Q&A FOCUSING ON MOTHERING THROUGH BREASTFEEDING WHEN ACCREDITING NEW LEADERS – REMOVING SEPARATION AS A BARRIER

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QUESTIONS & ANSWERS TO EXPAND YOUR UNDERSTANDING OF THE BOARD DECISION Regarding Revisions to Appendices 17 and 18 of the LLLI Policies and Standing Rules Notebook (LLLI PSR)

8 November 2018

SUMMARY

LLL has long advocated for the needs of the baby while acknowledging there may be times when the mother is absent. After reviewing the information received over the past two years, the Board has come to a decision. We will focus on the breastfeeding relationship itself rather than on the number of hours or type of separation. If at twelve months or beyond, a baby is still nursing, then a mothering through breastfeeding relationship exists, and shows that the mother values that bond. In addition to the longevity of the breastfeeding relationship, Leaders and Leader Applicant Department (LAD) representatives will continue to explore how a potential Applicant demonstrates sensitivity and responsiveness to the baby’s cues and needs when they are together and how they have incorporated all elements of LLL philosophy into their life.

The Questions and Answers that follow are grouped in several sections. You can click on the titles and the web page will ‘jump’ to the corresponding answer. You can also scroll through and read all the questions and answers, or those that particularly interest you. There is some repetition because some information recurs in several sections.

There is a concise version of these Questions & Answers.
If you have questions that have not been answered here, please discuss with your Area/ DCE representatives, and we also welcome you to ask us at board@llli.org.

CONTENTS:

WHAT, HOW, WHY DID YOU MAKE THE CHANGE?
Overview
Changes you might notice
What hasn’t changed
Why did you make this change?
LLL already accredits mothers who are not with their babies 24 hours a day under the existing guidelines and policy statements. Is this change just to help people in the USA? Why should the rest of LLL change for one country?
What process did you follow in making this change?
What is the LAD Task Force?
What did the LAD Task Force do?
Has the Board looked at research about the mother-baby relationship?

HOW DOES THIS CHANGE FIT WITH LLL PHILOSOPHY?
Babies’ needs haven’t changed; why has LLL?
How does this impact a baby who may be separated from mother for many hours?
Can anyone who is nursing at 12 months be a Leader then?

HOW SHOULD LEADERS & LAD REPRESENTATIVES APPLY THIS CHANGE?
How does this affect Leaders and Leader Accreditation Department (LAD) representatives?
How do we know how the mother and baby interact in the case of isolated potential Applicants?
Isn’t this the way we have always done this? We trust the Supporting Leader’s recommendation?
What if a mother is only breastfeeding once a day?
Are there any applications with separation that will not go through now?
Can we ask how a potential Applicant communicates their parenting style to their baby’s caregiver?
What kinds of questions can we ask to learn about the breastfeeding relationship and the mother’s responsiveness?
Will this affect a Leader’s ability to represent LLL?
What about applications on hold?
Do LAD reps need to go back to Leaders and tell them that previously declined applications may be resubmitted?
Is LAD still an international department?

HOW DOES THIS CHANGE HELP REMOVE SUBJECTIVITY IN THE APPLICATION PROCESS?
Will this new statement eliminate subjectivity?
Doesn’t the “looking at mothering through breastfeeding” focus risk making the process more arbitrary?
How do *I* make a decision that is less subjective?

FURTHER READING & INFORMATION

WHAT, HOW, WHY DID YOU MAKE THE CHANGE?

Overview
For years, Leaders have expressed concerns about disparities in how potential Applicants who have experienced separation are treated, how they are either accepted or rejected for accreditation, and how perceived discrimination against working parents particularly impacts less-privileged populations where both parents must work outside the home due to income constraints.
In surveys conducted by the Leader Accreditation Department (LAD), and through the work of the LLLI LAD Task Force, there were indications of a lack of clarity in LLLI policies and guidance documents, particularly with regards to Appendices 17 and 18. This has been noted from one entity to another and one country to another.
The Board is addressing these issues in order to assure equitable accreditation and greater diversity in our leadership.

