This interview episode highlights the journeys of Kimarie and Dalecia as they found their passion and purpose in helping lactating persons achieve their breastfeeding goals. Intertwining lived experience and the desire to make a difference, you will hear how Dalecia and Kimarie found their calling in breastfeeding work. You will learn about how breastfeeding has been a healing journey and a way to reconnect with our past. You will also hear about the ongoing challenges in accessing adequate and culturally appropriate breastfeeding, especially for black and brown communities.
Dr. Kimarie Bugg, Chief Empowerment Office and Change Leader, Reaching Our Sisters Everywhere, Inc. (ROSE)
Dalecia Young, Founder and Full Spectrum Doula, Due North Support Services
Reaching Our Sisters Everywhere, Inc (ROSE)
Centers for Disease Control and Prevention Breastfeeding Resources Library
American Academy of Pediatrics Breastfeeding Resources
Atyya Chaudhry: [00:00:00] Welcome to MCH Bridges, where we lift up innovative ideas and inspiring stories from people in the maternal child health field. My name is Atyya Chaudhry. I'm the senior program manager for Health Systems Transformation at AMCHP, and I'm your guest host for today.
About six years ago, I heard an indigenous woman speak at a public health conference about breastfeeding and how nursing, her four-year-old was about reclaiming her body and healing from historical traumas.
The concept of breastfeeding as a way to heal really stuck with me, but I didn't quite understand it until years later when I had my first baby. After delivery, my daughter was whisked away because the doctor said something was wrong. I was told to pump right away, and despite pumping nearly one and a half ounces of colostrum, the staff threw it all away because it had a little blood in it.
Can you imagine all of that amazing golden colostrum down the drain. [00:01:00] My daughter was low birth weight, but thankfully fine overall. However, I was told to continue pumping so that we could count the ounces of milk she was drinking, and that really set me off on this journey of constant anxiety and stress about her feeding from day one.
Although I successfully provided my breast milk for a year and a half, I didn't realize how stressful and traumatizing that experience was for me. And to be honest, I don't think I truly healed until present day where I'm in month 18 of nursing my little one and my current journey has helped me process the past and accept that as a history.
All of this got me thinking about hot breastfeeding can mean so much to different people. An opportunity to heal and reclaim your history, connection to your ancestors, to your culture, to decolonization and, nutrition and feeding, a connection to nature and this earth. I'm joined by Dalecia Young, founder and full spectrum doula at Due North Support Services based in Alaska. Welcome, Dalecia. I'd love to start off hearing about [00:02:00] you, your journey, and how you came to found Due North Support Services
Dalecia Young: In my language, this means my name is Anunga. My English name is Dalecia. I am from Anchorage Alaska and my mother's name is Nona Shark. Thank you. I feel led here by my ancestors and called to this work by my descendants. What I mean by that is one of my earliest memories is actually of my pregnant auntie and looking at her belly and being fascinated about everything that was going on that seemed so mysterious, but so laid back. I can remember seeing my hands on her belly and feeling like [00:03:00] so grateful that she was letting me touch her belly and I felt my baby cousin kick. When I had my first daughter. Um, I was very young. I was about two weeks before I turned 19.
I was the first in my close group of friends to have children and children so young that I was always talking about what I was learning and what I was experiencing, and a lot of my friends and relatives gave me this feedback that like you have a really good way of explaining things and I'm not sure if I want children, but I feel much less afraid.
Talking to you about it and learning from you about it, and I feel more confident and that really surprised me because to me, I was just geeking out and I was like, oh, this is so interesting and this is what I'm doing and this is what's so amazing. You know? Or talking about my struggles as well and what resources I found, what ways I was advocating for myself, what I had wished was available. And so when my children got older, I was very, very fortunate to have been able to stay home with [00:04:00] them until they went to school. And it's hard to go back to work , and there's lots of tools and ways that we can support people who are returning to work. But I was fortunate enough to have the.
Access to make a different choice and able to stay home and nurse my children. I nursed all together for six years, three years each. I was thinking about what I wanted to do with my time and with my talent. I need to feel a connection to the work that I do. Um, and my mother was very much the same when I was younger and we would talk about career paths.
