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Ep. 187 – A Salute to Veterans and Breastfeeding: Protecting moms who served. Interview with Dr. Jill Inderstrodt

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*We apologize for any typos, misspellings or incorrect grammar. Our transcript is auto-generated by software that’s trying its best, just like all of us.*

Hey everybody, welcome back to the Milk Minute. Welcome, welcome, and happy Veterans Day to all of our veteran and active duty friends out there. Absolutely, yes we are actually going to be having, like, episodes correlate with holidays for once in our careers as podcasters.

Yeah, I mean, that’s what you get when you’ve been doing this for three and a half years. It only took us three years to actually accurately predict when things would be post. It’s fine. It’s totally fine. But, you know, I hope you all are enjoying Veterans Day Parade. I’m going to be there with my new baby with little headphones on because, you know, I always love those little pictures of babies at concerts.

I’m going to need you to text it to me. Yes. Right away. I will do that. And my brother, Josiah, is a snare drummer for the West Virginia University Marching Band. Love that. And you know, we’re a small, we’re a big small town, so we’re just like really into our bands. So anyway, that’s what we’re going to be doing on our Veterans Day.

What are you doing? Nothing. I have no plans. No plans. Really, I am, despite the fact that we are actually planning for the podcast, I do basically no planning for my life around holidays because I have a million babies due right now. A million, actually just four in one month. But for a solo practicing midwife, that is a lot of babies due in one month when they are all home births and they are all like, Okay.

Far away. So texting you and yes, everybody’s texting and calling me at every hour of every night And I’m a little stressed out right now. You’re doing great But hopefully everybody’s just gonna have their babies peacefully at home and on time and not at the same time Not at the same time. That’s, yeah, they’re going to take turns.

Also, I whisper to them every, every time I measure, I’m like, take your turn. Also wanted to remind anybody that is local to Morgantown, West Virginia, that anything in my store. In my retail shop for breastfeeding stuff is 20 percent off if you are a veteran or active duty. So if you need a nursing bra or a underwear upgrade, and I know you do, I know you’re sitting there with a hole in your underwear.

I actually do. I have a hole in my underwear right now. Why don’t you grab some undies on the way out? Yeah. Okay. Anyway, we wanted to, revisit our Veterans Day episode today while I am still on maternity leave and enjoying my sweet baby with the headphones on. And while I’m covering for Heather at work and running all over the state, also catching babies and having the busiest month of my life so that my sweet, sweet best friend can have the less, least busy month of her life.

Thank you. You’re so welcome. I’m honestly, very happy to do that for you. Oh, thank you. And I know that our listeners who are also patients really enjoy the fact that they get to have you now. Yes. Hello, everybody. It’s me. It’s not Heather. Surprise. Surprise. So anyways, I hope you all enjoy this episode where we interview Dr. Jill Inderstrodt on her work with military families and breastfeeding, which is so important and it’s becoming much more of a hot topic as the years go on, as more and more women are joining the military. And it’s very important that we make sure that they have all the resources that they need. Absolutely. I’m excited to listen to this one as well.

Also can I give a quick shout out? Yes. I would like to shout out my buddy, Cassie Coya, who is active duty in the Navy. Well, I guess she’s in the Navy Reserves, but she’s currently breastfeeding and she has to go to Africa for two weeks for a training. Just, you know, AT.  Whatever. Annual training. And she’s like, what am I supposed to do? 

And I was like, dude, if it were me, I’d pump and dump.  I’m like not trying to ship breast milk back from Africa. But I mean, these are the these are the stresses that people have to think about and talk about and plan for. And she’s like, I don’t really want to wean before I go. Yeah. You know, and that’s an option.

Actually, we don’t talk about that as a viable option that much because most of our listeners and patients are like, save every drop. But also like, if that’s, that’s easiest while you’re traveling, it’s more important that you express the milk, then you save it.  And I’m going to send her over with a prescription mastitis because she’s going to be exclusive pumping and also like weaning beforehand.

You, I don’t want her to end up in a hormonal dip. No, in Africa, God,  it’s just not, there’s just not great options. And yeah, like let’s stress your body out hormonally and then stress it out physically. Exactly. No. So I have lots of sympathy for her and hopefully you can help her figure that one out.

Yep. I think we have a solid plan. But she’ll be back soon and You know, so if you are a  prayer, a prayer person or an energy person, send our friend, Cassie, all of your love.  All right. Well, let’s listen to this rerun. All right.

Maureen: Welcome to the Milk Minute Podcast everybody.

