LCW 2022: Academia
Lactation Celebration Week: Day 6
We’re nearing the end and I appreciate you sticking with me to learn about the warm chain of lactation support. Writing this week has been a labor of love. I truly love spreading the word about the importance of lactation and human milk. This blog has allowed me to reach my clients and beyond. Thank you for reading!
Today we chat about how academia supports lactation.
Academia encompasses all the people and investors working in research and higher education. They are an important link in the warm chain of lactation support. With more lactation research and education, we can make changes to health guidelines and legislation to support families, our planet, and our future.
While WABA focuses on academia in the research and higher education sense, I believe the most change will be made when we start normalizing lactation in early education. My kids’ generation will make a bigger impact on lactation legislation and health recommendations than my generation will ever be able to.
So in this post, I am also including steps for early educators to take to support lactation.
Academia can support lactation by…
Ensuring that appropriate and adequate lactation information is included in curricula taught by your institution
This section is big because I’m a huge believer in teaching kids about lactation and not hiding it. I believe our kids hold the power to change the world. If you have the opportunity to vote on the curriculum your child and their peers receive, I highly recommend you do the research and vote to support moving education forward.
Early Education
Required curriculum needs to incorporate lactation at every grade level. While some super awesome lactation advocate teachers will bring it up spontaneously and appropriately, we need to ensure that all kids get a basic introduction to human milk in every state, in every school.
Some of you may be thinking, “Teach 6 year olds about lactation?! You’re crazy!” and yes. That’s exactly what I mean.
But it’s not about teaching a 6 yr old how to latch…although my 6 yr old made a latching video with me and he knows what an efficient latch looks like.
In every K-5 curriculum there is a lesson on animals. Incorporating lactation into a lesson on animals is pretty simple because, well, humans are animals…mammals, to be exact.
When learning about vertebrates, talk about characteristics of each type and a few examples.
What are characteristics of a mammal? Live babies, hair, warm blooded, make milk, and a few other things.
Kids often give examples of animals like dog, cat, cow, etc. A teacher can mention that we are mammals and we drink milk from our parent. Some kids will volunteer that they used to drink milk or their baby sibling drinks milk. Yay, they remember or have seen lactation in action!
Everyone expects that a lesson on animals will talk about mammals at some point. But what about writing curriculum? Nutrition? Health?
There are so many ways our bodies are affected by human milk
Human growth and development in 4/5th grade should mention lactation with breast growth. It’s not enough to just teach how bodies will change. Kids also need to know why their bodies will change.
Do no separate kids by gender during this topic. Partner and community education is essential to lactation support.
All kids need all the information about all the bodies.
Separating by gender naturally excludes kids who are not cisgender. It excludes them from receiving medically accurate information about their body based on their gender.
It can “out” trans kids to their peers if they choose the group that matches their anatomy.
Trans kids don’t receive proper information if they choose the group that aligns with their gender.
Kids are separated into a girl group and a boy group. Which do nonbinary kids choose? Separating kids is problematic for everyone.
The thing with teaching young kids about lactation is that you just need to plan little seeds…that human milk is healthy, that it’s normal to feed a baby from your body, it’s how humans have been feeding babies for…forever. We’re not teaching a full prenatal latching class!
Little snippets of lactation information throughout the curricula normalizes lactation and body feeding
Books are a great way incorporate lactation with kids. There are many kids books that depict a latched baby and are age appropriate. I make no money off these links. But I do suggest you use AmazonSmile if you’re an Amazon user and donate to your local milk bank!
Magical Milk by Nasheeda Pollard is a brand new book (I’m waiting for my copies to arrive!!) that features a Black family with a new baby. It is so important that kids see Black lactation in action and represented in literature.
When I get my book, I’ll write a review!
Our country is fraught with systemic racism that has severely impacted Black families from being able to nurse their kids as long as their white peers.
This article from the CDC highlights the nursing initiation rates for 2019. It shows that 85% of white families vs 73% of Black families initiated lactation at birth.
This is a systemic problem that needs to be address at many levels across our culture, society, and government.
Black Breastfeeding Week is always the last week of August (Breastfeeding Awareness Month) to support, empower, and encourage the Black community.
We Drink Milk by Nanda Gasparini has beautiful drawings of all different kinds of animals drinking milk and at the end 3 moms nurse their kids (newborn-toddler). This is one of my kids’ favorites.
TW for gendered language: Of note, all the animals do something (lie, snuggle, cuddle) with their “mummy and drink her milk” on every page. If very gendered lactation language bothers you, you may want to skip this book. There is no mention of “breast" or “breastfeeding” until the last page where there’s a blurb to “mothers” about finding “breastfeeding” support.
