Learning from Stories: Breastfeeding and Younger Women

The Best Start Resource Centre resource booklet, Learning from Stories: Breastfeeding and Younger Women contains example stories collected from the experiences of three International Board Certified Lactation Consultants and a doula, and reviewed by an Advisory of medical professionals in the field of birthing and lactation. In developing the resource, the Best Start Resource Centre used a Healthy Communities Approach to explore the actions being taken in Ontario to support breastfeeding and younger women.  They have deliberately chosen to present the information in narrative form, as “the primary form of human understanding”.

Joan Hepp, a Registered Nurse and international Board Certified Lactation Consultant (IBCLC) completed the interviews for the case stories and reports, “Teenage mothers can and will breastfeed if given support and acceptance… Sometimes support happened informally through observation in a prenatal class or La Leche League meeting.  Sometimes it was found through social media.  Sometimes the connection was made through a formal buddy program.”  She quotes one young mother who says, “Everybody need a buddy system.”

Mary-Lynn Houston-Leask, Project Lead for Community Breastfeeding Support Circles at M’Wikwedong Native Cultural Resource Centre, is quoted, “The best way to learn about breastfeeding is to surround yourself with other women who are breastfeeding successfully.  It is our jobs as service providers to seek out those role models, give them confidence, and help them to see just how valuable they are in teaching others.”

The booklet features five case studies:

Breastfeeding Buddies Provide Peer Support in the Region of Waterloo

• A 17-year-old mother gives the following comment on how breastfeeding helps build her self-esteem: “No one else can feed my baby – not my caseworker, or my boyfriend or my mother.  It is just me doing it for my baby, and I feel very powerful!”
• The key elements of the program are developing a trusting relationship with each mother by listening to what they are saying, by providing hands-on learning through the free, peer-led, prenatal workshops: Me? Breastfeed?  And providing one-to-one support by 147 volunteers who are provided training based on the World Health Organization (WHO) 20-hour course.
• Ongoing support is offered through weekly breastfeeding cafés offering group support. The idea for the cafés originated with the mothers themselves who requested help with sorting through “too much information”.  The cafés are facilitated by peer volunteers and the topics for discussion at the cafés vary each week based on individual needs.

London La Leche League Provides Acceptance

• Jennifer Prince, La Leche League (LLL) Leader in London, Ontario, turned a personal memory of assumption and judgement during her first pregnancy into a learning opportunity for her work with young mothers. She comments: “Every mother deserves to be given a chance.  If we believe in them, they will believe in themselves.  Sometimes judgement gets in the way of the village it takes to raise a child.  This is especially true of mothers who are bringing up their babies as marginalized members of society.”
• She uses the LLL Bias/Acceptance Exercise to identify biases that may affect communication.
  • Look at a belief you hold strongly.
  • Identify the reasons for it.
  • Understand and recognize your right to your beliefs.
  • Identify reasons for different beliefs and approaches.
  • Understand and recognize that people who have different beliefs have the same rights.
  • Be willing to integrate other people’s information into your approach to helping.
  • Sarah, a young mother in the group, saw a friend breastfeeding and was shocked at first. “I didn’t know anyone who had breastfed and didn’t even know if I could do it.”  With the support and encouragement of her friend, she took classes through LLL and has breastfed her children successfully over the past three years, with mutual support between Sarah and her friend.  Sarah also has a supportive partner who has encouraged her through the initial challenges and all the criticism she received from family, professionals and even total strangers.  She comments, “Everyone had advice!”  She stresses the importance of knowing that you need to have at least one person who can guide you through.  “You need a buddy system.”

