Dr. Rebecca Dekker – 00:00:00:
Hi everyone, on today’s podcast, we’re going to talk with Dr. Kimarie Bugg about her work to address breastfeeding inequities in the African-American community. Welcome to the Evidence Based Birth Podcast. My name is Rebecca Dekker, and I’m a nurse with my PhD and the founder of Evidence Based Birth®. Join me each week as we work together to get evidence-based information into the hands of families and professionals around the world. As a reminder, this information is not medical advice. See ebbirth.com/disclaimer for more details. Hi everyone, and welcome to today’s episode of the Evidence Based Birth Podcast. Today, we are so honored to have with us Dr. Kimarie Bugg. Dr. Bugg is President and Chief Institutional Officer of Reaching Our Sisters Everywhere, or ROSE, a national nonprofit created in 2011 to address breastfeeding inequities in the African-American community, and Dr. Bugg is a career perinatal and neonatal nurse professional. Kimarie has spent nearly four decades working in the Atlanta metropolitan area and nationally promoting perinatal health, breastfeeding, and community-based impact solutions.
Previously, Dr. Bugg worked in private pediatric practice and for Emory University School of Medicine as a nurse practitioner, at the state level as a perinatal nurse consultant, and in the hospital on inpatient pediatrics, in the Pediatric Emergency Center Special Care Nursery, and as a bedside breastfeeding consultant from 1986 to 1994. In 1987, Dr. Bugg became the first African-American International Board Certified Lactation Consultant, or IBCLC. Dr. Bugg is a member of the Faculty for Boston Medical Center’s Community and Hospitals Advancing Maternity Practices, known as CHAMPS, a Baby-Friendly hospital initiative, and a past board of directors and chair of the Ethics Committee of the United States Breastfeeding Committee. Dr. Bugg is known nationally for her work in lactation, anti-racism and health equity, the nonprofit world, and marginalized community empowerment. She has received innumerable awards and recognition, including multiple Lifetime Achievement Awards. Dr. Bugg provides health equity through breastfeeding engagement, training, education, and resources for providers, lactation providers, and community transformers nationwide. Dr. Bugg is an adjunct faculty currently for Morehouse School of Medicine Pediatrics, and we are so excited to welcome her to the podcast. Welcome, Dr. Bugg. We’re excited to have you here.
Dr. Kimarie Bugg – 00:02:46:
Thank you so much. I am really happy to be here.
Dr. Rebecca Dekker – 00:02:48:
I was wondering if you could take us back a little bit before we move to present day and tell us about, you know, what inspired you to go into lactation? You were the first African-American to become an IBCLC. You know, what inspired you to go down that journey and how has the field changed since then after you tell us about your beginnings there?
Dr. Kimarie Bugg – 00:03:11:
Okay. I love to talk about the past because I feel like we have come so far. It is really amazing. But as many people, birthing people, women, mothers, it happened to me through trauma. In 1978, I became a registered nurse. I became an “MRS” and I also became a “MAMMA.” During that time, I had a set of twins in 1978. And I was away from my family, born and raised in Indiana. I was in Texas because that’s where my husband and I were in school there. And I had absolutely no one to help me with breastfeeding my twins. First of all, the twins were a surprise. And then I was reaching out to the community to find someone who could sort of give me some information because, again, you know, I had grown up watching folks breastfeed, but not breastfeeding twins. And so that was sort of a shocker to me. And at that time, we had telephone numbers that indicated where you live. And, of course, I lived where people like me look like live. And everybody knew, again, from your phone number where you were. And so I never received a phone call back from the folks I reached out to. Because, again, La Leche League was about the only folks we could contact at that time. Or that I knew of who was in the community doing breastfeeding support. So I felt like I failed miserably. And I decided that when I went back to work, which was in an inpatient area in a hospital, that the families that I served were not going to be as miserable as I was trying to and failing at breastfeeding my children. So I feel like I did not have the information and the resources. And there was no one for me to reach out to. So I, at that moment, started being the one that the community and the mothers who I worked with in pediatrics could count on for some breastfeeding information.
