A chat with Dr. Janelle McClain, the “B.O.O.B.S. lady” herself, about breastfeeding and Black maternal health
Do you know those people that make you feel welcome with their smiles and warm invitation? Janelle McClain is one of those rays of light. She is a wealth of knowledge, and her passion for people is palpable.
Janelle McClain, affectionately often referred to as “the boobs lady,” is the C.E.O. and executive director of the community health maternal and child health services nonprofit program, Breastfeeding Outreach for Our Beautiful Sisters, also known as B.O.O.B.S. She proudly serves the community as a counselor, trainer, and advocate for mothers and babies. She is driven by her desire for a healthier, more supported community. I left our meeting feeling inspired by Janelle and her team’s work to promote breastfeeding awareness, education, and resources to Black women.
Interview by Kourtni Gunalvson. Photography by Angie Lipscomb.
Could you tell us a bit about yourself?
I am a native of Cincinnati. I attended college at Tennessee State University, where I received a B.A. degree in healthcare administration and planning. I moved back to Cincinnati to work on my M.A. degree in healthcare planning and administration at the University of Cincinnati. And then, I went on to finish my doctoral work in health services at Walden University. During my doctoral work, I worked with the Cincinnati Children’s Hospital in the general community pediatric division. I am also a certified lactation consultant. I’ve been in health care services for more than 25 years.
Did you always know you wanted to go into the health field?
I didn't know at first, but I changed to healthcare because I like the structure, the process, and the planning. I think healthcare overall has tentacles in many different places, so you can serve and work with many populations. You can authentically and genuinely help in healthcare. And healthcare is part of our gross domestic product – it's a huge part of who we are as an economy. So, I felt like that fit me, personally and professionally.
Can you tell us about the B.O.O.B.S. program?
Of course! I am commonly referred to as the “boobs lady” in a good way. B.O.O.B.S. (Breastfeeding Outreach for Our Beautiful Sisters) is a nonprofit community-based program that offers lactation education, coaching, and resources to primarily African American women within the Cincinnati area. It was birthed from my personal experience with breastfeeding. When I was pregnant with my first son, I was diagnosed with a tumor-growing condition that wasn't malignant, but no one knew at that time whether the tumors would interfere with the breastfeeding process. I knew that breastfeeding was the best option for that child, and the thought of not being able to provide that for him was devastating. There wasn't much research about these particular tumors and whether or not breastfeeding would be successful.
So long story short, I delivered my son, and he was healthy and happy. I did have some breastfeeding struggles related to having a C-section which we know delays your breast milk and the tumor condition, which caused more delay. So, as I was going to school, working, and looking more into breastfeeding, I thought, “No woman should have to go through this. There should be some fundamental community resource where women can turn to get answers.”
I decided I could try to be that resource. I worked with a team of three researchers of human milk that genuinely had a big heart for serving the African American women's community. We have been running for six years and have served over 1,000 individual moms. We want to make sure that the moms in the community feel empowered to breastfeed, that they understand the importance of breastfeeding, and that they can use us as a resource to start that breastfeeding journey successfully. We are a culturally congruent program, meaning that there are African American women who speak to African American women with strong relatability, which allows the moms to have a safe space of communication and interaction with no judgment.
We offer sessions in different areas of the community because we want to ensure it’s accessible to moms who use the bus line or that it’s close enough to get a ride if they don’t have transportation. It’s not your typical breastfeeding education. We ask questions and provide visuals and videos, but all while the moms and their support system engage. There's far more interaction; there's far more engagement. The session is technology driven. I’m a big tech person because it’s here to stay. This thing right here [points to cell phone] is a part of our every day, so it makes sense that the session is driven by a handheld device.
We also have a demonstration on latching because we stress, stress, stress that latching is the key to successful breastfeeding. We want to normalize the conversation and help remove some of the doubt around possible pain or the lack of milk supply. We want moms and families to feel empowered to breastfeed.
B.O.O.B.S. is also involved in community engagement via health fairs, community fairs, and conferences. We were part of the Ohio Breastfeeding Disparity Conference. Another component of B.O.O.B.S. is data collection to inform the intention to breastfeed during pre- and post-class sessions. There is a significant increase in the number of moms intending to breastfeed once they leave our program. So, we know that we're making an impact by increasing that intention and breastfeeding self-efficacy. We build trusting relationships with those moms, and they feel like, “Hey, this is an organization that looks like me, that is not judging me. They care about me. I want to invite them into my life to a certain extent where they can call me and check on my baby and me.” We follow up to see how they’re doing and how breastfeeding is going. 90% of the moms that we've worked with have initiated breastfeeding.
