A comfy chair for nursing or pumping.

We love the giveaway Breastfeeding Support Packs from Healthy Baby Bags!

Open from January 27th through February 5th, with 24-hour coverage starting today through Monday, this lactation suite is the first ever to be approved by the NFL and is part of the Super Care Clinic.   The warm and cozy lactation room is outfitted with breastfeeding chairs,  a hospital grade pump;  sterile, individual-user pump accessory kits, activities for siblings and great WHO-Code compliant samples and information provided by Healthy Baby Bags.  ”Mothers who are bottle-feeding and need a quiet place or the use of a microwave are welcome, too”, explained Sarah Walter, Director of Communications for the Indiana Perinatal Network, which worked with MESH to set up the room.  The lactation room and Super Care Clinic are located at Union Station at 300 S. Meridian Street and  can be reached at (317) 636-CARE (2273).

For mothers who need to pump, or who are not comfortable nursing in public, the lactation station is a wonderful safe haven.  I imagine that breastfeeding tips and tricks will be shared, and experiences compared, as is usually the case when nursing mothers get together.   Luckily Indiana is one of 45 states that protect a mother’s right to breastfeed in public, and most moms will happily nurse while out and about, but a lactation station is also a great place to go if a nursing mother needs an ice pack for a plugged duct, has a breastfeeding question, or maybe if she has a restless toddler and just needs a quiet place to nurse that is free from distractions!

Fun for siblings. Mama's Milk is one of our fave books for kids.

Fans looking to keep up with the play-by-play needn’t worry:  a T.V. has been set up in the room so festivities and scores won’t be missed.    So far, the dozens of moms who have used the room have been thrilled.  ”They’re coming up and thanking us for including them and for making it easier for them to provide for their babies and still be able to participate in the fun,” says Walter. “Mothers who left a pump flange at the hotel room needn’t drive all the way back and miss the action.”

Just like the bi-partisan “Boob Cube” in Washington, we think this lactation station is awesome.  ”The NFL, and all the partners in the Super Clinic have been so supportive.  As soon as they realized there was a need, they backed it 100%,” says Walter.  Best for Babes hopes that the NFL will make it standard fare for every Superbowl.   It sends a powerful signal that breastfeeding is a normal, natural activity that is as healthy as exercise, and that moms deserve to be accommodated.  Considering that breastfeeding is associated with improved adolescent muscle strength, who knows, maybe a future quarterback will be nursed in Indianapolis this weekend!

Attractive photos by Anne Schollenberger inspire breastfeeding moms.

Do you want to help us encourage the NFL to bring the lactation station back year after year? Leave your comments to let the NFL know you think this is great, and we’ll collect them and forward them on!   Let’s show ‘em that nursing moms and babies count, from first down to Endzone!

Deena Kastor, 38, winning her first race since having Piper, the San Jose RocknRoll Half Marathon. Photo courtesy Andrew Kastor.

Deena Kastor, Olympic Running Medalist, American Record Holder, and new mom to daughter Piper, age 10 months, shares how treating breastfeeding like training for a race is a great game plan for success!  Deena’s steady focus on her goal,  smart choices, and some French Toast at 3am from her husband  — took her from breastfeeding intention to a strong finish with very few Booby Traps!  Congratulations Deena – you’re unstoppable and you’re an inspiration to moms everywhere!  (Read to end of post for our Runner’s Giveaway!)

Thanks to Fairhaven Health for sponsoring this post!

Best for Babes: Were you “Booby-Trapped“?  We often say that trying to breastfeed despite booby-traps is like trying to run a race in heels while people throw tomatoes at you! Deena Kastor:  I was lucky that Piper latched immediately in the hospital, but I did have a hard time producing enough for her monstrous appetite.  Hydration proved to be my biggest necessity to produce enough milk.  I always had my water bottle with me when I was nursing.  Hydration not only helped with my milk supply, but also helped stabilize my tired self throughout the day.  BfB: Most moms can more than meet their baby’s needs. See an IBCLC (find one at ILCA.org) if you are concerned about your milk supply. Drink a glass of water every time you nurse, especially if you are exercising.

Thanks to Britax and BOB for sponsoring this post!

How is breastfeeding going now? Piper is 10 months old and I stopped breastfeeding at 6 months . . .  she was taking the bottle and even food at this time.  It was a natural progression for our daughter.  Either way, it was Piper who decided to wean.  During breastfeeding it was very important for me to eat well and rest so that I was offering the optimal nutrition for my daughter.  BfB: Kudos to Deena for making it to six months! Despite recommendations from the AAP, CDC and WHO, only 44% of moms are breastfeeding at all at six months, and only 14% are breastfeeding exclusively).  Although Deena’s training schedule may have affected her supply, natural, baby-led weaning usually doesn’t occur until a child is well into their second year of life or later.  Your IBCLC can identify ways to help you boost your supply.  Pumping or hand-expressing can signal your body to make more milk.  Also, it is a myth that an improper diet will diminish your supply or make your milk nutrient-lacking: another one of breastfeeding’s miraculous “fail-safes” is that your body will take whatever vital nutrients you’ve got and make them available to your babe– leaving you potentially depleted.  So stock up on nutrients for YOU!

Did being a competitive runner help your mindset?  Did you have anyone cheer you on with breastfeeding? I think running helped in my entire approach to pregnancy, breastfeeding and raising Piper.  I would focus on the desired outcome and then make choices to get to my desired goal.  Most of the last year has been so rewarding in that we have a healthy daughter who sleeps through the night!