Dr. Rebecca Dekker – 00:05:23:
Wow. And that is just like a story, like you said, happened to you, but I’m sure it’s happened to many other African-American mothers during that time period. And you said your twins were a surprise, meaning you didn’t know that you were pregnant with twins.
Dr. Kimarie Bugg – 00:05:37:
Right. And I’m not surprised that you don’t understand that because at that time we didn’t have sonograms and all of those things. So, no, what we went on is signs and symptoms. And I had a phenomenal OB/GYN who was telling me because at that time I was a nursing student during my pregnancy. And I kept saying something’s wrong with this baby because this baby moves 24 hours a day. And so my OB just told me, look, you know, you’re not even a nurse yet. I’m the doctor. The baby’s OK. So at the end, actually, 11 days before they were born, my visit. He felt one great big head at the top and one great big head at the bottom. And so sent me for an X-ray, which is probably as tall as I am. That then showed the two babies.
Dr. Rebecca Dekker – 00:06:27:
Oh, wow. That’s back then.
Dr. Kimarie Bugg – 00:06:30:
1978. Were you born in 1978?
Dr. Rebecca Dekker – 00:06:34:
I’m not going to say exactly what year, but I will say my dad was a surprise twin as well. Yeah. So my grandmother was pregnant with what she thought was her sixth child and ended up being her sixth and her seventh. And apparently they should have known she was pregnant with twins because she got so large by the end. She carried them all the way to 40 weeks and she couldn’t get up out of the recliner.
Dr. Kimarie Bugg – 00:06:57:
Well, yeah, I was too, but you know what happens, especially with when you’ve had some, you get larger each time.
Dr. Rebecca Dekker – 00:07:04:
That’s true. So it’s hard to tell. It’s hard to tell. And yeah, so that’s really fascinating because I don’t hear that many surprise twin stories anymore. And what was difficult or different about breastfeeding twins? So you said you saw people in your community growing up in Indiana breastfeeding.
Dr. Kimarie Bugg – 00:07:21:
I did. I did. And it was all just, you know, kind of normal to see that. But again, it’s different when it is your own again, especially when it’s your first and parenting in general is just different when you’re doing it for the first time. But I was again, you know, if I had been in Indiana and again, they didn’t know many people who were breastfeeding twins, but I’m sure we could have found some folks. I would have had the village around me to help figure that out. But I had none of that where I was. And again, like I said, nobody calling me back to say, you know, hey, we can help you. Even my mother came to visit and I was a breastfed child. My mother breastfed me for a while, but she came to visit me. And her position was that this was too difficult of a task for her baby. And so she actually was advocating with my husband that, you know, this was too hard for me to do because, again, we weren’t getting any assistance. And, you know, I had all those things, the sore nipples, obstructed ducts.
Dr. Rebecca Dekker – 00:08:24:
Right.
Dr. Kimarie Bugg – 00:08:25:
Totally overwhelmed with lack of sleep. And so they didn’t have the information to be helpful either at that time. So it was, you know, a calamity of errors. But I just want to say, I can go on and say now, because you look sad.
Dr. Rebecca Dekker – 00:08:44:
Yeah.
Dr. Kimarie Bugg – 00:08:44:
That problem was fixed because in 1991, I had another set of twins and they weaned on their third birthday.
Dr. Rebecca Dekker – 00:08:52:
Oh my goodness. Two sets of twins.
Dr. Kimarie Bugg – 00:08:54:
Right, right. I said that, you know, God gave me that second set to fix the breastfeeding problems I had the first time.
Dr. Rebecca Dekker – 00:09:01:
Yeah, sometimes, like you said, our own trauma and challenges can inspire us to go help other people so they don’t have to experience the same thing. And I know you mentioned, you know, being a nursing student in the late 70s. And that’s when my mom was a nursing student as well. And she was in Kentucky. And she remembered the first, you know, African-American nurse that was hired around the same time she was hired. So you were kind of entering nursing at a time when it was just barely starting to be desegregated, correct?