Sudbury Better Beginnings Better Futures

• In response to a health study revealing that one in six children have emotional or behavioural issues, and that these children were more likely to come from families who receive social assistance or live in subsidized housing, the Ontario government has provided Better Beginnings Better Futures (BBBF) funding for the past 25 years to at-risk communities who submitted proposals for grants that would address the following goals:
  • To reduce social, emotional, or behavioural problems in children.
  • To promote social, emotional, behavioural, physical, and educational development in children.
  • To strengthen the abilities of parents and families to effectively respond to the needs of their children.
  • To develop high-quality programs for children from birth to 4 years of age or from 4-8 years of age and their families to effectively respond to the local needs of the community.
  • To encourage local parents and the broader community to participate as equal partners with service providers to plan, design, and carry out programs for children and families.
  • To establish partnerships with existing service providers and educational organizations and to coordinate program activities collaboratively.
  • The Sudbury communities of Flour Mill and Donovan have used BBBF funding to create their Baby’s Breath program, providing weekly support to young pregnant and parenting families since 2004.
  • As well as prenatal and parenting education, offered in a non-judgemental manner, Baby’s Breath also offers many forms of personal support such as labour, birthing and breastfeeding help. Program staff also assist with housing, child care, and court issues as needed.
  • The program offers a range of breastfeeding supports, including videos and discussion on important issues such as the stigma attached to teen mothers and what to expect during the hospital stay. Home visits are offed at the critical times of 48 hours, 72 hours, and one week.  An IBCL Consultant and volunteers are available to offer support and training, and mothers are encouraged to return to the group for ongoing breastfeeding support as soon as they are ready.
  • One of the many positive outcomes of the Baby’s Breath program has been improved breastfeeding initiation.  Program Assistant, Melissa Long, states, “Young mothers seem to be more comfortable with it now.  It’s rare today that a mother in our program doesn’t try to breastfeed.”
  • Discussions in the group provide information about the importance of breastfeeding. They also try to dispel some of the myths around body image and other reasons why teen mothers would hesitate to breastfeed.  The program also helps prepare pregnant women for reality by inviting experienced mothers to visit and talk about what to expect.
  • Another positive spin-off from the BBBF program is a youth engagement group, Mom2moM, a peer support group for mothers 19-21 years of age that began at the request of the mothers themselves. Melissa Long comments, “Through the monthly Mom2moM meetings, they develop and implement projects and activities to reach other pregnant and parenting young women, ” including the creation of We Are Teen Moms, an 8-minute YouTube video in which eight young mothers discuss the stigma and stereotypes associated with teen pregnancy.  In their own words, they share a collective story of resilience, strength and determination to be good parents.  The video ends with a quote from one of the young mothers, speaking to her child: “Being a young mom means that we met a little early but it also means I get to love you longer.  Some people said that my life ended when I had a baby, but my life had just begun.  You didn’t take me away from my future; you gave me a new one.”

