Culture, Choice, & Policies

The “Choice” to Breastfeed

There is often still confusion about lactation advocacy. Some things I often hear are: Are you anti-formula? Are you anti-choice? The idea that breastmilk vs formula is a “choice” is wildly misleading. In fact, only those who have the most privilege (with regard to racism, culture, family structure, income, ability, geography, etc) actually get to make the choice between human milk and formula. Most often, both in the US and around the world, parents become dependent on formula due to predatory marketing, lack of culturally relevant support and education, racism in perinatal care, historical trauma that impedes breastfeeding, lack of proximity to or knowledge of donor milk, and/or having to return to work too soon.

Among families who have the privilege of avoiding these barriers and others, it may actually be a personal choice between formula and breastmilk. But are those families truly informed of the risks associated with infant formula? The health risks of formula are so great and so well-established that researchers cannot ethically do a controlled study comparing breastmilk vs formula. Yet this understanding of the qualitative and indisputable differences between human milk and formula often don’t reach parents.

Our goal at Nurturely is to make it common knowledge that human milk access should be a human right. With this framing, it becomes more clear that this is a fight that everyone has a role in, regardless of how you personally feed your own baby or whether you even have babies at all. Join the conversation on this human rights issue that connects humans around the world. 

Policies x Culture

Policies supporting lactation have been slowly increasing, which is of course fantastic and very needed. And as much as I want to celebrate and support these policy advances, they’re falling support of 1) being equitably implemented, and 2) getting at the cultural change that needs to happen to be truly effective.. At its core, lactation is a cultural practice and so the solutions that aim to increase equitable access to lactation and human milk must shift culture, not just change rules or structures. 

As one example, corporate, state, and federal policies now support milk expression in the workplace (e.g., ACA, PUMP Act) and are associated with increased lactation duration (Kim et al., 2019), yet structural racism has created disparities where Black lactating parents are more likely to work in the service or transportation industry in jobs with less flexibility in comparison with white parents who are more likely to be in management positions (United States Bureau of Labor Statistics, 2018). This results in an unequal benefit from these policies, making education about and equitable enforcement of milk-friendly workplaces critical to health equity and racial equity (Johnson, Kirk, & Muzik, 2015). Among birthworkers and healthcare professionals who provide the majority of care to perinatal patients, almost none are required to obtain – or are routinely provided with – any training in lactation in general, much less milk expression specifically. Due to lack of expertise plus a lack of continuity between these providers, parents often receive conflicting messages and guidance about milk expression, a lack of coordination that threatens lactation and human milk access (NACCHO, 2021). 

Another example is the legislation and structural change of providing lactation rooms in airports. The Friendly Airports for Mothers Act was signed into law in 2020, requiring airports to have a private space for pumping and breast/chestfeeding. The easy-to-implement and compliant solution came in the form of a lactation pod, now seen widely across most US airports. Though structurally and systemically, this law and the corresponding solution are creating infrastructure to benefit lactating and pumping parents, let’s also look at the cultural message these pods are sending: 

– lactation/pumping should be shut away, out of public view

– lactation/pumping should be done alone

– lactation/pumping is a thing that happens at a specified and time

These messages are neither accurate nor supportive of the biology, psychology, and culture of how humans feed babies. 

– Is this law a win for parents and health equity advocates? YES!

– Is the lactation pod an easy and affordable solution for airports to stay compliant? YES. 

– Is it true that many parents would prefer feeding/pumping alone in the privacy of a pod? Of course. 

The long term goal should be cultural change, building a society that welcomes and supports feeding and pumping anywhere, anytime, and we all have a role to play.

Reach out to us to brainstorm how you can support a culture of lactation at your workplace, community group, or other public space. 

Celebrating Multicultural Lactation- A Transformative Partnership with CardCraft(1)

Celebrating Multicultural Lactation: A Transformative Partnership with CardCraft

Nurturely is excited to announce our partnership with CardCraft, a Black-founded and owned business based in Portland, Oregon. This collaboration is not just about creating beautiful art; it represents a powerful alliance in advocating for lactation equity and cultural inclusion.

August: A Month of Lactation Awareness and Advocacy

We launched our partnership in August, a significant month for lactation awareness as it is recognized as National Breastfeeding Month. Throughout this month, the world comes together to celebrate the beauty and importance of breastfeeding and human milk feeding. It begins with World Breastfeeding Week, followed by Indigenous Milk Medicine Week, Asian American Native Hawaiian and Pacific Islander Breastfeeding Week, and culminating with Black Breastfeeding Week. These events are essential in highlighting the diverse experiences of lactating parents across different cultures and communities.

Our Core Belief: Human Milk as a Human Right

At Nurturely, we firmly believe that human milk is a human right. We advocate for lactation equity, aiming to eliminate racial inequities in pregnancy, postpartum, and infant health. Lactation equity is not just about personal choice; it is about ensuring that every parent, regardless of their background, has access to culturally-relevant lactation support and resources.

A Collective Vision: Celebrating Multicultural and Underrepresented Lactation

Our partnership with CardCraft goes beyond a business alliance. It is a celebration of multicultural lactation and a commitment to advocating for lactation as a human rights issue. We worked together to create an exclusive art collection that captures the essence of lactation and the diverse experiences of parents from different global communities.

For example, this card design aims to represent bodyfeeding in Indigenous communities around the world, which so often occurs out-and-about with baby attached to caregiver’s body, participating in life as a dyad.