Thanks to Milkmakers for sponsoring this post!

My husband has been amazing throughout all of this.  I remember breastfeeding at 3 am and he came out from the bedroom asking if I need anything.  “French toast?”  He gladly made me his world’s best French toast at that absurd hour.  He is currently so hands-on with Piper.  He would win “Dad of the Century” if there was that honor.  BfB: Setting goals is a great way to awaken your inner breastfeeding athlete.  See “Get your Best Breastfeeding Game on, The Learning Curve, and our Ultimate Breastfeeding Preparation Checklist. Make a commitment to breastfeed and get great coaches and crowds of cheering peers, family, co-workers and employers to help you make your goal! With Dad on board, you’ve got the quintessential defender and teammate to help you get through any Booby Traps, and Dad gets loads of non-booby baby bonding time to cherish.

What advice would you give to new moms who are trying to re-gain their former fitness levels while breastfeeding? Any tips on overcoming the fatigue that comes with having a young baby? The only thing that got me back into shape was rest.  What a celebration to finally sleep through the night.  It is really important to take care of ourselves without the guilt of feeling selfish.  When we are operating optimally, we are better parents.  There is no rule of thumb on what to do and when.  I thought I would be active my entire pregnancy and found it so uncomfortable to even walk, that I was sedentary for 5 months.  After Piper was born, it was easy to get back into running because running felt good again.  Listen to your body.  I mean REALLY listen.  The feedback I got from my body was more valuable than any book I read.  BfB:  Studies show that breastfeeding mothers get at least as much, if not more sleep than formula-feeding mothers.

Thanks to Simple Wishes for sponsoring this post!

Did you notice any drop in your milk supply as you started to train harder? If so, what did you do about it? Breastfeeding is so important for the nutrition and development of your child.  It is also important for our own bodies to go through this natural process.  But, I wouldn’t stress if it isn’t working out.  I actually found that my milk supply went up when I integrated some formula and took some pressure off myself.  At this same time, I began training harder but I really think it was the alleviation of stress that helped with my supply.   BfB: We agree with Deena! Breastfeeding and human milk provide immediate and lifelong protection against many of the illnesses and diseases which have sadly become epidemic: for baby: ear and gastrointestinal infections, SIDS, leukemia, obesity, asthma, diabetes, and even breast cancer for baby girls; for mom: breast and ovarian cancer, postpartum depression, diabetes,obesity and heart disease.  Breastfed babies have even been shown to have stronger leg muscles at adolescence (watch out for future marathoners!). Breastfeeding burns 500 additional calories per day  (equivalent to 45 minutes of running 5mph for a 170 lb woman), so it’s a work-out for you, too! Too much stress can affect your confidence and your milk supply, so ask for help and let household chores fall to family and friends for a while. Remember that breastfeeding does not have to be all or nothing, any breastfeeding is better than none, and a good IBCLC can help make it all work for you. Best for Babes believes that what is best for moms and babies is to make informed decisions and to achieve their personal goals, whether that is to breastfeed for 2 days, 2 months, 2 years, use donor milk, or formula feed.  See Our Credo.

How do you feel about nursing in public? Recently a mother was harassed at Target, and another mother was humiliated by a judge for nursing discreetly in a courtroom, even though breastfeeding is legal and protected in public places. I fully support breastfeeding in public, even though I was a little more on the modest side.  Moms everywhere should be entitled to feed their children, and it is a shame that others would feel threatened by that.  BfB: Best for Babes advocates for an end to the harassment, humiliation and discrimination nursing moms unfairly face while trying to breastfeed their babies in public.  Condemning public breastfeeding is a cultural Booby Trap even more than a legal one – nearly every state has laws protecting a mother’s right to nurse but too many people are still squeamish and uncomfortable seeing babies breastfeeding.  To get involved, contact takeaction@BestforBabes.org.

We love Deena’s self-assured attitude, determination and special brand of encouragement.  Thanks Deena, for leading the pack and the way!  To learn more about our athletic teams working to Beat the Booby Traps and Put Prevention First visit Team BfB!  Special thanks to Fit Pregnancy and Runner’s World for helping us spread the word on this interview.

Runner’s Giveaway: In honor of Deena, and all the babes who are hitting the pavement while breastfeeding, we’ve put together a fabulous giveaway, valued at $776, courtesy of the generous sponsors of this post:

1. A BOB Stroller Strides Stroller, red, valued at $469

2. A Britax Baby Carrier in black, valued at $130

3. A Three -Month Supply of Fairhaven Health’s Nursing Blend, valued at $54

4. A Generous Supply of Milkmakers Cookies, valued at $54

4. A Simple Wishes Hands-Free Pumping Bustier, valued at $39

5.  Autographed copy of Run Like a Mother by Dimity McDowell and Sarah Bowen Shea, valued at $15, plus a gift certificate for Train Like a Mother, their new book due out in March, also valued at $15.

To win this fabulous prize package, enter by leaving a comment below by February 8th, 2012. U.S. addresses only, please. Winner will be chosen using random.org, and announced in the comments section. Winner will have three days to respond to an email from us, before we have to choose an alternate winner, and products will be directly shipped from the sponsor.

This is the 29th post in a series on Booby Traps, made possible by the generous support of Motherlove Herbal Company.

