfeeding and must be informed, educated and empowered to strengthen their capacity to provide and sustain breastfeeding-friendly environments for families in the post pandemic world. [https://worldbreastfeedingweek.org/] 

The following story is an example of multi-level engagement– from community members to the Ministry of Health– working toward the shared goal of ensuring food security and reducing inequalities.   

 

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Photo by Trevar Skillicorn-Chilver

There’s a sliver on the globe, a place called Timor Leste, one of the newest countries in the world. It gained independence from Indonesia in 2002.

In the spring of 2021, the small island country of about 1.3 million people endured major flooding, killing 44 people and affecting over 30,000 households. [More figures about this tragedy can be found in the OCHA situation report here.]  

Prior to the flooding, families in Timor Leste were already challenged by extreme child malnutrition. One in 24 children under five years old will not survive to celebrate their fifth birthday. [UNICEF 2018]

Nearly 2,000 people were displaced during the flooding, seeking safety at evacuation centers and camps. As is often the case during emergencies, those in Timor Leste dealt with the subsequent flooding of infant formula, baby cereals and feeding material donations. Artificial feeding methods can be dangerous especially during emergency situations and undermine breastfeeding.  

Dr. Magdalena Whoolery reported in Strategies for Infant and Young Child Feeding in Climate-Related Emergencies that the Indonesian Bank donated 180 kgs of infant formula during this emergency. The conditions in the camps are dire, she said. The situation did not welcome a safe environment for artificial feeding. Dr. Whoolery went on to show photos of children eating artificial milk powder from packages. 

In an effort to properly serve those facing disasters and emergencies, Whoolery and her colleagues developed the first “Nurturing Care Centers of Excellence (NCCE) for Emergencies and Beyond”, a cost-effective and innovative package of care for rapid integration of MCH-IYCF recommended practices. The centers were developed based on WHO’s five components of nurturing care. 

Whoolery proudly reported that over 1,000 families were supported through NCCE; 571 children under 5 and over 600 lactating and pregnant women.

The initiative included strategies like emphasizing the importance of skin-to-skin.  While skin-to-skin is often overlooked during emergencies, it helps mothers continue producing milk, offers calming effects to both mother and child and limits child trafficking because there is zero separation of the dyad. 

The program offers instruction on relactation and bottle amnesty where caregivers are made aware of the risks of bottle feeding and offered cups in exchange for their bottles. 

NCCE places an emphasis on cooking traditional foods to uphold a sustainable food system. 

Community members are also trained to manage and intercept artificial baby milk and other ultra-processed food product donations. 

Following the successful pilot of NCCE at an evacuation center, and improved outcomes of maternal, child and infant health and nutrition, the Ministry of Health requested UNICEF support in replicating the program in all 20 evacuation centers. NCCE is now integrated as part of the National Mother Support Group under the Alola Foundation’s directive. [https://www.globalbreastfeedingcollective.org/strategies-infant-and-young-child-feeding-climate-related-emergencies] 

Whoolery offers a higher understanding of these numbers and successes. Behind the statistics are children, she reminded us. Juxtaposed photos– the first of a 2 year old depicted with his arm measurement in the red (a danger sign for risk of death) and the next of him thriving, held by his smiling mother after she was able to feed him her expressed milk– demonstrate the power of human milk and the importance of supporting efforts like those of Whoolery and her colleagues.

Timor Leste’s “Country Profile for Early Childhood Development”, developed by UNICEF in collaboration with Countdown to 2030 Women’s, Children’s and Adolescent’s Health is available here. 

For more stories like this, read the Global Breastfeeding Collective’s Compendium of Skilled Breastfeeding Counselling Case Studies. 

#WBW2022

#WABA

#breastfeeding

#SDGs

#worldbreastfeedingweek2022

#buildingbackbetter

#stepupforbreastfeeding

#educateandsupport

#WarmChain

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