She would tell me what questions I needed to ask myself, and she would just reiterate that sort of introspection. Um, and she would share with me her introspection, how she chose her career path. So my mother was actually a beautician and so it was very relationship based. So that's something that I really liked about what she did. That was actually probably the, the career advice that I leaned [00:05:00] into the most, and I was wanting to figure out, you know, what I wanted to do for work. I, uh, started to lean into birth work. I followed the lead of my mother and I listened to my peers and my friends. My children led me here because it was when I was growing them in my body and feeding them with my body and taking care of them that I enriched myself and found a lot of amazing resources and a lot of amazing and inspiring birth workers. And so working with families and um, working with birthing people, checked all of those boxes for me.
And so there were a lot of barriers. I live in Alaska. Finding a doula training was very difficult and it was very expensive. A lot of the trainers actually came up here from other places, and so they weren't in and of our communities. They were coming here in the summer when it's beautiful and fun, and then also teaching on these weekend workshops. And that's how I got my training. That's how I got my foot in the door, . And then after that, I, uh, very soon started, [00:06:00] Due North Support Services .
Atyya Chaudhry: Thank you for sharing your journey and how you were led to this place. Tell me a little bit about how you connect breastfeeding to history and culture.
Dalecia Young: Well, first and foremost, from my own experience, I learned how to breastfeed by sitting next to my aunties and all of my mother's friends when I was younger. And so that connects me to history, um, in that sense. But also as a, um, as I become more aware of, My place in the context of the living history of my people, both black and native.
You know, learning that the barriers that we may face as black and brown bodies, there are barriers that are deliberately set in place to set us up for failure. And so connecting and reclaiming my culture and what that means to me and carrying that in my body. And giving [00:07:00] that to my children.
Breastfeeding is very much a part of that, that continuum for me as well. I'll also say that, you know when, when I was this 19 year old mom, I was my first and most fiercest advocate for myself. And so as I grew up and as my daughter was growing up and I was reaching beyond my uh, immediate. Communities, what barriers were out there that were on the backs of all of our necks and colonization colonialism, that is the first and primary interrupter of the parent baby Dia in whatever that looks like if we're talking about pregnancy or if we're talking about breastfeeding or if we're talking about child rearing.
And so learning that it wasn't just a matter of me getting older. That even if I were to become pregnant today at age 31, I very much like statistically speaking would have [00:08:00] barriers of care and disparities.
Atyya Chaudhry: You talk about the colonization of food and breastfeeding, that really sticks with me. And when we approach breastfeeding, sometimes it's with this Western perspective, so there is still a lot to understand and unpack about cultural approaches to breastfeeding and really honoring the history and traditions of different cultures.
In my own nursing journey, I realize how much support I have both personally and professionally. However, that's not the case for everyone. What ongoing challenges does the work you do face, and where do you see public health having a role in addressing these challenges?
Dalecia Young: Yeah, thank you. I think that public health to continue investing in community, community led and community centered approaches to problem solving, um, because, uh, nobody is a better authority than we are in our own communities.
Um, and what we need, you know, and I'm not, not just an affiliation, but a cultural [00:09:00] affiliation and then also this location, right? We need that everywhere. Or identities, I guess is a better term because that can also apply to queer folk as well. It's important for queer folk to know who amongst their community has, has experience feeding from their body, right?
Because that person is more qualified by their lived experience than by a seminar of how to provide care to this person or that person. And being more aware of practices too. I work both in exclusively indigenous and black birthing communities. And then I also am available to, um, anybody to hire me for my support services.
I have this experience where it's, um, much more interconnected. And this experience where, you know, there's this cart pushing through the system [00:10:00] of, okay, I need this add that to cart, I need this add that to cart, I need this specialist add that to cart. Right? Which is great that we have all of this choice, um, and that I'm one of those choices.
I love that. What I see is, you know, in this other group where it's more of a cohort and we do have that affinity to each other based off of, um, our identities. Even if we're not directly giving support, we're at least talking about. And we're aware of these things, you know? Um, so then even if it never comes to a point where a nursing parent needs milk to give to their baby, they already know that it's there and they can ask for it.
