This blog is born out of the conversations I have had / seen about about Black Breastfeeding Week in September 2019.
If you have thoughts like these, read on.
- Black breastfeeding week is a USA thing.
- I support everyone who seeks my support.
- I do enough, this week does not apply to me.
It is uncomfortable
If you meet me in real life, or online, you will know I am willing to have the uncomfortable conversations and as such, I have had requests for resources from others like me, who want to work through the issues around undeserved populations and parenting / breastfeeding support in the UK.
I do not write this blog to stoke my own ego ( although it is cathartic!), I write it to share things that helped me on my journey of self discovery so far. Please do share with me what helps you on yours, let us learn together and change the unacceptable.
From the beginning
Familiarize your self why black breastfeeding week has come to the UK.
Bais (see video) needs active self reflection to unpack – this is NORMAL and a continuous process & takes time.
Understand the lack of representation in supporters affects us all, from the angle of the text books to the ‘accepted wisdom’ of breastfeeding support.
Now, if you are ready, read on.
Last year, the first UK black breastfeeding week caught my attention. I was transfixed but unsure of it’s relevance to me, confused by what it all meant and still wrapped comfortably in my own privilege.
I read blogs about why black breastfeeding week was coming to the UK and I felt unsure what I could do to effect the change needed. I started conversations that met walls. I retreated, for a while.
Roll forward to the 2018 MBRACE report, and I was firstly aghast at the statistics before us. Black women where 5 times more likely to die in the perinatal period than white women, and for no obvious reason.
I repeated steps above, hit walls and retreated again. As time passed, I became confused by the lack of public outrage. I saw more voices in the circles I enhabit, talking louder and louder about bias, racial in equality and it just couldn’t keep it in along longer.
It became clear to me that I needed to know more and so began my own personal journey into the world of my own bias, privilege as a white, middle class, woman in the UK.
In April, I poured my energy into a poster about bias, I took it to a a place with many breastfeeding supporters and I met silence. I cannot know what this means, but I assume that it means, they where not ready to do the work. You can see the poster in its full glory, by downloading it bellow.
Maybe now you are a bit further along and think..
- I don’t know where to begin
- I want to fix this
Here are some things I found helpful and you might want to look at ;
Blog – a 2019 piece, with lots to think on. Good if you feel you need to ACT NOW.
Dear white women are you behind whats suppressing black breastfeeding rates by Kimberly Seals Allers
Food for thought
Why people of color need spaces without white people by Kelsey Blackwell
Work book – Unpacking White Privilege in her book (formally downloadable workbook) – Me and White Supremacy by Laya F Saad
Book/ Audio Book – Fabulous book about the UK perspective of being a person of color, in the UK Why I am no longer talking to white people about race by Reni Eddo-Lodge
In person events
Attend a Black Breastfeeding Week event near you, this one is streaming online for £5 tomorrow !
One to wait for…
I am Not your Baby Mother by Candice Brathwaite
To sum up…
When we stop and examine our own behaviors, we can check ourselves having different expectations of and reactions to people who do not look like us. It is unethical, once a harmful practice or action has been pointed out to us, to continue to act in the same wayTessa Clark April 2019
Social Media accounts to follow..
Nov Reid – Anti Racism speaker
Abuela Doula – Doula trainer for BAME familes
1-2-1 Doula – Doula, educator, running BBW 2919 in London
In many respects, the bulk of what parents need to know is as old as the sky’s are blue. There is however, a growing need to evolve with the birthing population of today.
Take the toy pictured, not quite as old as the hills but sturdy enough to pass though generations of children to my own. It’s capable of entertaining children, parents recognise it with fond memories but would it hold any relevance to a family of today with all it’s digital trappings.
I review the texts that I have trained with in with the benefit of all the learning I have done since and I am struck constantly by one glaring assumption.
These books, that many health care professionals, breastfeeding supporters and mothers alike, gleam their technical knowledge from are all based from an assumption on writiters norm being the norm. As these authors are mostly white, mostly privaiaged, there is are whole sections of our birthing population in the uk who would be poorly served by theses resources.
I think next about the services that are run, in the ways they have usually been run, with shrinking or demonishing budgets. They offer a fabulous services in many places around the UK but even some of these are closed without warning as money is needed else where.
So maybe it’s time we get out thinking caps on and we rethink the way we support families who want to breastfeed and deserve support for the entire journey of lactating.