Heather: Happy Veterans Day. Near and far. Yeah. 

Maureen: So today, I think, you know, a rare occasion we have an on-topic topic for the holiday. 

Heather: We don’t always schedule in advance, but when we do, we really try to crush it.

Maureen: Yes. So, in honor Veterans Day, we’ve asked. Dr. Jill Inderstrodt to come on the show and talk to us about what’s happening with lactating parents in the military and in the veteran 

Heather: population. Jill is a super cool person. First of all, she’s a patron of the podcast, so thank you. 

Maureen: Oh, automatically makes her so amazing,

Heather: So thank you Jill for being a patron. She also has done voiceovers in her career. She’s an avid runner. She was in the peace. She was in the Peace Corps a couple of times. Yeah. She’s a single mom who breastfed while she was single, which is absolutely amazing. And she’s doing some of the only breastfeeding research on mothers who have served in the military and now are now veterans, which is instrumental in supporting new legislation and new programming for veterans that are wanting to breastfeed.

Yeah. Did you know that Congress 

Maureen: passed the protecting moms who served ACT in 2020? Did 

Heather: you know that Heather? No. There’s so much that I did not know. 

Maureen: Yeah. It turns out I know basically nothing about this. So I’m really excited to hear from Dr. Inderstrodt. And I am also just so excited 

Heather: to talk to a patron.

I know, me too. If you’re one of our patrons and you do something cool for breastfeeding parents, can you let us know so we can bring you on the podcast? All right. 

Maureen: Well before we get into the interview, let’s thank some more of our 

Heather: wonderful patron. Okay, today we are thanking our new patrons, Madeline S Dana W and Holly h 

Maureen: And let’s take a quick minute to talk about one of our sponsors today, and then we’ll get right back to it.

Heather: You guys breastfeeding for busy moms. My little breastfeeding clinic isn’t so little anymore. I’m so 

Maureen: excited that not only can people book with you in person here or virtually, but they can book with the other IBCLCs 

Heather: in your clinic. We also do accept some insurance directly. A lot of insurance will actually pre-approve you for a certain amount of visits, even prenatally.

So please head on over to breastfeeding for busy and check out the services tab to see if your insurance is approved. Book with me or one of my IBCLCs, and we would love to work with. 

Maureen: You can do prenatal consults. 

Heather: What else can they do, Heather? Well, I often work with people who have supply issues.

We’ve got pumping, troubleshooting. We’ve got preparing to go back to work, weaning, starting solids. We really cover the entire journey. So if you’re struggling, stop struggling and just schedule with me or somebody on my team at breastfeeding for busy dot com.

Maureen: Okay. One last thing before the interview. I think we wanna read an email from a listener. 

Heather: I love this one. This email says Heather and Maureen. I have breastfed all five of my babies, but after a terrifying encounter with a breast pump 20 years ago, I vowed to never pump again. Well, 20 years ago, breast pumps, that must have been a, It must have been terrifying.

Yeah. Then I discovered your podcast and learned there are so many new ways to make pumping less difficult, so I won’t have to supplement with formula. This time when I return to work, shout out to Arrow Flow for hooking me up with a great pump, no paperwork or spending hours on hold with my insurance company.

Thank you so much for recommending their services on your podcast. It makes a world of difference. You’re welcome. She also says Your dedication to mental health is wonderful. I have D-MER and have dealt with it through all five kids. My Irish twins were born in 2002 and 2003, and back then there was no information about this, so I assume breastfeeding was just supposed to be miserable.

I suffered through it again with my daughter in 2012. Luckily, I was diagnosed five years ago by a WIC lactation consultant. When I described the icy cold feeling I experienced during letdown or while feeding my newborn son, I informed my doctor at my six week visit and he prescribed Wellbutrin. Ah, hell yeah.

I love that medication. . The medicine completely changed my breastfeeding experience. I now have a three week old daughter, and this time around I was able to walk out of the hospital with a prescription because my doctor knew right away that I had D-MER knowledge is. Thank you for giving so many mamas access to that power.

You are both so amazing. Also, I can’t wait to enjoy the Veterans Day episode just as much as I enjoy the rest of your content. My father is an Air Force vet and had things gone differently in my life. I would’ve been a vet myself, dropped out after MEPS because I got pregnant. So yeah, my recruiter was not impressed.

it’s great to hear that you’ll be addressing the subject of breastfeeding vets. Their lives are so hectic and stressful. Super not conducive to breastfeeding. It’s wonderful that you are providing resources and guidance they sorely need and from rural Oregon. Ah, thank you so much Anne. 