As a program, we're creating this community output from an upstream approach. In public health, upstream approaches have downstream results. This upstream education, support, and culturally congruent program lead to healthy mothers, healthy babies, and a healthier community.
In what ways would you like to see your program expand?
I’m constantly thinking about that. In terms of scalability, of course, we want to reach more women. We would love to provide home-based outreach where we could help with the latch because that is where the rubber meets the road. We’d love to provide that coaching piece. The only threat to our program is funding. Ideally, we’d have a parent funder to help expand our work with moms one on one after they’ve delivered. Once we’ve really polished the program, and I think we’re close to that, it would be a great model to be duplicated in other areas of Ohio and surrounding states.
There is more than just a simple choice of whether you're going to breastfeed when it comes to the actual initiation and continuation of nursing. Can you speak to some of the disparities Black women face regarding breastfeeding?
In both my doctoral research and work with the B.O.O.B.S. program, what has held true is that African American women are returning to work after delivering far sooner than other women. We have more moms who are not in a salary position that offers more flexibility in hours and paid time off. We’ve had several moms that have to return to work when the baby was two weeks old. They don't have the space or time even to allow themselves to think about being successful. The lactogenesis process happens within a week to a week and a half. Many of these women have to return to work just when they start to cultivate milk. Whether women work at bakeries, in customer service jobs, or as medical assistants, they are in a position where they are locked into their hours and time and must return to work. That's a huge issue.
There are still, unfortunately, prejudices that African American mothers receive about breastfeeding. There's no push for African American women to breastfeed their children. At least, that's how it's perceived by some B.O.O.B.S. participants when they're in the hospital. Why would you discourage or give up very quickly on African American mothers and breastfeeding when we know that the mortality rates among African American women are 2.2 times higher in Ohio than any other race? I have countless stories of Black mothers saying, “They just gave up on me,” or said, “Well, if they're not pushing for it, it must not be that important because I trust the healthcare professional.” There is less advocacy for Black women to breastfeed their babies.
Congress passed the Break Time for Nursing Mothers law in 2010. Unfortunately, this is not always respected by employers. How have you seen this impact members of the B.O.O.B.S. community?
I can’t tell you the countless stories where the mom says, “I don't know if my supervisor will take this out on me. I want to pump.” B.O.O.B.S. is connected with a great program called Work Life Law, a group of attorneys working with the Paternal Family Medical Leave Act. When moms return to work, they offer a free letter to H.R. or their supervisor to let them know that it is the employees' right to have pumping time. That's crucial to a mother who's lactating and wants to continue to provide breast milk for their baby while they're at work eight or nine hours a day. Nine hours away from the baby makes providing breast milk a challenge. It’s not the large corporations that our moms tend to run into this issue – it’s the mom-and-pop shops, the parking lot attendant positions. These smaller businesses don’t have emails from H.R. with updates about the Pump Act. It’s up to organizations like ours to provide that education.
Are there ways to help contribute to the program?
We have two larger events each year that we need volunteers for. We have our B.O.O.B.S. and Bows, a holiday session, but it's still very much centered on breastfeeding. There are holiday decorations and holiday cookies. Volunteers can come in and help decorate or help with entertainment. We also need volunteers for our community baby shower that we'll probably have next fall – 50 to 60 moms in the community will come to it. It’s a baby shower on steroids! Monetary donations are always needed. Let me just put on the record – we're not getting rich doing B.O.O.B.S. work. This is not for the glamorous. Everything goes to a mom for things like nipple shields, hand pumps, nursing covers, diapers, and wipes. Of course, sharing the program and increasing visibility so we can serve more moms is a help too.
Is there anything else you’d like to share?
My great-grandmother, Martha Pfizer, lived to be 101 years old in deep south Little Rock, Arkansas. Her mother died when she was young, and she was raised by her father and grandmother, a freed slave. When my great-grandmother was nine or ten years old, she became a midwife. That’s just how it was back in the day – you had a purpose, and you got in there. My great-grandmother was pregnant eleven times but had only two live births. This work is in my genes. This is what I'm supposed to do. This is why I'm supposed to care about African American women and children living and surviving. Before we got any grant for B.O.O.B.S., I did it for free. We went out into the community, and I waited on moms and provided them with education. This work is personal to me, and I do it with passion.
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