The digital age brings many trappings but also more opportunities. Some of the underserved members of my own local community do not feel comfortable to come along to a group, but are willing to pick up the phone.
Others might send a pm on Facebook or follow an influencer on Instagram gleeming information from their peers comments.
What if we rebuilt services from the ground up and adjusted how they run to great equitable care. This is different that it being available to all, this is activity accounting for barriers to services and making it easier for these families to get the same level of care. This isn’t just a nice thing to do, but what NEEDS to happen.
I meet so many people who say they wish they knew x, y or z when their littles ones where small. If I had a time machine I would happily send the information back to them but alaalas, I do not.
Time for change
So instead I shall build my services from the ground up, adjusting for those less served whilst also utilising the technology of the age.
For me this means asking if those who can afford the fee to attend a session run by me, to pay for a second for someone who is less able to afford or access support.
It means meeting in a neutral place, where many members of my community are used to meeting. It means not asking the local health care team to join in just now. It means trying something new, probably at a cost to me, to better server the wonderful families I meet. Many of whom don’t need much, but asking your questions to someone who will listen and help can be the make or break in breastfeeding journies sometimes.
So if you are local to High Wycombe or can get here by public transport, I hope my soon coming Sunday Sessions might be start of that change.
More to come soon.
Every year, all around the world, from 1 to 7 August is World Breastfeeding Week. Individuals and organisations alike, are encouraged celebrate, collaborate and empower parents to get more families breastfeeding and for longer.
This year, I was able to bring something new to my local town and community.
For The Big Latch on & Workshops, we met at the local Library for a 2 hour session with workshops from myself, a local independent Midwife, a Doula and an early year educator to help with the children.
For good measure, we added in a Big Latch On and the result was a whole lot of love and fun. See photos and read more about it here.
Breastfeeding Myths and Questions
All of the parents in attendance where given an index card and asked to write either a myth about breastfeeding that they have heard, or a question they had and give them back to me. We then discussed the answers as a room, with input and ideas from other supporters in the room too.
It turns out, the 20 mins I allocated myself to answer the questions was woefully short. We got through a few but honestly, we could have talked about most of them for 20 mins alone. and some, many hours!
So my promise to those in the room, was that I would blog the answers to their questions (see images bellow) and share. It also turns out, that I don’t know how to do a quick answer 😉 so here is part one with more to follow soon… ish.
Part 1 questions
- Can I drink wine when feeding?
- How do I know if I have mastitis if I don’t have pink nipples of white breasts? ( I can’t see a red mark on dark skin)
- Can you REALLY make breast milk if you are adopting a newborn and haven’t had kid previously? How does it work?
- What to do when baby has tongue tie? What else about the physiology of a babies mouth can hinder breastfeeding / other issues?
I could write a separate blog on each of these questions as there is so much to say on them all. Your interests might not run so deep so I have tried to keep to the main points for each but if you want to know more, or have information/experience to share, please do get in touch!
Can I drink wine when feeding?
The guidelines on drinking alcohol in pregnancy has swung backwards and forwards over the course of the past years so I wouldn’t blame you if you where confused about if it is safe to drink Alcohol whilst breastfeeding.
The short answer is yes, you can. A glass of wine, with your family as you eat your meal is A OK. However, if you feel to drunk to parent, you are probably also too drunk to breastfeed.
Whilst not feeding, you might need to express to relive engorgement during, but you need only wait until you feel sober again to breastfeed as your blood and milk have the same levels of Alcohol in them.
Knowing this Pumping and dumping for one drink is over the top but do not just take my word for it, see bellow for the science.
Dr Jack Newman, rewound IBCLC, explores the science and he reckons the perceived rules around drinking alcohol act as a barrier to longer breastfeeding and better all round health for everyone (due to lower disease rates, not more alcohol ;)).
This Blog by UK IBCLC Philippa Pearson-Glaze is also very comprehensive.
How do I know if I have mastitis if I don’t have pink nipples of white breasts?
( I can’t see a red mark on dark skin)
This is a fabulous question and related to many questions being asked since the 2018 MBRACE report starkly pointed out the difference in perinatal mortality rates in the UK for black and brown parents. ( see link for more information).
When asked, most health care professionals and supporters will tell you the common text book answer and then look puzzled when I point out theirs and the books assumption that the lactating person is white.
The lady who wrote this question told us her story of mastitis and miss diagnosis, another mother in the room told a similar which had a hospital admission for sepsis. Everyone was shocked by the experiences they had, a few of us though, where not so surprised. That could be a whole other blog post so back to what to look for when your skin comes in a different colour that the text book, when you suspect mastitis.