Maureen: We really appreciate your email.

And yeah, let, I’m so excited for this episode. 

Heather: Let’s get into it. Yep. And friendly reminder, Maureen and I both do lactation consults and those links to book with us are always in the show notes. . Let’s welcome our new friend and breastfeeding veteran advocate, Dr. Jill Intra. Jill, thank you so much for coming on the show, but also for everything you’re doing with your research and veteran families.

Thank you so 

Jill Inderstrodt: much for having me. 

Maureen: Okay. Let’s get right into it. How did you end up here? How did you end up in the field of researching lactation in military veteran families? And did anybody scoff at your project? 

Jill Inderstrodt: So I had a great experience as a graduate student where I managed the lab of a biological anthropologist.

Her name’s Amanda Wiley. She’s. Just awesome. You should check out her work. And she was doing research into infant and maternal health outcomes related to birth mode and breastfeeding. And I actually didn’t have any background in any of the subject matter. I just had the statistical knowledge to do some of the work and I just became mesmerized with her work, particularly because she works with the Yuca Maya and they have a 100% breastfeeding.

And so that just really fascinated me that that ability and the, the social support that’s there to breastfeed. My dissertation advisor was doing research with military families and then I got my PhD when I was about nine months pregnant. I walked across the stage and then gave birth 10 days later, and had had no ex.

Experience with, with breastfeeding at this point, other than the research I’d been doing with Amanda, and when my daughter was about three months old, I separated from her dad. And so I had been breastfeeding and my primary concern had been nutrition as far as breastfeeding went. But when that happened and we were dealing with custody arrangements and moving our residents and just all of the stress that came with that, that bond.

Became so much more critical for me because I didn’t always, you know, have control over where she was or what she was doing. And so the lactation consultants were just an absolute godsend to me in kind of shepherding me through that process and knowing what was going on and making sure that I could continue breastfeeding as long as I wanted to.

And so when I went on the job market, I was specifically looking for opportunities where I. Research breastfeeding and with the veteran population, it just really, for me, speaks to that ability of women to be able, or mothers to be able to breastfeed for as long as they want. . 

Heather: Wow. That’s quite a story.

And you know, I can absolutely relate to going through custody issues while lactating and how much anxiety that brings up. And it’s hard enough to co-parent with somebody. I mean, my god, it, it’s actually hard to co-parent with someone in the same house when you’re dealing with breast milk storage and how to handle breast milk and, you know, so props to you for getting through that time.

And if anyone out there listening is going through that, we do have a custody and breastfeeding episode that we will. Show notes because you know, it’s a very specific population that deals with it, but when you’re dealing with it, oh boy, is it a big deal. So you kind of spoke a little bit about how you got interested in it, but the specific work that you’re working on now, is the VA actually involved in this and are they wanting to use the information that comes out of it to be like more efficient for their veterans in providing better services for lactation?

Or is this more coming from the private sector and a passion for helping veteran families? . 

Jill Inderstrodt: Yeah, so I’m in a fellowship with the VA currently, and so all of this work is done under the auspices of, of VA operations in health services research and development. And something to kind of keep in mind while we’re talking about veterans is that veterans of childbearing age represent one of the fastest growing populations of veterans.

So coming out of those post nine 11 conflicts, there are a lot of veterans who are interested in becoming pregnant, have been pregnant. Interested in breastfeeding, trying to breastfeed. The way that this works within the VA is that we don’t actually have obstetricians and maternal health services within the VA.

That all goes to community care. So that’s all taken care of outside of the VA. However, the VA does pay for. Pregnancy and childbirth for all pregnant veterans, regardless of their service connected status. So they don’t have to have a certain level of disability or anything like that in order to have that covered.

So that can be challenging. It can be challenging to try to navigate both the community care setting and then also the VA setting. And so the VA has started this program called maternity care Coordination and. VA Medical Center has a designated maternity care coordinator who serves as that liaison or that go-between in helping the the veteran to navigate community care and VA care while they’re pregnant.

And part of that is lactation services. And so that is lactation services are one of the things that the maternity care coordination. Program calls for, and it really depends. It’s, it’s, it really varies. It depends on the facility, it depends on the regional catchment area, which is called the visin. But that can include things like giving nursing bras and breast pumps.

It can include lactation services and it can also include, Coordination of lactation services, so referring pregnant veterans or veteran moms to the services in their community that they’re able to then access. And so I would say that yes, definitely the VA is invested in this and is continually developing the framework.