Changes you might notice
More equitable attention to the ten concepts, prerequisites and accreditation standards for anyone interested in becoming an LLL Leader.
Focusing on the mother/baby relationship, observing how their bond is growing. The crucial keys to evaluating their mothering through breastfeeding journeys include:
• Observing these mothers with their babies
• Talking with them one-to-one
• Spending time together, whether in person or electronically (See “note” below)
• Engaging in online or written dialogue that encourages a potential Applicant to share details of her relationship with her baby

NOTE: Particularly when talking with isolated potential Applicants, Leaders and the potential Applicants both will benefit from conversations by online communication.
Emphasis on ‘contributing behaviors’ leading to an extended mother-baby relationship by nursing baby at 12 months and beyond, such as:
• Recognition of baby’s cues and responsive mothering when with the baby
• Baby-wearing or other holding and carrying behaviors
• Receptive mothering and nursing at night
• Gradual weaning that demonstrates awareness of the baby’s readiness for solids, the baby’s decreasing interest in breastfeeding, and the baby’s increased independence

What hasn’t changed?
“In the early years the baby has an intense need to be with his mother which is as basic as his need for food.” – Dialogue with anyone interested in LLL leadership will still include discussion of a potential Applicant’s understanding of this concept, its importance, and how they exemplify it in their parenting as a model for others.
The ten concepts are taken as a whole, each part contributing to the healthy mother-baby relationship .
• Leaders and LAD representatives will continue to explore the extent to which potential Applicants’ experiences and ideas are aligned with LLLI philosophy.
• Babies’ needs have not changed, yet our understanding of the length of time that their need for mother’s presence is intense has changed due to recent research. LLLI continues to support actions that accommodate the breastfeeding couple.
• LLLI continues to offer an opportunity to become a Leader to mothers who are committed to breastfeeding within the framework of the concepts.
• LLLI continues to focus on baby’s intense need for mother’s presence and how the mother demonstrates her responsiveness to her baby, understanding of her baby’s cues, and attention to her baby’s needs when she is with her baby.

LLLI will continue to look at the mother’s entire breastfeeding and mothering experience to see how it reflects LLLI philosophy in its entirety.

• LLLI continues to validate our concepts with evidence-based research.
• LLLI continues to look at “mothering the baby at breast” as our standard, although the same consideration to “special circumstances” will continue to be given.

Why did you make this change?
The LAD Council, LAD representatives, and Leaders in many Direct Connect Entities1  have asked for a number of years for support in ensuring there is equity and consistency in access to accreditation around the world.

The LLLI Board, responsible for accreditation globally, realized that the most critical criterion in becoming a Leader is the breastfeeding relationship and that this should be the focus of accreditation.

In some situations, the emphasis has been on the time a mother is NOT with her baby – the separation – rather than on the fact her baby is still nursing. Instead of looking at the separation itself, we will focus on the breastfeeding relationship and the fact that a mother is (or was) still nursing the baby at 12 months or beyond. The ‘contributing behaviors’ leading to the desired result (baby nursing at 12 months) include but are not limited to:

• recognition of baby’s cues and responsive mothering when with the baby
• baby-wearing or other holding and carrying behaviors
• receptive mothering and nursing at night
• gradual weaning that demonstrates awareness of the baby’s needs and readiness for solids
In addition, many of our other concepts describe the ‘contributing behaviors’ leading to the desired result of a caring, breastfeeding relationship at 12 months or beyond.

1 Direct Connect Entities (DCEs) are the European Area Network (EAN), the International Area Network (IAN), Ligue La Leche, LLL Canada, LLL Great Britain (GB), LLL New Zealand, LLL USA.

LLL already accredits mothers who are not with their babies 24 hours a day under the existing guidelines and policy statements. Is this change just to help people in the USA? Why should the rest of LLL change for one country?
The LAD Task Force discovered that in many LLL entities, individuals were turned down as Leader Applicants solely due to the separation they experienced, while other entities were accrediting people who had experienced separation after careful consideration of their breastfeeding and mothering experience.

As a global organization we need equity and consistency in the implementation of accreditation criteria.

What process did you follow in making this change?
In November 2017, Board member and former Associate LAD Director, Cecily Harkins, provided a summary of LAD history, and Linda Owens, owner of IMI,led the Board in a strategic discussion.
At that meeting, a Task Force was created to explore ways to add Board support and oversight to LAD, including a mechanism for review, enforcement, and accountability of the LAD to the Board. Leaders and LAD representatives from all over the world were invited to participate in this LAD Task Force to investigate these issues more thoroughly and to make some recommendations to the Board for their resolution.

2 IMI is LLLI’s management company.

What is the LAD Task Force?
The Leader Accreditation Department Task Force is a Board-created group charged with developing ideas and helpful guidance to ensure that implementation of Leader accreditation procedures is consistent worldwide.

The Task Force includes members of the LLLI Board, members of the LAD Council and other LAD representatives, and Leaders from every DCE, all bringing global perspectives and a breadth of experience to the discussion.