Dr. Kimarie Bugg – 00:09:34:
Well, I would say, you know, that is how it was in the South. Again, I’m from, well, I was from Indiana and there weren’t very many registered nurses of color where I was either. But, you know, but right after that, when my babies were a year old, I moved to the Atlanta, Georgia area. And that’s where we are today. It was like, you know. You know, phenomenal. You know, my eyes were just, you know, wide open because there are so many Black nurses in the area. Now, they had just gone from, you know, several segregated hospitals to integration. You know, again, around that time, I moved here in about 1980. But the Atlanta metro area, major cities, you know, the Detroit area, you know, Chicago, those are places that I had relatives that were nurses. And that’s one of the things that sparked me to want to be a nurse, too. But, yeah, it definitely was not a lot of nurses in rural areas, for sure, but in major cities, yeah.
Dr. Rebecca Dekker – 00:10:38:
Yeah. And then going into the field as an IBCLC, so you did that in 1987. And what was that experience like?
Dr. Kimarie Bugg – 00:10:47:
So again, you know, most of my adventures and journeys have definitely been a story. There was the Surgeon General C. Everett Koop was advocating for breastfeeding early 80s, late 70s, and they decided to give funds to all 10 public health regions. So the Atlanta area being, you know, sort of the hub of Region 4, they came to Atlanta to have a meeting and announce these grants. So myself working at a large inner city hospital and at that time in administration as, you know, charge nurse, decided that this was something I really wanted to do because again, after I learned about breastfeeding, the places I worked at sort of deemed me the breast nurse. All of the hospitals I went to after that because I was one who was reading and learning information so that I could help others. And that’s how I had to get it, by reading and getting resources myself. So our hospital applied for one of those grants and got it. And what we chose to do was to have what we call a bedside breastfeeding counselor. You know, they wanted to name it all types of other things, but we didn’t want to because we wanted the folks to understand what it was that we did. This hospital, Grady Hospital in Atlanta, was probably about 85% Black, 10% Latina, and then, you know, 5%. other. So I became the first bedside breastfeeding counselor. My boss had just come from a conference and this was in ’86, the end of ’86. And he said, I just came from a conference where they talked about this board certified thing. I want you to go take that test. So that’s how it became a thing for me. That was the end of the year. And in 1987, I think it was April is when the exam was. So, you know, I got some information and studied and took the exam. Had no idea really what was going on with this, but I knew the people, many of the people who were writing the exams and doing the process. So I did reach out to them and talk to them about things. And so I took that exam and, you know, it was pretty amazing at that time because Grady Hospital was the first one to have a bedside breastfeeding counselor. All the other hospitals in the area sort of looked at us and said, well, if Grady can do it, you know, we can too. And so after a year later or so, all the other hospitals started to have what they called lactation consultants. And at one hospital now in the city actually has about 45, you know, lactation consultants on their staff now. So we’ve definitely come a very long way as far as that is concerned.
Dr. Rebecca Dekker – 00:13:42:
And in terms of like what was happening in the 80s with breastfeeding, it’s my understanding that this was kind of, they were trying to bring breastfeeding back. Like it had kind of gone away in the decades before formula was heavily emphasized. And so now we were trying to like re-educate people about breastfeeding. And you were saying like you were the breastfeeding nurse, like all the nurses look to you as like, well, Kimarie knows what to do because it wasn’t necessarily included in nursing education.
Dr. Kimarie Bugg – 00:14:14:
So it was not included in nursing education. Absolutely not. It was not included in nutrition education. Physicians were only taught how to fix broke breast. So no, as far as healthcare providers are concerned, no one was really teaching about breastfeeding. Now you did get some information about the components of breast milk.
Dr. Rebecca Dekker – 00:14:38:
Okay.
Dr. Kimarie Bugg – 00:14:39:
And, you know, how it worked in that mammary gland. So that is all that we learned in our professional education. And again, it’s not a whole lot better today. It is much better than it has been because one of the things that we did, especially early on with training and education, especially of healthcare providers and public health providers, is to ask, you know, I’d be in a room with 300 people, how many of you were trained in lactation in your professional training? And, you know, you’d see two hands go up. Now, the majority of the folks feel like they did get some information in their trainings. However, we don’t know what that is yet. That might still be one class because it’s not showing in the community.
