Lactation Certificate Graduates First Class, Looks to Future

Health-care professionals have long known about breast feeding’s many benefits for mother and child: healthy weight gain, perfect nutrition and protection against illness for baby; mood elevation, weight loss and lowered risks of heart disease, diabetes and some forms of cancer for mom.

Breast milk has so many benefits, in fact, that the American Academy of Pediatrics recommends that newborns be exclusively breast-fed for their first six months.

But studies show that many Black mothers are slow to warm up to the idea of breastfeeding in spite of its well-documented benefits: according to a 2015 study from the CDC, Black infants are less likely to be breast fed than any other racial or ethnic group.

P2 students practice during the course’s clinical component.

Those statistics are exactly what Janiyah Mitnaul Williams, an International Board Certified Lactation Consultant and program director of the new Pathway 2 Human Lactation Training Program at N.C. A&T, is working to change.

The program took a major step toward that goal this spring, when the 11 students of its first class graduated, prepared to sit for the accreditation exam to become board-certified lactation consultants.

“We’re already making a difference,” said Williams. “This program is one of only nine similar programs in the world and one of the few that requires an undergraduate degree first. The program is taught face-to-face and emphasizes communication and cultural diversity in each course. Working in health care, I found that was the piece that was missing.

“For the past 50 years, African Americans have had lower rates of breastfeeding initiation and duration than other races. At the same time, Black babies have higher infant mortality, and Black children have higher risks for obesity, SIDS and female cancers that breast milk can protect from, than other races,” says Williams. “We need to challenge our cultural assumptions and break down the barriers to Black mothers’ breast feeding so that we can change those outcomes. A good way to start to do that is by training more lactation consultants that look like them.”

One of only two lactation programs housed at Historically Black Colleges and Universities in the U.S., A&T’s curriculum trains students to work in hospitals, doctors’ offices, and in the community in ways that support and encourage breast feeding, particularly in marginalized communities.

“Breastfeeding is a complicated subject culturally for African American families and families with marginalized voices,” says Williams, who was the first Black lactation consultant in Greensboro’s Cone Health system. “There are historic reasons, such as wet-nursing; unconscious bias on the part of health care professionals, stereotyping – some health care providers assume that Black mothers aren’t interested. Some Black mothers aren’t comfortable with the subject, or say, ‘Oh, that’s nasty.’ But when you ask them, ‘Why is it nasty? They can’t really point to a reason.”

Williams, a 2005 Aggie alumna who majored in speech pathology and audiology, became interested in lactation consulting the old-fashioned way: she had children and nursed them.

Janiya Williams, right, is the program’s director. She was the first Black lactation consultant in Greensboro’s Cone Health system, and the first who was not a registered nurse.

“In 2007, I had my son at Cone. They were revamping their marketing, and they asked if they could take pictures of me nursing the baby to have a representation of a Black family nursing. They took the picture and made it huge, and put it right in front of the nursery, and also printed it on the breastfeeding pamphlets that they’d send home with nursing families. So people started asking me breast feeding questions when I was out in public, especially people who looked like me because they could identify with me. That was when I decided that I wanted to teach other people how to nurse their babies.”

Williams went back to school to earn her master’s degree from Union Institute and University in Cincinnati, the only institution in the world offering a degree in health and wellness with a concentration in human lactation. She became Cone’s first Black lactation consultant, and the first who was not a registered nurse.

In short order, questions started coming from mothers of color. To provide answers and build a network, Williams started a support group at the hospital called Mahogany Milk. Quickly, she realized that more moms could be helped through social media, and migrated the group to Facebook and Instagram.

“It just caught on like wildfire,” she said. “This is a group that needs support, and nobody was doing that in our area. I knew that there were not many African Americans in the profession, and I wanted to bring in more people of color.”

Through a grant from the Kellogg Foundation, the University of North Carolina at Chapel Hill secured funding to establish lactation programs at six HBCUs. Williams was one of the first to propose a program using grant funds; the other, so far, is Johnson C. Smith University in Charlotte.

Although the program opened last fall, planning for it began in 2017, when Williams approached various departments at the university about the program. She found a good fit within the Department of Family and Consumer Sciences, which is already home to the child development and family studies program.

“I saw it as an excellent opportunity for the community and for our department,” said Valerie Giddings, Ph.D., chair of the department. “The interdisciplinary nature of the program makes it a great fit for students in food and nutritional sciences as well as child development and family studies, and it addresses a critical need in the community, especially for people of color. It also addresses a need in the healthcare industry by increasing the diversity of lactation consultants.”

The program’s students this year came from many different professions: nurses, teachers, social workers, students from doctoral programs and A&T undergraduates.

“There is a huge social media following for people aspiring to be birth workers of color, and many of our applicants found us that way,” Williams said. “Our students are very excited about having a program at an HBCU and at a local university, because it’s a hard field to get into, and expensive. and students in the program are able to apply for financial aid, which usually not the case with certificate programs. That eases the program’s costs as well.”

Students fulfilled the program’s clinical component at Cone Health Women’s and Children’s Centers in Greensboro and Burlington, and will next year also rotate through Novant Health in Winston-Salem and Thomasville as well as the Alamance County Health Department.

“We’ve heard from those sites that they’ve seen an increase in the number of Black babies being breastfed and mothers showing up for support groups and perinatal classes. That’s never happened before,” Williams said.

Giddings is pleased by the positive feedback and support the program has received from healthcare partners and the community, and that the program has been permanently added to the university’s course offerings.

“Ultimately, I expect this program to be a model for other HBCUs so that we can truly expand the program and its benefits to a national level,” she said.

“We were really successful this year,” Williams said. “If we can start educating people in the prenatal period, we can start shifting the mindset.”