Ottawa Buns in the Oven and Little Milk Miracles

• Buns in the Oven, a CPNP program that has run in Ottawa for the past 20 years, offers a weekly, two-hour class where pregnant youth and their partners learn about pregnancy, babies, and life skills through cooking and eating together. They also get to take home food and grocery vouchers.  Cathryn Fortier, CAPC/CPNP Project Manager, says, “We are a place where young parents can come together and find support and acceptance.  They share a meal and conversation.”
• In addition to offering nutritional support, the sessions also provide counseling on prenatal health and lifestyle issues. Information on breastfeeding and infant and child development is also promoted.  Self-referrals to the program are encouraged.  Referrals are also accepted from family, friends and health care providers.  Registration must, however, occur prenatally.
• “Once the ‘buns’ are out of the oven”, the program continues until the baby is 6 months old, and the nutritional benefits of the program include breastfeeding support. Kim Ledoux, Program Coordinator, reports that the group has a strong influence on breastfeeding.  She sees great value in the role modeling provided by the breastfeeding mothers returning to the group.  She explains, “Some of the pregnant teens have never seen anyone breastfeed.  Seeing peers breastfeed and sharing their experiences has had a positive influence on their decision to breastfeed.  Breastfeeding is becoming more visible here.  This is due largely in part to an increase in messaging and to the role modeling that is being done.
• Cathryn adds, “The opportunity for prenatal and postnatal women to attend together, along with the length of time that many come to the program, results in the development of incredible social support among participants and the opportunity for peer education to occur.”
• A lactation consultant attends the group on a monthly basis and provides breastfeeding teaching. Kim notes, ”It’s important for the teens to make that connection early so that trust is developed.  They are more likely to seek help when they are breastfeeding it that connection has been made.”  One-to-one support is also available as needed.  Mothers are most often referred to one of the daily breastfeeding support drop-in clinics throughout the city, and individual help is also made available though the Healthy Babies Healthy Children Program delivered through Ottawa Public Health.
• An outgrowth of the program has been the development of the Breastfeeding Community Project, initiated by St. Mary’s Home, which has witnessed the positive impact of peer support on breastfeeding, which has led to the creation of Little Milk Miracles as a youth-informed breastfeeding program with the goals of creating a supportive breastfeeding environment and increasing the intention and duration of breastfeeding. The specific elements of the Breastfeeding Community Project, which involved focus groups of young pregnant and parenting women who were essential in informing and designing the structures of the new  program, were:
  • The revision of prenatal class content with input from young mothers.
  • Staff training to ensure that all staff have basic breastfeeding knowledge, to foster a culture of breastfeeding support.
  • Peer support to offer a weekly, in-person support group facilitated by peer-mom leaders with support from staff.
  • Cathryn notes that young mothers in the Buns in the Oven program to Bethany Hope Centre and St Mary’s Home looking for information, food, and social support. “They walk away with much more.  They gain increased confidence and self-esteem, new friends, and valuable knowledge related to nutrition, health, and parenting.

1. CPNP Promotes Good Nutrition through Breastfeeding

• Celebrating and Building on Success: The Canada Prenatal Nutrition Program (2010) reports:
  • CPNP participants who received breastfeeding education and support were more likely to initiate breastfeeding.
  • Women who had more frequent exposure to CPNP (i.e., they attended more often over a longer period) were over four times more likely to breastfeed longer than those with less contact.
  • Women who attended CPNP projects for a longer period were 21 times more likely to breastfeed longer than those who attended for a shorter length of time.
  • Smart Start for Babies, is a full-service CPNP program at the Middlesex-London Health Unit, led by public health nurses and Registered Dieticians, which also offers sessions for pregnant teens, and which includes a meal. Participants are involved in food preparation for the class, where healthy eating is modeled.  Jody Shepherd, a Registered Nurse who is Teen Group Facilitator and Smart Start for Babies Program Coordinator, reports, “There is lots of talking and socializing going on in the kitchen.  They are having fun and celebrating their success.”
  • Participants in the program are given Harvest Bucks coupons to spend on fresh produce at local farmers markets. Jody comments, “It’s a win-win situation.  The mothers get healthy food and the local community is being supported.”
  • Smart Start for Babies – Teens has successfully incorporated peer-run classes, where teen mothers who have been breastfeeding are invited to attend and share their experiences with the group. Jody says, “The peers ran the class and in this informal setting were able to demonstrate responding to a baby’s feeding cues, and latching on.  Seeing other teen mothers breastfeeding gave pregnant teens confidence that they also could successfully breastfeed.”
  • The program also offers a Teen Prenatal Health Fair, where service providers working with adolescents and young adults are invited to set up a table to hand out information about their services. Teen mothers who are breastfeeding set up a table and they share breastfeeding information with pregnant women.  Jody note, “It’s a fun way to get the information out there, and the teen mothers are happy to help.”

Young mothers talk about the physical challenges they have encountered with breastfeeding, and how they overcame them, and one young woman, Chantelle, talks about her greatest challenge, which was dealing with her boyfriend’s very negative feelings about her decision to breastfeed.  She says, “It was really hard doing something you think is right when the one person who should be there for you tells you it is wrong.”  Chantelle persevered, and her boyfriend became more accepting of breastfeed by the time their son was 7-8 months old.  Now, having seen the benefits that breastfeeding has had for their son, he has completely changed his attitude and tells Chantelle that if they have another child, he hopes that she will breastfeed again.