Dr. Rebecca Dekker – 00:15:24:
Yeah. And I know when I was having my babies in like 2008 to the 20 teens, I still was running into doctors who thought the cure for everything was to stop breastfeeding. I can’t tell you how many times I was just, well, you should just stop, you know, because it’s causing this or it’s causing that. Like they thought breastfeeding was causing problems. And I was like, did you study this in medical school? And my hunch was no.
Dr. Kimarie Bugg – 00:15:51:
Absolutely not. And again, that’s one of the things that, you know, we’ve had the opportunity to do, especially in the metro Atlanta area. You know, this is a very rich area for civil rights and many things, the Atlanta metropolitan area. So being African-American and doing breastfeeding in the community, we had the opportunity to really meet a lot of those icons and actually work with many of them and their families and their lactation problems. That really helped us to really position ourselves to where we are today. Because, you know, knowing the Dr. David Satchers and the Andrew Youngs and Vivian, so all the people that we were able to meet, the Hamilton Holmes, and those are, you know, really sort of big icons here. But, you know, they had problems, you know, their families, their wives, their children had problems with lactation and breastfeeding also. And we had the ability a lot of these times to do home visits and really get to know folks. And that made a difference for us. But, yeah, there was very, very little to help with breastfeeding. And, you know, one of the things during that time, we also got a grant to spend some time in San Diego, which is the San Diego Lactation Program. And meet a lot of folks who have definitely, you know, written the books and write the articles and all those things and learn different strategies to push it forward. Dr. Audrey Naylor, who is someone that I consider my mentor mom was absolutely amazing. I had spent much time with Dr. Ruth Lawrence. When I mentioned Dr. David Satcher, who is the 16th Surgeon General of the United States, and he was here at Morehouse Medical School for many years, and he helped to mentor us. So during that time, we really learned about a lot about how to encourage and advocate for breastfeeding in the African-American community.
Dr. Rebecca Dekker – 00:17:50:
Mm hmm. So in terms of like overcoming challenges, can you talk about maybe what are the most common challenges that anybody can face with breastfeeding, like regardless of their background? And then we’ll move into some of like the more unique challenges for the African-American community. Is that okay?
Dr. Kimarie Bugg – 00:18:08:
So workforce is a big problem in this country. You know, we keep saying that we want women to breastfeed exclusively for six months. And then, you know, past a year and past two years. But exclusive breastfeeding is a financial burden to a lot of families to, you know, if you are able to have that time off, a lot of times it’s not with the same pay. And if you have other children, you know, that, you know, you need to provide for and take care of, it can truly, truly be a huge burden. Child care costs are extremely expensive these days. So again, a lot of jobs don’t even provide six month leaves. And if you do take that six month leave, you know, you may get paid for three months. And so then you get not paid for those other three months. So that is a burden. That’s a burden. That’s one of the things policy wise that we just truly, truly got to work out. And then, you know, the types of jobs a lot of folks have, and that’s one of the unique challenges for African-American families may not provide even, you know, those three months of leave. It’s difficult to get a lot of companies to actually have lactation rooms and provide time for women birthing people to actually go and spend time to be able to pump and even save the milk for their babies. So that’s some of the biggest problems is lack of resources, not having supportive lactation support providers available to help that are affordable. And then actually for them to get paid, because so many of the people I know that works in my community actually provide services free on sliding scales and free. It shouldn’t have to be like that. You know, folks should be able to get paid for their service. And, you know, when I started again, you know, I had so many people on my couch coming to my home, to my couch sitting that I would help with breastfeeding. And I might get a rotisserie chicken. You know, they may bring, you know, a rack of ribs or, you know, some vegetables from their gardens. And that was my pay a lot of times. And it still seems like it’s a lot that a lot now. I was just talking to three young lactation support providers yesterday who were all saying that they do do a lot of their work free. They have jobs where, you know, they’re doing what it is they need to do. But then they work on their own doing home visits and calling and telehealth. And a lot of those things are free. And, you know, these are not well-off people.