In my last post I wrote about cultural issues and breastfeeding support in the hospital.  Today I’m pleased to share a post asking the question:  Is there a racial Booby Trap?

You may know that there are significant disparities in breastfeeding rates among racial and ethnic groups in the U.S.  Probably the clearest example of this is the breastfeeding initiation rate of African American moms, which in 2007 was 60%, compared to the overall U.S. rate of 75%.

There are a number of reasons why the rates are different, and I explored some of them in this interview with Kathi Barber, founder of the African American Breastfeeding Alliance.

One reason we didn’t discuss, but which I’ve heard a number of times, is an assumption among health care providers that African American moms don’t plan on breastfeeding.  The result of this expectation is that moms sometimes get poor or no support in the hospital at getting breastfeeding off to a good start.

So, is there a “soft bigotry of low expectations” when it comes to breastfeeding support?  I certainly hear stories reflecting that, like this one in which a mother who is committed to breastfeeding gets no help (but plenty of formula samples) from her postpartum nurse, who “seemed surprised to find [her] breastfeeding.”

But I’ve been wondering whether any research might bear that out, so I spent some time looking at the limited literature on this topic, and I think the studies below add up to a “yes.”

Here’s what I found:

- One study examined racial disparities according to women’s self-report of advice received from health care providers during pregnancy about breast-feeding, among other topics.  It found that “the difference [in advice] between Blacks and Whites…approached significance for breast-feeding.”  Another study concluded that “the prenatal period may be a critical time to influence a prospective black mother’s decision to breastfeed.”

- One recent study of WIC breastfeeding support in North Carolina found that “those with higher African American populations were significantly less likely to offer clinic-based breastfeeding support services and trended toward fewer services in general” and found that “differences in the availability of breastfeeding support services were associated with the racial/ethnic composition of the catchment area.”

- A study using older data found that “being African American was associated with less likelihood of breastfeeding advice and greater likelihood of bottlefeeding advice from WIC nutrition counselors.”

- A small interview-based study of African American women and breastfeeding found that “support and advice about infant feeding from the health care system were uneven.”

Why is strong provider support important?  Because study after study has found that when African American women (and all women, for that matter) are given good advice and support, breastfeeding rates go up and up.

Take for example, Boston Medical Center, which became a Baby Friendly Hospital in 1999.  The rate of breastfeeding among African American women went from 34% in 1995 to 74% in 1999.

Another study found that Baby Friendly Hospitals, whether they serve high or low proportions of African American mothers, all had similarly high breastfeeding rates.  In other words: disparity, what disparity?

Is there good news to share on the disparity front?  Yes.  The gap between black and other mothers’ breastfeeding rates is closing at a strong rate, declining from a gap of 19% down to 15% in just seven years (2000-2007).

This is a real achievement, and something to celebrate.  But I would hope that continued progress occurs with the full support of our health care providers.

Do you think your race had any impact on your providers’ assumptions about whether you would breastfeed?  Have you experienced a Booby Trap based on your race?

Image credit:  Indiana Black Breastfeeding Coalition

“Infant feeding is very much part of the storyline on Sesame Street, so the argument that breastfeeding isn’t part of the storyline, doesn’t make a lot of sense. The Elmo’s World “Babies, Dogs and More” DVD teaches children what babies eat and only talks about and shows bottle feeding. Another example is the “you’re my baby” video that included both breastfeeding and bottle feeding in the 1980s, but was replaced by a newer version with only bottle fed babies in the 1990s.”

So, we thought it would be great to ask some top-notch pediatricians for their thoughts on whether children should see breastfeeding, and whether breastfeeding has a place on Sesame Street. Here are their responses:

Natasha Sriraman, MD

The normalization of breastfeeding via Sesame Street–this seems like a natural fit. Unfortunately, this seemingly benign idea is being met with controversy. Sesame Street is an institution, teaching kids for the past 30+ years! What better way to teach children (and their parents) about something that helps prevent obesity, illness, chronic disease, AND can also keep their moms healthy–yes, breastfeeding does ALL that! As a pediatrician and mother of 3, my children have seen me breastfeed and, as a result, for them it’s not gross or something to be shunned, but instead it’s just a natural, healthy act between a mother and baby. For Sesame Street to model something so simple and natural is an important public health message–which aligns perfectly with Sesame Street’s mission on childhood education. — Natasha K. Sriraman, MD, MPH, FAAP, IBCLC; Assistant Professor of Pediatrics, Children’s Hospital of the King’s Daughters, Eastern Virginia Medical School

Lori Feldman-Winter, MD, Courtesy of UMDNJ.edu

“In our society most people, including our youth, do not see breastfeeding as the norm, but instead have grown accustomed to bottle feeding. Billions of health care dollars and hundreds of lives could be saved if our society could support exclusive breastfeeding. The better we become at supporting breastfeeding mothers to continue to breastfeed the more comfortable we will be as a society to incorporate breastfeeding as a natural and ideal part of child rearing. Sesame Street is a perfect venue to show the cultural norm of breastfeeding.” — Lori Feldman-Winter, MD, MPH, Div. Head, Adolescent Medicine, Cooper University Hospital; Professor of Pediatrics, UMDNJ-RWJMS & frequent spokesperson for the AAP.

