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Episode 2 - Being the Voice for Breastfeeding

Welcome to the Lactation Training Lab Podcast. This podcast is about becoming a better lactation consultant. This work is hard. Lactation is simple, but our feelings, belief systems, and structural barriers in our societies make it complicated. Together we’ll explore mindset, knowledge, and connection resources to expand your mind and get you thinking and get you working and committed to becoming a better lactation consultant every day.

Welcome back to the Lactation Training Lab Podcast where we are exploring ways to become a better lactation care provider every day. We’re looking at advocacy today - going to talk about advocacy because it is the time of year where we’re getting ready to celebrate the awareness campaigns that all come in August: World Breastfeeding Week, National Breastfeeding Month in the United States, and Black Breastfeeding Week, and Indigenous Breastfeeding Week.

We have these opportunities to make a really great impact on the larger masses of people when we talk about breastfeeding as a public health strategy, when we talk about the importance of breastfeeding - not the benefits, the importance - when we talk about how supports are needed to ensure that people can actually meet their own infant feeding goals, when we have the opportunity to talk about countering the commercial influences over infant feeding that make it really hard. And all of this really goes back to our main theme here, our main mission here, talking about how lactation is simple, but our feelings and our belief systems and the structural barriers around it are what make it complicated and make it this issue that we are spending all this time talking about and the reason, probably, that you are here today listening to this podcast.

So thanks for joining me, I appreciate your presence, I appreciate this, and I’d love to hear back from you. I’d love your feedback when this is all over, and I hope that you’ll come back after this.

Let’s talk about advocacy for a moment in terms of what that means in the lactation field. We know that there are plenty of voices out there that are saying, “it’s okay not to breastfeed, it’s okay if you don’t” and we can debate all day long about the difference between personal choices about infant feeding and public health strategies. But the real thing that needs to come out of this conversation is that if you’re part of the healthcare team, if you say that your mission and your goal in what you do as a healthcare worker is to affect positive health outcomes for populations, then you have to advocate for breastfeeding. You have to be the voice that is always there to remind people what an important cornerstone of a health strategy for life this really is.

There’s no time and there’s no room and there’s no space anymore for healthcare workers to be taking a different stand on that. This is a physiological function. There’s no reason for science to continue to spend tons of money trying to prove that breastfeeding is good, breastfeeding has benefits, breastfeeding is better. That simply isn’t the place to begin. We have to remember that breastfeeding and lactation are normal, physiological functions.

What we should be studying is how to make that process doable, how to make it easier, how to make it liveable in the society and the cultures that have sprung up around humans, and really about how to help people who have to use different infant feeding choices, or who choose different infant feeding choices. How to help them protect health outcomes as well. Let’s spend our resources on making sure that everybody gets the best health outcomes that we can.

We don’t really have time for people to make excuses or to get stuck in mindset things and we’re going to explore some of those mindset issues today. These are things that come up when we have new students who are coming through our lactation training.

They’re things that sometimes I’ve encountered over the years with other healthcare workers who are not necessarily trained in lactation but are understanding or hearing from their leadership that they’re supposed to be advocating for breastfeeding. Sometimes even things like - I’ve spoken with doctors who’ve told me that they just can’t - they don’t want to make people feel guilty, and then all the arguments that go along with the individual choice part of it which tends to be a very big issue in developed countries.

It’s a huge thing in America because we have this thing about personal choice and individual freedom and liberty that crops up all the time in health things and so really quick I want to make this distinction: we’re talking about advocacy on a large scale, advocacy to a group, not individual counseling of a person, not telling one person “this is what you should do” because that is what we do as clinicians, that’s what we do when we’re one-to-one and we talk to somebody about their preferences, their needs, their medical history.

One-to-one counseling and discussion of what their choices are is very very, very different than public health messaging about lactation and breastfeeding. That’s such an important point to make as we head into World Breastfeeding Week and we will encounter all of those negative messages and all of the bad stories that tell us how it’s bad that we even have World Breastfeeding Week because somehow that’s making everybody feel bad about themselves.

This is a really different conversation. This is about advocacy on the large scale, advocacy for lactation and breastfeeding as public health strategy and part of that mission and vision of seeing better health outcomes for everyone.

Let’s take a look at that definition of advocacy that you see most often: influencing the powerful on behalf of the powerless. But in lactation, it’s actually more accurate to think of this as influencing the powerful on behalf of the vulnerable. And the reason and the distinction between powerless and vulnerable: expectant parents and new parents: it’s not that they’re powerless. It’s that they’re in a biological state hormonally where their attention needs to be different and it needs to be focused inward on their baby, an extension of themselves. So thinking about them as powerless is not quite accurate whereas thinking of them as more vulnerable because they aren’t as able to manage and process external voices, that’s what makes them a little bit more vulnerable.

