Tuesday, January 29, 2008

The US Breastfeeding Committee Conference I

Where do I begin. That conference was freaking awesome. I made some great contacts, found some wonderful new research, sat in on some thought provoking sessions, got some great ideas for my breastfeeding committee, ate some great Maryland crabcakes, found a mentor, bought a book, won two door prizes, got compliments on my new glasses and new hair-do, and saw lots of presidential and wartime memorials. What more could a breastfeeding conference atttending lactivist ask for? I got to talk to two pioneers in the biz, Marion Thompson and Marsha Walker. I attend a lot of conferences and this one had a very upbeat, hopeful tone to it. Lots of talk about advocacy and legislative action. It was so wonderful to be in a room with over 200 lactation advocates from all over the US (and US territories and tribal agencies). The energy was infectious and the content, worth the plane ride (including the layover in Detroit!). Here's a few things I learned:

I loved the two sessions I attended on presentation skills by Joan Detz, professional speaker and speech writer. I got away with two of her books and read them both on the plane ride home.

There was a State Breastfeeding Report Card. We looked at state data gathered by the CDC. (Center for Disease Control) Though the numbers look decent, I got a real appreciation for the challenges of how to measure breastfeeding rates. Do you measure intent to breastfeed or actual breastfeeding? How do you define 'exclusive' breastfeeding? How do you count supplemental nursing, what constitutes supplementing? Do you count it as breastfeeding if the mother only did it once? So on and so forth.

I want to mention some others but it will have to wait until the next post, I'm out of time.

Friday, January 25, 2008

Leaving on a jet plane...

By the time this is read, I should be on my way to Washington DC to attend the US Breastfeeding Committee Annual Conference. I am attending with 4 others from my state. I'm quite excited to attend for the first time. I'm hoping to get exposed to some great research, and to hear something about lactation supportive workplace practices (an emphasis this year). This will be the first conference in a very long time, that I've attended without a kiddo in tow. I will enjoy being able to just soak in the ambiance of hanging out for three days with hundreds of other lactation enthusiasts. Can't wait to report back what I've learned. If you happen to be attending, look for me to say hello. I've met readers in person at every conference I've attended since starting this blog!

Tuesday, January 22, 2008

Letter to the Editor

Kansas City in 44th Place? Now There's A Shocker

As a active voice for safe, sane, and sacred birth, and as an obstetrical nurse, I have to say I'm not surprised that Kansas City is in 44th place. The conservative medical establishment here has long resisted those very elements that would improve perinatal outcomes for moms and babies. These include ubiquitous access to midwifery care, and the widespread promotion and acceptance of breastfeeding. Nowhere is this more obvious than in the African-American community (my community) where breastfeeding rates are lowest and infant mortality rates are highest. If Kansas City really wants to rise in the rankings of the best place to have a baby, then the powers that be need to ensure that Kansas City women have as much access to a lactation consultant as they do to goody bags full of artificial breastmilk substitutes (paid for by formula companies), and as much access to a doula as they do to an epidural.

Submitted this morning to the Kansas City Star.
I'll let you know if it gets printed. If it does somebody's morning coffee is fucked.