You might see..
- Swollen breast due to poor/non existent drainage.
- You might notice a painful, hotter area on your breast
- You might feel a harder area, a lump but this is not always present.
- Some parents report feeling like being hit with the flu all of a sudden, others others mention vertigo and feeling dizzy.
If a milk duct is blocked, unless there is milk at the tip of the nipple, this will be only a subtle, if at all visible difference. There is often nipple pain when you press where the suspected blockage is, and a small swelling might be visible after a feed/pumping session.
Read more? Plugged Ducts and Mastitis – Kelly Mom (US IBCLC)
A book worth waiting for (2020)- I am Not your Baby Mother by Candice Brathwaite
Black Breastfeeding Week Celebration – Breaking Barriers & Uplifting Education – 1-2-1 Doula
Why are black mothers at more risk of dying? – BBC News 2019
Can you REALLY make breast milk if you are adopting a newborn and haven’t had kid previously? How does it work?
The short answer is, yes you can! Many of these parents are experts at defining their own success with a range of options and a range of amounts of milk supply reached.
As we know even a few drops, at any stage of lactation will contain thousands of immune factors. It literally is liquid gold!
Some parents will choose to offer comfort at their breast/chest and not try to induce a supply specifically, where as others will embark upon a regime of simulation and sometimes hormones before the baby is due. Just with anything in life, parents do what works for them and their family.
Sweat Pea Breastfeeding support is run by a US IBCLC, she also co-hosts a fab podcast, Breastfeeding outside the box
Breastfeeding Without Birthing: A Breastfeeding Guide for Mothers through Adoption, Surrogacy, and Other Special Circumstances – Alyssa Schnell
Where’s the Mother?: Stories from a Transgender Dad – Trevor MacDonald . A compelling read.
What to do when baby has tongue tie?
What else about the physiology of a babies mouth can hinder breastfeeding / other issues?
Breastfeeding with a Tongue Tie, is a complex subject and one that often requires specially trained individuals to diagnose and ideally ongoing skilled help to help you both re learn how to latch and attach more effectively.
All of this is best done 1:1, with a skilled helper and this is also where other physical issues (differential diagnosis) can be explored. You can read more general information in the links bellow.
Some general tips
Research and talk to other parents who have been affected too.
Many parents find the flipple or exaggerated latch helpful
Ask for help when you need it.
Tongue-tie in Babies: A Guide for Parents - Sarah Okley (IBCLC) a direct pdf download.
Tongue Tie - La Leche Leauge
Association of Tongue-tie Practitioners to find trained individuals (Link ATP)
Supporting Sucking Skills - For supporters and medically minded parents.
Flipple - Milk Meg (IBCLC)
The WHO code & your business.
So you run a baby business and some has mentioned the WHO code on marketing baby milk. They might have suggested that you are unintentionally violating it.
You are confused right? You are passionate about breastfeeding, how could you be doing something unhelpful?
Here’s what you need to know. This is COMPLEX issue. This is brief .
Thing 1 This is not just about hippies boycotting Nestle
Thing 2 Protects all, not just breastfeeding families
Parents need impartial information about feeding their babies, free from misleading or idealised marketing. It is available here via First Steps Nutrition
Thing 3 Advertising influences our behaviours
In the new age of sponsorship and social media, companies are finding even more inventive ways to reach parents. If you are paid by a code violating company to advertise their product, you are complicit in their sneaky ways. Do you mean to be?
Thing 4 When you know better, you can do better.
What you say and do online will reach many people. Make sure the partnerships and giveaways you do, are inline with your personal values.
The British Medical Journal just ended their advertising agreements with baby milk companies , its an interesting read.
Thing 5 There are good companies out there!
The Global Big Latch on have a fab recent blog with examples,
Think of a big brand in the baby world, there is a large chance they are
Known violators, Medela, Lansinoh, Mothercare.
Thing 6 Parents are being misled
All Party Parliamentary Group on Infant Feeding and Inequalities (APPGIFI) was formed to address these issues. You can invite your local MP to attend.
Thing 7 The ripples spread
The lure of a network of breastfeeding events with freebies is a sneaky way of increasing brand loyalty. You have a platform, why not use it to explain why you will *not participate in, or partner with events & companies who undermine breastfeeding?
