Exclusive

Carolina Global Breastfeeding Institute Newsletter Volume 7, Issue 2, June 2015

In This Issue: Breastfeeding and Feminism - 10th Anniversary The Breastfeeding and Feminism International Conference (BFIC), co- Breastfeeding and Feminism 1 hosted by founder Paige Hall Smith, PhD, Professor, UNC-Greensboro and Project Update - Miriam Labbok, MD, MPH, IBCLC, Professor, UNC at Chapel Hill and Donor Banking 2 CGBI director, was held March 19/20, 2015, in Chapel Hill, celebrating its EMPower Breastfeeding Update 2 10th year with growing participation and enthusiasm. Letter from the Director 3 This year’s theme, “Breastfeeding, Social Justice and Equity: Reflecting, Associates’ Corner - Reclaiming, Re-Visioning” brought in 70 speakers, presenting in 33 panels, Jay Sharma 4 breakouts, and poster sessions, in addition to the amazing keynote speakers: Alumni Spotlight - Dr Camara Jones, MD, MPH, PhD, president-elect of the American Public Rebecca Costello 5 Health Association, shared her “Gardener’s Tale” on health disparities; Alison Carolina BEBES Update 5 Stuebe, MD, MSc, presented on the important issue of breastfeeding and Publications and Presentations 6 postpartum depression; returning favorite Jacquelyn Wolf, PhD, spoke on breastfeeding as the great social equalizer; Clifton J Kenon, Jr., DNP, RN, IBCLC from USAID led in creative thinking about how to include the next generation of “lactivists”, and Quinn Gentry, PhD, MBA, founder and CEO of Messages of Empowerment Productions, LLC, gave the final word on breastfeeding motivation and Black Feminism. Each of these keynotes and other invited speakers, including Anayah Sangodele-Ayoka, graduate nurse- /nurse-practitioner, of MomsRising and Liz Brooks, JD, IBCLC, past president of ILCA, offered different perspectives on the past, present and future of breastfeeding, social justice and equity, informing and inspiring the participants.

A special program was presented in honor of the 10th anniversary. This included a presentation by Anita Woodley (pictured right), award- winning entertainer, journalist and visual artist, creator of the critically acclaimed “Mama Juggs” & “The Men In Me” Shows. She presented her Mama Jugs character in a conversation designed to address the conference theme. We were especially honored that the entire Board of ILCA, the international consultant association, chose to attend and participate throughout the meeting.

Continued on page 2 Breastfeeding and Feminism 10th Anniversary Continued

We were also pleased to launch a new book, “Breastfeeding: It Takes a Village”, published by Praeclarus Press, based on the presentations of BFIC 2013. We invite you to visit the BFIC Facebook and web pages: http://breastfeedingandfeminism.org/ and https://www.facebook. com/BreastfeedingAndFeminismInternationalConference.

Please join us next year, March 20-22, 2016, as we continue into our second decade.

PROJECT UPDATE Donor Human Milk Banking

The issue of ‘Donor Human Milk Banking in the US’ was explored in depth by Emily Taylor and Miriam Labbok, along with many students and colleagues, with support from the W.K.Kellogg Foundation. This exploration included a background literature review, a large number of key informant interviews, a physician survey, and a cost-benefit analysis.

The result of this effort is a manuscript available in the Tools for Action section of the CGBI website: http://breastfeeding.sph.unc.edu/what-we-do/programs-and-initiatives/tools-for-- action-donor-human-milk-banking/, and a separate publication on the cost benefit of using human milk in the NICU will be made available, once published.

A summary of findings and recommendations are also available at this site, arranged under four categories that highlight the fact that the importance of human milk, especially for the most vulnerable , is not as yet the norm among providers or the public; there are very limited research funds available at this time, despite the immediate need for data and targeted analyses to inform action; the level of involvement of the federal government in human milk banking is controversial, however, national oversight and/or involvement is recommended; and there are several program issues that might be further explored to increase availability of human milk.