That supports the maternity care coordination program. 

Heather: I think it’s really cool that the VA is acknowledging that lactation’s really important for like a lifetime of health for infants and their veteran moms, you know, the people that have actually served. It’s like, Oh, we do care about the fact that.

You know, breastfeeding for a certain length of time will actually decrease your risk for breast cancer potentially. And you know, we want you to have a lifetime of health and it’s really neat that they are taking a stand. For that proactively. But I do kinda wonder, you know, and I, I hope that eventually the research will show us how to do this better.

But, you know, lactation is such a time sensitive issue that I’m sure the mcc, you know, this group that you were talking about, has their work cut out for them in coordinating for lactation services because it’s so time sensitive. You know, it’s like, sorry, we delivered our baby on a Friday night and it’s Sunday and my nipples are gonna fall off.

Is anyone at the MCC answering today? 

Jill Inderstrodt: right? Because most of that’s done at the hospital level. If, you know, if a mom gives birth in a hospital, it’s kind of assumed, I think that that first 24, 48 hours is going to be in the community care hospital and not necessarily in the VA. But I just wanted to mention as well at the end of 2021, Congress passed the protecting moms who served act.

And that was signed into law by Joe Biden. And one of the things that that. Allows for is codification of this MCC program. So it’s the, the act is part of the mom nobus bill, like the greater mom Nobus bill. That’s working to decrease disparities in maternal morbidity and mortality, but, Inside of this, protecting Moms who served Act is the at least the, the congressional support for this program.

So you do have it at the VA level, and then you also have it at the, at the congressional level. The, the challenge then becomes how do we make those services consistent across facilities and across, you know, regions or vision? 

Maureen: Yeah. And I imagine that our veterans who are having babies and feeding babies have some extra challenges than the average person.

Do you think you could tell us a little bit about that and, and also let, tell us kind of what does the data tell us about how, you know, rates of breastfeeding are compared to the general population. 

Jill Inderstrodt: Yeah. So when we talk about breastfeeding research or we talk about measurement we, most of the time we talk about initiation versus duration.

So initiation being whether or not a mom began breastfeeding, even sometimes tried breastfeeding, and then duration being for how long that mom breastfed. And even within duration, we. Exclusive breastfeeding, and then we’ve got what we call some breastfeeding usually, which is some or any breastfeeding, which can then include complimentary breastfeeding.

It can, like with formula, it can include complimentary feeding with food once the, once the baby’s old enough. And so that’s kind of what we’re looking at when we’re looking at the data. There are a lot. Veteran moms. I don’t have any raw data as to how many veterans have given birth, but I can tell you that within the data sets that I’m looking at for my research, it is a very, very high initiation rate overall.

So in, you know, 90%, 91%, 96%, which is better than the civilian population. That kind of comes with a caveat, however, which is that when we divide that up into racial groups, black, non-Hispanic, black women are initiating at much lower rates than white or other race moms. And so, and that is the same as in the civilian population.

And so one of the challenges is definitely related to health disparities. A really cool fact that I that I think exists in the research is that there is evidence that suggests that when you only include the only initiated moms, so you only include those moms who tried to breastfeed and you follow them for the duration of breastfeeding those disparities essentially, Eva, Hmm.

So there are a couple of studies that show that. So really it seems like there is an issue with initiation and that that can be related to a lot of things. Another challenge is just the unique mental health and trauma needs of veterans. So for example, with s. If I’m looking at some of the survey data that, that I’m using for the secondary analysis that I’m con conducting with one of my teams, we have about a 40% rate of ever being diagnosed with T s D by the moms in that, in that group.

For civilians, it’s a 5.2% over the lifetime. Wow. So you’ve got about 40%. Of moms, of veteran moms who gave birth in this, you know, in this particular data set that we’re looking at, have ever been diagnosed with PTSD versus 5% for civilians. Anxiety disorder. There’s a lot of disparities as well. Around 50% of the moms in our sample.

Report having been diagnosed with an anxiety disorder and for civilian women, so not necessarily mothers, but for civilian women, it’s about 25% in the last year. So that kind of speaks to the types of mental health conditions that veterans are dealing with. We also know that mental health conditions can affect exclusive breastfeeding, that high levels of mental health conditions are associated with non-exclusive breastfeeding.

And then finally, I just wanted to talk about military sexual trauma. . When we talk about military sexual trauma, we talk about experiencing uninvited attention and harassment, and then we also talk about forced or threatened sexual contact. And there’s not a lot of research on veterans and, and breastfeeding.