You can read about the membership of the LAD Task Force here: https://www.llli.org/about/whos-who-in-la-leche-league/board-committees-task-forces-work-groups/

What did the LAD Task Force do?
The Task Force reviewed Leaders’ concerns and brainstormed ideas for resolving issues. The members then honed ideas and made a number of recommendations to the Board. Due to the urgency expressed by Leaders, the first issue to be considered by the Board was the separation issue.

Has the Board looked at research about the mother-baby relationship?
Yes. The Board is currently compiling supportive data which validate what LLL has been saying for 62 years. LLL knew the importance of our philosophy long before science began to validate our concepts with evidence-based research. Please refer to our article A More Encompassing Way to Look at Mothering-through-Breastfeeding which includes numerous relevant references, listed at the end.

HOW DOES THIS CHANGE FIT WITH LLL PHILOSOPHY?

Babies’ needs haven’t changed; why has LLL?
The original concept about the intense needs of a baby to be with his mother was adopted in 1971. At the time it read, “The baby has a basic need for his mother’s love and presence which is as intense as his need for food. This need remains even though his mother may be absent for a time for needs or reasons of her own.” We are reflecting the Founders’ recognition that a mother may be absent from her baby.
Babies’ needs have not changed. LLLI celebrates and supports the work done around the world by LLL Leaders and entities in advocating for mothers and babies to be together, in supporting better maternity leave, in developing suitable childcare options. We believe that society must change to support the breastfeeding couple. Governments, communities, universities, colleges or other schools, and workplaces must change to accommodate mothers who are working and studying. We also recognize that in many countries, there are many families who will not be able to survive without the mother’s employment and concomitant separation. With this change, separation in and of itself will no longer be a reason to reject an application.

How does this impact a baby who may be separated from mother for many hours?
It is unusual for a mother to be able to maintain a breastfeeding relationship to 12 months when she and her baby experience long hours of separation.
The fact that she has maintained a breastfeeding relationship speaks to her dedication to reconnecting with her baby in the most deeply sensitive act of meeting her baby’s need for that reconnection as well as the baby’s need for the nourishment and comfort that breastfeeding provides. As we know, there is no other act that so beautifully meets all the baby’s needs for warmth, comfort, and nourishment as well as both baby’s and mother’s need for that physical and emotional relationship established by breastfeeding.

Can anyone who is nursing at 12 months be a Leader then?
Breastfeeding at 12 months is only one factor in considering someone’s eligibility for leadership. As always, accredited Leaders are asked to represent all of LLL philosophy, and sponsoring Leaders should explore their understanding of the concepts and how they have incorporated them into their own lives with potential Applicants for leadership.

HOW SHOULD LEADERS & LAD REPRESENTATIVES APPLY THIS CHANGE?

How does this affect Leaders and LAD representatives?
This decision will allow Leaders and LAD to focus on the entire breastfeeding relationship. Questions Leaders and LAD representatives might use to explore a potential Applicant’s understanding of their breastfeeding relationship and how they have maintained it with their baby include:
• how she demonstrates responsive mothering through breastfeeding
• what the mother is doing to sustain breastfeeding her baby and their relationship
• how the potential Applicant demonstrates responsive mothering when with the baby
• what she has done to maintain the breastfeeding relationship
• how she understands this concept and how it is reflected in her mothering when she and baby are together
As a supporting Leader:
• You will be able to dialogue as you have always done in most cases.
• You will explore the full mother-baby relationship when talking with potential Leader Applicant, without any one particular aspect taking greater precedence.
As a LAD representative:
• You will continue to focus on the entire mother-baby relationship when dialoguing with potential Leader Applicants without one topic getting more emphasis than another.
• Separation itself will not exclude a mother from applying for leadership.
Leaders and LAD representatives will continue to explore all the concepts and how the mother incorporates them into her own life. Breastfeeding for 12 months is one indication of a strong breastfeeding relationship, but it is not the only aspect that is important.

How do we know how the mother and baby interact in the case of isolated potential Applicants for leadership/Applicants?
The Board encourages Leaders and LAD representatives to use online communication as a means of getting to know a potential Applicant as well as possible.

Isn’t this the way we have always done this? We trust the Supporting Leader’s recommendation?
While LAD representatives and sponsoring Leaders endeavor to work together when considering a potential Applicant for leadership, some disparities were revealed in how separation is managed around the world. Our decision is to ensure accreditation procedures are globally followed.

What if a mother is only breastfeeding once a day?
Though this does seem unusual, it isn’t possible to determine whether nursing only once a day is right or wrong for a particular baby, as many factors play into how often a little one breastfeeds at 12 months of age. Hence, we cannot set an arbitrary number for “the right” breastfeeding frequency. However, we can ask the Applicants to share information about responsive mothering and how they recognize and respond to their baby’s cues when they are together.