EMPower Breastfeeding: Enhancing Maternity Practices Update

There are many exciting updates to share about the EMPower Breastfeeding initiative. In April, the EMPower team met in Chapel Hill to solidify project plans, share knowledge, and form relationships in preparation for the extensive and important work that lies ahead. This included members from the CDC, Abt Associates, Carolina Global Breastfeeding Institute, Center for Public Health Quality (CPHQ), as well as numerous physician champions from across the country. Baby-Friendly USA provided Coaches Julia Bourg and Sue training to the entire team on the Baby-Friendly Hospital Butts-Dion at a recent visit Initiative Guidelines and Evaluation Criteria. to an EMPower hospital. Continued on page 4 Letter from the Director Professor Miriam H. Labbok, MD, MPH, IBCLC

Dear Friends and Colleagues:

It is the time of the year, yet again, when preparations for World Breastfeeding Week (WBW) are beginning in earnest. WBW has been celebrated for over 20 years, catalyzing continuing attention to the importance of breastfeeding protection, promotion and support. This event is held either the first week in August, to commemorate the Innocenti Declaration of 1990, or the first week in October, frequently to ensure that it happens at a time when media coverage may be more readily available and when populations are not away on their summer holidays.

This year, WBW is dedicated to Innocenti Declaration’s 4th operational target: Maternity Protection. The slogan is Breastfeeding and Work: Making it Work! Be sure to start planning now to address this important issue in your workplace. The World Alliance for Breastfeeding Action (WABA) created this annual celebration and offers downloadable materials at: http:// worldbreastfeedingweek.org/ . Materials are available for download in multiple languages. All that WABA requests in exchange is that you let them know what you are planning to do, and share any stories about your organization’s journey. You can locate an activity pledge form for download at the same site.

As things slow down for the summer in many organizations, CGBI finds itself in acceleration mode. The EMPower project is starting its hospital support activities towards achievement of Baby-Friendly designation, and, while one W.K. Kellogg Foundation (WKKF) project is winding down, another is starting up, along with an interesting new project supported by the Kate B Reynolds Foundation in Forsyth County. The new WKKF project will increasingly support replication and sustainable scale up of our breastfeeding-friendly efforts, and the work in Forsyth County allows us to support early childhood development among all populations through optimal breastfeeding and child-responsive feeding from birth.

On the global front, CGBI has been pleased to have been invited to be an active participant in the UNICEF effort to revitalize breastfeeding support, most recently through the global Breastfeeding Advocacy Initiative (BAI). Kathy Parry and I attended the first official meeting of this group at UNICEF on April 29-30, and are involved in follow up activities. In addition, we both were invited speakers at the CORE Group meeting held on April 12-16. The concept of combining support for breastfeeding and for complementary feeding by educating and young -takers on feeding and satiety cues was extremely well received. Our thanks to TOPS for their support for the work to ensure that both breastfeeding and continued breastfeeding with appropriate complementary feeding programs include special attention to learning and respecting the child’s “cues” and needs for response from the caretaker.

One special treat for me in this quarter was to renew contact with so many colleagues here, on the west coast, and globally as LLLI is also revitalizing and stepping up to address new challenges. Keep up the exciting work! Best wishes, Miriam Associates Corner Jay Sharma

Jay Sharma, lawyer and consultant, is now the Executive Director of the World Alliance for Breastfeeding Action, or WABA. WABA was formed on 14 February, 1991, and is a global network of organizations and individuals who believe breastfeeding is the right of all children and and who dedicate themselves to protect, promote and support this right. WABA acts on the Innocenti Declaration and works in close liaison with UNICEF. WABA is well known for the development and continued support for the annual World Breastfeeding Week, a world-wide call to action to support breastfeeding globally and in local communities everywhere. This year’s theme is in support of maternity protection: “Breastfeeding and Work: Let’s Make it Work!”. (Read more in the Letter from the Director)

In his role at WABA, Jay is responsible for resource mobilization and leads the management team in the areas of overall policy and program development, WABA governance, administration and financial management. He is currently working to help WABA reach a wider audience through the use of social and other media, such as videos. He also works to cultivate partnerships and alliances that are contemporary, relevant and outcome driven.