Dr. Rebecca Dekker – 00:20:59:
Right. And it just kind of shows like how our society doesn’t really value parenting and motherhood and with dollars, like it’s like not valuable enough for us to actually pay someone to help you. And, and when I think of breastfeeding challenges, I think of like milk supply issues or sore nipples or all of the things that make your life as the parent miserable or difficult or feeling like a failure. And then I love how you’re looking at the systems and being like, there’s no one to support you. Like these are all fixable issues or issues we can address at least. But you have to have people who know how to support you. And so the workforce.
Dr. Kimarie Bugg – 00:21:42:
In fact, you know, the CDC says about 60 percent of women do not reach their breastfeeding goals. And those are some things that could tremendously be fixed if there were enough lactation support providers and easy access to be able to get to those folks. So because, I mean, I could fit breastfeeding into your lifestyle. You know, if I have a conversation with you and you say, oh, well, I can’t do this or, you know, this is what I can do. I can help you to solve those issues. But, you know, if you don’t have someone to get to to be able to help you do that, then, you know, and then you got all these other folks on the other side saying, yeah, that’s too much trouble. You know, we got this new scientific formula. You could just give them that. And it’s almost the same, which is pure, pure lie and fabrication. But that’s what they get. I had a client, actually a family member who, this is her third child. And she was exclusively breastfeeding, took the child for her two month visit. Now she’s exclusively breastfeeding for two whole months. She gets in there and it’s a new pediatrician. And she was going to a practice where, you know, her other children went. But this was July and July. The new residents are just graduating and they’re starting their practice. So in practice and pediatric practices, they usually give the newborns to the newbies because, you know, you get to develop a relationship with them, you know, as they grow up. So this new pediatrician in July that she’s brand new tells my family member that her two month old skin is dry and that she’s probably allergic to something in her milk. And she should stop breastfeeding for a while till they find out what’s in her milk that the baby is allergic to. And so it just so happens again that this person who is my family member and this is her third child and she’s exclusively breastfed, you know, for 18 months and longer with the first two thought it was hilarious and just laughed hysterically and just told her, you know, I know you. And that was when the show Ashton Kutcher was out called Punk’d was out. She’s like, where’s Ashton? He has to be here. Tell him to come out of the closet. And she just laughed and laughed. And she said, finally, you know, the woman was trying to tell her she’s serious. And so she finally said to her, well, I tell you what, you do what you have to do to find out what’s going on with her skin. But I will not not breastfeeding. But can you imagine if she had said that to someone who had exclusively breastfed for two months and she goes there thinking they had done phenomenal job? And then the physician says that to you. She could have totally destroyed.
Dr. Rebecca Dekker – 00:24:34:
You’re hurting your baby. Yeah. So what ended up happening? Did they figure it out?
Dr. Kimarie Bugg – 00:24:39:
Oh, yeah. Yeah. I mean, first of all, her other children have eczema. So it wasn’t difficult. You know, we could have told him that, you know, we knew that we’ve been sitting at bay for two months. We know our little skin was dry. Moisturize it. That’s all she needed. She was fine. She was growing.
Dr. Rebecca Dekker – 00:24:55:
I would go back again to the cures to stop breastfeeding is like what they teach or something in medical school. I don’t know. So. Can you talk about your work at ROSE and just tell us about kind of a little history of that and what you all do at ROSE?
