Good morning to all (or whatever time it is for you when you are
reading this in your corner of the world!),
I have been following the message thread about breastfeeding in the
military, and now the justification for BFHI in military hospitals,
with great interest. My story is sort of long, but I'd like to share
it here if you are interested.
Most of you know I am a mother on active duty in the U.S. Army,
myself. My story is this: I got pregnant and gave birth to my first
baby in 2002, after 7-1/2 years of service. I wanted desperately to
separate at that time (any enlisted mother can make a case for
"hardship" anytime after she gives birth, even if she signs the
counseling form at 20 weeks committing to stay on active duty) but my
husband told me flat out that my not working didn't fit into his
vision for our family. Knowing that I could either honor my marriage
or be a single mother (who would still have to work outside the home),
I found myself going back to work when my baby was 3 months old, with
a broken heart and many questions about life in general (which, 7
years later, are coming to a head but that is a whole other story).
The Army does not give "maternity leave;" it gives "convalescent
leave." This is an important distinction. The Army gives 42 days
after a vaginal or surgical birth so that a woman can "physically
recover" and return "fit for duty." Any of us who has given birth
knows quite well that 6 weeks doesn't really amount to much after
giving birth. Nor does 180 days, which is the next big milestone for
a mother returning to active duty; that is when the first required
fitness test and weigh-in can be administered. I can safely say the
stress caused by having to lose weight and demonstrate fitness (push-
ups, sit-ups, and a 2-mile run) at 6 months postpartum was
monumental. I have 2 co-workers who believed breastfeeding would
complicate their ability to achieve this requirement and weaned their
babies at 6 weeks. (Yes I am hoping you all can see where support is
necessary and possible for these mothers ... such as being able to
encourage them that they CAN exercise and breastfeed.)
I did as Gloria suggested - I saved up regular leave time before and
during my pregnancies, which yes, means, I often worked for a year
straight with no rest or relaxation from my job in order to have
enough days saved up to stay with my babies. I went back after 3
months for each of them (I have 3 children), and I also planned my
pregnancies such that I would be returning to work during "slower
seasons" in our year. I am a musician in a special Army band (not to
be confused with the bands that are attached to divisions or major
commands). My first several months back each time, I managed to limit
my separations to 15-20 hours/week for the next 3 months. THis was
accomplished by my taking work home and doing it when the baby napped
in the sling or, as I had more children, after everyone had gone to
bed at night. So, I was going to bed late, nursing my babies through
the night, and going to work in a relatively challenging (mentally)
job. I continue to be surrounded by young people, fresh out of their
master's degrees in clarinet performance, who think I don't belong in
my seat anymore, and make that abundantly known to me. I don't have 3
hours a day to practice anymore. I'm lucky when I can find an hour, 4
days a week, beyond my rehearsal time.
My assignment is a unique one, we do not deploy nor do we get regular
reassignments every few years like most members of the military. This
has been both a blessing and a curse. We do not deploy, but since I
had my children we have taken several trips, some extended, to perform
in various places around the country. My struggle hasn't been whether
or how to leave my babies for a year or more, but it has been how to
find people to accompany me on trips so that I could keep my babies
with me. We do not live near family and since my husband is also in
the band, we don't have much time to socialize and meet other people
outside of our workplace (we work on the usual "barbecue holidays"
like 4th of July and Labor Day and Memorial Day, etc.). I got tired
of needing one caregiver in my home for rehearsals and having to find
others who could travel with us, sometimes during the week, sometimes
on holiday weekends, sometimes by car, often by plane. The expense
was great. I finally decided to have an au pair live in our home,
which again was terrific for the children who got to have one
caregiver who lived in our home and was an extension of mamma or
daddy, but it has been hell on me having another young person in my
home to take care of and manage. It has also required that I take a
job with the au pair agency so that we could afford this childcare
solution! (My husband and are both E-7's. Go ahead and look up what
we earn in a year. It isn't much.) I am currently in my final month
in that 2nd job because, due to chronic lack of sleep, chronic
sadness, frustration, and anger, my health is not optimal. We also
don't have the benefit of a new assignment every few years, with new
people and fresh starts. We are stuck with the same people who
remember every move you've made for the last 15 years.