That’s why that language is really used in the International Code. That’s why we think of them in this way: so that we know that what we’re advocating for is - we are being that voice that stands in between them and for instance, the large loud voices of commercial influence, as well as the voices of others who feel that they are well-meaning, but maybe aren’t as well-informed.

Always remember if we are not advocating for breastfeeding and for lactation, then we are actively working against it. We have to be proactively advocating for it in everything that we do. Again, this is not an individual one-to-one thing. This is not about telling your one client about what they should’ve done or what they can do to get back to breastfeeding if that’s not their goal. This is about the strategies that we are using in the work that we do, in the public health messaging that we are doing, in the ways that we talk to the media, especially during these awareness campaigns, in the way that we talk to large groups of people when we have the opportunity to educate others.

What we are doing is advocating for it so that we are actively working for it instead of actively working against it. We see this all the time. We see others who are sort of, not taking a stand about it and that gets really difficult for us to see. It’s one of those demoralizing things that causes burnout for us when we see others who have the opportunity or the platform, they may have what we think of as power to be able to advocate for lactation and breastfeeding and they choose not to for reasons that are not- well, for reasons that don’t fit in with what we’re doing here, and when they have those issues or when they have those issues or they’re having those mindset blocks that we’re going to talk about. That’s where they’re losing the opportunity. They have power but they’re losing opportunity to be able to influence and to be able to advocate for better health outcomes.

Here’s one of those mindset blocks right here. Sometimes people feel like if they themselves did not breastfeed, did not proceed through lactation, did not have children for whatever reason, that it’s not okay for them to be out there advocating for their patients to breastfeed, telling their patients about breastfeeding, asking people to consider breastfeeding and lactation as part of their infant feeding choices. It’s this thought that, “if I am out there saying that people should do this but I didn’t do it myself, then I’m being a hypocrite.”

But here’s the thing about life, we are all different people who make different choices and land ourselves in different situations. We have different experiences all the time in lots of different things. We connect with each other and we make each other’s lives better by supporting them in the choices that they make. We don’t always - we’re not always out there trying to influence other people. We are working with them to make sure that their choices are supported and what they want to do is something that they actually can do. So whether that means working against systemic barriers, or helping dismantle belief systems that are not helpful, or leaving our own feelings out of the situation, all those things can be supportive of somebody who is working to do something that maybe you didn’t do or weren’t able to do, didn’t have the opportunity to do, or everything worked against you in your situation so you didn’t get to breastfeed or you didn’t get to make milk for your baby for as long as you wanted to.

That’s one of those mindset blocks that really stops people. It stops a lot of nurses. It stops a lot of doctors from even bringing this up and from moving past that.

One example of a just, of not being hypocritical here, one thing that a lot of people choose to do now, it’s a very common, a sort of trendy thing to do in the United States is to take on athletic challenges that might be extreme or might be really different and out-there from what most people would do for their normal fitness routine. And my husband is one of those people.

The man loves to challenge himself, and he does. He comes up with challenges that, to me, seem extreme. They seem like things that I wouldn’t do myself, but that doesn’t mean I don’t support him in doing it. I do my best not to undermine him. I do my best to find ways to make sure that it’s easier for him to do that because I’ve seen the health outcomes. I’ve seen the positive outcomes of the choices that he makes. And while it’s not something I would choose to do and not something I ever have done, I can still advocate for him to do that. And in the same way, whatever your personal experience, you can still be a powerful, strong, knowledgeable advocate for breastfeeding and lactation.

The next mindset block we’ll look at here is really about breastfeeding self-efficacy. So when we’re working with populations of people who have low breastfeeding self-efficacy, and this is really low confidence in themselves that they have the ability to accomplish what they want to accomplish in terms of breastfeeding, it’s really a great - the best - tool that we have. The most powerful tool that we have is connecting those people with the resources, the help, the assistance, whatever they’re going to need to navigate obstacles.

One of the reasons that people often have low breastfeeding self-efficacy is because they haven’t seen a lot of other people either be successful or perform the activity in front of them or navigate obstacles around it. They don't think that other people have struggled with the same thing that they’re struggling with and so it becomes a thing that it seems like they just can’t do and what we want people to understand, what we really want to give them as a tool is that connection. By connecting them with somebody who can help them navigate through whatever obstacles might come up, we give them a little bit more confidence. It’s another way to get through and if we don’t give them those tools, don’t worry, there’s plenty of commercial influences out there who are going to step right in and give them other tools that they can use that are going to lead them down different paths.

