A Call to Our Healthcare Providers and Lactation Advocates

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As we mark the commencement of Black Maternal Health Week, a moment of reflection at the day’s end has brought to light a pressing concern that sits heavily with me. Living in the so-called city of medicine, we find ourselves amidst a paradox where the disparities in infant and maternal health are among the highest in the state. It’s a stark reminder of the work that lies ahead of us.

Here is one thing you can do each day this week to impact health equity.

  1. Observe and Act: I encourage you to take a moment to walk around the waiting area and other patient-facing spaces within your care facility. Look for formula advertising. If you find any, please consider removing it. This action, though small, can make a significant difference in promoting a breastfeeding-friendly environment.
  2. Normalize Breastfeeding: Check if there are posters or materials that normalize human milk feeding. If not, do you have the authority or the means to install a poster or display educational materials? Breastfeed Durham is here to support you with resources designed to foster an environment supportive of chest/breastfeeding. Order a new poster or print a new handout today.
  3. Review one technique
  4. Send an email asking about your Breastfeeding-Friendly Office Policy
    • If You Have One: Review it and share it.
    • If You Don’t: Email your leadership suggesting the adoption of a policy. Start with this sample policy for guidance.
  5. Complete one Breastfeeding University module. (20 minutes)
  6. Connect one family with Breastfeeding Community Resources
  7. Register today for Equity in Infant Feeding and Family Health Nutrition Workshops

Research unequivocally positions Breastfeeding Friendly practices as a pivotal method for bridging these health disparities. A notable study, “The Breastfeeding-Friendly Pediatric Office Practice” by Joan Younger Meek, MD, et al., in Pediatrics (2017), illuminates the transformative power of integrating breastfeeding support within pediatric care. This groundbreaking work, alongside inspiring outcomes from Mississippi, underscores the potential impact of concerted efforts in this domain.

This moment calls for more than reflection; it demands action. I encourage you to review the 14 best practices closely and consider how we, within our capacities and through our daily interactions, can advance these practices. Your expertise and commitment are invaluable assets in this endeavor, and together, we can make a substantial difference.

Here are the 14 best practices that we will delve into:

  1. Establish a Written Breastfeeding-Friendly Office Policy
  2. Train Staff in Breastfeeding Support Skills
  3. Discuss Breastfeeding During Prenatal Visits and at Each Well-Child Visit
  4. Encourage Exclusive Breastfeeding for Approximately 6 Months
  5. Provide Appropriate Anticipatory Guidance That Supports the Continuation of Breastfeeding as Long as Desired
  6. Incorporate Breastfeeding Observation into Routine Care
  7. Educate Mothers on Breast-Milk Expression and Return to Work
  8. Provide Noncommercial Breastfeeding Educational Resources for Parents
  9. Encourage Breastfeeding in the Waiting Room, But Provide Private Space on Request
  10. Eliminate the Distribution of Free Formula
  11. Train Staff to Follow Telephone Triage Protocols to Address Breastfeeding Concerns
  12. Collaborate with the Local Hospital or Birthing Center and Obstetric Community Regarding Breastfeeding-Friendly Care
  13. Link with Breastfeeding Community Resources
  14. Monitor Breastfeeding Rates in Your Practice

Understanding that each practice is a step towards transformative change, during Black maternal health week Breastfeed Durham will be sending a detailed email each day focusing on one of these practices. These emails will break down the significance of each practice and also suggest ways you, as our valued lactation advocates, can implement or support these actions in your daily professional engagements.

Imagine a world where Black Mothers and Babies in our community have equitable access to the benefits of breastfeeding.

  • Decreased risk of respiratory tract infections, ear infections, sudden infant death syndrome (SIDS), and diarrhea for the baby..[3][4]
  • Lower risks of asthma, food allergies, and diabetes.[4][8]
  • Breastfeeding may also improve cognitive development and decrease the risk of obesity in adulthood.[3][10]
  • Benefits for the mother include less blood loss following delivery, better contraction of the uterus, and a decreased risk of postpartum depression.[4] 
  • Breastfeeding delays the return of menstruation.[4]
  • Long-term benefits for the mother include decreased risk of breast cancer, cardiovascular disease, diabetes, metabolic syndrome, and rheumatoid arthritis.[4][8]

Your insights, feedback, and active participation are welcomed and they are essential for the success of this initiative. Thank you for your dedication to improving the health outcomes of parents and their children. Together, we can make a significant difference.