Jay was born in Penang, Malaysia, and has returned to the place of his birth to join the WABA team after living in the UK for over 30 years. He was in attendance as one of several WABA representatives at the recent meeting of UNICEF’s new Global Breastfeeding Advocacy Initiative.

EMPower Update Continued from Page 2

In May, the team began notifying hospitals of their selection into the EMPower Breastfeeding initiative. All hospitals participating in EMPower will be announced on the EMPowerbreastfeeding.org website in early July.

CGBI and CPHQ began Coach Visits in June and will continue to do so throughout the upcoming months. The visits to date have been exciting and productive, and the coaches are very much looking forward to meeting hospital teams. They will provide customized technical assistance to help maternity centers and birthing facilities implement evidenced- based practices, promoting optimal and equitable breastfeeding support and outcomes, nationwide. The ultimate goal for all is the achievement of the US Baby-Friendly Designation. Alumni Spotlight: Rebecca Costello, MPH, IBCLC

A proud native of Ithaca, NY, Rebecca studied public health and anthropology at Hampshire College in Amherst, MA. She wrote her senior thesis on the role of breastfeeding in public health, which sparked an interest in maternal and child health. After graduating, she lived and worked in various places including Colorado, Hawaii and New York City before moving to North Carolina in 2008 to earn her Master’s in Public Health within the department of Maternal and Child Health at UNC-Chapel Hill, graduating in 2010. She helped stimulate the development of the Mary Rose Tully Training Initiative and was in the first class, also completed in 2010. Following this she was hired as the first night shift at UNC Hospitals, and worked full-time there through 2013.

Rebecca became the new coordinator of lactation services at Women’s Birth and Wellness Center (WBWC) in Chapel Hill in January, 2014. She both sees patients in WBWC’s outpatient lactation clinic, and oversees efforts to expand and strengthen breastfeeding support at WBWC and in the wider community. Through a grant awarded to the North Carolina Breastfeeding Coalition, Rebecca’s role at WBWC now also includes coordinating a program to bring increased peer and professional support to African-American moms in Durham. She has also collaborated with CGBI to produce a version of Ready, Set, Baby customized to birth centers.

Carolina BEBES: Birth and Breastfeeding: Evidence Based Education and Support

This spring, BEBES collaborated with UNC’s Student Wellness to hold Reproductive Health Trivia Night at Steel String Craft Brewery in Carrboro, NC. The event raised funds for the organization’s scholarship fund for Mary Rose Tully Training Initiative students. BEBES was able to award $450 in scholarships to help cover exam fees for students who will be taking the IBLCE exam this July.

BEBES congratulates its members who graduated this spring, especially its Executive Board members: Jeniece Alvey, Holly Krohn, Jaimie Lea, Katie Mitchell and Jennifer Schroeder. We look forward to seeing what great things our graduates accomplish in the coming years, and we are excited to welcome new leadership to BEBES: Nicole Carbone and Paige Schildkamp will be taking on the positions of Co-Presidents, and Joanna Percher will be the new BEBES Treasurer.

The BEBES leadership is currently planning projects for the coming year. Please be in touch with ideas for how BEBES can collaborate with you on your organizations’ projects or initiatives. [email protected]. Publications and Presentations

