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We are the Maternal Health Learning and Innovation Center, a network of maternal health equity experts and organizations working to make real change for women and birthing people in the U.S.
Our podcast is a series of episodes connecting around culture, lifting voices and stories, exploring innovations in maternal care and discussing ways we can center equity in the way we approach our health and wellness.
Learn more about us, explore our resource center and find support for all maternal health professionals at MaternalHealthLearning.org.
For more podcast information and content, visit MaternalHealthPodcast.org.
Kelli Sheppard - 00:00:03:
Welcome to the Maternal Health Innovation podcast, Season 4. I'm your host, Kelli Sheppard, Communications Director at the Maternal Health Learning and Innovation Center. On this podcast, we listen to maternal health innovators about ways we can implement change to improve maternal health in the U.S., be sure you're subscribed. In this episode, I'm talking with Tenesha Sellers. Tenesha Sellers, BSCH, WIC, CLC, is the Community Transformer Coordinating for Reaching Our Sisters Everywhere, or ROSE. She is currently the NICU milk wax Supervisor with Emory Decatur's NICU Department in their milk room laboratory, while working in lactation there. Tenesha has trained and mentored approximately 600 community transformers through her position as community transformer coordinator at ROSE. She has also worked as a proud peer counselor where she taught breastfeeding classes and followed moms on their breastfeeding journey through the Loving Support curriculum. With 15 plus years of experience, Tenesha has stayed committed to lactation while serving as a WIC peer counselor, Rockdale County School Liaison, and Emory Decatur Hospital, Active Perinatal Equity Committee. Tenesha has been a member of the United States Breastfeeding Committee, USBC, since 2016. And serves on their workplace constellation board. Tenesha has received several certificates and acknowledgements for her work and participation in advocating and supporting breastfeeding in and out of her local communities and beyond. She's a modern mom of six beautiful children and a wonderful husband. Thanks for joining me, Tenesha.
Tenesha Sellers - 00:02:09:
Hey, Kelli. Thanks for having me.
Kelli Sheppard - 00:02:12:
I'm so glad you were able to join us. I'm going to hop right into our conversation. I'm going to start with our first question. What specific gaps in maternal health care were you seeing among Black and Brown families when ROSE first started? And how have your programs worked to close those gaps?
Tenesha Sellers - 00:02:31:
Well, let's see. So Rose started in about 2011, right? That's the inception of it. But our first big like summit and like coming out celebration wasn't actually until 2012 of our conference. And it was an amazing conference here in Atlanta, Georgia at that time. And so in 2011, when it began, Dr. Kimarie Bugg, Mary Nicholson Jackson, there's two other young ladies I'm trying to think of, I think Tammy, who is no longer with us as well. And then a slew of other people that have been like charged with doing things in the community. And they had been mentoring a lot of birth workers and lactation people that came together. Dr. Bugg kind of pulled us together for what we call the spaghetti dinner. And so oftentimes she talks about the spaghetti dinner in one of our conferences. So for those that have not heard of the infamous spaghetti dinner with roses, that is when. The inception of ROSE came. And there was about 10 or 12 of us at this meeting. She pulled in different people in the community, nurses and doctors and researchers and peer counselors like myself at the time and talked about what was going on and what they were seeing while working in one of our local hospitals here that she was working in, her and her sis, I should say, Ms. Mary Nicholson Jackson. And so one of the gaps that we were seeing, the big gaps, was that people weren't talking to each other. So we had some things going on in the community where people were trying to boost up initiation rates at that time. Initiation was really big. And so they weren't talking to each other, but everybody was coming to Dr. Bugg and coming to Ms. Mary Nicholson Jackson and Tammy and the other people that were part of it and was like, hey, we're trying to start this. This is what's going on in our neck of the woods. And so they would be in each other's backyard. And it's like they're talking about the disparities that they're seeing where our moms are not, our Black moms are not initiated. And the duration was a whole nother piece. And so at that time, they were like, okay, well, you know what? Let's see if we can bring these people together. So we're all seeing some of the same things that are going on. Not only in Georgia, but like across the nation. Because at first, I think initially it was going to be like, a Georgia thing, and then once they realized how much they were being called on from across the nation, it was like, no, we need to make this a national organization. And let's charge it with being a member network. And so that became one of what I call our niches. We became really good at networking and putting people together and saying. Hey, they'd call and say, hey. We got some breastfeeding people in the community that we would love to be able to train, but we don't have anybody here. We're thinking like we just talked to someone down the street from you. Do you know of them? And they have this excellent program going on. And like, no, we didn't know they weren't talking. So instead of us going to be the experts in someone else's neighborhood, because that's one thing that we also like to keep in mind is that you don't do things to the community. You do them with them. So we know what's going on in our community. We didn't want to just go in and say we're the experts in the community in INDIANA or the communities in Kentucky. No, we knew what we knew about maternal health and breastfeeding, but we didn't particularly know everybody's backyard. So the member network membership is like one of those things where we network together and then we're all addressing these facts of supporting, promoting and advocating for initiation of breastfeeding. And so that's where it all began. This is kind of how we started trying to build the gaps with our programs. And our signature Program, ROSE Community Transformers was at the start of it at that time.
