Breast Feeding Disparities: What I learned from Kathleen Kendall-Tackett

 Yesterday I attended a workshop with Kathleen Kendall-Tackett at SEAHEC’s 2014 Breast Feeding Summit entitled “Hot Topics in Breastfeeding: Disparities, Depression, Obesity, Sexual Trauma, and Sleep.” Some of the topics, including trauma and the effects on the physical body were so similar to what I have learned with Koaverii Weber in the 500-hour training. Until we start addressing trauma when talking about bodily experiences such as yoga, birth and breastfeeding, we are really missing out on the big picture. Here is a summary of some of the most fascinating research that Kendall-Tackett presented. Please consider everything below cited for Kathleen Kendall-Tackett and check out her website at http://www.uppitysciencechick.com.

In the SWAN, Study of Women’s Health Across the Nation, 342 middle-aged women were studied on the effects of childhood sexual abuse. 34 percent of the women studied had a history of abuse. According to the study, a history of childhood physical abuse had a direct correlation to metabolic syndrome in midlife women.[1] This study directly relates to the ACE study, which notes that the more adverse childhood experiences a child undergoes, the more likely the child is to have increased risk for morbidity and early death.

When you are pregnant, your body places you into a temporary metabolic syndrome state, increasing visceral fat, increasing insulin resistance, and increasing lipid and triglyceride levels.[2] But breastfeeding after birth completely RESETS those levels, taking you out of a metabolic state. That means, women NEED breastfeeding, if possible, for their maternal metabolism, otherwise their bodies have a harder time exiting the state of metabolic syndrome. We also know that women who are in a metabolic state, perhaps from a trauma history, have a chance to REVERSE those effects through breast feeding.

            Now, check this out. The data from the Nurses’ Health Study II showed the relationship between physical and sexual abuse in childhood teens and the risk for type II diabetes.[3] Depending on the severity of the symptoms of abuse, there was a 50% increase in type II diabetes with physical abuse and 69% increase in risk for those who had experienced repeated forced sex.[4] What does this even mean? First of all let’s stop judging those with Type II diabetes for their lifestyle choices…there is a direct correlation between trauma and weight gain. So, let’s approach every woman with a loving and compassionate demeanor, and stop fat shaming. Second, we know the effects of Type II diabetes can be reversed through some of the effects of yoga, so let’s work on getting better access to yoga therapy.

            Now for the big kicker: inflammation. We know that current diseases in the US such as diabetes, heart disease, etc are diseases of inflammation. So where is that coming from? When the body is in a constant state of stress, or a constant state of “fight or flight” the body increases pro-inflammatory cytokines, which are increasing inflammation so that just in case you get injured in that “fight” your body can heal and repair the wounds. But what about when you are experiencing constant complex emotional or sexual trauma, where the wounds may not be physical? The body is still creating that inflammation, regardless of whether there are physical injuries.

               According to Kendall-Tackett, “Rejection or negative social evaluation is associated with increases in stress hormones, increased cardiovascular response, and greater pro-inflammatory cytokines. Emotional pain, grief, and loneliness share the same neural pathways as physical pain.”[5] Given this information, we can expect to find increased inflammation and insulin resistance in people who feel they are being discriminated against, for example, pregnant women in jail or prison, teen moms, low-income mothers, minority mothers, etc. What happens to inflammation in women who are pregnant, say women who have PTSD, depression, perceived discrimination, etc who are in that fight or flight state? Pre-term birth is one possibility. Pro-inflammatory cytozines such as IL-6, TNF alpha were found in low-income moms in one study, and these are the very same enzymes that ripen the cervix.[6] These levels of pro-inflammatory enzymes can also cause pre-eclampsia and infection, and risks to the mom.[7]

            So clearly inflammation is bad on all counts, and can have harmful effects in pregnancy. How do you lower it? During pregnancy you can try the Omega 3 fatty acid DHA, which was shown to increase gestation length in low-income moms by 6 days on average.[8] Also seek out support for depression, anxiety, PTSD and past trauma histories, whether pregnant or not. Finding that counseling and community support can help to down regulate the nervous system’s response system, taking you out of “fight or flight” and back into the parasympathetic nervous system, the calm/safe side. This can help to cut back on the inflammation in the body, and increase health outcomes for any woman.

            Also, yoga!! We know from the work of Timothy McCall and Gary Kraftsow that yoga has a lot of success in decreasing inflammation in the body and increasing health outcomes. David Berceli has also used yoga to help to remove the built of metabolic energy in trauma from the body. So, if you do have a trauma history. Find support networks and yoga to help to reduce inflammation in the body, and reduce the risk of a traumatic birth experience from pre-term labor complications. Also, work to find a supportive lactation consultant, since we know that breast-feeding reduces inflammation and reverses metabolic syndrome in the body.  We need to be more proactive in stopping the cycles of abuse, and helping our mommas to have better health outcomes for themselves and their children. Trauma support and compassion is a women’s rights issue: no more judging, no more fat-shaming, and no more assumptions about women. We are all fighting a hard battle, and when one in four American women have experienced a history of sexual assault or violence in their lifetimes, the only thing we can assume is that women have been through trauma, thus trauma-sensitive language is always important.

[1] Midel et al. Health Psychology 2013: 32(5); 121-127

[2] Stube & Rich-Edwards, American Journal of Perinatal 2009: 26:81-88

[3] Rich-Edwards et al. Americal Journal of Preventative Medicine 2010 39(6): 529-536.

[4] ibid

[5] Dickerson, 2011. Social Pain (79-94) American Psychology Association

[6] Coussons-Read et al. Psychosomatic medicine 2005, 67: 625-631

[7] Ibid.

[8] Smuts et al, Obstetrics and Gynocology 2003, 101: 469-479.