-- Kimberly Seals Allers is on vacation this week. --

Intensely aware of what health care advocates gently refer to as "health disparities," members of state coalitions meeting over the weekend confessed that they were struggling to find a best strategy to promote breastfeeding among African-American mothers.

Studies to date indicate that African American mothers are least likely to breastfeed--even though they are more at risk for breast cancer, obesity and high blood pressure. In addition, they are more likely to give birth early and breast milk can literally save the lives of preemies in a way formula does not.

As more than 300 breastfeeding activists--physicians, nurses, lactation consultants, and health activists-- gathered in Arlington, Va. to expand the support for breastfeeding in hospitals, families, law and workplaces, the toughest question was how can we be more successful with African American mothers and mothers-to-be?

http://www.usbreastfeeding.org/

Part of my work at the conference was to discuss at a breakfast table how Women's eNews is changing the media narrative about African maternal and infant health. I talked about Women's eNews'Black Maternal Health project and the value of shifting breastfeeding news focused on babies to the lives of the mothers, particularly black mothers.

http://www.womensenews.org/story/090922/black-maternal-health-legacy-and-future

Black moms are three-to six times more likely to die during pregnancy and during the post-partum weeks and thus they are the face of our country's most acute maternal health problems. If the United States can mend poor health outcomes among black women and their infants, certainly the entire health care system will benefit.

But confronting the reality of black maternal health and breastfeeding at the conference is not so easy.

"Nooo," said Lorine Bizzell, a regional nutritionist with the United States Department of Agriculture, in Atlanta. That was her response when I asked for her input on the fact that that college-educated black women breastfeed less than low-income moms, teen moms, and moms with only 12 years of schooling.

http://www.womensenews.org/story/black-maternal-health/090922/breastfeeding-not-you-sisters-listen

"That's hard to believe. Young black career women that I know are all nursing their children under a variety of challenging circumstances."

Laura Sinai is a North Carolina-based pediatrician. She works in a private practice outside Charlotte and a third of her clients are black. Talking to black mothers about breastfeeding has been difficult. "They just say, 'You don't know my life. I will not breastfeed.'"

Melissa Bartick, a physician with the Massachusetts Breastfeeding Coalition, spearheads efforts for hospitals in the state to become Baby Friendly, an award given for prioritizing breastfeeding in maternity wards and backed by the World Health Organization.

After I asked Bartick how she's targeting black mothers, she took a deep breath and said: "Yes, there are disparities. They do exist."

"Where do I find black women who want to be lactation consultants?" said Anna Uttar, the regional director of the International Board of Lactation Consultant Examiners in Falls Church, Virginia. "They are not coming out to get trained."

As the conference was coming to an end, I was starting to worry that the question of how to increase breastfeeding among black mothers was left hanging, like a great news story unpublished.

Right as I gathered my bags and headed out the conference hall, Napiera Loveless approached me.

She is co-founder of MamaTotoMatema, a Cincinnati agency urging breastfeeding among African-American families. We got to talking and laughing and sharing how we wished the conference had a dance party.

http://www.mamatotomatema.com/

Loveless told me about how she reports to black women and activates their interest. Immediately I realized she should have been a keynote speaker; she was a guru of connecting ideas to messages, to challenges.

When talking to low-income black women, Loveless appeals to fashion. Many young black women like the bling, she said. The shiny things. The nice clothes. "I tell some mothers, 'You know how you like your Dereon jeans and Gucci? Well breast milk is the name-brand jeans. Formula is the rip-off!'"

When talking to upper-income black women, Loveless said that family support systems may be lacking. Many families look to a high-earning black woman for financial and emotional support, so a lot is riding on her shoulders.

"I want to find out who their support system is," she said. "It might be her best friend or her co-worker. Can your co-worker help you on the job? Watch your work while you get a chance to pump?"

She said her strategy is gaining effect in Ohio.

As I left the Third National Conference of State/Territory/Tribal Breastfeeding Coalitions, my heart was warmed by Loveless, and the many leaders talking about black maternal health. My mind was racing.

There is always a way to get through.

Malena Amusa is a reporter living in New York City.

We Need Our Village Back

For some time now, I've been lamenting the demise of our "village."

When our parents grew up the whole neighborhood helped raise them (and probably had spanking privileges). And when I grew up you could best believe that any neighbor would quickly tell my mother or father if I was ever seen someplace I wasn't supposed to be. There was an "we're all in this together" mentality and a thinking that my child is my responsibility and your child is my responsibility because at the end of the day, we are all in this community together and one success is our collective success and one failure is our collective failure and affects us all.