Kelli Sheppard - 00:06:05:
That's awesome. So can we, or can you, I can't. Can you please elaborate on the Community Transformers and actually also the Breastfriends Program. And you just touched on what inspired their creation. So what's what's inspired their continuation? And yes, tell us a little bit more about
Tenesha Sellers - 00:06:26:
them. So as a former peer counselor, I absolutely love and go hard in the, when I tell y'all hard for my peer counselors and my birth workers, and I'm like, no, you know, we've got to make sure that we're recognizing them because they make the world of difference. They're the ones on the grounds doing like all of the work. Right. And so the ROSE transformer is a model program that came from also a peer counselor. So Dr. Kimarie Bugg, Jeretha McKinley, Ms. Mary Nicholson Jackson. I remember they all were my trainers and facilitators when I became a WIC peer counselor at the time. And so they were training all of the different peer counselors in Georgia from the state. And they help create along with, what is her name? I think Cathy Carothers, who does the WIC program, Love and Support, which anything of WIC, if everybody knows, the stuff on site is great. They have wonderful things. It's free to use. And so we're not about reinventing the wheel. We already knew there was a wheel that was out there that they were a part of and have been instrumental in getting things going. So it didn't make any sense for them to say, oh, let's just reinvent it. We knew it was working. Research had shown that peer-to-peer support, no matter what it is, whether it's breastfeeding, whether it's dental, everything, we know that even about children and our kids, your peers have a lot of influence on you, right? So we know that that model works. So we took the Loving What Is curriculum and we added what we call, we put a spin on it and added that cultural piece to it. Because what we were missing in our community was that cultural piece. And so that's where the ROSE Community Transformer came in. And so we created a two-day training. Originally, the WIC peer counselor programs were always a three-day training, right? And I think they still kind of do like a three-day or a week. I don't keep up with it a whole lot like I used to. But we created a two-day training where they did different didactics and we did a lot of communication skills and counseling. And then we talked about the things that were happening within our community and culturally, like what does that take? How can we get other people saying we want to help each other out? Right? And so that's where the RCT came in. And so it's a two-day training program where they do get a certificate of completion. And they also, it comes with certs now, right? So they get these certs for any of them that are trying to advance in the career later that a lot of people want that breastfeeding education. So ROSE Community Transformer do the exact same thing as a peer counselor does because that's what they are, peer counselors. But they're just called Rose Community Transformer, because they have that cultural piece that we add to our training for our Black families where the gap was. And then you have our Breastfriends Program. So our Breastfriends Program is a one-day training. So RCT is two days, the Breastfriends is a one-day training. And so it's about six hours, right? And then they have some homework. We give them resources. But that program really focuses on being what we call master affirmers. And so they will follow the moms for eight weeks postpartum. So they are your breast buddy. They are your breast friend. And that's why we call them breast friends. And for those eight weeks, because those are critical times right after delivery. And so if we can get, remember in the beginning, we started with this initiation thing of just let's get us back initiating. Let's get that going. And then we moved to duration. That's how the Breastfriends Program came about because we were trying to get duration going at this point because of some of the research we looked at from different mPINC scores, from the hospitals, different researchers that we knew and worked with from California to Georgia that were telling us different things about like, hey, if we can get those moms within that first, if we can give them that support that they need in that first six to eight weeks, if they have their baby or their prenatal and they say, I want to breastfeed for six months, I want to breastfeed for a year, I want to breastfeed for two days, whatever it is, if they have that eight weeks of support. They're going to reach their goal. And then we saw duration was increasing. So Breastfriends , you know, came about trying to get that duration going and they are master affirmers. So we do a lot of training on empowerment and uplifting and communicating and just really being that friend for someone that needs you because they're looking for you.
Kelli Sheppard - 00:10:40:
That is awesome. I could only wish, I think, during my breastfeeding journey, I actually had an incident with my first child where I woke up in the middle of the night and she was gone. And I looked like I got up. And looked around at the nurses station, a nurse had her and had a bottle in her mouth. After I had given specific instructions that I wanted to breastfeed.
Tenesha Sellers - 00:11:08:
Ooh, Kelli, you see, I almost clutched my pearls, right?
Kelli Sheppard - 00:11:12:
But something like that, where if maybe there was like a lactation specialist or even a breast friend that. Could have been at the hospital, been a support. Do you know what I mean? Like,
Tenesha Sellers - 00:11:26:
mm-hmm.