Together, we can pave the way towards a more equitable health landscape, one where breastfeeding support acts as a cornerstone for nurturing and health. Thank you for your unwavering dedication and for everything you do each day to make a difference.

Monday

As we continue to reflect on our collective efforts during Black Maternal Health Week, I wanted to share specific action—one that has the potential to significantly impact health disparities faced by Black mothers and their children.

Lactation plays a crucial role in maternal and infant health, offering numerous benefits that are especially vital for communities disproportionately affected by health disparities. Yet, the environment in which we provide care can subtly influence the choices and perceptions of the families we serve. During a recent visit, I observed formula advertising in the pediatric lobby, which could inadvertently detract from our efforts to normalize and promote chest/breastfeeding as the optimal source of nutrition for infants and toddlers.

Here’s where we can take a simple yet powerful step towards change:

  • Take a Walk: I encourage you to take a moment to walk around the waiting area and other patient-facing spaces within your care facility.
  • Observe and Act: Look for formula advertising. If you find any, please consider removing it. This action, though small, can make a significant difference in promoting a breastfeeding-friendly environment.
  • Normalize Breastfeeding: Check if there are posters or materials that normalize human milk feeding. If not, do you have the authority or the means to install a poster or display educational materials? Breastfeed Durham is here to support you with resources designed to foster an environment supportive of chest/breastfeeding.

To assist in these efforts, we provide a range of materials available at no cost for Durham providers. These include:

This may seem like a small gesture, but its impact on promoting breastfeeding and addressing health disparities can be profound. See the data. By ensuring our spaces reflect our commitment to breastfeeding and human milk feeding as the norm, we contribute to a healthier start for all children, laying the groundwork for a future where health equity is a reality. And feel free to connect us with your facilities management, Breastfeed Durham has funding to provide signage for both indoor and outdoor spaces to any Durham organization that’s interested.

Thank you for your dedication to this important cause. I am here to support you in these efforts and look forward to hearing about the actions you’ve taken and any assistance you might need. Together, we can make a significant difference.

Tuesday

As we continue our recognition of Black Maternal Health Week within our Durham community, I’m reaching out this Tuesday to spotlight a cornerstone of the AAP guidelines: the importance of discussing breastfeeding—or nursing, chest feeding, and other reflective terms that resonate with diverse family structures—during prenatal visits and at each well-child visit.

The philosophy that “every drop of human milk counts” is a powerful and inclusive approach to breastfeeding support. It acknowledges the wide range of experiences, challenges, and goals that parents may have around breastfeeding. Encouraging and supporting breastfeeding for any duration, even if it’s just for one day or three days, can have a positive impact on both the infant and the parent. It’s important to validate and support parents’ choices and efforts, recognizing the benefits of any amount of breastmilk.

Here are the essentials that every care provider should keep in mind:

  • Discuss Breastfeeding Early and Often: Incorporate conversations about breastfeeding into prenatal visits and continue these discussions at every well-child visit. Utilize resources like “Ready, Set, Baby” by the UNC Gillings School of Global Public Health to offer comprehensive guidance for each stage. (UNC SPH Resources)
  • Flexible Goals: Parents should be encouraged to set their own breastfeeding goals, whether that’s until they return to work or for a longer term. Support should be personalized and adaptable to their unique situations. Share the significant benefits, including the reduction in SIDS risk and the promotion of a healthier start in life. Remember, breastfeeding is a learning process for both the parent and the baby. Reinforce the message that breastfeeding babies may wake more frequently during the night, but this is normal and even beneficial. 
  • Long-Term Breastfeeding: While the World Health Organization recommends breastfeeding up to two years of age or beyond, it’s important to support parents’ decisions without pressure. Providing education on the benefits of extended breastfeeding, alongside practical support for those who choose this path, can empower parents to make the best decision for their families. Highlight the lack of regulation on toddler formulas and the developmental advantages of continued breastfeeding. Tailor your approach to the needs and lifestyles of each family, acknowledging that patterns of breastfeeding can evolve as the child grows.
  • Normalize Breastfeeding in Healthcare Settings: After procedures such as immunizations, encourage breastfeeding within the care room. A simple invitation to parents to feed their child can profoundly affirm their efforts and alleviate concerns. Recognizing and validating their hard work in nurturing their child can be a powerful antidote to the ubiquitous “mommy guilt.”
  • Engaging Fathers and Partners in the Process: Engagement shouldn’t stop with the breastfeeding parent. Involve partners in the conversation, emphasizing their role in supporting breastfeeding. For instance, explaining to cisgender straight fathers the importance of providing practical support, like ensuring the breastfeeding parent stays hydrated, can be instrumental. Encourage them to see feeding the parent as a vital role they play in their child’s nutrition and well-being.

