Saturday, May 25th 2013

What do CMAJ, Midwifery Today, Pubmed and CAPPA have to do with Eats On Feets?
By Maria Armstrong

Eats On Feets... First, why do I choose to volunteer at Eats On Feets? I am not a milksharing mother; I don't plan on being a milksharing mother in the future. I am all done with babies… of my own that is. My breastfeeding days are over and are a fond memory of a growingly distant past. I nursed my babies well past the AAP's minimum recommendation of breastfeeding for at least one year. I never even had any problems.

No, my interest in milksharing, and in Eats On Feets specifically, comes from my work and passion: being a birth doula. Unfortunately, I have had clients who had supply issues for various reasons, and it was a frustrating experience to see them having formula as their only recourse, whether short term as the issues were being resolved, or long term in case of unresolvable issues. Formula simply is not as health giving as breastmilk is. It did not occur to me however that mothers would want milk from another mother except via milk banks and thus for medically indicated reasons, nor did I know the birth community well enough to realize that some midwives may have known lactating mothers who had milk to share.

After one such experience yet again, I ran into Shell Walker (now Shell Luttrell), a midwife in Phoenix, AZ. I "met" her on, yes, Facebook, this awesome social networking medium. Shell had an active and local milksharing community going on called Eats On Feets, and the idea of having more communities like that all over the world inspired many of us. It seems to me now that all it took was one evening of brainstorming with a few people and Eats On Feets, the grassroots milksharing network, was born. I set up the Oregon chapter that same night, and it quickly took off, growing to 100 likers in a couple of days.

With the unexpected rapid growth of this network however, and the eagerness with which mothers were jumping on milksharing, also came the question about safety. How safe was it, really, when the milksharing happened outside of your own [Shell's] direct midwifery community? Mothers were asking questions about expressing, storing, shipping, feeding options, bacteria, screening, blood tests, mitigating diseases with pasteurization, and much more. We needed answers; parents needed answers.

Shell and I, as well as a handful of dedicated volunteers, poured ourselves over the information available to us and we quickly realized that we needed to make all this information more accessible, to both parents and professionals. There was so much to read, analyze, research and gather that we felt this was an impossible task for any, often sleep deprived, new parent to do, especially in acute need situations. We also wanted to make the information more easily available to medical, birth and lactational professionals, so that they could support community based breastmilk sharing and their clients or patients.

In the end, it took countless hours, a couple of all-nighters, days of missed work from daytime jobs, and several months to get our heads around all the information. We also talked to scientists, doctors (one of them using donor breastmilk for his grandchild from within his community), researchers, the very people involved with the studies we were reading about, always checking and double checking that we had it right. At times, steam came off of the Google document where we collaborated; some virtual doors were slammed. It was hard, hard work and crazy times.

Not only that, but as we researched, we discovered that some of our long held opinions and assumptions about certain issues like screening and pasteurization were inaccurate. Yikes! There was no way to go back and correct ourselves everywhere we had gone on record with some of these inaccuracies. However, the Canadian Medical Association Journal had published a news article earlier that year (Milk Sharing: Boon or Biohazard. 2011) for which Eats On Feets was interviewed, and considering the scope of the journal, we decided that it was important to send them a correction. Thankfully, it was published as a response to the article.

Finally, finally, out of the extensive research that we did, "The Resource for Informed Breastmilk Sharing" was created. This resource is truly unique in its kind. It is a searchable database, containing all the current information and research on breastmilk sharing, its safety concerns and informed choice process. It is complete with references, links, and official recommendations. This resource is continuously scrutinized and updated by volunteers in the medical, lactating and research community.

Out of our research, and the writing of our resource, came Shell's easy to understand and implement concept of the 4 pillars of safe breastmilk sharing: Informed choice, donor screening, safe handling and, if needed, pasteurization. These four pillars were elaborated on in our article "The Four Pillars of Safe Breastmilk Sharing," which was written for and published in the spring 2012 edition of Midwifery Today Magazine. This article is now also cited in PubMed!

But it doesn’t stop there: "The Four Pillars of Breastmilk Sharing," as well as an excerpt from the article, are also being used and cited in CAPPA's recently released document for perinatal professionals, called "Milk Sharing and Perinatal Professionals" by Laurel Wilson, IBCLC, CLE, CCCE, CLD, CAPPA Executive Director of Lactation. In it, Laurel Wilson writes that "parents considering peer-to-peer milk sharing should follow the '4 Pillars of Safe Breastmilk Sharing.'" [emphasis added]

Now, this is really why I am with Eats On Feets specifically, and what excites me the most personally, aside from babies getting breastmilk: Not only has Eats On Feets become a leading resource in providing safety information and setting a standard for community based breastmilk sharing, Eats On Feets is also influencing and supporting changes in breastmilk sharing policy. From a correction to the CMAJ to Midwifery Today, Pubmed and CAPPA, we have made a long and fruitful journey. We have become a reference on other people's documents and guidelines!

And we are not done! There is so much to do still; there are so many plans, ideas and hopes. As we grow, we are attracting people in the research field who want to research methodologies for safe milk sharing. We want to look into education opportunities and collaborate with health professionals who have a direct impact on the most vulnerable members of our society so as to normalize community breastmilk sharing. I cannot wait to see what the future brings!

I absolutely love being part of such a wonderful grassroots movement as Eats On Feets! I am so grateful for everything that I have learned these past few years, and for the deep relationships made. But most of all, I thank everyone who is involved in making breastmilk normal for every baby! Nowadays, when I have a client who has supply issues, I can offer an alternative to formula: I can offer to find someone who can safely provide her baby with species appropriate nutrition. And that is HUGE.

Maria Armstrong, is a doula, childbirth educator and community breastmilk sharing consultant who practices in Portland, OR.