Mama’s Milk by Michael Elsohn Ross has drawings of all kinds of mammals nursing, including humans. And it’s available in Spanish!
TW for gendered language and the use of “breast”
Lots of nursing facts for different animals including “Mama’s milk helps to protect babies from common diseases.” And “A breastfeeding mama get more sleep.”
Each page has the name for the animal and their baby. Do you know what a platypus baby is called?
Who In the World Likes to Nurse by Cristie Henry
Lots of illustrations of latched babies and other animals
Shows a variety of cultures nursing
Babies Nurse by Phoebe Fox; I don’t have this book but the water color paintings a wonderful
Teachers: If you are pumping, let kids know why you need to step away from the classroom. It’s important they know you are taking time away from class to care for your baby.
You don’t need to tell them every detail of how you pump
Let them be curious to your comfort level about what you’re doing
Shutting down questions kills their curiosity and sends the message that pumping is not something that is talked about. Be cautious with your words.
Secondary Education
Human lactation should be weaved into any animal biology studies
Dissecting animals? If it’s frogs and not a mammal, talk about how the anatomy is different and why
Make a project out of choosing a mammal to research with extra credit for choosing humans and incorporating lactation
Human growth and development should always include breast health and mention lactation
This isn’t a latching class or a “you better breastfeed when you have kids” class
It’s presenting information of how the body works, why is there breast pain during a monthly cycle? Why do breasts look so different? How does breast size affect bodies? We should be celebrating and building body confidence as well as educating on why our body grows the way it does and the impacts on our health.
Lactation education should always be taught when talking about sex
Do students have to carry around an AI baby? It’s the perfect time to talk about human milk vs formula with evidence-based information
This is also a huge opportunity to talk about the risks of formula feeding vs the benefits of breastfeeding
Teens understand risk/benefit analysis
Helps teens understand that using human milk vs formula is a medical decision that should be made with all the information
Present human lactation as the biologic norm and formula feeding as a treatment when the norm is unavailable or not desired
Introduces informed decision making
In Oregon, at age 14, teens are able to start making their own medical decisions without parental knowledge.
They need to understand what informed decision making is and how to advocate for themselves
Lactation, gender, and sex, while often presented as taboo information, should be incorporated in a variety of subjects, not just science
English/language arts is another opportunity to bring up lactation
Ask them to be mindful of gendered language. Trans men and nonbinary folx lactate. Respect pronouns, parent words, and be mindful of the use of the word "breastfeeding"
Not everyone identifies with the word “breastfeeding” so use alternative/additional language when speaking to a large group
Teens are much more open to this than adults so if this is triggering to you, check your cisgender-heteronormative bias. Learn about the LGBTQIA+ community and be respectful.
A class can be split (not by gender) in 1/2 or in groups to write a persuasive essay
Before researching infant feeding, ask them what they know about human milk and formula
Assign one group to be pro formula and one group to be pro human milk and have them write to their topic.
After they write, have a group discussion
Ask them to think about how families choose to feed their baby. Should everyone make the same choice? Why or why not? How does the advertising of infant formula affect a family’s decision? How does a prenatal lactation class impact a family’s decision?
Narrative
Interview a non-family member about how they fed their kid and why they chose that method
Include interview questions about lactation support
Math
Statistics—use breastfeeding rates around the country/state/county
Teachers: If you are lactating, let students know why you’re unavailable during your 10:00 free period.
Maybe you’re a lucky teacher that has onsite childcare and you need to go nurse your baby
Maybe you’re pumping in your classroom
Pencil in your pumping/feeding times if you have a posted schedule
They’ll understand, “Oh, I can’t get help at that time because they’re pumping/feeding their baby.”
Older kids need to understand the time commitment of pumping and how important it is to not cut the time short
You can explain getting mastitis or engorgement (discomfort of being full) and the potential decrease in milk supply if you don’t pump long enough or wait too long to pump
These things aren’t gross. They’re reality. We need to be honest with kids and teens to give them realistic expectations of what pumping is so they can see it’s not easy peasy lemon squeezy but it’s doable and important.
Higher Education
Undergrad
The majority of the students in undergrad are not parents and it is the perfect time to continue watering their lactation knowledge seeds so they are ready to sprout when the time is right for them.
In anatomy and physiology (A/P) classes, I learned about many different types of glands and organs. But I did not learn about the mammary gland. Yes, there was mention of it and that it makes milk but that’s it.
There are many opportunities to talk about lactation in A/P courses, as it involves all the body systems
Have a lactation consultant come in and talk about the anatomy and physiology of the mammary gland!