Kelli Sheppard - 00:11:27:
Taking that program and like you said, making it nationwide, it could have impacted me positively. I could have had an advocate, you know?
Tenesha Sellers - 00:11:35:
Right.
Kelli Sheppard - 00:11:36:
I think that's a really, really wonderful framework that y'all have with that program.
Tenesha Sellers - 00:11:41:
It's been working.
Kelli Sheppard - 00:11:42:
Good. The community transform, just stepping back to that, because you mentioned cultural aspects, that where they were like gaps. Can you be a little specific and talk about those cultural needs that Black and Brown families in the maternal health space need met?
Tenesha Sellers - 00:12:00:
So representation is the very first one that comes to mind all the time for us, right? Because culturally Blacks, we need our representation. We need to know that cis made it, right? Tell me, how that works because that works for us. And we're going to talk. We're going to talk when we're sitting in a beauty salon, talking to each other about things that's going on from babies to our grown children. We're doing that. And we're trusting our assists in the community to give us some honest feedback. So representation is big to say, hey, I can look at Kelli and see that she has successfully been able to do what she wanted to. How were you able to do that? Right. One of the other things that comes to mind culturally is also that aspect outside of representation of just knowing how to connect is like being seen and heard because that's really huge for us. It's like we could care less. And this is for all spectrums. But when you think about the Black communities and the Black and Brown communities, respect is huge with us. Right? So it's like if we feel disrespected, we're done. We're not talking to you. We don't want to hear anything that come out your mouth. And you can be the most brilliant person and have the answers we need, but we're not going to hear it or see it. And so we need to feel respected and we need to feel like we're being heard and seen. And unfortunately, culturally and just calling it out and calling it in of exactly what it is, is race. You know, we know that we go to the hospitals, we go to our doctors and we are already got a stigma with us of saying, oh, they're not going to breastfeed. Oh, they're probably let's let's screen them from drugs for drugs because, you know, that's what they do. Right. And so you have all these other stereotypical things that comes with it. And then these gaps of where we are dying. Like. It's sad to know that in 2024 that we are still fighting the fight and talking about how our Black and Brown babies and mamas are dying at an alarming rate. And so that gap there is like we're trying to close it. You know, it's been like here forever. Right. And so, like, we're trying to like slowly just move it closer to where it's at the basic human needs that we all get. And like our counterparts who are White and even other brown, some of other brown families, they don't go through some of the same things as our particularly Black babies do. But us as a Black and Brown as a whole. We're dying. We are dying. We're losing our mamas. We're losing our babies for things that can be preventable, for things that can be. Protected. And, you know, if we just know that we have our voice and we're seen and we heard, and we have representation to know, like, you know, things are different, you know, like take something as simple as the chart, a growth chart, right? And this isn't necessarily looking at black and brown and white, but this is looking at breastfeeding. So there is actually a breastfeeding chart for growing babies that, you know, they should be looking at and comparing your baby to when you're exclusively breastfeeding that the CDC has on their website and all the pediatricians have at their hand and they should be using. But oftentimes they use that one standard chart that is really for our formula babies. And that's not happening. So you have those things happening. You think about like, as Black women and men, that we have other things that come at us like diabetes and high blood pressure that we have to be screened for because of the things that we have endured and have gone through and just our lives in general. And so that representation, that being heard and being seen and being able to be screened properly and know about those sides, and what's normal and what's not normal, you know, in our community, unfortunately. Normalcy for us has gone to so many different lengths because we have been in survival mode. So our normalcy isn't necessarily always healthy. They'll say, well, you know, big mama, she's been cooking like that and we've been eating like this and we've been fine. But have we? So things are rising on us and we're dying. And it's just, and this is why we do. And I do what I've been doing is because it's like. I've got to be there for my sis because I know what we need.
Kelli Sheppard - 00:16:08:
Thank you for that. So... Just piggybacking off of that, you were talking about being there for each other. Can you share a story or maybe just in general, the overall impact that the peer counselors have had in their communities?