Monday, January 21, 2008

Here's A Shocker

According to Fit Pregnancy magazine, Kansas City Missouri (my city) finds itself number 44 among cities ranked for the "Best place to have a baby." Find all the particulars on this website. http://www.fitpregnancy.com/bestcities2007/main07 Check it out to see if your American city is on the list. Now this is in no way scientific, its more for novelty. However it does draw attention to some important issues and it does use real numbers gathered from government agencies, private foundations, professional associations and public databases. Of course I'm not surprised that things are so dismal for my city. Fit Pregnancy cites very low breastfeeding rates (both initiation and duration), low access to midwifery care (just 2.6% statewide vs 7.3%nationwide- also low in my opinion), high smoking rates (12%), and low access to daycare. (It also sites our high crime rate and low access to healthy foods). Whew, where do I begin? While I have lots to say about crime and access to quality food (especially in the urban core) my focus is mainly on low breastfeeding rates, and low access to midwifery care. It strikes me that women choosing homebirth almost automatically use midwives and breastfeed. Among women who follow the typical course of perinatal care (OB care and complete or supplemental artificial breastmilk feeding) the skirting of midwifery care and good lactation education and support is almost complete. (Be honest, how many conversations did you have with your OB about breastfeeding?) Here in Missouri, lay midwives are illegal, but even CNMs aren't exactly welcomed with open arms. Doulas are still an anomaly in most places (downright unwelcome in some). Most hospitals around here don't get the importance of hiring LCs and most L&D nurses would just as soon stick a bottle in your kid's mouth than to blow 20 minutes teaching you how to latch. Kansas City's limited options means pregnant women and newborns have limited access to the very things that help ensure positive health outcomes.

Wednesday, January 16, 2008

Still pity the fool

Okay folks, we need to shift this argument a bit. Encouraging women to breastfeed is NOT about making them feel guilty. Encouraging a look at non-tech, out of hospital birth is NOT naive. As a nurse, these issues are about SAFETY. Safety of the mother, safety of the baby, period. As I prepare for my presentation for an upcoming conference on African-American women and breastfeeding, and as I read countless research articles in that preparation, it comes across loud and clear that techno-birth followed by artificial milk feeding is DANGEROUS to babies and moms- especially African-American babies and moms. But a study of African-American populations has really given me a bird's eye view of the havoc these cultural norms have wreaked in the health of women and babies in our country as a whole. A look at AA culture as a microcosm of all the worst effects of our perinatal healthcare practices and policies reflects a bleak and horrifying picture. Of course I knew this before reading those articles, hell, I've been saying the same thing for 20 years (just a voice, crying in the wilderness...) but the articles put it in writing with pie charts and graphs. Caucasian mamas and babies bear it better only because they have a socio-economic cushion in the form of better access to healthcare and other necessary resources. The meatiest article I came across was a study from the Joint Center for Political and Economic Studies Health Policy Institute out of Washington DC. Barbara Philipp and Sheina Jean-Marie from the local infant mortality commission penned this research as cautionary tale. "African American Women and Breastfeeding" links low rates of breastfeeding with high infant mortality rates. This isn't about warm fuzzies, its about life and death. Our city has an infant mortality commission as well. There are also national/ federally funded organizations devoted to lowering infant mortality (ever hear of Healthy Start?) Breastfeeding and access to quality care has long been part and parcel of those plans (high tech and high quality are not synonymous in my vocabulary- as a nurse I saw technology used just because it was available not because it was beneficial). Don't let naysayers throw up a smoke screen about homebirth or natural birth just being 'a nice experience for the mother' or breastfeeding promotion being about 'making women feel guilty.' It's a matter of infant and maternal health. So the next time this pitiful fool has a conversation about the impact of birth and breastfeeding practices, it will be framed in terms of sound healthcare policy and the impact on our national health.

Tuesday, January 15, 2008

Pity the Fool

It has been two weeks and my mind is filled with thoughts common to birthaholics and lactivists. I muse, ruminate, ponder, and get pissed. Then I write. The healthcare system is going to hell in a handbasket, infant and maternal mortality rates are actually rising (along with cesarean rates) and women really don't seem to have a clue and are lulled into a false sense of security that their doctors have their best interests at heart. Yet all of this doesn't make me despair. It makes me feel a sense of purpose. I feel more committed than ever to bringing my book to press. In last Wednesday's New York Times, there was a somewhat tepid review of Ricki Lake's film, "The Business of Being Born." Granted, homebirth is a hard sell in this day of insta-births. It boils down to a classic less is more argument. It will take real finesse to make this a palatable (or plausable) argument for those who think excessive use of technology in birth represents the best and the safest.