Somewhere along the way, we lost this village mentality. The changing economic climate has dictated that we move away from relatives or that we move often because of job opportunities. As a result, we never really grow roots in our communities anymore. We don't have our extended family of aunties, uncles and grandparents nearby anymore.

This week Women's eNews hosted a screening of Tonya Lewis Lee's powerful documentary on reducing infant mortality and improving maternal health, in celebration of the second year of The Black Maternal Health Project. It was a full house. The film, Crisis in the Crib--Saving Our Nation's Babies (view the trailer here) speaks directly to preconception health, mobilizing young people as peer educators in the movement and putting a face and voice to the infant mortality issue. The conversation afterward with Tonya and our fabulous guests was even more empowering.

We couldn't understand while infant mortality remains a taboo topic in our country's agenda. Even when you remove African American statistics from the equation, the United States still had an embarrassing ranking as far as infant mortality is concerned. We couldn't understand why maternal health is absent from the current debate about healthcare reform. And we certainly couldn't understand why very little is being done to save our most vulnerable population. There was so much that didn't make sense.

But here's what was crystal clear. We can't wait for the government to solve this crisis. Yes, we have to push for laws. But we also have to advocate in our communities to remove some of the social barriers to our health issues. We need to advocate for safe places to exercise, removing toxins from our communities, having fresh fruit and vegetables available in our communities and more.

It was clear that we need our village of womenfolk. And then some.

In Crisis in the Crib, the 'Healthy Baby Begins With You' Campaign,  takes on a peer education model. It uses college students to go into their own communities and also speak to high school students about preconception health. It goes back to that "village" mentality.

That night of the screening we deployed our own village, a room full of women of all races with personal and professional interests in embracing mothers and producing healthy babies. We thought of ways we could let our own network know about the OMH campaign, spread more awareness about the problem, or help be a part of the solution.

We saw the powerful ripple effect that could be sparked just from those in the room doing one thing. For that evening, we brought our village back. And it felt oh so good.

What can you do to help bring our village back to our babies? What more can we be doing? I'd love to hear from you. Please post a comment here.

Bruce Jenner, Breastfeeding and Keeping it Real with the Kardashians

Earlier this week, after a long day of deadlines and meetings, I was desperately in need of a mindless television moment and channel surfed my way to the "Keeping up with the Kardashians" reality TV show.

 

Have you seen this quality production?

 

Three sisters on an unclear mission. One became famous for having a big booty (an apparent first for a non-black or Latina person), another recently married an NBA superstar after two months of dating, and alas, the third, Courtney, is very pregnant. At least in this episode she was. (I know from a recent trip to the supermarket checkout line that she has already had her baby and sold all the pictures.) But I digress.

 

In this particular episode, the often reviled baby daddy, Scott, did the unthinkable. He didn't show up for a breastfeeding class. O.M.G! Courtney returns home in a huff. Scott says, he didn't think he needed to go to a breastfeeding class because it has nothing to do with him. Courtney lets him know with a few well-timed F-bombs that it absolutely does have something to do with him and if he doesn't "get on her team" immediately then the relationship is over. Drama!!

 

Scott, feeling like he just received an unwarranted tongue lashing from a hormone charged pregnant woman, heads over to talk to Courtney's step father, Olympic great Bruce Jenner. Scott tells Bruce his story. "Breastfeeding is not about me," he says, looking for manly sympathy. Bruce, in his infinite wisdom and having scaled a few hurdles in his own life, sets him straight. "It is about you. It's about support."

 

Ahhhh, a teachable moment in reality TV. I feel like notifying some authorities.

 

But yes, men, breastfeeding is about you. And you don't have to have graced a Corn Flakes box to know it. In fact, many moms say their partners' attitude and support played a major role in whether or not they continued breastfeeding. This is particularly true in the black community.

 

Consider these striking findings from a recent survey by the Bravado Breastfeeding Information Council, or BBIC. (Full disclosure: I'm an advisory board member).

 

When asked to choose the person who had the most important influence in her life as a nursing mom, almost three times as many women selected their partner (54%) over their mothers (21%), even if their mother had breastfeeding experience.

 

Approximately 70% of mothers consider their partners support to be extremely important to their overall confidence as a new mom, and their overall well-being as a nursing mother.

 

With our historically low breastfeeding rates and our woefully high infant mortality rates, it is really important to get our men on board. They are an important part of our "village."