Susan Vierczhalek, MD

“Breastfeeding is the best low cost way to improve the health of mothers and children and to fight the obesity epidemic. As scientific knowledge of its health benefits for women and children has accelerated in recent years, it has advanced beyond simply a “lifestyle choice” to become an important health decision. Children learn through experience and will model adult behavior, both healthy and unhealthy.  Presenting breastfeeding as a normal, healthy behavior could have a big impact on improving breastfeeding rates which is an important public health goal. I am sure that most of my pediatrician colleagues would support and welcome episodes of Sesame Street showing breastfeeding as the normal healthy way to nourish and nurture infants.  In fact, it would make a great clip to run in office waiting rooms to help normalize breastfeeding for children, their parents, grandparents and other caregivers!” — Susan Vierczhalek, MD; Clinical Assistant Professor, NYU Langone Medical Center; Vice Chief, American Academy of Pediatrics Chapter Breastfeeding Coordinators Steering Committee

Jennifer Shaer, MD

Why is this such a controversy?  Babies breastfeed.  It’s a fact of nature and it is the norm.  Children accept this without question.  As more and more women breastfeed, we are seeing a generation of children who are watching their younger siblings nurse and are completely comfortable with it.  It’s the adults who are too uptight to accept breastfeeding.  Breastfeeding should not be hidden. I applaud programs that reflect what we are seeing in the community and modeling this natural, healthy behavior for children. — Jennifer Shaer MD, FAAP, IBCLC; Peconic Pediatrics and Breastfeeding Medicine, Allied Pediatrics of New York, PLLC

Sahira Long, MD

“When children grow up seeing mothers in their family or community breastfeed, they are less likely to take issue with or even notice others nursing in public or on television.  It becomes normalized for them.  This is especially needed in the African American community where the decision to not breastfeed for generations has undoubtedly played a role in higher rates of health problems that breastfeeding provides protection against, such as obesity, asthma and diabetes.  Too many African American women breastfeed in the shadows or choose not to do so at all because they fear the disparaging looks or comments they may receive.  In fact, I had one mother share with me that her decision to breastfeed in church was met with remarks that it should be a sin.  This was from a child who clearly had not been taught that breastfeeding is the normal way to feed your baby.  My response would have been it can’t be a sin because Jesus was breastfed.  It would be great to see more female African American celebrities breastfeeding publicly since so many of our young girls look up to and emulate them.  Perhaps those young girls will take notice and follow suit when they have their own children.” – Sahira Long, MD, FAAP, IBCLC; President, DC Breastfeeding Coalition

Harvey Karp, MD

“Breastfeeding has been shown tastefully and wonderfully on Sesame Street in the past, and it’s time to bring it back.  It’s important that children see breastfeeding as a beautiful, natural and normal way to feed babies, as long as mother and baby are willing and are able to . . . it is just as important as teaching children about exercise and eating vegetables. Breastfeeding increases a baby’s health, can reduce obesity and diabetes and reduce a mother’s risk of breast cancer. Sesame Street has had great success in helping to remove cultural stigmas, promoting healthful habits and educating children on tolerance, respect and understanding. Breastfeeding and bottle-feeding mothers and babies alike deserve to be treated in that wonderful Sesame Street tradition.”  – Harvey Karp, MD, FAAP; author, The Happiest Baby on the Block (DVD/book)

If your pediatrician wants to learn more about lactation management, point them to the Academy of Breastfeeding Medicine and the American Academy of Pediatrics Section on Breastfeeding.

Do you agree with these pediatricians?  Should Sesame Street include breastfeeding along with bottle-feeding (whether pumped milk, donor milk or formula) on the show?

We reached out to Target last week on Wednesday, December 21st to see if we could work with them so that the nurse-in scheduled for tomorrow, Dec. 28, 2011 would not be necessary.  Nurse-ins require a lot of time, planning and effort from busy moms.  All of us have other things we would rather be doing during our holidays.  I am a Target shopper and fan, and given my corporate communications background, was hopeful that I could interest Target in taking some proactive steps to ensure that other mothers would not have to go through what Michelle Hickman had experienced, and that we could ask Michelle Hickman to cancel the nurse-in.

So, Danielle and I spoke to Antoine LaFramboise, a corporate spokesperson. We commended Target for having a corporate policy on handling breastfeeding customers and applauded those stores and employees who get rave reviews for supporting nursing moms. At the same time, we expressed our concern that we had heard multiple reports of mothers having negative experiences breastfeeding at Target, that Michelle Hickman’s experience was not an isolated incident.  We offered to work with Target on a plan of action to turn a negative into a positive and position them as a leader among retailers in supporting nursing mothers, and help them reap positive publicity for setting a great example.  This plan of action would include strengthening their corporate policy, and working with them to develop an employee toolkit that other companies could use–after all, nursing mothers are being harassed at stores, restaurants, airports, courtrooms, etc.!   We sent Antoine LaFromboise an email summarizing our conversation on December 22.

Here’s where the frustration sets in.  We didn’t hear a peep.  We left 2 voice messages and a text message just asking Mr. LaFromboise to confirm that he got our email.  Nothing.   We checked with Michelle Hickman to see if she had received an apology or had seen any public statement or post from Target that they were addressing the issue with their employees and welcoming moms, similar to what Whole Foods had done in August.  Still nothing.

Today, at the proverbial midnight hour before the nurse-in, I thought I would try one last time to reach someone in management at Target.  After much effort I finally got a call back from Jessica Clarkson in Media Relations, and shared with her what I had shared with the spokesperson last week.  I asked her if she would please summarize her conversation in an email so I could share it with our followers, and here is what she sent.