Thing 8 Ethical sources of funding matter
There are many sources of funding for small businesses, other than the comity coin types. Usually, getting in contact with your local council will have resources. There is national lottery funding and many more. Yes this will take more effort, but it is honestly the right thing to do.
Thing 9 Supermarket community schemes
The WHO code and UK LAW prohibit a number of commonly ignored practices around sales of baby milk & food. For this reason, many organizations prohibit the use of their schemes. If you use one, you may find yourself being turned away from events who need to be WHO code compliant.
Thing 10 Closing off collatorations
Be mindful of your partnerships when you are seeking collaborative projects with other organisations. You may find, that Baby friendly healthcare teams refuse to work with you if you are unaware of the WHO code. An International Board certified Lactation Consultant would not be able to work with any known code violators or with someone who is in breach of their code of ethics. (Conflict of interests)
An International Board certified Lactation Consultant would not be able to work with any known code violators or with someone who is in breach of their code of ethics. (Conflict of interests)
Baby Milk Action (UK), Baby Feeding Law Group, The International Baby Food Action Network (IBFAN0 for reports and monitoring
First Steps Nutrition Impartial information on baby milk & food <5 years
Unicef Baby Friendly Health care teams
We are standing in our uniforms and she interrupts my conversation to ask, “Is that even a real thing? This lactation thingy? “
There is no attempt to hide the contempt in her voice, neither the less, I reply with confidence.
“Yes! My full title will be an International Board Certified Lactation Consultant (IBCLC) when I pass the exam in October. “
I puff with pride with anticipation of my impending status.
A medical consultant in the room, back turned to me, shares a joke at my expense with the questioning lady. They both laugh and I falter.
I have been carting my 1000+ word textbook around with me for over a year now, fitting study into every available moment of downtime.
Once a shiny new, this expensive textbook now sports pages that are scared with notes and the spine that held it together, gave out a while ago.
Standing in a room of moking health professionals, I feel like the glue holding us both together evaporated in an instant.
This is not an uncommon experience I am told as in the UK, IBCLC’s are not a recognised professional group. A lactation consultant is not a protected term either. Yet all around the world, it is the premier, gold standard in lacation education & support.
Through their training, an IBCLC has the skills to support every parent, from the normal course of breastfeeding to helping a family navigate the complexities of lactation during cancer treatment. You will find them working as Midwives, leading Infant feeding teams within NHS trusts, and running drop in clinics within the community.
Some IBCLC’s work even harder, to enter the field as a non health care professional investing even more time and money that their health care counter parts. It is a much needed profession, with much research backing up their value.
I have been on the journey here since the first mother-baby duo I supported on a maternity ward as a college student. Since then, I have spent 1000’s of hours (paid and voluntary) & thousands of pounds working towards this goal.
Parents want to breastfeed
Here in the UK, 80% of mothers start breastfeeding, but by 6 months 1% remains breastfeeding. That’s a sharp drop off and its not down to just one thing.
Since starting this job, I have heard all the staff feeding journeys and in their vulnerable moments even seen their tears. Very few met their breastfeeding goals and even though it’s not in my job description as a Paediatric nurse to listen, it’s in my nature as a Breastfeeding Counsellor, so listen I do.
So I hear the grief behind the words, I see how it translates into resentment and undermining of other professionals & parents alike. This is not sustainable.
It’s time for change
I remember a conversation with one member of staff, who was so angry about the levels of training of health professionals helping her family. She was enraged the IBCLC they had eventually seen, said they did not fail, it was the system that failed them.
I shared with her the amount of training on breastfeeding in the various health care professionals education and we both agreed, parents & health care workers desedrve better.
There is no one easy way to change the systemic bias above but what if we rethink our approach?
What if our next efforts to normative breastfeeding start with the next generation in schools. The Association of Breastfeeding Mothers has released free lesson plans for teachers & I love this idea.
Reading through some of the exercises though, I realised that some of the content would be news to people I work within hospitals.
But if generations of children know the basics of breastfeeding, the ones who enter healthcare will already be better breastfeeding advocates without any change in training. It might just work.
Either way, the next time someone asks me,
“Is that even a real thing? This lactation thingy? “
I shall reply;
“Why yes it is, and the fact you asked illustrates perfectly why.”
Then again, maybe not 😉
Tessa Clark BSc, RNc
Balances being a Paediatric nurse, Breastfeeding counselor (private and voluntary) & IBCLC exam candidate Oct 2019 with motherhood.