Uplifting Lactation Awareness Through Art

The prints designed by CardCraft artists serve as powerful reminders of the historical and cultural inequities in lactation access.

For example, this card design amplifies Black bodyfeeding. Due to historical barriers, including the trauma of enslavement and being forced into oppressive wet nursing, as well as present-day barriers, including racism in perinatal care and lack of culturally-matched support, Black breast/chestfeeding rates are consistently the lowest. Lack of representation of Black bodyfeeding exacerbates these inequities. By leaning into the mantra that #BlackWomenDOBreastfeed and the work started by the Founders of Black Breastfeeding Week, this card aims to prioritize the joy and commitment of Black parents who are reclaiming being able to feed their baby from their body.

Through their art, we hope to raise awareness about the systemic and cultural barriers that parents face when seeking to nourish their babies with human milk. Use these cards to tell stories, spark conversations, and inspire action towards creating a more equitable and supportive environment for lactating parents.

Why This Partnership Matters

CardCraft’s commitment to anti-racism and advocacy aligns perfectly with Nurturely’s core values. Together, we can bridge the public and private sectors to create impactful opportunities for change. Art has a unique power to touch hearts and change minds. Through the art created by CardCraft’s artists, we hope to foster a deeper understanding of lactation as a human right and the importance of culturally relevant lactation support.

Join the Celebration

We’re excited to be working with CardCraft – and with YOU! – to make sure multicultural, global lactation is celebrated and equitable access to human milk is prioritized.

Now’s a great time to use these cards to send a quick note to a friend, fellow parent, or community advocate that you admire. Sending this card (and letting CardCraft do the handwriting and the mailing for you!) is a great easy way to spread the lactation equity love all year long.

Milk Magic Educators: Tteka

To describe the communities in which I serve, I would say we are resilient and strong birth warriors, because we must battle iatrogenetic medical apartheid and obstetric violence and continue to be dependent on the system that turns a blind eye to our mistreatment especially with regard to medical care. We suffer the highest statistical rates of three of the top five annual preventable killers here in the U.S. (Heart disease, diabetes & cancer) and we suffer the highest statistics for infant mortality and maternal mortality as well. There are so many disparities that interact in the lives of the families I serve such as, initiation of breast/chestfeeding and duration of continued breast/chestfeeding, poverty/financial burdens, food insecurity, job insecurity, stress, psychological trauma as well as other environmental, economic and social disparities that are highly racialized, but also affect other marginalized communities such as LGBTQIA folks, differently-abled families, non-nuclear families and immigrant & refugee families. The communities that I serve are those that are most affected by discrimination and those least likely to receive the equitable support and care they need and deserve.

Milk Magic Educators: Julia

As a doula, student midwife, and mother, I know how hard it is to get access to lactation support when you are not able to pay for classes or consultants. It is also hard for people like me to afford education to provide these services, so the fact that I could join the program and use the curriculum within the non-profit, extending the support these families could get, I thought it was a wonderful opportunity.

Milk Magic Educators: Sterling

When I had my first child I was 21. I was the first one in my family to breastfeed. Through that I saw that there were many women in similar positions. I became the person all of my friends called asking about breastfeeding. I knew that there were things that needed to be addressed. I often tell my clients I aim to provide them with the support and education I wish I had received as a first time mom.

Milk Magic Educators: Trina

I’m a mama on a mission. I want to support and encourage mamas along their journey. I want to share the information I’ve learned in hopes to encourage breastfeeding mamas to keep going. There’s a lack of support and quality resources and I want to step in a fill that gap. What started off as a kind gesture, a post here and there, has grown and matured into a passion. I think that human milk is amazing and I want mamas to be able to make the BEST and most informed decision when it comes to feeding their children.

Racial Disparities in Breastfeeding

According to Kimberly Seals Allers, expert breastfeeding advocate and author of “The Big Letdown”, the disparity is due to bias and racism. Research conducted by the Centers for Disease Control and Prevention (CDC) shows that hospital maternity wards “are less likely to help black women initiate breastfeeding after giving birth or offer lactation support following delivery” (Santhanam, 2019). Hospital staff offer black babies formula more often than white babies (Santhanam, 2019), which can be one of the most important predictors of breastfeeding duration (McKinney et al., 2016).

Human Milk Sharing – Part II

With the help of a financial gift from Hannah and Zachary Johnson, the UC San Diego Health will create the region’s first breastmilk bank (The San Diego Union-Tribune) led by Dr. Lisa M. Stellwagen, MD. The goals of the bank are “to help mothers breastfeed, to improve breastmilk donation and to ensure that all premature or ill babies in Southern California have access to donor milk” (UC San Diego Health).

Human Milk Sharing – Part I

Human milk is a critical resource for infants designed to meet the needs of baby at every stage of development. Human milk is alive with immune cells, stem cells, and microbes that come from both the lactating parent and from the baby (Hassiotou et al., 2013; Funkhouser and Bordenstein, 2013). For example, a thick yellow milk produced a few days after birth called colostrum (American Pregnancy, n.d.) can be thought of as baby’s first immunization (Khan, 2012)…. The use of donor milk (or “milk sharing”) is not a new practice for humans. “Allomaternal care” and shared nursing has long been a part of many, if not most, human cultures yet there are no federal laws regulating the use of donor human milk or milk sharing. Milk banks provide a degree of quality control by screening donors based on lifestyle, teaching donors about best practices for expression, storage/transport of breastmilk as well as pasteurizing the donated milk.