Hello Bettina,

Thank you for your inquiry regarding Target’s breastfeeding policy. As mentioned during our conversation, as a family-oriented retailer, Target has a long-standing corporate policy that supports breastfeeding in our stores. We want everyone to feel comfortable shopping at Target.  Guests who choose to breastfeed in public areas of the store are welcome to do so without being made to feel uncomfortable. Additionally, we support the use of fitting rooms for women who wish to breastfeed their babies, even if others are waiting to use the fitting rooms.

We continually educate our team members in stores across the country on store policies to ensure all guests have a great experience and we have been in touch with the store where the incident occurred to ensure all team members are aware of our breastfeeding policy.

We’ve worked with this guest directly to address her concerns and are sorry for any inconvenience it has caused.

Jessica Clarkson

Personally, I’m grumpy that I had to work so hard to get a response.  For pete’s sake, Target has a whole PR staff.  It also feels like too little, too late . . . this could have been so easily solved a month ago–Michelle Hickman even suggested to Target back then that they do what Whole Foods did, and welcome the nursing moms.  What are your thoughts?  How do you think Target has handled this issue? (For the full background on this story, see: Huffington Post, Time.com and our FAQs on the National Target Nurse-In)

What is a “Nurse-In”? A “nurse-in” is a peaceful demonstration to raise awareness about a barrier to breastfeeding.  According to the State of Breastfeeding in the United States, breastfeeding rates are lower in the U.S. than in most industrialized countries. Barriers to breastfeeding, a.k.a. “Booby Traps,” are pervasive.  Negative health consequences for mothers, babies, all of society and the planet are epidemic.

A statue of Themis, a favorite in courtrooms and law offices, often exposes more breast than a nursing mother. Ironically, Themis, or "Lady Justice", symbolizes equal justice before the law.

Why is there a nurse-in at Target? On Nov. 29th, Michelle Hickman was nursing her baby in a remote corner of a Houston Target store, using a cover and unseen by customers, and was accosted by employees who insisted she nurse in the fitting room, threatened her, and embarrassed and humiliated her.   When Ms. Hickman called Target Guest Relations, she was told that Target’s policies “are different from the law” and was further harassed.  Upon going up the chain of command, she was promised an apology, however, to date she has only received a written re-stating of Target’s corporate policy; with no mention of the words “we are sorry”, “we regret”, “we apologize” or any other phrase that can be interpreted as apologetic.  There has been no public statement, consequence for the employees that we know of, or indication that Target will make an effort to properly train employees on the rights of breastfeeding mothers and the need to support their efforts.

Why are other Target stores affected besides the store in Houston? Target has a history of inconsistency in how they treat breastfeeding customers.   Some mothers give their local stores rave reviews, others have come forth to say they were embarrassed or humiliated for nursing in their local store.  Clearly, the corporate policy on breastfeeding customers that Target announced after such an incident in 2006 is not being implemented effectively across all 1700 stores in the U.S., and it is not acceptable that women continue to be harassed at Target stores for exercising their basic human right to nurse their babies as they see fit.  It is not acceptable that a mother who contacts Guest Relations has not received an official apology.

What is Best for Babes’ role in the nurse-in? Best for Babes was contacted by Michelle Hickman on December 12th.  We shared her story because we believe that negative attitudes about breastfeeding in public create a big Booby Trap that keeps mothers from initiating breastfeeding and from reaching their personal breastfeeding goals; leading to increased negative health consequences for mothers, babies, society and the planet.  We believe that all mothers deserve to achieve their personal goals–whether those are to breastfeed for 2 days, 2 months, 2 years or not at all–without being undermined, harassed, humiliated or discriminated against.   We are tired of seeing mothers urged to breastfeed by every major health and medical organization, yet kicked out of stores, restaurants, airplanes and even courtrooms for breastfeeding.  Almost all states have laws that allow mothers to nurse their babies in any public or private location, but these laws are frequently not being upheld.   Click here to find the laws in your state.  We are tired of hearing that breastfeeding mothers are being told how and when and where they can nurse. We hope that eventually breastfeeding mothers will be protected nationally through an amendment to the Civil Rights Act.)

Best for Babes has not helped organize the nurse-in.   We see our role as 1) raising awareness through our blog posts and Facebook page, 2) acting as a mediator by reaching out to Target constructively and positively and 3) providing guidance and resources.  We have reached out to Target Headquarters to commend them on having a corporate policy, to applaud those employees who have been supportive and welcoming towards nursing mothers, and to offer our help in reviewing the corporate policy and developing and employee training toolkit on supporting breastfeeding customers so that employee actions are consistent across all stores and regions.  We see the national nurse-in as an opportunity for Target to turn a negative into a positive:  by working with us to develop a toolkit and being the first to implement the toolkit they can set a positive example for ALL customer-oriented businesses in the U.S., help us reward and recognize those companies that have an effective corporate policy and excellent track record in training employees, help mothers and babies, and reap positive publicity for turning this situation around.   We have assembled a working group of senior corporate Human Resources and Communications professionals who stand at the ready.  We had a very productive conversation with Antoine LaFromboise, a corporate spokesperson from Target and sent a follow-up email, but have not received a response, which is disappointing.  It appears that all calls to Target Executive Management are being directed to Guest Relations.

