Taking ‘if’ out of the equation

In a remote town called Patmara in Nepal, there’s little doubt that women can breastfeed, Beth Amy Carter, MSN, RN, CNM of Montezuma County Health Department’s Montelores Nurse Family Partnership (NFP) reports. 

“Everybody breastfeeds,” she says. 

Carter poses with one of the health workers in the town of Patmara.
“She was so kind to me and stuck by my side the whole time we taught at her village,” Carter says.

Carter had the opportunity to venture to Patmara to teach women’s health alongside colleagues and friends visiting on a research visa. After a couple of flights, and a hike up the valley, she spent three weeks teaching health care workers and village women about female anatomy, cycles, birth and beyond. 

What she learned was how effective simple support can be. 

Carter explains:

“The four health workers in that village are each responsible for 19 families. They make home visits and hold monthly teaching for the families in their village. 

The health care workers are not necessarily highly educated, but they are trained to support [the women]. They know about the 1,000 Golden Days…and just by supporting the women in the community, they have changed the health of their babies and breastfeeding durations.

Pretty amazing what dedicated, compassionate women can do to support one another.”

 She notes that these health care providers are unpaid volunteers.

Carter used a knit uterus– complete with a removable endometrial lining and egg– that one of her colleagues created as an educational tool.

Because people in Patmara don’t consistently have access to clean water or safe artificial formula milks, breastfeeding is the expectation. 

Health care providers measure infant and children’s weight once a month for the first five years of life.

“If someone falls off [the growth curve], then they supplement,” she continues. 

This phenomenon is what Carter brought back to share with the families she works with through NFP in her corner of the world. 

“…Let’s remove that doubt,” she says of breastfeeding. “If you need support, we will support you, but take the ‘if’ out of this equation.” 

Once a practicing nurse-midwife, Carter says that her work with NFP better meets her mission to serve families; it allows her to create long(er)-term relationships.

The goal is to enroll expecting mothers before their 28th week of pregnancy to ensure ample prenatal support and education. In rural Montezuma, Carter says it’s not always prenatal care they’re focused on; sometimes there are substance abuse issues to address and other unhealthy behaviors. 

Montelores NFP serves a large Ute Native American population. Generational trauma affects infant feeding in this community. 

“In a lot of situations, we are the only [ones] committed to modeling positive, healthy behavior,” Carter says. “We are consistent– always there for them. We are not there to do it for them, but we facilitate their success.” 

On a mission to create a more breastfeeding-friendly community, Carter and colleagues designed a Baby Oasis at the Montezuma County Fair over the summer. The pop-up pavillion featured comfy spaces with beautiful fabrics for mothers to feed their babies. Healthy snacks were provided in partnership with the local WIC office. 

Montezuma County Fair Baby Oasis
From left to right:
Delilah Mott (WIC), Carter behind her, Deborah Meyers RN (NFP), Donna Pettigrew (WIC), and Christa Zubieta RN (NFP) in the front.

Carter says she appreciated watching mothers nurse their babies together, chatting as they did. 

“Part of the goal has just been to build community,” she notes. “It seems like young women have a harder time building a young mom support group, so we are trying to help make those connections so they can support one another.” 

Carter and her colleagues also recently completed the Lactation Counselor Training Course (LCTC), and she says they are motivated to share the knowledge they gained with other health care providers in their area.

“The information was just fabulous,” Carter says.

Montelores NFP has partnered with Pinon Project to better serve families in the area too. Together they are in the process of establishing a breastfeeding committee. 

In September, they will host Celebrate the Bump and Beyond, a free family conference modeled after a professional conference with breakout educational sessions.  

Carter is optimistic about the future of families in her community. 

“I work with fabulous nurses who are passionate about supporting women,” she says. “It’s really neat to have the privilege to do that. We have the chance to build a community to change what health looks like here.”

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