I had a client on the other side who had hired me privately to support them, and they had told me about a doctor's visit that they had had and what the doctor had shared and advised and given them, and. At our postpartum visit, and I asked if they had any interest in milk sharing, and she said yes, and I was able to connect her with that [00:11:00] at our postpartum visit.
After that, she told me that she mentioned it to her, uh, to her pediatrician. And that her pediatrician was sort of like, oh yeah, . And had actually also known about some, some m sharing resources that, that weren't even part of the network that I had put her onto. And my client was actually very upset and she told her doctor at the next visit, because she and I, what we worked on together was a like, okay, what, what do I wanna say?
How do I wanna say it respectfully? That sort of, that's something that I work on with, with, with clients prenatally, um, and postpartum as well, because you start to have a lot more conversations and you, your boundaries tested a lot more in these periods. And so we talked about, you know, I was, I was hearing her anger, um, and I wanted to empower her to do something with that.
Um, and she, she was into it. She was like, I do too, because I want him to know that this should be the first thing he shares, you know? Um, and the way that she had [00:12:00] framed it was that she had felt that this wasn't informed consent and practice because if he had known about these resources as her pediatrician, I had wanted to have been given that choice before you had given me formula and, and sent me to this other lactation consultant.
And so knowing what resources are available and not nec, not necessarily just in the system of ROIs and referrals between professionals and what resources are available, not just to them as providers to share, but available to the people that they serve to tap into.
Atyya Chaudhry: I'd like to revisit the conversation of breastfeeding as a way to heal from trauma.
I opened with this a little bit talking about the indigenous woman reclaiming sovereignty over her body and history through breastfeeding. And I know you work primarily with black and brown birthing people. How have you seen breastfeeding as a healing journey among some of your clients?
Dalecia Young: There's nobody more aware [00:13:00] of the disparities than black and brown birthing people, right? Because when they're looking for resources, any, uh, you know, if you type, you do a search, and this is something you can even do with postpartum depression too, is you just type in the word, you know, you type in pregnancy for black moms or something like that, right? You're not going to find just a lush forest of resources. You're going to find a lot of really scary articles, and then maybe a couple of resources, probably in a different state. At least that's true for here. So what I see is prenatally is that anxiety coupled with that determination, um, to being like, I know what a steep journey this is going to be, and I'm trying to pack my bag right. Right? That's the attitude I see when Baby is Earth side, when they [00:14:00] brought their baby into the world and they're starting that relationship. What I witnessed and what I experienced as well, was joy, and I think that that joy is the medicine that we get in that relationship, in that dyad, baby gets the milk.
The parent feels the joy. So when we think of the ways that we as providers even interrupt and disrupt that joy, like at the beginning of this recording, you'd said that your baby was, was whisked away from you. That was joy. That was a moment of joy that was taken from you and your baby and all of these other things.
Anytime you're made to worry about your baby, that's a thief of joy. I also personally, and also I know in my community and the communities of the people that I serve, um, healing from sexual trauma comes up when, and, but it's not talked a whole lot about when we're talking about our nursing [00:15:00] relationships and being able to practice consent with my baby in the sense of I am getting ready, I am coming into this to feed you.
And saying yes and affirming that and supporting my baby into latching and practicing loving touch on my body, not for the first time, but in a new way, and in a way that was healing touch that had harmed me. Or a birthing person or a nursing person experiencing touch that had harmed them in this very intimate part of our body.
So being able to reclaim that. In the nursing, uh, in, in my nursing experience. In my nursing relationship. I think that's also why it's one of my greatest accomplishments that I will take to my deathbed when I'm thinking about my life and looking back on everything that I did well. Breastfeeding is probably going to be one of the first things that comes to my mind for what I did for them and for what I did for [00:16:00] me.
Atyya Chaudhry: Thank you. I think that's great that you find your passion and drive and you feel more energized by the end of the day. That's such a great feeling. As we wrap up our conversation, I wanted to see if there is anything else that we didn't cover that you want to share about your work.