Was Michelle Hickman covered when she nursed her baby? It is immaterial.   Some mothers feel more comfortable using a cover or a blanket while nursing, some do not.  Sometimes babies do not like to be covered regardless of what the mother wants.  At Best for Babes, we believe that mothers should nurse in the way that they are most comfortable, and we agree with PhDinParenting that telling women to cover up or strip down is a frequently used tactic to oppress women.  We also agree with Phdinparenting that there are more than 50 Reasons for Breastfeeding Anytime and Anywhere.  In a bottle-feeding culture, it is understandable that not everyone is completely comfortable seeing babies nurse–yet–but we all have a responsibility to help others overcome this barrier and learn to see that breastfeeding is not only healthy but beautiful! (As someone who was once squeamish about breastfeeding I can relate, but if I can now see breastfeeding as amazing and wonderful so can everyone else.)

Why didn’t she go to the fitting room, as the employee requested, and why did she feed the baby sitting on the floor? Because it is her legal right to feed the baby wherever she is comfortable.  I can’t speak for Michelle, but I can say that sometimes it is not convenient to go to the Fitting Room.  Some mothers don’t feel comfortable asking for what they need, some may be all the way on the other side of the store and don’t have time to haul all the way back.   Some mothers don’t feel comfortable sitting in a chair in the furniture section, some may prefer a spot out of the view of customers.  Some may find that sitting on the floor is more secure with an active baby.  Let me add that 10 years ago, when I was nursing my first child, I found a spot to sit and nurse behind the stairwell in the World Financial Center where I used to work as an executive.  Yes, I sat on the floor because that was more comfortable for me than sitting on the bench in full view because I was nervous!  Imagine a mother waiting in the check-out line during the holiday rush who needs to pick up her toddler from daycare or school; her infant starts crying . . . wouldn’t it just be easier to quiet and comfort the baby with nursing right then and there?  If we want to see more mothers achieve their breastfeeding goals, we need to make it as easy and convenient to breastfeed in public as we have made it to bottlefeed.

Finally, it has been a pleasure speaking with Michelle Hickman, we admire her strength, calm and reasoned approach and we stand behind her and her desire for a peaceful demonstration.  We hope that it will shed light on the societal barriers mothers face and further the dialogue about how we can best protect breastfeeding mothers.   We loved it when Michelle said “this is SO not about me.  It is about all the moms who might not breastfeed or might stop early because they have been humiliated.”  We couldn’t agree more!

Any questions we didn’t answer?  Leave them below!

This post is the 28th in a series on Booby Traps, made possible by the generous support of Motherlove Herbal Company.

I’ll be writing for a few weeks about a set of Booby Traps which are both seldom discussed and vitally important.  Cultural, language, and racial factors can have a tremendous impact on breastfeeding success, and the failure of providers to recognize this represents a significant Booby Trap for many mothers. I’ll begin today by talking about culture and breastfeeding in the hospital.

Culture

Once, a few years ago, I was asked to see a new mom in her hospital room.  The mother was of Indian background, and both the baby’s grandmother and an aunt were also in the room.

The mother asked me if there were any foods she should eat so that she would make enough milk.  Before thinking, I said what I always say, which is that it’s not necessary to eat or drink anything special; she would make enough milk on her own as long as she was feeding her baby frequently and effectively.

Off in the corner or my eye, I saw the grandmother and aunt exchange a look.  It was a specific look, recognizable across cultures and generations.  The look said, “this chick doesn’t know what she’s talking about.”

I suddenly realized that my answer, while technically correct, was really not the right response.

I had contradicted some influential people in the mother’s life and thousands of years of tradition.  Chances were, this mom wasn’t going to take much of anything else I said very seriously, and we’d barely started talking.

I mean, would you take Thanksgiving cooking advice from an “expert” who told you that, while serving turkey is an interesting and quaint tradition, there’s no scientific evidence that it’s the appropriate food for the occasion?

If I could go back, I would have returned the question with one of my own.  Something like, “what traditions do you have around eating foods to help with milk production?”  That would have 1) sparked an informative (especially to me) discussion, 2) made it more likely that my subsequent advice would be taken seriously, and 3) established some trust and mutual respect among us.

The two questions providers should ask themselves when encountering a tradition like this is, “is it harmless?” and “is it harmful?”  If it’s harmless, and especially if it could help the mother reach her goals, then by all means we should support it.  If it’s harmful to breastfeeding (for example, supplementing with formula without an understanding of its effect on milk supply, or not feeding colostrum because of a “colostrum taboo”), then there is cause for a discussion.

So when mothers of Chinese background have told me how important it is to eat a certain chicken dish, or mothers of Mexican descent say that they have to drink atole, should I say that there is no evidence that this has any effect on breastfeeding?  No, I should ask myself if these traditions are harmless or harmful, and get out of the way.  (Except maybe to ask for a taste?  These foods usually sound pretty good.)  That “look” taught me that important lesson.

Now that I’ve given you an example of what not to do, here’s an example of a cultural Booby Trap smashed to smithereens by some outstanding hospital staff:

In 2008, Cambodian American moms in Massachusetts had the lowest breastfeeding rates of any ethnic group in the state.  At one hospital, the rate for Cambodian moms was a dismal 17%, when the rate for non-Cambodian moms was 61%.

In Cambodian culture, as in many others, there are specific foods that are to be eaten postpartum.  And the staff recognized that “one barrier to breastfeeding is a lack of hospital foods that allow women to follow a traditional diet postpartum.”

So the forward thinking staff of the childbirth unit and food service department teamed up to offer a traditional Cambodian menu for moms in the postpartum period, and they studied the results.