Health sciences and nursing programs should have mandatory lactation education because human milk (or a lack of) impacts all humans and their health for the rest of their lives
Psychology
Discuss the WHO Code of Marketing of Breast-milk Substitutes and why the marketing of formula is unethical
Discuss informed decision making—is the decision to formula feed really a choice or is this medical and health decision influenced by a product?
Discuss parent shaming—how can we come together to support each other?
Art
So much art is based on the human form
Have students depict lactation or nursing in their preferred (or your preferred) medium
Have a nursing parent and child come in to model (extra challenge because of the time constraint!)
Gender studies
Gender inclusion a huge topic in the lactation community
Thankfully, last year the Journal of Human Lactation created a policy statement on using inclusive language in their publications
There are many people working in and around lactation that refuse to use gender inclusive language which is causes harm to trans and nonbinary folx.
Postgrad
There are many postgrad study paths but I’m going to focus on healthcare and mental wellness
All postgrad healthcare curricula should include information about the World Health Organization’s International Code of Marketing of Breast-milk Substitutes (AKA “the Code”) and encourage all students to adhere to it.
While the Code is not (yet) law, healthcare providers have an ethical duty to promote optimal health
Ensure curriculum includes referral to an IBCLC for anyone having a baby. Formula feeding families can still have problems with milk suppression, clogs, engorgement, mastitis, milk blebs…the list goes on.
Dentistry and dental hygiene
The dental office is a place where lactating parents are frequently told they need to wean without consulting with an IBCLC
Curriculum must include lactation and latching as the biological infant feeding norm for the health and wellness of our kids
A baby’s mechanics of latching and their duration of nursing directly optimizes oral health, palatal width, and dentition
A baby’s mechanics of bottle feeding and their duration of bottle feeding directly and negatively impacts oral health, palatal width, and dentition
Dr. Brian Palmer, DDS understood that human milk does not cause caries. Though he has passed, he requested that his website remain active so his work would continue to be available to the masses.
Night nursing does not cause cavities
If dentists understood how milk pooling and flow differed with body latching and bottle feeding, they would understand why night nursing directly causing caries is not logical
Stopping night nursing is not the solution to caries. Look for open mouth posture and ties. Ask about diet and brushing. Find the root cause. Don’t interfere with human lactation.
Teach dentists to refer to and work with IBCLCs. If you have a concern about breastfeeding/latching/human milk causing a problem with dentistry in some way, refer the parent to a lactation consultant.
Medical, nursing, and PA school
All programs should include lactation curriculum
Basic lactation management—what do lactation problems look like?
Actively encourage referrals to IBCLCs
Medication interactions and their affect on human milk (most are compatible)
Assigning all students to shadow a lactation consultant can help them understand what IBCLCs do and that what can be accomplished in a 15 min PCP visit is nowhere near what happens during a 2 hr lactation consult.
Lactation comes up regularly with patient care in almost every patient population
Medical professionals need to understand any information they receive in school is NOT equivalent to what an IBCLC knows about lactation
And what they did learn in school is probably not evidence-based practice anymore
OT, PT, SLP
Therapy schools need to teach lactation as the biological norm for infant feeding
All babies should be physically capable of latching and should be held to that standard, even when bottle and formula feeding.
That does NOT mean a family’s feeding choice should be questioned.
We should be attempting to mimic latch mechanics when providing bottle feeding therapy.
Therapists need to understand the oral mechanics of latching in order for this to happen and properly treat young babies.
So many therapists, SLPs in particularly, are taught bottle feeding and how to address bottle feeding problems then attempt to apply bottle feeding mechanics to body feeding babies. They are not equivalent.
Yes, it is in the scope of OTs, PTs, and SLPs to care for and provide therapy to babies; however, it is not in their training to care for the lactating dyad and manage the parental problems that come with infant complications.
Therapists need to work collaboratively, ideally simultaneously in a consult, with an IBCLC in order to provide the best care for babies needing OT, PT, and SLP expertise and their lactating parent
“Inability to breastfeed is a red flag for further infant problems; breastfeeding is an essential component of normal infant life, and its absence means something is fundamentally wrong with the infant’s world.”
Mental wellness practitioners
Curriculum should include the hormonal impact of lactation on mental health, the effects of society’s pressure on parents to breastfeed, and the lack of support that many families have which impact mental health
Weaning is not always the answer; in many cases, having lactation support can improve mental health
Practitioners must learn the impact of medication on human milk and that there are often alternatives
If a particular medication is ideal for the parent but negatively impacts the baby via milk, refer to a lactation consultant for advice on lactation management
Prioritizing research in human lactation
Early Education
Help kids get curious about animals, including humans, and how they eat at all stages of life
Incorporate human milk into units on healthy eating
Encourage discovery activities and books that involve learning about human lactation
Secondary Education
Implement assignments which I mentioned above
Get creative! What are some assignments that would work well for your class and your students? I’m not an educator so I’m sure you have better ideas that me!