Tenesha Sellers - 00:16:25:
Oh, I have so many of those. Right. And the sad thing is, is that we don't hear a lot about them. So we're always trying to uplift these voices. And I love that we're doing that. You guys are doing this because this is one of the ways that we get our voices out and heard. Like, hey, Black women do breastfeed. Black women do take care of their kids. Like we there. Black fathers are in the house, contrary to what people think. Like, I'm in there. But like, I can think of a story of one of my mentees. And I remember her getting pregnant. Going through like your prenatal visits and things, right? And so one thing that we're really big on when we're doing the training is what we call anticipatory guidance, right? And so we train our ROSE Community Transformer and our Breastfriends on giving anticipatory guidance to our families. So that we can be prepared, right? So you want to be prepared for things. Well, in this instant, with this young lady who was trained as a Rose Community Transformer and ended up being one of my mentees, she was pregnant and we were talking and she had been through the training. And so the first appointment she went to, she didn't feel like she was heard or seen. And so she called me and was like, Tenesha , so this is what happened at this appointment. She was like, is that normal? Like, I don't, I didn't know how to feel. And, you know, he told me that this was going to happen. And because of my stature and because of this, that I was going to have to have these things. And so already putting her in the high risk category and hadn't even really touched her. And so, you know, she was calling me and we were talking about those things. And every time she would call and have a question about something, just being able to contact me, put her at so much ease. And so when she went back to the next visit, she was like, you know, it was like I was just locking, loading her. She had like ready to fire. Every time he came, she knew questions to ask. She was like. So then he came, he was like, so what do you do? And she was like, what do you mean? He wanted to know if she was a nurse or a doctor by then, because just because of how she was starting to ask the questions and being able to be prepared for these visits of things, it just like totally turned for her. And she was like, yeah. So thankful. So, you know, she was able to have a beautiful birth story, did pictures, you know, had a good delivery. And then, you know, we went on and I was also there for her when she was nursing. And so it was better. But I came into her life with her second baby. And she just was like, it's like night and day between one and two. And I felt and she was like, and I felt like, you know, I was pretty good and I knew what I was doing. But having you to be able to talk to and bounce off ideas and tell you what was said and acts like, is that normal? You know, because that's what it is. We want to know what normal is. And that's what we talk about in our trainings and we go through like we want to know normal. So when you see something that's not normal, a yellow flag comes up, a red flag comes up and says, oh, wait a minute. I need to push this issue. I need to tell them, no, I need to be tested for this or no, I want a second opinion. And that type of thing. So that's just one. I could probably give you so many more. We've had pediatricians that have come and sit at our what we call the drip now. It used to be our Baby Cafe. We had a Baby Cafe for a long time. That's a national thing that everybody knows about. And it was wonderful. And so now we changed it into what's called The Drip. And so we meet every Monday. It's open and available. It's a free clinic from 1 to 3 PM. And we have had so many different families from black, brown, all. All the colors of the rainbow have been there because we're big on equity. So all of them have been there. But like socioeconomic status, it didn't matter. We have lawyers sitting there and they're like, listen, we've had even people that have been doulas and doing this work for a minute. And they still need some assistance. And I'm like, I'm coming to the Baby Cafe. I'm coming to The Drip. I'm sorry. Not the Baby Cafe anymore, The Drip. I'm coming to The Drip. I'm like, all right, what's the come? And then the great thing about having our breast friend program, if they come to The Drip and we see they need some additional support, I can say, hey, you know what? What area to live in? And they'll tell me. I'm like, oh, you're in Georgia. I've got I've just trained this wonderful breast. And I'll tell them about the program and ask if they will be interested in being connected to someone. So while we do not necessarily find the Breastfriends leaders to do it, sometimes that happens through our drip and through some of our success story. And so then we have these continuational success stories. And we have seen other people that have become Breastfriends that work with a Breastfriends leader, that ended up going through the program and then turned around and say, hey, I want to do the same thing. So now they are coming to the training and being Breastfriends and giving back and doing. And so it's exactly what we wanted to have a domino effect. And now they in the community and they ready to go locked and loaded. And like we know what to say. We know what to look for. And we're ready to help.
Kelli Sheppard - 00:21:12:
That's awesome. Keeping the cycle going. I love it.
Tenesha Sellers - 00:21:14:
Yes.
Kelli Sheppard - 00:21:15:
Since we're talking about Breastfriends, and you also mentioned affirmations earlier. So how does the Breastfriends program support new mothers in their first six weeks postpartum?