There’s. One or two studies and one was done using the same data that my team is using. There’s an overlap in the, in the participants, and she found in 2020 that 50% of her sample had experienced uninvited attention and harassment, and 30% had experienced, forced or threatened sexual contact. Wow. And so when we’re talking about.

You know, tending to these veteran moms, there is a ne a necessity for a trauma informed care that, while I know is very important in the civilian population here, it’s really critical because of the effect that that trauma can have on a mom’s ability to breastfeed. 

Heather: Yeah, it sounds like a very good idea to separate the veteran population and really pick apart the specific issues to that group.

And you know, historically the military has done a pretty decent job of. You know, like with childcare for example, like identifying a problem within their group and being like, this is affecting the group negatively. How can we make this work better for the group? So if they can make this work for a group of people that have like 40% reporting some PTSD in their life, and a high rate of sexual assault, you know, if we can make it work for that group, then wouldn’t it be great if we could take all the things that they do to help and support that group and translate them to everyone in the world.

That would be wonderful. 

Jill Inderstrodt: Definitely, definitely. And, and my work is really concerned with why moms quit breastfeeding. And so again, we’re, you know, there’s that initiation piece and then that, there’s that duration piece. And what a lot of my work is trying to figure out is what are those barriers that exist during the process?

And what we find is that some of them are extraordinary, you know, such. Military sexual trauma or mental health conditions. But really, Heather, a lot of them are the same things that you as a, as an lc would hear that any lactation consultant working with any individual would hear, which is breast pain perceived low milk supply, latching issues.

So in the interview data that we are analyzing, we’re seeing the same themes and commonalities when it comes to, why did you quit? That the civilian population or just the general population that is, that consists of both civilians and veterans would see, 

Maureen: You know, I’m curious how deployment affects breastfeeding and, you know, I don’t, I don’t know really anything about this.

If people defer deployment when they have babies, do they have to wean when they’re deployed? Can they pump? Can you tell us a little bit about. 

Jill Inderstrodt: Yeah, I mean, because I’m working with data that is involved with veterans, we don’t get as much evidence or anecdotal evidence related to deployment because this is all, this is, the deployment is retrospective.

Mm-hmm. . And so what we do know is that moms who have been deployed are almost two times more likely to breastfeed than those who have never deployed. Interesting. And so the, the ones who have been deployed, are more likely to breastfeed. Huh? I mean, 

Heather: feels very significant, you know? Yeah. That, that does feel very significant.

So, I mean, any, Have you found any reason why yet? 

Jill Inderstrodt: Well, we’re looking at interview data, as I said. So this, this isn’t necessarily statistical data, and so I can’t speak to any causal relationships or even necessarily any associative relationships. But I can tell you that in one of the projects that I’m working on, our sample is about 60% ever deployed.

Moms and we do we do see a lot of the same commonalities or the same repeated themes, such as breastfeeding is best or breastfeeding is better. And when you kind of deconstruct that, you’ve got two tracks. One of those being better for the baby, better for their health, immunity, allergies. Weight gain and those sorts of things.

And then you also have the bonding piece. And so I can’t necessarily, like I said, speak to a causal or an associated associative relationship, but amongst a sample that has a lot of deployed moms, there’s also a commonality and a repetition of I wanted to be able to bond with my. The bonding is important and so I, I can only, this is very speculative.

I can only speculate at this point, but if we could figure out what that mechanism is that that causes or allows moms who have been deployed to breastfeed at higher rates, then like you said, if we can. Figure out what that mechanism is. How could we perhaps design interventions using that that can both reach the moms who have not been breastfeeding, who are veterans, but then also non-vet moms as well.

Heather: Yeah. Wow. This is fascinating. I’m sure everybody listening right now has probably spent about maybe a whole two minutes of their life considering what it would be like to be a veteran in general, much less a breastfeeding veteran. And we are gonna take a quick commercial break, but when we come back, we’re gonna really dig into all kinds of other things about being a breastfeeding veteran.

So we’ll be right back.

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Heather: All right, welcome back everybody. We are here with Jill talking about breastfeeding research on veterans. Jill, you and I actually first met because you were listening to the podcast and you sent me an email and you specifically were requesting an episode on breastfeeding as a single parent and dating, but this kind of pops up in your research too.

So can we give a quick nod to our single breastfeeding veterans and maybe talk a little bit about that? 