As healthcare providers, we are in a unique position to influence positive health outcomes through supportive, inclusive, and informed conversations about breastfeeding. Let’s utilize these opportunities to foster a community where every family feels supported in their choices, contributing to a healthier start for our youngest members.

Thank you for your commitment to this vital aspect of care. Together, we are making a difference.

Wednesday

In the midst of our ongoing recognition of Black Maternal Health Week, there lies a profound opportunity—to stand by lactating parents and families as they navigate one of their most challenging transitions: a new baby. This journey, filled with hope and resilience, also carries the weight of systemic barriers that disproportionately affect Durham Black mothers. Today, let’s reaffirm our commitment to not just understanding these challenges but actively dismantling them, one supportive action at a time.

⭐ The Importance of Breastmilk Expression

Imagine the strength it takes for a mother to balance the tender early days of motherhood with the anticipation of returning to work or problems inducing lactation in those early days. Expressing breast milk is a vital skill for all lactating parents. It’s important to educate parentson effective techniques for milk expression, including hand expression, which can be especially beneficial alongside pumping to increase milk supply. I  recommend this Global Health Media video on hand expression, which emphasizes the importance of relaxation for the milk flow.

⭐ Navigating the Return to Work

The return to work is a steep hill to climb, laden with obstacles. Statistically, we know that Black mothers often find themselves walking this path sooner and amidst a storm of life’s challenges. The NC Making It Work Tool Kit offers comprehensive resources for supporting breastfeeding mothers returning to work, addressing legal rights, workplace accommodations, and strategies for maintaining milk supply. Yet, our role extends beyond sharing resources. It’s about creating spaces where families feel seen, heard, and genuinely supported in their choices..

⭐Connecting with Community Resources

Support networks are invaluable for breastfeeding mothers, providing guidance, encouragement, and practical assistance. I encourage healthcare providers to familiarize themselves with and refer mothers to local resources, including lactation consultants and breastfeeding support groups, to ensure they receive comprehensive support:

As healthcare providers, we play a critical role in supporting lactating parents through education on breastmilk expression and navigating the return to work. By addressing these topics with sensitivity and awareness of the broader social contexts, we can better support families, particularly those facing systemic challenges. Let’s be the change that empowers every parent to nourish thier child with confidence, dignity, and joy.

Your passion, your dedication, and your compassion are the heartbeat of this initiative.

With deepest gratitude and respect,

Thursday

Has black, maternal health Weik comes to a close, the journey of transforming our environment into a more breastfeeding-friendly space continues as a collective mission. Let’s start with actionable steps each of us can take today. Here’s how you can make a difference, right now:

1. Advocate for a Breastfeeding-Friendly Policy

  • If We Have One: Share it with Breastfeed Durham for community inspiration.
  • If We Don’t: Email your leadership suggesting the adoption of a policy. Start with this sample policy for guidance.

2. Training

  • Self-Improvement: Explore Breastfeeding University for online courses to enhance your support skills.
  • Spread the Word: Invite a colleague to join you in training. Every additional ally counts.
  • Speak Up: Suggest to your supervisor the importance of team-wide breastfeeding support training.
  • Join Us: Register for Breastfeed Durham’s bi-monthly workshops for in-depth knowledge on supporting breastfeeding families. Learn more here.

Change starts with action. No matter your position, you have the power to contribute to a welcoming, supportive environment for breastfeeding families. Let’s take these steps today for a healthier tomorrow.

Together, we make a difference.