Dr. Kimarie Bugg – 00:25:13:
Okay, so, yes, you know, started again because so many folks who look like us was just not having problems. So many of lactation support providers that I knew who were, you know, not labeled that at these times were doing the same thing we were doing. I was doing this, having folks come over to your house and you’re helping them with their breastfeeding. So we said, why don’t we put something together so we can do this? And so we did. And it was just overwhelmingly just nationally folks saying, wow, you know, this is amazing. And one of the first things we did was a summit. And at our summit, like we wanted to make sure that this flowed like a Black family reunion. We wanted everybody there that touches babies. So we actually had, you know, physicians and social workers and nurses and mothers. And babies and doulas and midwives and off the entire spectrum there. And nobody had titles. Everybody’s just, you know, their first name. And it went extremely well. We probably had 200 people there. And we call them summits because we always do an action plan at the end. So at that summit, we walked to work together and actually did a mission and vision and goals again with physicians, with mothers and babies. All in the room together. And it just so happens that the Kellogg Foundation people were there who we had no idea because we did not know these folks. And they at that time offered us a grant to work nationally. And that was our very first year getting started. So it was just it could not have happened in a better way. And that funding that they gave us at that time really helped us to put together a national directory of who is where, and what they’re doing. So we were able to, you know, find folks in New York who were doing lactation support. And there were there have always been people out there doing things, but everybody always felt they were doing it all by themselves. So that was one of our biggest things is to create a network so that if someone in New York calls and says, hey, can you come here and teach us, you know, this about breastfeeding? We can say, hey, there’s someone right up the street from you, and with stork and cradle, give her a call because she does the exact same things we do. And she knows your geography. She knows what’s happening in your state.
And so we have, you know, been able to do that all of this time. We’ve done African-American breastfeeding blueprint to see what we did. Lots of listening sessions. We call this the State of Black Breastfeeding to see what was happening. Brought people together again from all over the country, included the HBCUs, Historical Black Universities and Colleges, to talk with them and see what’s happening in communities. And then we put together a blueprint. One of the things we found out that was 2019 is that about 20% of Black women were stopping breastfeeding every week. And the reasons for that was little things like sore nipples, going back to work and not having pumps. And so we put together initiatives to make sure that these folks had somebody they can talk to for at least eight weeks. Because what the research, again, showed us is that the rates of dropping off got better after eight weeks. And so we did what we called a breast friend program, where we would connect someone who was successful with breastfeeding for at least six months with someone who was pregnant and having a new baby. And they would just… mentor them through those first eight weeks, and we’d give them a stipend. And that has been very successful.
So little things like that, a ROSE Community Transformer trainings to help folks so they can just help folks in their communities. Making sure that we present at lots of conferences and workshops and community forums. We’ve also put together a fatherhood initiative, ROBE, Reaching Our Brothers Everywhere. And they have been absolutely phenomenal. With working specifically with Black men to help them to equip, empower, and educate Black men to protect breastfeeding. They actually, you know, are just sought after a lot more than we are these days. And we’re really excited about them. Because Black men were just really feeling invisible in this space. You know, it’s maternal child health. You know, where’s the place for them? And then even going to the hospitals with their significant others, having the babies, you know, they felt that people just totally ignored them. And so, you know, their job is to help Black men not feel invisible in these spaces. And they’re really doing a phenomenal job. They’ve had some training and they call themselves doulos now. Instead of the doulas, they’re doulos. And again, they are there to help the fathers to fit in and get the resources they need to make sure that, you know, that breastfeeding is supported and also just birth and, you know, the risk factors that Black women go through having babies too. We work a lot with baby-friendly initiatives nationally, and that really has made a difference for us. We feel that, again, you know, a rising tide can float all boats. Policy makes a difference, especially for nurses.
If you’re telling a nurse to do something and they’re going to ask you, where’s the policy? You know, you can say, okay, the policy says so-and-so, and they’ll do it, even if that policy is not there. Policies are something we grew up on as nurses. So Baby-Friendly, you know, insists on policies being made. So that makes a difference. We work very closely with the Academy of Pediatrics, The Academy of Breastfeeding Medicine, which are mostly physicians, American Public Health Association to make sure that breastfeeding is embedded into what’s happening in public health nationally. We’ve been on the expert work groups again for Baby-Friendly USA for many years when they’re updating and looking at different things and in fact, speaking of a long time ago, you know, Baby Friendly in the United States started around 1990, 1991. So I was one of the first to do assessments in the hospitals with Minda Lazaroff, who was the first executive director. So, you know, it went way back for me and Baby Friendly. I actually went to Manila to see the very first Baby-Friendly Hospital and spent some time there. That was one of the other grants that we got. So Baby Friendly is really important to us. And again, it truly makes a difference in how people are treated. It makes a true difference in equity. So we are promoting that. You know, there are some issues these days, as it is with everything, but it really is a great initiative to work with.