Jill Inderstrodt: Yeah, and those who are trying to date while date while lactating, so, One of the things that stands out in, I mentioned that there’s, there’s one previous paper that uses some overlapping sample with ours, is that they found that one of the one of the significant factors, at least in, in unadjusted models, That contributed to breastfeeding was living alone versus living with a partner.

And moms living with a partner are about two times more likely to breastfeed than those not living with a partner. And, you know, I don’t think it’s rocket sites to, to think about why that might be. You know, obviously social support is really important but also the fact that veteran populations are different, veteran.

Veteran moms are different in that they might be a single parent by choice or by divorce. They might be living alone under those conditions, but they also might be living alone because their partner is deployed. And so we might see more of this in veteran populations, and it also might fluctuate depending on, you know, depending on conflicts and depending on deployments.

And so that’s just something to consider. Those moms might be at a higher need of services because they don’t have that person in the house. In the interview data that we’re analyzing currently we have seen a repetition of moms saying that they are supported by partners, but that also that they’re partners.

Are the ones who have initiated the breastfeeding conversations. So we have moms saying, I breastfed because it was important that for my husband that I breastfed, or I breastfed because my partner said that they were breastfed, or something along those lines. And so again, that’s not necessarily a causal relationship, but it’s just a theme that we have seen is that the person with whom.

The pregnant veteran is living, might be an influencer, and that if the mom is single or if the mom is living alone, it seems as if that makes breastfeeding more challenging, which again, I don’t think is necessarily surprising information. 

Heather: Absolutely. Well, yeah, and also Maureen and I talk all the time about, you know, just the confidence.

To do it , you know, like if, if I choose to breastfeed and something goes wrong, is it all on me? If I’m the only one there at my home mm-hmm. , you know, just knowing who to call, knowing that you have social support outside of your home, and also being willing. To have the grace to give yourself if something does go wrong, that you don’t completely internalize it.

Yeah. And be like, Well, it’s all me because I’m alone and I made this choice, and why did I make the harder choice? And it’s like so much pressure in so many ways. And I, if we can do anything through this podcast today, it’s just to give people. Some confidence that if you wanna make this choice, there are some resources available.

And also hope that for the future, there’s people like you, Jill, who are looking at how we can make this better through actual hard data, which is so cool. So thank you. Thanks. You know, I’m 

Maureen: really curious about the more personal experiences that people are having, especially trying to access those resources.

You know, you kind of mentioned that it can be a little complicated and we know that TRICARE doesn’t really reimburse lactation consultants very well and it can be frustrating from this side. And often take a loss when, when they’re serving to veterans. So You know, how do you think we can better support people in that?

How can that system work 

Jill Inderstrodt: better? Well, first thanks to you, Thanks to you, Heather, and anybody who is doing that work and who is. You know, serve, who is serving veteran moms at a, at a loss, at a lower reimbursement. I just think that you know, obviously the work that lactation consultants do is just absolutely amazing and just thank you for that work.

You know, as I talked about, I talked about the, the maternity care coordination program and that within. You know, within that veteran ecosystem, there’s just a lot of opportunity there for those coordinators to become more in tune with the lactation and breastfeeding needs of veterans. We have some really unique populations too, within, within the veteran community.

So rural veterans and urban veterans or veterans who live in low resource areas have different needs. Than other veterans. So it could be that, for example, in rural areas it’s really difficult to get to even an obstetrician, you know, let alone a midwife or lactation consultant in urban areas. It could just be a matter of distribution that there aren’t enough of lactation professionals available, or there aren’t enough individuals who can help with that.

And so I think that what Covid has taught us is that telehealth. a really, really important piece of that equation. And I know that amongst lactation professionals, there’s a lot of agreement and disagreement as to whether or not lactation can be done over, you know, over telehealth appointments. But I think that any system that can provide for increased virtual care is going to be a good a good system.

There’s a really, really high. within this veteran population. Most moms say that they want to breastfeed when they’re pregnant. They say that they want to after they give birth. And so there are different barriers, but a lot of those barriers are similar, like I was saying, the same barriers that you would, that you would see.

And so I think keeping in mind that trauma informed care while also, you know, being willing to support in a. That is very much the same as how you would traditionally be supporting a, a mom with breastfeeding. 

Heather: Yeah. Well, I just want to give my 2 cents here about the telehealth. I love it. It’s absolutely working for my patients.

I know it’s working for Maureen’s patients. I actually did have a veteran mom who I was working with via telehealth on the other side of the country and diagnosed a thyroid issue. I sent the lab order, you know, you can send lab orders across state lines. And actually, because of the pandemic, and because I’m an advanced practice nurse and I can prescribe, they took away the barriers for prescribing over state lines, you know, Things.