Guess what happened?  The breastfeeding rate for Cambodian American moms jumped from 17% to 67%.

So, to follow the guidelines above, we ask:  Is serving traditional foods postpartum harmless?  Yes.  Is it helpful to breastfeeding?  Oh, yes!  And just look what can happen when you eliminate an easily overlooked cultural barrier.

To close this topic, I want to quote a wonderful article on this topic by Jan Riordan and Kathy Gill-Hopple, which sums up the issue beautifully:

Culturally sensitive care for breastfeeding women
begins with an honest and critical awareness of the differences
among cultural groups. By becoming aware of
these differences, we begin a process of partnership in
which all groups have something to contribute. Working
within the cultural constraints of the group to which the
mother belongs, the nurse can serve her client more
completely and is more likely to be viewed as a helper
rather than as one who “does not understand us.” Breastfeeding
families have the right to be treated in a nonjudgmental
manner that accepts their cultural diversity.
The study of traditions of a given culture is crucial to all
health care professionals who work with young families.

Were you Booby Trapped by a cultural issue in the hospital?  What cultural breastfeeding traditions do you follow?

This mother was told by two security guards to stop nursing her baby outside a courtroom in Washington, DC because it was “indecent”.

The fact that mothers are being harassed, humiliated and discriminated against for feeding their babies while going on about their daily lives (a.k.a. nursing in public, or “NIP”) makes clear that we need to do more to protect moms.  Here’s how it works:  Breastfeeding and breastmilk-donating moms protect babies; the leaders, entrepreneurs, inventors and workforce of the future, saving the U.S. billions in healthcare and associated costs, saving employers time and money, boosting our global competitiveness, and protecting the planet.  We, in turn, need to protect moms.

Here’s what we need:

1.  A national law that protects moms breastfeeding rights, wherever they are.   What will it take to get the Breastfeeding Promotion Act of 2011, and any others, passed?  It will take action from all of us (click here) but it will also take celebrity leadership.  Michael J. Fox, Julia Roberts, Bono, Christopher Reeve, Don Cheadle and Kerry Washington are just a few of the celebrities who have testified before Congress on behalf of disease research, education, the environment, human rights and the arts.  Celebrities can raise awareness and motivate funding like few others can, and that is why Best for Babes is leading the charge to build the first ever celebrity cabinet for breastfeeding, our Celebrity Champions for Moms. Your support of us makes this possible–donate now to help us help the whole breastfeeding community!

2.  An employee training toolkit for companies big and small that makes it easy for them to implement a corporate policy protecting customers that are breastfeeding mothers and to train their employees to embrace and uphold this policy.  (Note: companies already have a lot of tools to support breastfeeding employees, this is for customers).

Here’s where you come in.  As a tiny non-profit, we want to make this a team effort!  We need your help to create a Employee Training Toolkit. Please leave any suggestions and/or useful links in the comments, and e-mail bettina AT bestforbabes.org if you want to lead or help with this project.  If you have a background in employment law, corporate policy, marketing and communications, breastfeeding research, or are just savvy about what has been done and what works, then we need you!  The toolkit needs to be positive and constructive and be “universal”.  To get the ball rolling, we are looking for components that companies can:

• download easily from our website
• customize with their own corporate brand and logos
• display proudly (aesthetic, visually appealing, mainstream) where customers and employees can see it
• use to educate employees about the rights of breastfeeding mothers
• use to educate employees how breastfeeding benefits all of us (and maybe more employees will breastfeed for longer themselves!)
• use to change the perception of breastfeeding among employees (positive, encouraging, appealing, mainstream)
• use to further Best for Babes’ Credo and to protect ALL parents from judgment, pressure or guilt, whether they breastfeed for 2 days, 2 months, or 2 years or NOT AT ALL.
• use to apply for recognition for exemplary implementation of a “Babe-friendly”–i.e. mother and baby friendly–policy.

Thank you in advance for all your help!  Together we can build a breastfeeding-friendly culture free of Booby Traps!

Yesterday, we received a phone call and an email from Michelle Hickman about her treatment in a Houston Target Store on November 29th. Michelle is organizing a nurse-in at the store for December 28th at 10 a.m.  For more information, join the Facebook group Michelle has started.  Here is her story: “

“For guests in our stores, we support the use of fitting rooms for women who wish to breastfeed their babies, even if others are waiting to use the fitting rooms. In addition, guests who choose to breastfeed discreetly in more public areas of the store are welcome to do so without being made to feel uncomfortable.

Clearly, this policy is not translating through to employees. Best for Babes hopes that this can be resolved quickly before December 28th and that Target will implement improved employee training across all stores and for all new hires so as to end harassment and discrimination against nursing customers.  We have contacted Target headquarters and have offered to help develop materials that can help them effectively communicate with their employees about nursing in public; our information is being passed on to the employee training department and we will keep you posted!

We hope that Target will take this issue as seriously as any other anti-discrimination policies, and make a greater effort to educate employees that breastfeeding benefits everyone, is truly beautiful, and that ALL mothers deserve to be cheered on and encouraged, whether they breastfeed for 2 days, 2 months, 2 years or not at all! They may even find that their own employee breastfeeding rates improve, which only helps the company’s bottom line, since every $1 invested in corporate lactation programs yields a $3 return.  We hope they will turn to “The Business Case for Breastfeeding“, an excellent program and toolkit for employers developed by womenshealth.gov.  Despite recent advances in employer and insurance policies, we still have a long way to go to change our culture, and we need Target to embrace this opportunity and apply their fantastic marketing skills to improving the public perception, and the perception of their employees, towards breastfeeding!