Dr. Rebecca Dekker – 00:32:15:
Yeah, and I want to encourage our listeners to go to breastfeedingrose.org. Click on programs and see a lot of the programs you mentioned, like the Breast Friends and the Community Transformers, which looks like it’s like a two-day training for people to learn how to support people with breastfeeding. And then I also wanted to ask you, you have a program called the Queen’s Circle for Grandparents. Can you talk a little bit about healing generational trauma and how important that is in the African American community?
Dr. Kimarie Bugg – 00:32:46:
No, it definitely is. And, you know, we missed out on many generations who did not breastfeed. Now, you know, Black women have always breastfed, but because of generational trauma and racism, there have been periods where, you know, a lot of times they may not have been breastfeeding their own children. They may have had to, you know, breastfeed master’s children. So that is definitely traumatic. And that’s why one of the major things that we do is to talk about why breastfeeding is important, not just beneficial. Because, again, you know, you have to work with what we can to get over the trauma.
Dr. Rebecca Dekker – 00:33:29:
And can you talk a little bit more about what do you mean the difference between like why it’s important versus why it’s not?
Dr. Kimarie Bugg – 00:33:35:
Because Black women die, you know, four or five times more, than white women with breast cancer. So it’s important for us to understand that breastfeeding can help you live longer. It decreases diabetes. It, you know, protects against osteoporosis. All of these things Black women have a much higher risk factor for. Even, you know, obesity, all of these things is not just beneficial. It’s actually important to your longevity. There are risks to formula feeding. And those are some, you know, that’s some of the ways we’re changing the narrative. Instead of just, you know, breastfeeding is beneficial and important. There are risks of not breastfeeding. So those are some things that we also talk about now as opposed to just, you know, this is wonderful. This is why you need to do it. Because there are challenges. There are barriers. But it is important to work through those again. Because you can live longer.
Dr. Rebecca Dekker – 00:34:44:
So both for your longevity and then also for the survival of children as well. I saw that you do a lot of work in NICUs. Can you talk a little bit about that?
Dr. Kimarie Bugg – 00:34:53:
So, yeah, in NICUs, it’s become a much easier spot because physicians in NICUs, the neonatologists, definitely use human milk as a medication. They very strongly advocate for mothers of sick newborns and preemies to provide breast milk. And just those words from those providers really helps women to provide breast milk for their infants. And then if there’s not at this point, they can get donor human milk. So, you know, that is something that has definitely evolved over the years. But neonatologists have always been huge advocates for human milk feeding. So we are extremely happy about that. We are sort of, you know, disappointed with community pediatricians, again, because there’s so much that they could do to make a difference. Just having a lactation support provider in their offices. Because, again, you know, you’re in the hospital two days, two to three days. You’re in the community, you know, 360 of those days left that you want to at least make it up to a year. And that’s where the problems and issues and concerns are. So if pediatricians had a lactation support provider, even, you know, two days a week, a Tuesday and a Thursday, come in for four hours and bring their lactating patients in to see them at that time, that could make a huge difference in this country. That’s one of the things we’re advocating for. Not, you know, because we don’t expect pediatricians to spend 45 minutes with a lactating mother. And it’s going to take that a lot of times early on. And that’s why they’re working on these lactation support providers. Like Morehouse School of Medicine has a training that they call the Perinatal Navigator where folks for 20 weeks are trained as a community health worker, a doula, and also a lactation support provider. And we provide the lactation training for them. ROSE does. And Health Connect One does the doula training for them. And they’ve been in that space for a while, and they’re doing phenomenal. And then they also have that other training as a community health worker. That is a perfect sort of lactation support provider that wouldn’t cost, you know, what a nurse costs to come in two days a week to do lactation support training. Also, training doulas will make a huge difference because 90% of their clients do breastfeed. And so they don’t, a lot of times they aren’t able to help them sustain breastfeeding, but they start. So those who start are, you know, low hanging fruit for getting them to continue if they have the resources they need. And we say a lot of times that our community is resource deprived, because they just don’t have the information they need to go forward.