Tenesha Sellers - 00:21:25:
Yeah, it's six to eight. So one of the things, the biggest things for them is, like I said, they will follow these families week to week because oftentimes, like Kelli, you remember having your baby, right? And you remember, you know, everybody want to be on the list to be called and text and, you know, don't forget. But. I'm guaranteed almost, I can say 100%, you probably forgot somebody that might have got a little bit in their feelings. And it wasn't intentional, right? But you ain't, you know, you got a lot going on. You've given birth. Your body is into, I've got to take care of my baby. I've got to take care of me. And so those extra things of reaching out to others should not be on the mother. To get support and help because our late midwives and back in the day, what we did as a village was we came and we gathered around the mother and we cooked the meals for her and we took care of her and they drew her a bath. Like she did nothing but took care of her and the baby. Like literally go to the bathroom, you know, just worry about you and that baby and nursing and healing because it's such a healing and beautiful process. And it takes a good six to eight weeks for them to really, you know, get into that groove and get a good dance and going on. And so many things happen and change. And so the best friend is the one who says, I'm coming to check on you. So I'm calling and texting you and you tell me the best way to connect with you. So if you're one of those families and parents that say, hey, you know, I don't have time to be on FaceTime with you. I don't have time to be on social media with you, but I'm great. Just shoot me a text. And so just shooting that text week to week may be the way they communicate to say, hey, is there anything that you need? How can I help you? And so that's take off the mother and the family. And even sometimes the dad may need it. And the dad may say, hey, I need to call the lifeline because my wife over here or the spouse, you know, may say. I saw them struggling, you know, with trying to get the baby on and, you know, they were breaking down. So I'm calling because I know she won't. I know they won't call. And so let me reach out to the breast friend and say, can you come over and check in with us? And so they may do some home visits. They may do some video visits. And so that's how they affirm them each time they're talking to them and letting them know, like, hey, you got this. We are equipped with everything that we need for our babies right from the start. We just need to be reminded of it sometimes. We just need to be shown and be loved on. You know, think about an accident, right? When you're in an accident, sometimes you may know all the things you need to look out for and start it, start getting things going, right? But sometimes your mind go for a blank. And so you need that person to be like, hey, you got this. You know what you're doing. You know, just tap in. What is your body telling you? How are you feeling? And then it's like, oh, you're right. I know how to clean this womb. I know how to start CPR. I know how to put the baby on. I need to just take a breath. And this is what I need to do. And that's where those empowerment and affirmations and those weekly check-ins that those Breastfriends do come in and make a huge difference. And so then duration rates come. And so now that my family is like, well, we said three months and we right here at that three month mark. Maybe we'll do another three months. It's not that bad. And they're starting solids. And I was like, yeah, we can keep it moving. And then sometimes because the Breastfriends only do the first six to eight weeks. Oftentimes, a lot of our breast friends have also been Rose trained as a ROSE Community Transformer. So then what they will do then is just put that hat on for RCT. And now I'm still supporting you. So I'm not dropping you off. Or if that doesn't happen, sometimes they will pass them off to someone else. That's a ROSE Community Transformer that has a little bit more training, a little bit more experience. If they don't have that and they're getting just getting started, they need that support. They'll pass them off to someone else within our community where they've already built a rapport and feel safe with us at ROSE. So they're like, OK, well, Kelli told me that this person is good and they're working with them. And I've had a great experience and she's been on it. I'll be willing and wonderfully happy to work with the RCT now. And so then, you know, you keep keep them moving and keep supporting them and helping them to meet their goals. So whatever their goals and needs are, you make sure that they get there.
Kelli Sheppard - 00:25:49:
That's awesome, Tenesha. It just sounds more of continuing the cycle, continuing the... Hate to use the word intersection, but that's the, like, because things, it seems like the two programs, although they are very different, they still intersect in different ways. And there's different ways that someone who's a best friend can become a Rose Community Transformer or RCT and vice versa. Am I hearing all that right?
Tenesha Sellers - 00:26:15:
Exactly. And it helps that family and parents to start to build what their care, their village of care needs to look like. And they want and they get to pick. And then they get that representation if they need it. Right. Because think of an RCT to your Breastfriends like as a doula. So I've got to do I got a breast friend doula. I've got to do a postpartum doula that they get to pick. You know, their team, they build it. And that's some of the encouragement. They get to see what it looks like in their village for them and their family.
Kelli Sheppard - 00:26:45:
That's awesome. Building and impacting communities. I love it. So I've heard that breastfeeding rates have improved since the inception of your programs. Is that a safe assumption?
Tenesha Sellers - 00:26:59:
Oh, I would definitely say yes. Now, you know, I'm going to toot our own horn a little bit. And I can't say that we're the only ones that have contributed because there are so many other fabulous programs nationwide that are out there from... And I don't want to start calling names of all the ones because I'll miss someone. But. They're wonderful programs from Detroit to Indiana University to Pittsburgh that do cultural things just like ROSE. And we all have like worked together and collaborating in some way to boost those rates. And so when as we have watched the trend from 2011 to new rates of the that's on our CDC website and even a World health organization, we can definitely contribute to say, oh. All of this happened, like, this was pre-RCTs. This was pre-Breastfriends. This is pre-whatever the other programs that are modeled similar to, you know, addressing culturally aspects of Nationwide that we've all collaborated with. We all have seen this gap increase. So, like, I can remember breastfeeding rates being in 2011 because I remember thinking, like, oh, we got to do better than this. It was, like, under 75%, Kelli. It was, like, 73.6 or 72. And so when you look at that report card on CDC or those stats, you'll always see this plus or minus three. Now, I'm going to tell you, when we start seeing it going up, I'm always adding a three. So if it was 73, I said plus or minus that. So we really had, like, 76. Now, when you look at the rates, we're at 83, you know, percents. And so that, even though it's not a huge jump, when we look at all the compacted things and hurdles and barriers, that faces us as Black and Brown families, that's pretty significant. And we can see how that's impacted. And then we have those stories that are told to us that tells us that. So, like, our families come back and tell us specifically that, like, and there's no way I would have breastfed a toddler until I met Tenesha , right? There's no way I would have even thought about doing it until I met ROSE, until I met Mary Nicholson Jackson, until I met whoever it was that's impacting them in a positive way. That was connected with us in any form or fashion or another organization that's doing great work. We're like, well, hey. The proof is in the pudding, right? Until is one of my favorite words in the English language, Kelli, right? I tell people this all the time because it's always that turning point.