So I can prescribe antibiotics and I can write lab orders, and I can follow up and have them faxed back to my office. And really they’re just trying to increase access to care and it is working and if it’s ever not working, the lactation consultants that I know. Refer out and we tap into our resources and we say, Hold on.

You know, this is something that I think really should be seen in person. We either refer back to the pediatrician or we dig into our own network and we find someone that can either do a home visit or an office visit closer by. So, you know, don’t ever be afraid to try telehealth. It doesn’t have to be the end of the line, but it can absolutely be a really, really good first and possibly last step.

It might be all you. . 

Jill Inderstrodt: Yeah. And, and the VA is always sort of at the forefront of a lot of these technologies because of the because of the unique population. So, for example, the VA has. You know, electronic health records that go back to the 1970s before any of us had heard of portals or mm-hmm. Alerts or anything like that.

And so there’s a lot of really great work being done with the VA on telehealth for all kinds of services, whether it’s traumatic brain injury, whether it’s mental health counseling, whether It’s just everything. And so I think that there’s a huge opportunity there. And so a lot of the research that, that I’m doing and that, that my colleagues are doing isn’t yet to the intervention stage.

So we are right now just trying to figure out what the landscape is of lactation practices and veteran moms. But the next step is then to be designing interventions that can be tested to see if it, if, if it can reduce disparities if it can increase initiation, and if it can extend duration for those moms who want.

Heather: Well, please let us know how we can help with any of that if they need to phone a friend and get the opinion, you know, hard opinions of two lactation podcasters. We are happy to help with any of that at any time. Of course. Thanks Heather, totally and, you know, we have access to all of these lactating parents on all of our social platforms, and we’d be happy to put out a call for any that are veterans if you need more data.

Absolutely. So happy to help there as well. But you know, what, what do you think is the one thing that you want listeners to take away from our conversation today? ? 

Jill Inderstrodt: Well, I think if, if a veteran is listening, just to know that the VA does cover that pregnancy care for all veterans regardless of their service connected status and that there are mechanisms in place that will help you to navigate that difficult landscape of going in and out of the VA for that obstetric care.

If you’re a lactation consultant, I think what I’d like for you to take is just that there are some differences to support with veterans. Again, that military sexual trauma statistic of, you know, 30%. Of the, the sample having experienced, forced or threatened sexual contact. And to really think about, think about how that veteran population might be different.

There’s actually a professional credential that’s a military lactation counselor credential, and I didn’t know if you guys were aware that or had heard of it. Mm-hmm. , But that might be something to look into too, if you’re a lactation consultant or a lactation professional. Find that you’re encountering a lot of veterans or you want to increase your efforts to reach veterans, that might be something to look into.

Heather: Well, heck yeah. No, I did not know that was a thing. And yes, it is going on the list. Maureen and I just gave each other a silent thumbs up. . Thanks for letting us know . Well, Jill, where can people follow your work? How do we get updates and is there anything that you want us to do with all of this information?

Jill Inderstrodt: Well, my research is always available on Google Scholar or Research Gate, which is where the, you know, the nerdy research people post all of their, their newest publication stuff. But you might also look into, there’s just a really cool organization slash movement. It started out of Germany. It’s called Mom to Mom Global or breastfeeding in Combat Boots.

And when we talk about the fact that, you know, we have a really high intent with the veteran population, we don’t know, but one of the questions we have is whether or not the breastfeeding Combat Boots movement has influenced Veteran mom to breastfeed at all. And so that’s a really cool organization slash movement that you might look into if you’re, if you’re more interested in this topic.

And then just for everybody who’s listening, you know, if you know a female veteran you know, a, you know, a veteran mom or you know, a, a military mom to just, you know, reach out to them and just let them know that you’re, you’re impressed by them, that you are there for them. That there are resources for them in their, in their lactation, you know, slash breastfeeding slash chest feeding journey.


Heather: that’s great. And we’re gonna link all of that in our show notes so that the organization that you mentioned, as well as the link to your Google Scholars. So if anyone wants to go hang out with the cool nerds, they can do that easily . Well, Joel, thank you so much for coming on today on this. Find Veterans Day.

I think this is gonna help a lot of people and really give people a lot of hope that things are going to be better cuz people are caring about it. Big organizations are caring about it. It’s not just like grassroots us trying to pull each other up by our bootstraps. It’s large organizations that are seeing the value in lactation and trying to find a way to make it better.