Dalecia Young: Yes, . Uh, I guess I, I was having a thought on, you know, if there are any listeners who are breastfeeding, um, or have, have breastfed before and are feeling any sense of shame about how little they were able to do, or what little they're doing to help release that shame from this part of our bodies. I think shame is one of the biggest congestions of joy that we can feel in our bodies. Um, and I would say too is even if your nursing journey has ended, um, every ounce counted every ounce was important. And ounce was needed. That is still something [00:17:00] to celebrate and whatever feeding your baby looks like and whatever you were able to provide from your body, it's still an immeasurable gift, whether it was for three weeks or three years.
Atyya Chaudhry: We're gonna continue this important conversation about breastfeeding history, culture, and healing, and are joined by Kimarie Bugg from Reaching Our Sisters Everywhere, Inc. Or ROSE for short. Welcome Kimarie, and tell me a little bit about yourself and how you came to join ROSE.
Kimarie Bugg: My name is Dr. Kimarie Bugg and I am located in the Atlanta, Georgia area.
And I am a nurse practitioner by trade, and I also have a degree in public health. And the way that I came to this work was pretty organically. Um, my [00:18:00] paternal grandmother is a lay midwife in Arkansas. Um, Originally am from Indiana. That's where I was born and raised, but every spring I was allowed to go and visit my grandmother, and when I was 12, she allowed me to help with the baby.
Um, women would come to her house and they would rock and they would squat. And they would walk and a couple hours later they'd have a baby. And so a grandma would feed them and they would nurse the baby and then, um, she would allow me to have the baby. And so that is how my love and passion for babies began.
So, uh, later on I went to nursing school and was totally shocked, um, of all the bells and whistles and machines that were in the room where, um, mothers were, uh, [00:19:00] laboring and having their babies and stuck to the, um, baby side of things. I became a registered nurse in 1978 and after that same year I had a set of twins and it just so happens I was went to school in Texas, and again, I'm from Indiana, did not have any family in Texas, and I had a horrible, horrible experience with breastfeeding.
So, um, at that time, the only folks that you know, I heard about were to help you with breastfeeding was La Leche League and also at that time your, you had a phone number that indicated, uh, where you lived. So I lived on the side of the track with other people who looked like me, uh, African Americans, uh, black people, and I never did get a call.
And so I did what I call token breastfeeding with my first set of twins, [00:20:00] and I was absolutely miserable. I always felt bad about that. But then when I went back to work as a nurse in the pediatric area, I decided that I did not want mothers to be as miserable as I was with my breastfeeding experience.
So I started to learn about breastfeeding so that I could help the mothers on the pediatric inpatient units where I. Fast forward, move to Atlanta, Georgia. I worked in pediatric emergency for a while, then went to special care nursery, and in that area I was known as the breast nurse because everybody , whenever there was a question or concern about breastfeeding would come to me because I had read more probably than the rest of the folks in the area, nursing school did not teach me anything about breastfeeding. Uh, and, you know, uh, had to really pretty much learn it on my own. So, uh, Dr. C. Everett Koop, who was the surgeon general, [00:21:00] um, late seventies, early eighties, actually developed some SPRANS grants to special projects and, um, we at our hospital got one and we started what's called a bedside breastfeeding counselor.
And since I was, um, the person most folks were talking to about breastfeeding, they asked me to do it. And so that is how I truly, truly got started with it, um, along the way, uh, through trauma, through joy, through pain, through all of those things, but it was mostly because of the experience that I had where I felt that I had filled with breastfeeding my own children.
Atyya Chaudhry: Thank you for opening up and sharing your story. Tell us a little bit more about ROSE. What does the organization do and what is your mission?
Kimarie Bugg: So Reaching Our Sisters Everywhere was developed in 2011 to address breastfeeding, uh, disparities and inequities in the African [00:22:00] American community. So what we do is build networking, uh, communities, uh, for providers like patient support providers. And communities so that we can ensure that resources are shared. Uh, we do training and we also do some direct services, not a whole lot. And so we have had the wonderful opportunity to work with, you know, most of the, the organization's, community based organizations and federal and state organizations that do breastfeeding support and training and monitoring and all of those things, and, uh, it has been a wonderful, wonderful experience.
Atyya Chaudhry: So you and I both shared a little bit about how our first breastfeeding experience had its trauma, and yet we still persisted. We still tried our best. In what ways do you connect breastfeeding to history, culture, and or healing?