Kelli Sheppard - 00:29:25:
Yes.
Tenesha Sellers - 00:29:25:
And we've seen that. Like I said, those rates were real low in 2011, 2012, until RCTs came about and we started saying, you know what? And then they started looking at it by race. Our Black race and mamas, we're going to get this up. They say we don't breastfeed. We're going to help. Until Breastfriends became about. Until the peer counselors started acting. They saw all of this, these trends going on. So yes, the rates have definitely increased, even though we still hadn't seen like a 10 to 15 point gap. We're definitely taking our five to eight points that we get and it's trending up. So it hasn't declined. And so that we know that that has a lot to do with the programs that's implemented because now we have more people that are on the ground that not necessarily are IBCLCs or CLCs, all these acronyms I'm throwing out. Don't even worry about them. They all have to do with lactation, right? CLEs. But they met, all they know is that I had a breast friend buddy that helped me out with my baby that needed to come to the breast run. And he or she was more like a friend and we needed to get more of us knowing good information, good basic breastfeeding information, and just knowing how to communicate with others and helping our sisters and brothers in those times of need out there on the ground at the level so we can make things happen.
Kelli Sheppard - 00:30:52:
So how do the programs work to ensure that Black mothers are seen? Heard and supported throughout their breastfeeding and maternal health journeys, particularly during prenatal and postnatal appointment.
Tenesha Sellers - 00:31:07:
So the Breastfriends Program, if we're thinking about that, because they work with them postpartum, they're going to be on that end of the postpartum of being there for them and helping them to navigate those spaces and giving them what we talked about earlier called anticipatory guidance, right? To help with those different hurdles and to help find some resources that they need. We talk a lot about referring out and yielding when it's beyond your scope, right? Because we want them to be protected and we want to make sure that the families are getting what they need. And so they're going to be on that postpartum end. ROSE Community Transformer, however, they're the ones that are really in that prenatal. They're in both spaces. So they're prenatal and they're postpartum. So knowing that prenatally, if you are well equipped and prepared and know what's going on and have the anticipatory guidance and have thought about your feeding options, because oftentimes you don't think about that in the beginning until it gets towards the end and it's like, oh, wait, what am I going to feed this little joker when they get here? Like, how do we do this? Especially if this is your first time. And so having that ROSE Community Transformer to say, hey, tell me, you know, what your plans are for feeding once the baby gets here. And so then it's like, oh, wait, no one's asked me that question. Let me think about that. You know, and so if I want to take the formula route, which formula do I want to take? So then that means let's give them some anticipatory guidance of doing your research on which formula that you want. Now, honestly, formulas like peanut butter to me. Pick which one, you know, it has come around to be for a safety reason. So I get the whole reason of why formula is around, especially being a NICU lactation consultant, right? But. To help that mom and that family and those parents to figure out what works for them. This brings me to one of the stories of one of our, it's a success story. And it also is one that I remember being like, oh, I can't wait to figure out how this works. And so one of our ROSE Community Transformer who has done some work with us, I remember her calling. She called in for The Drip. She was planning to what we call relactate. And she was like, hey, my wife is about to have a baby. And we just started talking about different ways of feeding. And she's not sure if she really wants to do the feeding. And so I plan to do it. Now, this mom had particularly already had children. And so relactating and talking about that and helping them through that was going to be even easier on this one. Relactation is very possible if you have not even had a baby, right? You just need a functioning pituitary gland and... A great pump and working with a crew, so an IBCLC and doctors to make sure that it gets going. So it's possible, right? But this particular story, we didn't need that with her, right? She just needed to, you know, get some medication that would kind of help and trick her body to say, hey, I'm pregnant. Um, let's get going. How do we make this happen? Because I want to start pumping. Do you know that this, that one of my favorite couples, cause I could not believe. The mom that was not having the baby, she ended up producing more milk than her wife to be able to nurse and provide human milk for their baby. All the way up until, I think he was two. But they were successful at it. And so it was like to see her milk come in and how it came in and to get it going. And we worked with both of them. But it was wonderful to just see that flourish and see how that happened and help them meet that goal that they were like, listen, we both want to be able to do this. This is our desire. I want to do it in the hospital when the baby is born. She wants to do it as well, she already knew the parent that was not going to be doing it long term. And they hadn't had this discussion and came up with a plan and a goal. And we said, okay, let's fight. Like, I don't know what to get to what you guys desire. And they got that and beyond. And now she helps others to do exactly that if they need it. And so she's like one of our go to's to help families just like her to get right where they got.
