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.


Meet Speakers from Milk | Mood | Moves: Dr. Sara Moukarzel

As part of our countdown to Milk | Mood | Moves conference, we are highlighting a few of our speakers. Next up: Dr. Sara Moukarzel!

After conducting research as bench scientist studying minor fat molecules in human milk, Sara Moukarzel, Ph.D became frustrated with the lack of research findings that were reaching the public and the large amount of health misinformation reaching the public, especially on social media. With her own frustration as the impetuous, she began a new strand of research looking into how scientists can create accurate and effective social media messages so that their findings can reach a larger audience outside of the scientific community. Dr. Moukarzel entered a relatively new and growing field of research that, until recently had few widely available tools and few researchers. While large organizations and commercial enterprises often analyzed user behavior for marketing purposes, few scientists were looking at the spread of scientific health (mis) information.

However, that changed recently as the term “misinformation” entered the public consciousness with the spread of COVID-vaccine misinformation and the increased scrutiny placed on social media companies and their role in propagating misinformation more broadly. With the public awareness about misinformation as well as the creation of widely available analytics tools and the ever-increasing number of users on social media platforms, Dr. Moukarzel’s research has become all the more timely and relevant.

Her primary findings on how to create engaging posts shows that posts that are short, empowering, and simple to understand as well as show diversity and include photos illicit the most engagement. In addition, her work stresses the importance of using trusted sources such as community leaders to share health information. She recommends campaigns partner with already-existing trusted organizations to garner more attention. In many ways, “we are all influencers” for our communities, she said.

However, she does not want to minimize the challenge of educating the public. Information from researchers can be misconstrued or misinterpreted by more public facing media and by individuals. Nuance can be lost.

Learn more about Dr. Moukarzel and her research here and be sure to register for Milk | Mood | Moves, an interdisciplinary conference on September 23-24, 2021 for health professionals, researchers, and advocates to share the latest science and clinical knowledge of pregnancy, birth, and postpartum, focusing on human milk and lactation, perinatal mood disorders, and physiology and biomechanics of the perinatal period. Dr. Moukarzel will be speaking on how you can be an effective on social media especially in the field of chestfeeding.


Meet Speakers from Milk | Mood | Moves: Dr. Catherine Monk

As part of our preparation for our upcoming Milk | Mood | Moves conference, we are highlighting a few of our speakers. First up: Dr. Catherine Monk!

Dr. Catherine Monk fell into the psychology field by first studying journalism. She realized that what she loved in the journalism field was hearing people’s stories and it was this first love that led her to become not only a Professor of Medical Psychology in the Departments of Obstetrics & Gynecology and Psychiatry at Columbia University but also the founding director of a novel initiative that embeds mental health services into the OB/GYN clinic. Patients of all ages and backgrounds are referred to the integrated and insurance-covered mental health services by their OB/GYN providers and through universal depression screenings. The providing of mental health services is part of an effort to provide “whole person” care by examining the health of the person outside of only the traditionally considered biomedical indicators. While this shift is not new, it is still relatively unique in the OB/GYN field. It is more commonly seen in pediatric clinics, according to Dr. Monk.

The COVID-19 pandemic has accelerated the move to long distance medicine: During the COVID-19 pandemic, the mental health services offered in the OB/GYN clinic have been offered through telemedicine instead of in-person. While there are some cons of this acceleration to care over the internet, according to Dr. Monk, the convenience alone outweighs the cons. Another benefit in addition to convenience for patients, is accessibility of services. She expects more pregnant and postpartum people will receive mental health services after the pandemic. While this may change as state laws are tightening regarding provider licensure after being relaxed during the height of the pandemic, Dr. Monk still thinks more people will still be able to access mental health services with telemedicine. The pandemic has also made a cultural shift towards acceptance of mental health care, said Dr. Monk.

In addition to clinical work, Dr. Monk leads a research lab, Perinatal Pathways, that investigates how influences on the fetus can affect the health of the child throughout development. The lab currently has multiple ongoing projects that have continued throughout the pandemic with the use of videotaping, zoom sessions and other web-based systems with minimal bio data collection. Dr. Monk’s lab is a part of the COVID-19 Mother Baby Outcome (COMBO) initiative, a group of scientists at Columbia that “follows SARS-CoV-2 exposed laboring mothers and their newborns and compare their long- term health outcomes to case-matched dyads without prenatal exposure.” The hypothesis of this study is “that prenatal SARS-CoV-2 exposure affects (1) mother and (2) child brain and behavior, and (3) demonstrate that the socioemotional health of each member of the mother- child dyad is intrinsically related to that of the other.” Monk credits her lab colleagues for their energy and ability to pivot during the pandemic to continue the lab’s ongoing studies and participate in COVID-related investigations.

All of Dr. Monk’s work, both in the clinic and in the lab, indicates that the transition into parenthood is an important biological and psychological one, like adolescence, and that support is crucial to the success of the parents and the child.

To learn more about Dr. Monk’s work, register for Milk | Mood | Moves, an interdisciplinary conference on September 23-24, 2021 for health professionals, researchers, and advocates to share the latest science and clinical knowledge of pregnancy, birth, and postpartum, focusing on human milk and lactation, perinatal mood disorders, and physiology and biomechanics of the perinatal period.

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.

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.