I breastfed my first child to age 3y8m. My second child weaned at
3y10m. My baby, at almost 26 months old, is still nursing and I hope
with all my heart she never stops since she will be my last baby. A
lot of my nursing months were tandem ... 22 months after my 2nd child
was born and 8 months after my 3rd was born. I am unsure about
whether my husband and I will be married for much longer but I am
desperate to create a situation whereby my children have access to
both of us. He has been a bad husband but a very good father. He
sees the error of his ways now that my physical and emotional
deterioration have become "clinical" and I'm under a doctor's care.
I believe I am the only IBCLC on active military duty in the U.S. Army
(even though I am, as yet, not working at all as an IBCLC other than
to write articles and present sessions at conferences). There are
IBCLCs at military hospitals, but I don't believe any of them are on
active duty. They are civilians. My life's dream is to have a
position created for me in the military. I want to educate healthcare
providers, to travel to every Army hospital/clinic in the system and
spend some time building their breastfeeding support programs, and
ultimately have the Army lead the U.S. in progress toward a completely
BFHI-compliant hospital system. I have a few physicians interested in
my proposal but I am still working to make that proposal irresistible
and a "must-have" in the eyes of the big decision-makers. I have been
asked to do a grand rounds day at our Army hospital this spring, where
I will spend the day with the Family Medicine staff and talk about
lactation, breastfeeding, and how to support mothers both serving and
married to servicemembers. Both parts of our community have unique
challenges that are not experienced by civilians.
I tell my story because I realize there are many people who believe I
have "made it work" and I "have it all." I won a position in an
extremely competitive field in 1995 and have maintained it, for what
it's worth, while also mothering in an attached manner and
breastfeeding 3 children. My career has not progressed as it might
have had I not been the type who asks forgiveness instead of asking
permission (and I wouldn't change a thing about the choices I made
within the framework I was dealt). There were supportive and not-so-
supportive members of my chain of command over the years. The not-so-
supportive ones took great exception to the fact that I stood up for
myself and did what was best for my babies even if it seemed
unconventional. I had one XO (Executive Officer - 2nd in command) try
to tell me it was "illegal" to bring my baby on an overnight trip. I
knew he had nothing to stand on and I told him as much, then told him
that if he tried to issue a direct order that I not bring my child, I
would challenge him to stop my mother from vacationing at our
destination and staying in the same hotel and bringing my baby along
for HER trip. I think smart women with strong wills are going to have
a hard time no matter where they function in our current society
(United States) but I am doing all I can to teach my own daughters to
stand up for what they know is right and to always put people before
things (ironic that I have no trouble with this at work but struggled
with it at home). My son is learning to be sensitive and advocate for
what is right, as well. I continue to receive outstanding NCOERs (our
annual performance evaluation), awards for service and impact, and I
contribute in significant ways at my job ... I just often make my
contributions from home, at 11:00 at night when the chores are done
and everyone is asleep.
I am here to tell you that, in my situation, I believe no one wins. I
suffer daily heartbreak that I did not mother my children as God
intended me to. I did all I possibly could to minimize the impact of
my separations on my babies, and I also took great care to minimize
those separations at all. Even now that they are older and in school
(the first two), my heart breaks that I am not the one dropping them
off and picking them up. I chaperone whenever my job allows me to be
absent but I don't feel as involved in their lives as I'd like to be.
I'm tired. Bone tired, all the time. Every minute of every day, I'm
tired. I know this is part and parcel of being a mother but if I may
say so, I think for me, there is the additional component of feeling
emotionally overwrought on top of the physical exhaustion. My husband
has felt resentment because his formerly self-sufficient, independent
wife developed needs for support and that detracted from his career
aspirations. I have trouble feeling sympathetic after he forced me to
stay in a career that requires a singular focus that I really had no
heart for anymore. I go through the motions, I perform my duty, but
my heart is at home. I have over 5 years left until I can retire and
I am one of those women who counts the days. My children will be 12,
10, and 7 when I am done. I pull out every stop when I am with my
children to still be their "home base" and maintain a physically
close, high-touch relationship with all three of them. My older two
don't nurse anymore but love to snuggle up to me after I've slept in
pajamas and "smell mamma's sleep." They both remember nursing and
talk about how great it was. They are compassionate and in touch with
their feelings. I continue to encourage them to express themselves in
effective and constructive manners, which I believe is at the very
core of breastfeeding. I could write an entire dissertation about how
breastfeeding is the basis of all communication and feelings from
birth to death because I believe in my heart that nursing them as I
did, for as long as I did, is a huge factor in everything else that
followed in my mothering. When other parents at our job were going
out after concerts because "the kids are asleep anyway and the sitter
doesn't mind a few extra hours of pay," I rushed home to snuggle into
bed with my kids so that they could make up the nursing we missed at
bedtime (I'm not talking about an infant here ... the infants were
always with me on site).