Kelli Sheppard - 00:35:31:
That's awesome. So I'm going to transition just a little bit to some of the, I guess, the hurdles that some women face when breastfeeding. If you could discuss breastfeeding in public, or you just touched on breastfeeding a toddler and then how to overcome some of the not so positive. Views that others may have?
Tenesha Sellers - 00:36:01:
Oh my, there's so many. We have what we call our closet feeders, right? And we have our moms that are just embarrassed. And embarrassment is huge amongst us as humans. You get embarrassed and I'm shutting down. And that's where a lot of our closet feeders would come in. And what I mean by a closet feeder, there have been times when we have gone to different states and did trainings, right? And they may have called ROSE in because they say, these women are breastfeeding. We're trying to get our rates up in our hospital. We don't know what's going on. I'm like, okay, well, let's talk to them. Let's talk to the community. Have you started there yet? So we get in the room with these beautiful women that are doing things. And just because they don't look like what they want them to look like or sound like what they want them to sound like, they just cut them off and think like, oh, they're not doing it. But then what we found out is when we started talking to them is that these mamas have been nursing extendedly. And so you think they're not breastfeeding and putting their babies to the breast. They may not just be doing it in the hospital because they didn't have the support and the way like you when you shared your story. No one was like listening and no one was there. Right. And so they just thought, well, maybe I'm not going to do it here because no one came and asked me that open ended question about feeding. So I just want to let them know that I'm going to go home and I'm a breastfeed my baby because this is what I do. And they breastfeed for a long time, but they don't breastfeed out in public. So then people don't know and then they're not telling their doctors because it's not being asked when they go back to those appointments.
Kelli Sheppard - 00:37:34:
Right.
Tenesha Sellers - 00:37:35:
So then they become what we call our closet feeders. And so they're doing it in private and not letting people know and not sharing. There used to be a time when I wouldn't share with people that I was a tandem nurse. Now mind you, This is 10 years into being a peer counselor. This is having done this. Well, actually, maybe not 10 years at that time because I started doing it. Maybe I was probably about four or five years. But I've been doing this work and I myself knew the stats and I knew like, you know, me having a peer person would help. And I had all these people and I had the resources. And that's why we know socioeconomic status doesn't make a difference. Having the knowledge doesn't make that huge of a difference. It's having a peer-to-peer, right? But I wouldn't tell people that I was tandem nursing a toddler and a newborn. And I wouldn't even tell some of my family members because they were looking like, you nursing that big old boy? Because my son was a big boy. So I'm like, he is. I said he was big at six months. You know, at three months old, the boy was wearing 18 month clothes, y'all. So, you know, he looked huge. He was huge, Kelly. And so they're like, you nursing that big old boy. And now you got the new one and you're nursing them at the same time. And you get all of these things. They're telling you you shouldn't nurse because he's a boy past a certain age or, you know, don't nurse because they're telling him to nurse. And then I nursed the last one until she was almost five. But I don't share that with a lot of people. Right. And so when I do decide to share that with people that I'm working with, they're like, you did what? And you made milk that long? And how did it feel? They had teeth and they walking in it. I'm like, yeah, but these are the benefits of extended nurses. This is why I do share it so that people know that we are out here doing it. We are extended nursing. We're not just in the closet doing it. We're not just only doing it in the hospital. Or. I'm not doing it in the hospital because no one's saying anything to us. And so embarrassing. It takes over a lot. And then being accepted by your family. So you're not shunned, you know, when you come in and like, oh, you know, when Kelli come, she's going to have to breastfeed the baby. She's going to be pulling it out at the table. And we're going to do about that. Maybe we need to have this room. I'm up. I done seen it. I done heard it all. I've dealt with some of it. And we've just got to really be okay with, we feeding our baby. It's no different than you giving.
Kelli Sheppard - 00:39:48:
Right.