2.  Inform mothers of their rights.  Click here for your state breastfeeding laws.  Also, thanks to PhDinParenting via Crunchy Domestic Goddess for this excellent information: This woman, and any woman, that experiences this type of harassment should report it to FirstRight. They maintain an inventory of such harassment cases and can also help mothers to figure out the best course of action (for example, nurse-ins can be good tools but are not always the best first step). Here is the link to FirstRight: http://www.firstright.org/reportdiscrimination

3.  Ask your elected officials to support the Breastfeeding Promotion Act.  The stronger our national policies, the better for everyone.

Let us know if you have any other suggestions!

This is the 27th in a series on Booby Traps, made possible by the generous support of Motherlove Herbal Company.

There are few topics that get me going more than the quality of help mothers get in the hospital getting their babies latched on comfortably and effectively.  So I hope you’ll forgive the frustration you’ll hear in this post.

Why do I get worked up about this?  Because CDC data show that one in three mothers who stop breastfeeding in the first month do so because “breastfeeding is too painful.”  37% percent of moms who stop in the first month report, “sore, cracked, or bleeding nipples.”  And because a good latch results in good milk transfer and the development of a full milk supply, and 50% of mothers report early weaning because “breastmilk alone didn’t satisfy my baby,” and another 50% report “I didn’t have enough milk.”

But most of all, I get upset because all of this could so easily be avoided.  When I hear mothers who have left the hospital with sore and bleeding nipples, say “they said the latch was fine” (an assessment made, in one case, from the doorway), I know that in the vast majority of cases their pain was avoidable.

Of course, not all pain with breastfeeding is a result of a poor latch.  Things like tongue ties, milk blisters, and thrush certainly cause pain.  But the vast majority of mothers I’ve seen who have left the hospital with pain have babies who are simply not latching on deeply.

For moms with ‘run of the mill’ latch problems, some good help can usually make breastfeeding significantly more comfortable in a matter of minutes.  In other words, it can go from “I’ve been crying through feedings,” or “This hurts more than labor did,” to “Oh my God, so this is what it’s supposed to feel like?” almost instantaneously.  How do I know?  Because I’ve helped moms get from here to there over, and over, and over.

Though I try not to show it, when moms thank me for helping them with the latch, I feel less gratified than angry.  I feel angry that the simple adjustments I made weren’t taught from the beginning.  I feel angry because, for many moms, this goes beyond “breastfeeding duration.”  It means that the early days of motherhood – a precious, irreplaceable time – are filled with pain, frustration, and doubt.  Most of all, I feel angry that all of that could be so easily avoided.

Is it too harsh a statement to say that moms are being robbed?  Robbed of peaceful early days with a new baby?  Robbed of good memories?  Robbed of the chance to fulfill their breastfeeding hopes and meet their goals?

I’ve thought a lot about the causes of this poor help, and here’s my list of contributing factors:

Poor training. As I’ve written before, preservice training for nurses, doctors, and other providers is generally cursory at best, and once on the job inservice training is not consistently done.  So some of the staff at hospitals just don’t know how help moms with latch.  And some dispense inaccurate information (i.e. “Your nipples with toughen up”).

Workload or low priority? Nurses, doctors, and other hospital staff are busy, and getting busier.  Helping with breastfeeding can take a while.  I’m sympathetic to the nurse who is running her behind off to keep up with her patients.  But I also know that organizations can make time for things they consider important.  So, what does it say about a hospital’s priorities that mothers are permitted to leave the hospital in such pain?

Changes in practice. To some extent, the target has been a moving one when it comes to teaching about latch and positioning.  Until maybe ten years ago, the state of the art advice on how to get a baby latched on was “line up the nipple with the baby’s mouth and ram her on she opens her mouth.”  Then research and clinical practice started to support the “asymmetrical latch,” in which the baby is lined up “nose to nipple” and the chin is touched to the underside of the breast, eliciting a wide gape (see this video for the best illustration).  When latched on this way, it looks like the baby has more of the breast in the chin side of the mouth than the nose side.  Newer research is supporting the use of reclined positions (“laid-back breastfeeding,” or “Biological Nurturing”) to elicit babies’ innate feeding instincts and ability to latch deeply.  At this point I think that hospital staff can be forgiven for not knowing about this latest trend, since the research is still fairly new.  But I would hope that in the next few years that will change.  For now, if you encounter a nurse who hasn’t heard the phrase “asymmetrical latch,” move on.

Deferring to lactation consultants.  I think I’m seeing a trend toward viewing basic breastfeeding support as the job of lactation consultants, rather than the job of the nurse.  It’s wonderful that more hospitals are employing lactation consultants, but unless a hospital intends for them to see every mother (and this is not common), it appropriately remains the job of nurses and others to get mothers going with breastfeeding, barring anything complicated.  I worry that mothers who just need basic help getting a good latch end up waiting to see a lactation consultant, who is appropriately busy with more complicated situations (prematurity, tongue tie, breast surgeries, and twins are a few that come to mind).  Meanwhile, many moms whose problems could be solved quite easily, wait for the cavalry which never comes.

Did you get good help with your baby’s latch when you were in the hospital?  Why do you think moms often get poor help with latch in hospitals?