Jill Inderstrodt: Well, thank you so much. I, it’s just been really cool to. All 

Heather: right. Thanks Jill. We’ll talk to you soon. All right.

If you’re pumping milk away from your baby at all at work or wherever you go, you deserve a bougie product to make that easier for you. 

Maureen: You deserve a series chiller and frankly, I could not live without one right now. 

Heather: The series Chiller is an excellent way to store your breast milk safely, and it keeps your breast milk cold for 24 hours.

It is the only thing I use to 

Maureen: transport my breast milk to and from work while I’m working. It’s got a sleek and beautiful design, lots of great colors, high quality 

Heather: materials, and manufacturing. Series Chill also has other products that you might wanna check out too. My personal favorite is the milk stash.

They have 

Maureen: a great nipple shield that actually changes colors 

Heather: and it’s not clear like all the other ones. And you 

Maureen: know how we feel about that . If you want to have your very own series chiller, please go to the Lincoln, our show notes and use code milk minute 15 

Heather: at checkout. That’s Milk Minute 15 for 15% off your series.

Chill Products. Enjoy.

Jill Inderstrodt: Well, 

Maureen: that was a pretty awesome interview and certainly not a topic I thought we would be talking about here. And it was awesome. It was incredible. I’m so impressed about the high initiation rate, especially in a population where it feels like there’s 

Heather: only barriers. Right. And also, you know, while I’m listening to that, I’m like really excited about it and obviously a little embarrassed that I didn’t know about all of these organizations.

I didn’t even know that in 2021. A Congressional Act pass. I did not know that I could have a special certification to help military families. I guess we’re going to go get that now, . Yeah. So, you know, make your list everyone, This is how we can be better. I just have like a, a running list going of like how to be a better lactation professional.

I mean, you just pick one, one little bit every day and you do your best. You know? Yeah. We’re all doing our best, but today we’re gonna do our best in the direction of helping breastfeeding veterans. So, absolutely. 

Maureen: Well, to bring us out of the episode, I would love to give an award to somebody. 

Heather: Ooh, it’s a good one.


Maureen: so this award today goes to Ashley Nicholas, who’s a patron from Morgantown. We love our locals, and she said that she wants to share her breastfeeding win for this week. Ashley made it to two years in July and this week when she thought about wean. It didn’t make her emotional, which is a huge win.

Oh my gosh, the thought of getting her body back is starting to look so enticing, and she’s worked so hard in the beginning of the breastfeeding journey and the thought of stopping, like used to make her really sad and stressed out, which we can absolutely relate to. So this week she thought about, Didn’t feel super emotional and was so happy then to reflect on that.

They’re not quite there yet, but she’s super ready to move on to that next chapter. 

Heather: Oh man, that’s actually really big. Yeah. I think half the battle with weaning is getting into the right mental space to make that change. . And she’s doing it. And she’s doing it with a smile on her face, which means it’s all gonna be fine.

Oh yeah. I 

Maureen: am not there yet. I’m really impressed. . 

Heather: Yeah. Well, I want to give Ashley the Contented Conclusion Award. Aw, that’s sweet. It’s also very hard to say. 10 times better. 

Maureen: contented, Conclusion. Contented. I can’t even 

Heather: say it twice. You can’t do. But if you wanna see a cute picture of Ashley, she’s gonna be posted on our Instagram story with her award.

And if you would like an award, you should become a patron because patrons get first dibs on awards in our episodes. Ah, absolutely 

Maureen: they do. And you can find that on minute podcast. Yeah, 

Heather: come on over. Be a V I P with us. All the proceeds go to supporting. And before we go, I wanna read an Apple review cuz we read them all and they make us so happy.

This one is from Vero Doula and the subject line says, Favorite Friday podcast, Vero Doula says, Being in the field of lactation, in the trenches. In parentheses, , I love listening to your reviews and general info. You pass along so authentically and with humor and a dash of grit. Keep ’em coming. All right.

We will. We will. We don’t know when to stop. It’s gonna be 10 more years. People will not believe that we haven’t run out of topics yet. 

Maureen: Absolutely. Well, thank you guys so much for listening to another episode of our 

Heather: podcast. The way we change this big system, especially for our veteran friends, is by educating ourselves, our friends, sometimes our providers, and our loved ones.

And like I mentioned before, if you wanna join 

Maureen: our Patreon and support your favorite podcast , you can do that. You can become a Paton at a bunch of different levels. You can get episodes early and add free all kinds of other perks. So check it out at Bye bye bye. 


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