Kimarie Bugg: Especially looking at, [00:23:00] I guess we'll start with with history. I as a 65 year old black woman was a breastfed baby. Everyone around me in Indiana was breastfeeding, but I am told that that is not the norm. And I do understand, uh, my brother told me, uh, when I was in college that, that we were poor when we were growing up. I didn't know that until he told me. And so our folks, our families did breastfeed. As I traveled to other places, uh, that was definitely not the norm. I found out later, especially, when I got to Georgia, the history of wet nursing, black women, nursing, the slave enslavers children is something that is pretty prevalent in areas that I was when in the early seventies and sixties, and we talked about that a lot [00:24:00] also, the problem was that a lot of the, the families that we served at the hospital I worked, um, were low income families and their, the jobs that they had did not allow them, some of them to stay home from work for six to eight weeks.
A lot of times I work with a lot of fam with young, um, mothers and women who actually went back to, may have had a baby on a Thursday or Friday and returned to work on Monday and Tuesday. Several. Several, several. And so, um, you know, the history is that a lot of times because of lack of policies that have been implemented, um, because of structural and systematic racism. That definitely, um, feeds into the history of the low breastfeeding rates for African-American women in this country. With healing, uh, [00:25:00] breastfeeding is such a bonding experience that, you know, when a mother breastfeeds her child, that child actually becomes a support mechanism for the mother also.
Um, there's just nothing like it, you know, the, the sense of accomplishment. And that's one of the main reasons that we started what we call our ROSE community transformers, because to help women to be able to sustain breastfeeding because it is just such, um, a wonderful feeling to be able to successfully breastfeed your child.
And what we know, the CDC says about 60% of women are not able to, um, meet their breastfeeding goals. And that is a terrible, terrible statistic. So that is something we have been chasing, um, for several years now.
Atyya Chaudhry: Yeah, you bring up some really important points about the history. I [00:26:00] come from an immigrant family and once upon a time in my parents' home country, it was almost exclusive breastfeeding, a practice that is so deeply rooted in culture and religion.
However, now I see a huge shift away from breastfeeding for many reasons, and probably much of it having to do with lack of information, support, and encouragement. So we talked a little bit about the connections of breastfeeding in history, but let's fast forward to present day. What have you seen happen with breastfeeding support and outreach during this pandemic?
Kimarie Bugg: So we have actually seen some wonderful work being done during the pandemic virtually there's nothing like the in-person support, um, especially when there are problems. However, we did have to very rapidly shift to online support and we had the opportunity during the pandemic with some, um, funds from UNC Chapel Hill and HRSA to, um, develop a program that we called the [00:27:00] VIPs Villages Innovating Perinatal Services, where we were able to support about 63, um, community-based organizations.
To help give them a little funds so that they could do better with online support, virtual support. And it was amazing because a lot of these small community-based organizations that were doing really good work said they probably would've had to close up if they had not gotten those little funds, but, What we've seen is there has been a huge, um, burst of online services and resources and information, but again, it is still always so vitally important to be able to do direct services and help a woman or mother personally.
There are many things that can be done virtual. But we also need to be able to refer and have folks in the [00:28:00] communities. You know, the American Academy of Pediatrics recommends breastfeeding for exclusively for six months and then up to 12 months and beyond with complimentary foods.
So we know that, that the babies are in the hospital generally normal. Um, you know, birth labors, birth delivery for two to three days at the most. So we still got that other 362 days that we want families to breastfeed. And so they're going to be some things that come up, some issues, some concerns. And so we need to have culturally appropriate, lactation support in the community so that, um, the families, the mothers, the women, the birthing people will have culturally appropriate support to go to and to come to them when, when at all necessary. And it is, it does become necessary a lot along with the online services, which also are very important.
Atyya Chaudhry: It's great that the virtual options improved [00:29:00] access to breastfeeding support for some lactating persons.
However, there remain challenges and barriers in this work. What are your recommendations for public health agencies to either become more involved in the work you do, or how can they better support organizations like yours?
Kimarie Bugg: Well, the challenges is sustainability and so there's so many things that need to be done.