Publications: Cox EQ, Stuebe A, Pearson B, Grewen K, Rubinow D, Meltzer-Brody S. and HPA stress axis reactivity in postpartum women. Psychoneuroendocrinology. 2015 Feb 25;55:164-172. [Epub ahead of print] Eng G, Labbok M. Latest thinking on community-based participatory approaches to behavior change in: Breastfeeding – It Takes a Village. Praeclarus Press, 2015. Labbok M. The Global Village: Do women live there? A critical look at global approaches to , protection and support in: Breastfeeding – It Takes a Village. Praeclarus Press, 2015. Lopez LM, Grey TW, Stuebe AM, Chen M, Truitt ST, Gallo MF. Combined hormonal versus nonhormonal versus progestin-only contraception in lactation. Cochrane Database Syst Rev. 2015 Mar 20;3:CD003988. [Epub ahead of print] Smith PH, Labbok M (Eds). Breastfeeding – It Takes a Village. Praeclarus Press, 2015. Stuebe AM, Meltzer-Brody S, Pearson B, Pedersen C, Grewen K. Maternal neuroendocrine serum levels in exclusively breastfeeding mothers. Breastfeed Med. 2015 May;10:197-202. [Epub 2015 Apr 1.] Sullivan C. Breastfeeding Friendly Maternity Care Practices in the United States. Women’s Health Report. Issue 4, 2015; Women’s Health Dietetic Practice Group, Academy of Nutrition and Dietetics. Taylor CE, Tully KP, Ball HL. Night-time on a postnatal ward: experiences of mothers, infants, and staff. In Dykes, F. & Flacking, R. (Eds). Ethnographic Research in Maternal and Child Health. Routledge Press, 2015. Tully KP, Holditch-Davis D, Brandon D. The challenge of late on realizing breastfeeding intentions. In Smith, P.H. and Labbok, M. (Eds.). It Takes a Village: The Role of the Greater Community in Inspiring and Empowering Women to Breastfeed. Praeclarus Press, 2015 (pp. 123-135) Tully KP, Ball HL, Ward Platt M. The role of postnatal unit bassinets on enabling early breastfeeding. In Smith, P.H. and Labbok, M. (Eds.). It Takes a Village: The Role of the Greater Community in Inspiring and Empowering Women to Breastfeed. Praeclarus Press, 2015 (pp. 239-247) Blogs: Labbok, MH. Caretakers’ rights to support what is best for their family. April 18, 2015. Accessed online: http://www.breastfeeding4health.com/ Stuebe AM. Fallout from IQ study ignores barriers to breastfeeding. Breastfeeding Medicine Blog. March 22, 2015. Accessed online: https://bfmed.wordpress.com/2015/03/22/fallout-from-iq-study-ignores-barriers-to-breastfeeding/ Stuebe AM. I #March4Nutrition to make #breastfeeding a right, not a privilege. Breastfeeding Medicine Blog. March 19, 2015. Accessed online: https://bfmed.wordpress.com/2015/03/19/i-march4nutrition-to-make-breastfeeding-a-right-not-a- privilege/ Presentations: Anderson KL. Innovative Projects to Support Breastfeeding Beyond the Hospital. Breastfeeding and Feminism International Conference. Chapel Hill, NC, March 2015. Anderson KL. Breastfeeding Friendly Child Care. NC Division of Child Development and Early Education (DCDEE) Regulatory Section Spring Trainings: North Central Regional Training, Raleigh, NC. April 8, 2015; Western Regional Training. Hickory, NC, April 16, 2015; South Central Regional Training. Pine Hurst, NC, April 22, 2015; Eastern Regional Training. Rocky Mount, NC, April 28, 2015. Anderson KL. Supporting NC breastfeeding families in the early care and education setting. WIC Region III Breastfeeding Peer Counselor Quarterly Training. Charlotte, NC, May, 2015. Houk K, Chetwynd E, Sullivan C. Advocacy for IBCLC Care: A Toolkit for Action Based on Cost Publications and Presentations