Anyway, I'd like to say that I agree with Nina that the system is
grossly flawed if the proper care (my faith tells me that God created
a perfect bodily system that governs everything from pregnancy, birth,
breastfeeding, and beyond if we just listen to our bodies - some might
say this is "nature" or an "organic" way of doing things but for me it
has been about recognizing and honoring God's will ... I accept that
others will see the root in a different place but I think we
ultimately all believe the same things about mother/baby togetherness
being part of that perfect system) of babies is not the very first
priority of that system, because everything flows from that care and
protection of those who cannot speak for themselves. I also hear
Robyn loud and clear when she says the situation is what it is and
we've got to work within the framework we're given to offer support
and ultimately, hopefully, make small changes every day that lead to
bigger changes.
All of my ramblings do have a significant point and if you're still
with me at this place, thank you for reading and I hope what I have to
share is helpful to you as you support mothers and their babies in
breastfeeding. Why is the BFHI important in a military setting?
Because in the military, everything, and I do mean EVERYTHING is based
upon the recognition of authority. If the medical side embraces the
BFHI, it sets the tone for everything that follows. In the military,
commanders/supervisors are at the mercy of physicians/healthcare
providers. When I was developing mastitis, and a DOCTOR wrote a note
saying I needed to have 72 hours "in quarters" to rest and be with my
baby, I got the time off to take care of myself (and the mission was
protected because I wasn't debilitated/sick 5 days later when the
performance was, and I always practiced my parts when I missed a
rehearsal so I was prepared to contribute). If the military embraces
breastfeeding as important and as a bottom line, so much of the
support we have to give won't be necessary anymore. If breastfeeding
is considered the norm, it won't seem like mothers are getting
something for nothing if breastfeeding is encouraged and supported.
The BFHI establishes that breastfeeding is the next step in the
biological sequence of pregnancy and birth. The military is on its
way to embracing that pregnancy is a self-limiting situation, but
isn't eager to extend the time of that limitation by encouraging
breastfeeding (they still haven't realized that a baby who was
breastfed grows into a child who doesn't need to miss school as often
because of stronger overall health and immunity, etc.). Like I said,
I have navigated my own course such that I get what I need; a place to
pump or nurse wherever we are, an appropriate space on-site for my
baby to be with a caregiver while I'm on stage, separate travel
arrangements from the rest of the band so that I can more easily bring
my 2-year old on a trip to Texas in February ... I've asserted my
needs, promised and delivered the "product" of good job performance,
and won the support of enough people in charge that other mothers
following behind me are able to work similar situations in favor of
balancing. It is not ideal or perfect but for the mother who chooses
or is coerced into keeping her career, it is a big step in the right
direction. BFHI-compliance in the military would set the groundwork
for breastfeeding as the norm, not as "extra credit" as so many people
seem to believe it is. It is one tool that would yield a huge bang
for a small buck, so to speak. The system has to support the truth
and currently, it does not.
One more thing, Jeanette, there is a military hospital that has become
Baby-Friendly, and another that was but no longer has a mother/baby
ward so still is recognized for having gone through the process.
I know this has been long and I appreciate those of you who have
chosen to read the whole message I am trying to send. I'm not sure I
adequately communicated everything I hoped to, I started this message
more than 5 hours ago but between cleaning up breakfast, getting
little people dressed, nursing the little one (or just holding her
when she says "Mamma, YOUUUUU!"), etc. I'm sure I worded something or
poorly expressed a thought or feeling ...
--Diana Cassar-Uhl
IBCLC, LLLL, and mother of 3 on active duty in the U.S. Army (as a
Sergeant First Class/clarinetist/Education Outreach Non-Commissioned
Officer in Charge)
dreaming of an opportunity to leave music behind in order to educate
healthcare providers and policy-makers for as long as it takes!
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