As advocates for lactation, as advocates for breastfeeding, it really, truly is our role to make sure that expectant parents and that new parents are connected with the resources that they will need to navigate obstacles so that they turn to those resources rather than turning to, for instance, a website that sells them a product that is allegedly going to make their breastfeeding easier, or something else that they can feed their baby other than their milk, etc, you get where I’m going with this. So keeping in mind that the most powerful tool is connecting people with others and other resources that can really get them through those obstacles, that’s going to overcome some of their low confidence level in their ability to actually accomplish their breastfeeding or lactation goals.

And then finally, this- this other one, this is something that comes up a lot for people who are already in the field, and even people who are starting out and who are kind of surprised at what they find as they begin to do their work. They find that sometimes this work is rather demoralizing. We see this as frustration, and we see this as feeling like nothing that we’re saying is getting through or nothing that we’re doing in our job is really making a difference. We start to have this negative spiral of, “well I can’t make a difference, I’m only one person, my voice is small.”

We’re talking about advocacy here. So let’s think about this from a- let’s take a really strong standpoint and look at this from a position of more power. What is really demoralizing to those of us who do this work is watching how parents are shushed, how they’re cowed by others, how they are told that what their beliefs or their desires or their commitments are are not as important as they maybe thought they were, and this happens when they’re given untruths about how lactation works, when they experience laziness on the part of others who don’t want to take the time to help them or take the time to find the information that would be really helpful for them, and a failure to act justly. A failure on the part of people who do not treat everyone the same and who do not treat people with respect or dignity for their choices and their positions and their needs really.

So looking at this when we think about, for example, breastfeeding rates, making sure that we use breastfeeding rates for their actual purpose: that breastfeeding rates don’t give us this sense of who is willing to breastfeed, or who is more intending to breastfeed, but rather looking at breastfeeding rates and saying, “oh my goodness, why is there such a disparity in between these two groups of people, whether they’re breastfeeding by three months or six months or a year?”

The difference really is - what breastfeeding rates should be telling us, is where our intentions should be focused and who is actually getting the most resources and the most support to meet their infant feeding goals. When we look at those rates, and we think of it from that position from powerful - of advocacy really, then we can start to think about what we can do differently.

If you’re feeling demoralized, if you’re feeling burned out, that’s one way to shift your energy and shift your focus: understanding where energies and resources are being focused and shifting it to where it really should be. And using the information and the data that we have on breastfeeding rates, we know that we should be shifting resources and support toward people who are currently not getting those and making sure that others are not using breastfeeding rates as a way to become lazy or use untruths or fail to act justly about what it is that they’re doing when they are failing to provide the support or the information or assistance that is needed by their clients or their patients.

Failing to speak out and to advocate for lactation and breastfeeding, let’s face it: it happens to all of us, it happens to us sometimes when we have to, you know, take cover and protect ourselves in certain situations, but it is our responsibility, it is our role, and it is a privilege to be able to speak out on behalf of lactation and breastfeeding because we have the knowledge to do so. So whatever your education level, whatever your training level, whatever your experience level, your commitment to, your mission of improving health and improving health outcomes as a public health strategy, that comes from the knowledge that performing biological functions as the body is intended to do is a huge piece of making sure that health outcomes are going to be as positive as possible and optimizing those things.

That is the power that we have and the knowledge that we have. Whether we are coming to it from where we feel like we’re in the beginning of our education or training or we’re well along the way, or we feel that we’re very experienced, it’s that knowledge that lactation and breastfeeding are important, not beneficial, they’re not good, they’re not better, they’re important. And keeping that powerful stance on it is how we advocate.

We always work to be a resource. We are a resource for the clients that we work with. We are a resource for the colleagues that we have in health facilities or other places where we work and do our lactation advocacy. And we are part of the healthcare team which needs us. It requires us to be advocates for lactation. It’s the whole reason we are there. We’re not there to be quiet. We are not there to fit in. We are there to advocate for lactation and for breastfeeding and for the people who need to accomplish those behaviors, who want to accomplish those behaviors. We are there for them, and if we keep them always top of mind, it’s a little easier for us sometimes to be able to speak up and advocate for the things that we are really there to do.

And I’ll leave you with this thought: this work is hard. And we know this. This is why people get burned out. This is why people become demoralized. This work is hard in lactation. But here’s the thing: so what? There’s a lot of things that we do that are hard. We can do this. We definitely know that it matters. It definitely matters. It makes a difference when we advocate for lactation and for breastfeeding and for parents and their desires. Acknowledging that it’s hard doesn’t tell us that we shouldn’t do it. It doesn’t give us a reason not to do it anymore, it just reminds us to take care of ourselves while we do it. It reminds us that we need to take care of ourselves and stay strong and stay connected with each other while we’re busy advocating for others. Thanks for being here. I’ll be back with you soon. Thanks for joining us on the Lactation Training Lab Podcast.


Listen to Episode 2 here!

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