It is very difficult when you have places I know for, for a fact where there's such terrible, um, family leave that um, women are unable to stay home but six to eight weeks with their babies when it is just really imperative that we have some much better legislation, uh, here so that, um, you know, women, mothers, birthing people are allowed to stay with their babies longer than just a couple of weeks.
[00:30:00] Um, to, to be able to feed and nurture and, um, just care for those babies that need it. Um, the Pump Act, you know, breast pumps are all over the chart. Um, there are decent ones and there are terrible ones, and a lot of times insurance companies get to just do whatever they want. So we need some consistency with that.
And some, um, you know, regulation and looking, you know, caring for those pumps. We need to policies that are positive for both of, for all of these things, but not just, you know, throw a policy in there. The policies have to be implemented. Uh, they have to, you know, get some, have some, some teeth behind them so that you know employers and, you know, others are, are, feel compelled to follow what the policies are.
And as far as other challenges [00:31:00] is, You know, there's so many things that that happen to, to, um, breastfeeding, um, parents that could easily be worked out if they have, again, lactation support providers that are appropriate, uh, a lot of times, you know, that just isn't so and, and, um, at reasonable cost. You know, some folks say they, you know, can't spend $200 for that 45 minutes to an hour to talk to a lactation consultant. And so again, at, at appropriate, um, cost also. And as far as public health is concerned, breastfeeding has been deemed a public health priority. So we have got to treat it like that. You know, there are some phenomenal policies and, uh, resources and information, and it's you know, not widely distributed. Um, the federal agencies, several of [00:32:00] them have some really good stuff and we just don't understand why it is not disseminated and, you know, shared with, with communities. So we better, you know, sharing of information and networking. It would be phenomenal, um, to be able to help out with that.
Atyya Chaudhry: I'm so glad you mentioned the importance of having parental leave after. It goes back to what you said earlier, some people give birth on a Thursday and are back to work on Monday. Like even if you did initially latch the baby, how do you sustain breastfeeding? How do you keep it up if you have to return to work so soon?
Or is this person in a job that allows them frequent breaks to pump if they wanted to? And most likely the answer is no. I think about that a lot. So you did touch on this a little bit earlier, but what drives you to this work? What's your why?
Kimarie Bugg: So, uh, again, my, my why is because I. Remember the pain when I felt that [00:33:00] I failed my daughters, um, who were born in 1978.
Uh, there were two of 'em. I found out 11 days before they were born. That totally threw me. Um, you know, back then they didn't do all the ultrasounds and stuff. They didn't have all that. So I, I token breastfed for about nine months. Was doing both at the same time. So, uh, fast forward to 1991 where I had learned about breastfeeding, I had been helping other families as a nurse, and so in 1991 I had a second set of twins and they weaned on their third birthday.
And so again, just the sense of accomplishment, but still feeling guilty about the others. That has just always been in my spirit, and so it is a huge difference when you're truly successful at doing something that you choose to do. And I have seen so many black women totally [00:34:00] moved and changed and empowered when they are successful at breastfeeding their babies, their children, and that is why I do what I, I do. So for those babies, every baby is my baby, and it is my desire that every baby on earth gets breast milk. Um, and if not donor milk. And if not, then, you know, of course infant formula is, uh, a good, very good, um, solution as long as there's clean water and all of that stuff. And so that is my why, because babies are just fabulous and, and I love them.
There's just so much love and passion in that and I'm so glad you do what you do. And back to that sense of accomplishment you mentioned with both of my children, I wish I could just wear like a badge of honor or something just to say, Hey, I did this, I am doing this.
And you should be celebrated cuz it is not an easy task.
Atyya Chaudhry: Thank you Delicia and Kimarie for leading this beautiful conversation about breastfeeding, [00:35:00] honoring history and culture and paving the path forward. While each day brings progress, there is still a lot of work to do in helping birthing people realize their goals in breastfeeding, their infants, working with and supporting community rooted organizations like Due North Support Services and ROSE is a critical step in the right direction. Thank you. To our listeners, thank you all for joining us on this MCH Bridges. We kindly ask that you take a few minutes to fill out a quick feedback survey and let us know what MCH related topics you're interested in. And who you want to hear from on future episodes. A link to the podcast feedback survey as well as the transcript of this episode can be email@example.com.
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