 

If you or your partner don't know what he can do, I found these great tips for Dads.  Share them with your man.

 

1. The first thing a father can do to promote success is to create a positive family atmosphere toward breastfeeding. As a practical matter, breastfed babies need to accompany their mothers whenever possible. A father who views a baby's continual presence as intrusive will subtly undermine breastfeeding. The father who naturally assumes that his baby will accompany the couple to restaurants, movies, dinner parties, and meetings has given breastfeeding his strong endorsement. There's a big difference between a man who agrees to let his partner breastfeed and one who deliberately creates an atmosphere of success.

 

2. Fathers can play a key role in bolstering their breastfeeding partner's confidence by showering them with compliments, praising their efforts, and offering words of encouragement. When a woman is under extreme stress, a man may not know how best to support his mate. He may be uncertain whether she wants to hear, "Don't give up; you can do it!" or "You've done your best. It's okay to switch to bottle-feeding." If you are not sure how to respond to your partner, try explaining that you don't know exactly what to say, but you want to support her in any way you can. Just being a sounding board might be all she needs on a specific day.

 

3. A father can help in so many ways that it's hard to imagine why many men feel left out when their wives breastfeed. A father can go to the baby when he or she awakens and bring the hungry infant to his wife. While the mother is nursing, he can pour her a nutritious beverage, massage her shoulders, compliment her, and lovingly admire his nursing baby. After the first breast, he can burp the baby and help arouse the infant for the second side. When the feeding is complete, the father can change the infant and put him or her down to sleep.

 

In the BBIC survey, moms said, partners could best help by changing diapers, listening to them, praising them, supporting them with family and friends, and burping the baby as key examples of support. 45% of moms would like more help with chores and 36% would like their partners to get up with them at night.

 

So you see Scott, and thousands of other Scott-like men, we do need you. There is much for you to do. It is about the support. Thank you Bruce Jenner.

 

Watch this video to see the webcast of the full release of the BBIC's findings on women and breastfeeding.

 

Folic Acid and You—What Every Woman of Color Needs to Know

It’s the New Year! And who knows what 2010 will bring. According to recent stats approximately 50 percent of women aged 15-44 have at least one unplanned pregnancy in their lives. That means a good number of us may have an surprise in 2010.

 

That also means every woman of childbearing age, should be thinking about their health all day, every day. That’s why I wanted to tell you that this week, January 4-10^th, is Folic Acid Awareness Week. Sponsored by the National Council on Folic Acid (NCFA) http://www.folicacidinfo.org/pages/folicacid_info.php, the week is intended to educate all women about folic acid. If taken before and during early pregnancy from a multi-vitamin or fortified foods, folic acid can prevent from 50 percent to 70 percent of some forms of serious birth defects of the brain and spine, called neural tube defects (NTD).

 

Getting the right amount of folic acid is particularly important to Black and Latina women. Not only do Latinas have higher rates of NTD-affected pregnancies, they also have the lowest awareness about folic acid than women of other ethnic groups, and lower consumption of folic acid than white non-Hispanic women, according to recent studies.

 

In addition to preventing NTDs, increased folic acid has been linked to preventing preeclampsia, a form of severe high blood pressure that usually occurs after 37 weeks of pregnancy. The potentially fatal condition is more common in black women. Studies indicate that when black women have preeclampsia they tend to have a severe form of the disorder and experience it as early as six months in the pregnancy compared to the typical ninth month. 

 

Doctors have not yet pinpointed exactly why this disparity exists, however, one study found that black women had less folic acid and more of a certain amino acid than white women as a pre-existing condition, which put them at a higher risk during pregnancy. The findings suggest that black women take more folic acid before and during pregnancy and as early as possible. (http://www.msnbc.msn.com/id/4781703 )

 

The easiest way to make sure you’re getting enough folic acid all the time is by taking a multi-vitamin, B vitamin complex pill or folic acid pill and eating fortified foods like grains, pastas or breakfast cereals. Folate is found naturally in foods such as leafy green vegetables, beans, liver and some fruit. But for some reason, scientists have found that folic acid, the synthetic version of folate, is actually easier for your body to absorb than folate.

 

Even if you don’t have a planned or unplanned pregnancy in the cards, folic acid is pretty important to your healthy living. Studies show that folic acid reduces the risk of certain cancers; cardiovascular diseases including coronary heart disease and stroke; and cognitive diseases or mental conditions such as Alzheimer's disease, age-related dementia or cognitive decline and depression. We can all use that.