Higher Education
Encourage and fund lactation research in your field
We need continued data collection on lactation initiation and duration rates by state and around the world; knowing where we stand helps drive research that supports lactation supportive legislation
We need to continue to explore the components of human milk and how they change over time
We need research on cultural and societal barrier to lactation
So much research is needed. All so we can continue to support families.
More research is done on cows by the dairy and formula industries than healthcare does on human lactation. Why? There’s no money to make from human milk research if it’s optimizing health and decreasing the amount of money we spend on medications and medical appliances (braces)
Supporting the dissemination and implementation of research evidence in lactation to relevant stakeholders and the public at large
Post new research everywhere!
Send it to pediatricians, midwives, obstetricians, IBCLCs, present at conferences, tell your colleagues
Publish new research in medical journals and get it to the people who write policy statements and guidelines for different professional associations
New policies and guidelines from professional organizations drives changes in legislature to support lactation. It’s also how we get insurance companies to start covering all lactation care at 100%.
The revised 2022 AAP Policy Statement on Breastfeeding and the Use of Human Milk has finally caught up to the World Health Organization’s recommendation to provide human milk exclusively for 6 mo and continued to 2 years and beyond.
WHO has been recommending to breastfeed to 2+ years since at least 2003 so I give a slow clap to the AAP for taking nearly 20 years to catch up
The previous AAP policy (2012) recommended breastfeeding for 1 year and beyond. It automatically expired in 2017 and was not updated until this year
The AAP has received backlash for this change because there is not currently enough lactation support in the US for families to be educated on the benefits of nursing a child past 2 years nor is there enough governmental support to actually do it
If nursing isn’t well established and supported in the first weeks and months, it is very difficult to continue nursing into toddlerhood
This change in recommendations is positive and (even though it’s late AF) will help create and encourage law makers to vote for lactation support
Empowering parents with strategies to enable them to combine lactation and work
Early and secondary Education
School districts need lactation policies for all employees and work out a plan for lactating to meet the needs of their babies.
It’s important that districts do everything they can to retain teachers and support youth. Isn’t school all about supporting youth?
Help staff manage their workload so they can pump/latch when needed. Get instructional assistants or the principal to take over a class and help.
The 15 min kids are at recess is really a 5 min (if that) break to go pee (ASAP) and prepare for the next activity. Telling someone to “just pump during recess” is unrealistic, patronizing, and unsupportive. Not to mention, illegal.
Higher Education
Are there pumping facilities available on campus for staff, students, and campus guests?
Are they easy to find or is the map of them easy to find?
Are they easily accessible from all parts of campus?
Are they ADA accessible?
Working together with others to ensure a continuum of care for the lactating dyad
Advocate for your institution’s health insurance to cover lactation care at 100% without any other qualifications than “lactation care”
Advocate for paid parental leave from your company
Ensure families can get a free, high quality breast pump from their health insurance
Have policies in place to protect lactating parents’ right to pump/latch breaks and make pump rooms accessible to employees and guests
Refusing gifts, samples, sponsorship, or displays of infant formula, bottles, or teats from companies
Higher Education
Sponsorship and funding for lactation research from formula companies completely undermines any of the work scientists are doing in the study
Take a peek at the irony of the HALF program by the AAP/Healthy Children I mention in a post earlier this week.
Teach students to watch for this marketing at clinical sites and encourage them to uphold the code in their own practices
The Code prohibits advertising and accepting samples and gifts in order to promote giving unbiased, evidence-based information to families
This video from UNICEF highlights why the advertisement of infant formula is detrimental to our babies
If you watch this video and think “but not in my country” think again. Pay attention. The HALF program is a great example of a junk food company undermining our health.
Formula companies bring sugar cookies shaped like bottles to staff on the postpartum floor all the time. And those cookies aren’t cheap!
Is Abbott hosting the next free lunch and continuing education session at the hospital?
Is there a formula logo on the rulers used to measure a baby’s head circumference?
Does your hospital give out swag bags of formula to families discharging home with a newborn?
These are all examples of things I have seen at hospitals I have worked at in the US since 2006. And I’m sure it was much worse before that.
Question time!
Teachers
What subject or age do you teach and how can you incorporate lactation into everyday topics?
Do you have adequate pumping facilities and breaks?
Healthcare workers
How much lactation education was presented during your education?
Is the WHO Code upheld at your place of work?
Comment below!