Dr. Rebecca Dekker – 00:37:49:
Wow. I feel like I’m talking to a living legend. Your organization has done so much work. It’s so incredible. I was wondering, is there anything else you want to talk about that’s on your mind or looking towards the future, advancing breastfeeding equity or anything else you want our listeners to be thinking about?
Dr. Kimarie Bugg – 00:38:10:
So the major thing is workforce. Again, we have got to have enough people to be available to give accurate information. You know, I’ve been told for so long by from mothers that if you ask five nurses, five physicians, you know, five public health professionals, the same question that you’re going to get 15 different answers. So we need consistency from professionals. There is something called an interprofessional educational module that the folks at Boston Medical Center did. And it is phenomenal. It’s for seven different disciplines. And it’s consistent, wonderful information. And I’ll send you the link to that. And it’s free. Anybody can do it free. Now, you know, it’s basically for lactation for physicians and nurses and dieticians and their pharmacists there and public health providers. But it is wonderful consistent little information that is wonderful. And we just need to have more things like that to make sure that we’re giving consistent information because that confuses parents when, you know, they’re getting five different answers.
Dr. Rebecca Dekker – 00:39:23:
And you mentioned, you know, training for listeners who are maybe doulas, a birth worker who doesn’t necessarily have the time or resources to become an IBCLC, which can be quite extensive, especially if you don’t already have a nursing license. What would you recommend are some of like the first easy, not easy, but maybe the best ways to kind of just gain some basic info so that they can help their clients troubleshoot some basic concerns?
Dr. Kimarie Bugg – 00:39:51:
So let me say that there are lots of lactation support providers. And what we consider, you know, from the beginning levels, there are intermediate levels and there are expert levels. There are, you know, WIC peer counselors are phenomenal. They have changed the landscape of America. Truly, they have been phenomenal. Then, you know, our Rose Community Transformers, and we’ve trained folks in 39 states. There are certified lactation counselors, the certified lactation educators. There are the IBCLCs. There are breastfeeding medicine physicians who are the expert level. The Academy of Breastfeeding Medicine has many, and we have access to them. If I have a problem or issue, we’re always, always making sure that we have levels to refer to. So I’ve seen some things that I hadn’t seen before, and I definitely call my breastfeeding medicine physicians. Dr. Allison Stuebe is one of those who is phenomenal. And so. From the peer counselor, everybody doesn’t need a cardiologist. Everybody doesn’t need an IBCLC. You can, you know, may just need somebody to rub your back and say, you got this. You can do this. Peer counselors are phenomenal at that. And so we need that workforce to include all of these folks. The doulas don’t have time either to spend a whole lot of time. But if they can get the moms over that acute problem and then refer them to a lactation support provider. Then that would be phenomenal because they have that captive audience, folks seeking them out and they do wonderful work with what they do. So we are, that’s one of the things we are focused on now, spending time with training doulas because doulas are definitely a hot commodity right now. And we love it.
Dr. Rebecca Dekker – 00:41:39:
If you’re a doula and listening, just remember that Dr. Bugg said you’re a hot commodity. And I love the advice to look into becoming a peer counselor first as a great first step into helping support the community. Well, thank you so much, Dr. Bugg, for just letting us pick your brain about your incredible career and all of the things you’ve seen and helped with. And we really are just excited that you’re here. And I hope our listeners learned a whole bunch of new things from you today.
Dr. Kimarie Bugg – 00:42:13:
Thank you so much. There’s nothing I love better than talking about this and definitely serving the community. So thank you so much for having me.
Dr. Rebecca Dekker – 00:42:23:
This podcast episode was brought to you by the book, Babies Are Not Pizzas: They’re Born, Not Delivered. Babies Are Not Pizzas is a memoir that tells the story of how I navigated a broken healthcare system and uncovered how I could still receive evidence-based care. In this book, you’ll learn about the history of childbirth and midwifery, the evidence on a variety of birth topics, and how we can prevent preventable trauma in childbirth. Babies Are Not Pizzas is available on Amazon as a Kindle, paperback, hardcover, and Audible book. Get your copy today and make sure to email me after you read it to let me know your thoughts.