Are there any applications with separation that will not go through now?
This change of focus will not mean that every application with separation must automatically be accepted. Supporting Leaders and LAD representatives are asked to consider leadership eligibility based on the totality of the prerequisites, including someone’s understanding of mothering through breastfeeding and their breastfeeding relationship with their little one.

Can we ask how a potential Applicant communicates their parenting style to their baby’s caregiver?
We can ask whether someone has shared information about loving guidance to the caregiver, but we can’t require the caregiver to use it, any more than the mother can require it. We hope that mothers will seek out caregivers who will support their mothering choices. In a deeper consideration of this issue, we have never accredited Leaders based on whether their partners use loving guidance; indeed, we have many Leaders whose partners use punitive measures with their children despite those Leaders offering them information about loving guidance. We will not be evaluating a potential Applicant on how others enact LLL philosophy—only on how that mother enacts the philosophy in her own life.

What kinds of questions can we ask to learn about the breastfeeding relationship and the mother’s responsiveness?
As always, Leaders and LAD representatives will want to explore someone’s understanding of philosophy, their mothering and breastfeeding experience, and the role of mothering through breastfeeding in their life.
Questions that may help reveal how a potential Applicant has incorporated LLL philosophy and mothering through breastfeeding into their life include:
• What is a typical day like when you are with your baby?
• How do you handle fussy times?
• What’s night-time parenting like for you?
We can also ask potential Applicants to share how they meet their baby’s needs for their presence when they are together.

Will this change affect a Leader’s ability to represent LLL?
We don’t believe it will, indeed, we hope to see LLL leadership develop in underserved populations, thus increasing the spread of breastfeeding support and LLL philosophy to more people. As in the past, we encourage Leaders to remember that their own “experiences, choices, and use of time are not guides by which to measure others” (from LAD Manual). Each person we accredit brings different strengths and knowledge to our organization.

What about applications on hold?
Applications that were placed on hold while the Board discussed the issues pertaining to separation will now be considered in light of the Board’s decision.

Do LAD reps need to go back to Leaders and tell them that previously declined applications may be resubmitted?
The decision will be announced to all Leaders. If Leaders know of interested mothers who were previously declined and who might want to re-apply, they can share this information with them.

Is LAD still an international department?
The accreditation of Leaders has always been a global process and will continue to be, because LLLI’s credibility as an authority in the support of breastfeeding families depends on global criteria for leadership accreditation.

HOW DOES THIS CHANGE HELP REMOVE SUBJECTIVITY IN THE APPLICATION PROCESS?

Will this new statement eliminate subjectivity?
Yes, in regards to separation. This decision will allow Leaders and LAD to focus on the relationship rather than the separation. How the potential Applicant for Leadership demonstrates responsive mothering through breastfeeding. How the mother demonstrates togetherness and more. We will be looking at the totally of their mothering, instead of looking at separation. If the baby is still breastfeeding at one year, that indicates a strong breastfeeding relationship.

Doesn’t the “looking at mothering-through-breastfeeding” focus risk making the process more arbitrary?
We will be offering some guidance to help Leaders and LAD representatives explore how a potential Applicant enacts breastfeeding through mothering in her own life. Instead of looking at separation, we will be looking at the totality of their mothering.

How do *I* make a decision that is less subjective?
There have never been strict “rules” on how someone meets each of the prerequisites, because there are so many variables and individual circumstances. We can’t provide a simple, “Yes/No” checklist that will completely objectify the decision-making process. Hence, while assessing someone’s eligibility for leadership will always be somewhat subjective, their understanding of and ability to reflect our philosophy as a whole is the key. Encouraging them to share their thoughts about each of the concepts and how they have incorporated them into their own life and that of their family will offer you good insight into their ability to represent our philosophy to others.

FURTHER READING & INFORMATION

Appendix 17: Concept Policy Statements from LLLI Policies and Standing Rules Notebook (LLLI PSR)
Appendix 18: Applying For Leadership from LLLI Policies and Standing Rules Notebook (LLLI PSR)
A More Encompassing Way to Look at “Mothering Through Breastfeeding”  – an explanatory article complete with references to current research.
Concise Version: Questions & Answers To Expand Your Understanding Of The Board Decision Regarding Revisions To Appendices 17 And 18

You may also want to contact your local LAD representatives, your Area or DCE Council or the LLLI Board.
Contact the Board at board@llli.org.

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Learn how abuse can impact ability and desire to breastfeed, red flags that could indicate a history of sexual abuse and practical tools to support all families in a thoughtful way.

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