Benefit Analysis and GIS Mapping in North Carolina. 10th Breastfeeding and Feminism International Conference, Chapel Hill, NC, March 2015. Labbok M. 1)Supplementation in the Early Postpartum: Exclusivity and Exclusive Breastfeeding Beyond Early Supplementation; 2)Creating a Breastfeeding Friendly Community: A Collaborative Effort to Define the Parameters for a United States and a Global Designation; and 3)Breastfeeding as Primary Prevention: Creating an Agenda. San Francisco Breastfeeding Coalition Conference. April 2-3, 2015 Labbok M. Global and US Policy and Programs: Reflecting, Reclaiming, Re- Visioning, 10th Breastfeeding and Feminism Conference, March 20, 2015 Labbok M. 1)Breastfeeding: Beyond Health, Beyond Choice; Breastfeeding and Fertility: Old Wives’ Tale or Modern Contraceptive Issue?; 2)The Language We Use…The Double-Edged Sword of How We Communicate; and 3)What Happens Before and After the Maternity Stay? Creating a Community-Wide Ten Steps Approach. La Leche League of Southern California/Nevada Conference, “Supporting a Breastfeeding Culture 2015, May 23-24, 2015 Labbok M. 1)Breastfeeding as a Human Right: Whose Right Is it Anyway?; 2) Breastfeeding in Child Care: New Ten Steps Approach; 3)Donor Milk in the NICU: Is It Worth the Cost?; and 4)Standing on Firm Ground: Understanding and Interpreting Breastfeeding Research. BreastfeedLA, From Local to Global: BFing Still Matters. Children’s Hospital Los Angeles. May 22, 2015 Parry K and Labbok MH. CGBI Tools for Action. Breastfeeding and Feminism International Conference. Chapel Hill, NC, March 2015. Parry K and Calani K. Early Childhood Development Training Curricula. CORE Group Global Health Practitioner Conference. April 13-17, 2015. Scott P, Sturza M, Grewen KM, Meltzer-Brody SE, Fredrickson BL, Houk K, Stuebe We welcome your AM. Perinatal Post-Traumatic Stress Symptoms, Mood, and Infant Feeding [abstract]. Reproductive Sciences. 2015; 22 (suppl 1): 277A. Poster presented at 62nd feedback. Please send Annual Meeting of the Society for Reproductive Investigation; San Francisco, CA, your comments or March 25-28, 2015. suggestions regarding Sturza M, Scott P, Grewen KM, Meltzer-Brody SE, Zerwas SC, Fredrickson BL, Breastfeeding Exclusive Houk K, Stuebe AM. Perinatal Eating Disorder Symptoms, Parenting Stress, and to the editor at Infant Feeding [abstract]. Reproductive Sciences. 2015; 22 (suppl 1): 277A. Poster presented at 62nd Annual Meeting of the Society for Reproductive Investigation; [email protected] San Francisco, CA, March 25-28, 2015. Stuebe AM. Enabling women to achieve their infant feeding goals. Pediatric and Obstetric Grand Rounds. New Hanover Hospital. Wilmington, NC. May 2015. Be In Touch! Stuebe AM. 1)It’s so much more than the : Skills for talking about breastfeeding; 2)Why does it hurt?: A differential diagnosis for breastfeeding-associated pain; and Carolina Global Breastfeeding Institute 3)Metabolic Syndrome and Breastfeeding: Implications and Outcomes. Building a Department of Maternal and Child Health Breastfeeding Culture. Ottawa, Ontario, Canada. April 2015. Gillings School of Global Public Health Stuebe AM. 1)Biopsychosocial vulnerability, lactation and postpartum depression; and 422 Rosenau Hall, CB# 7445 2)The risks of risk-based language. 10th Breastfeeding and Feminism International University of North Carlina at Chapel Hill Conference. Breastfeeding, Social Justice and Equity: Reflecting, Reclaiming, Re- Chapel Hill, NC 27599-7445 Visioning. Chapel Hill, NC, March 2015. Email: [email protected] Stuebe AM. 1)Why does it hurt?: A differential diagnosis for breastfeeding-associated Phone: (919) 966-3774 pain and Mood, and Infant: Infant Feeding; and 2)Postpartum Depression. Fax: (919) 966-0458 26th Annual Conference on Breastfeeding: Promoting and Protecting Babies’ Health. http://breastfeeding.unc.edu Atlanta, GA. March 2015.