Tenesha Sellers - 00:39:49:
Like no one says when you pull out that bottle, a formula to that baby, why are you doing that? But as soon as you pull out your breast and your chest to feed your baby, then you got people. What are you doing? The same thing I would be doing if it was in a bottle. But the natural way and the way that works out better for me and my family. And this is what I choose to do. And so, you know, having those best friends in our Rose Community Foundation to share their own stories and the successes that they've heard and worked with people that have tandem nurse and closet fit and, you know, are normalizing it. And so you're hearing this and you're like, oh, we do do this. You mean other people do it? More Black people. Yeah. You're doing it even longer. Yes. And then we look at how our babies are growing and it's like, oh. Yeah, we need to because we have so many other hurdles that come to us. So, you know, we already have just being black and trying not to die. Being black and being pregnant is a big thing now, you know. It's a dangerous thing or... The other hurdles of, like I said, embarrassment and not having the support of your provider and not having the support of your spouse. Because You can breastfeed the girl, but I don't want you breastfeeding my son. And it's like, well, what? Why? You know, and just educating them on like what's really happening, you know, and why we're doing it and the importance of it. And so we talk a lot about importance of giving human milk and human feeding as opposed to the benefits. Because a lot of people know the benefits, right? And I'm like, well, that's a benefit. That's a benefit. But why is it important that I do this? What does this mean for my family and my family history? This means that, you know. Maybe I can live. I will survive and I won't die postpartum. Like we just had a tragic death in our community of one of our mamas that died postpartum after, I think within two weeks, I've got to read up on the story. I just heard about it yesterday and it just hit me because, you know, she was advocating. She was out there already empowering and she gave birth. And it probably was something preventable. I don't know. But a lot of times that happened. We've lost so many like that. Because of the hurdles that we face and we don't have anyone to help us with those hurdles or know how to find them.
Kelli Sheppard - 00:42:15:
Right. Our solutions.
Tenesha Sellers - 00:42:18:
Yeah.
Kelli Sheppard - 00:42:19:
While you were talking, I was also thinking, like... About just my general breastfeeding journey. Like when I got pregnant, my husband said, you're breastfeeding. So maybe he was my breast friend when I think about it. But he was in hospital that night when that incident happened. And he was always about, it doesn't matter where we're at, just as long as you at least you know, cover up. Put a blanket or something over yourself. I do remember, this is kind of a funny story. I had my first daughter in one of those baby carriers in the grocery store.
Tenesha Sellers - 00:42:55:
Oh, I love hearing babies.
Kelli Sheppard - 00:42:57:
But she was so fussy. She was an infant. I was trying to grocery shop. And I was getting fed up. And I had a dress on. And I went to the bathroom. I put that baby carrier on me, put her on me, stuck a breast in her mouth. And she breastfed while I grocery shopped. Under my dress. And all people could see was like her little head poking out of the top. But it got the job done. Do you know what I mean? I have a few other stories. I won't take up all our time. But that was the one that I remember. I was not about to be embarrassed that my child was hungry in a grocery store. I'm going to feed her. I'm going to grocery shop. We're going to get this thing done. I don't remember getting anything more than maybe like a... Like a stare. Do you know what I mean? Like-
Tenesha Sellers - 00:43:57:
What's she really doing?
Kelli Sheppard - 00:43:58:
Yeah. But that's it. No one spoke up. Like, I think some of that, so I say, I say sometimes we just have to like, get our bravery up and not care about what others are thinking about what we're doing, which is a natural thing to do in the first place.
Tenesha Sellers - 00:44:17:
Exactly. And then I get real savvy with telling them about, you know, putting things, get those breasts. I don't know if you've seen them, but I love them. They're like the little hats that you can put on the baby's head and it looks like a boob. And so when they're nursing, all they can see is the head. And so, you know, people don't. Keep looking. It ain't none of your business. You know, don't worry about it. And so, like you said, you just got to.
Kelli Sheppard - 00:44:46:
Right.
Tenesha Sellers - 00:44:46:
Get that on in you to be like, listen, this works for me and my family, and I'm going to feed my child.
Kelli Sheppard - 00:44:52:
Right. Do it work for you and your family and your situation.
Tenesha Sellers - 00:44:57:
Yeah.
Kelli Sheppard - 00:44:59:
Thank you so much, Tenesha, for joining me today on Maternal Health Innovation podcast.
Tenesha Sellers - 00:45:04:
Thank you.
Kelli Sheppard - 00:45:06:
And thank you for listening. For more podcasts, videos, blogs, and maternal health content, visit Maternal Health Learning and Innovation Center's website, maternalhealthlearning.org. We do want to hear from you. Tell us what you want to hear more of, review our podcast and share with like-minded innovators. We've got some great episodes recording now, so be sure you are subscribed. And let's keep talking. Tag us in your posts and use hashtag maternal health innovation. I'm Kelli Sheppard, and we'll talk with you again soon on Maternal Health Innovation podcast.
Outro - 00:45:52:
This project is supported by the Health Resources and Services Administration, HRSA, of the U.S. Department of Health and Human Services, HHS, under grant number U7-CMC-33636, State Maternal Health Innovation Support and Implementation Program Cooperative Agreement. This information or content and conclusions are those of the author and should not be construed as the official position or policy, nor should any endorsements be inferred by HRSA, HHS, or the U.S.