EBB 189 – Why Black Lactation Matters and the Importance of Black Breastfeeding Week with IBCLC, Janiya Mitnaul Williams

Learn more about Janiya Mitnaul Williams’ Pathway 2 Human Lactation Training Program at NC A&T State University here (https://www.ncat.edu/caes/departments/family-and-consumer-sciences/lactation-cert.php). Follow Janiya on Instagram here (https://www.instagram.com/janiyamwilliams). Follow Mahogany Milk on Facebook (https://www.facebook.com/mahoganymilk/) and Instagram (https://www.instagram.com/mahoganymilk). 

Learn more about NC A&T State University here (https://www.ncat.edu). Follow NC A&T State University on Facebook (https://www.facebook.com/ncatsuaggies/) and Instagram (https://www.instagram.com/ncatsuaggies). 

Learn about Union Institute & University here (https://myunion.edu/). 

Learn about the Mary Rose Tully Training Initiative at UNC-Chapel Hill University here (https://sph.unc.edu/cgbi/lactation-consultant-training/). 

Learn about International Board of Certified Lactation Consultant Examiners (IBCLE) here (https://iblce.org/). 

Learn more about Black Breastfeeding Week here (https://blackbreastfeedingweek.org/). Follow Black Breastfeeding Week on Facebook (https://www.facebook.com/BlackBreastfeedingWeek), Twitter (https://twitter.com/BlkBfingWeek), and Instagram (https://www.instagram.com/blkbfingweek/). 

Learn more about The Melanated Mammary Atlas here (https://www.mmatlas.com/). Follow The Melanated Mammary Atlas on Facebook (https://www.facebook.com/TheMMAtlas/) and Instagram (https://www.instagram.com/themmatlas/). 

Learn more about Nekisha Killings from Linus Lactation here (https://www.nekishakillings.com/). 

Learn more about Alamance County Health Department here (https://www.alamance-nc.com/healthdept/). 

Learn more about Guilford County Health Department here (https://www.guilfordcountync.gov/our-county/human-services/health-department). 

Learn more about the Women’s and Children’s Center at Cone Health here (https://www.conehealth.com/locations/profile/womens-and-childrens-center/). 

Learn more about Queen City Cocoa B.E.A.N.S. here (https://www.harmonynl.com/cocoa-b-e-a-n-s). 

Learn more about Johnson C. Smith University and their Pathway 2 Human Lactation Training program here (https://www.jcsu.edu/academics/lactation-program). 

Learn more about North Carolina Breastfeeding Coalition here (https://www.ncbfc.org/). 

Learn more about Novant Health here (https://www.novanthealth.org/).

Rebecca Dekker: Hi, everyone. On today’s podcast, we’re going to talk with Janiya Mitnaul Williams about becoming a lactation consultant and the importance of Black Breastfeeding Week.

Welcome to the Evidence Based Birth® Podcast. My name is Rebecca Dekker, and I’m a nurse with my Ph.D. and the founder of Evidence Based Birth®. Join me each week as we work together to get evidence-based information into the hands of families and professionals around the world. As a reminder, this information is not medical advice. See ebbirth.com/disclaimer for more details. 

Hi, everyone. I’d like to introduce our honored guest, Janiya Mitnaul Williams, who will be talking with us about becoming a lactation consultant and the importance of Black Breastfeeding Week. Janiya Mitnaul Williams is an international board-certified lactation consultant, a registered lactation consultant, and a certified lactation counselor who has been supporting nursing families since 2007. She holds degrees from North Carolina Agricultural and Technical State University, and Union Institute & University in Speech Language Pathology in Audiology, and Health and Wellness with a concentration in Human Lactation, respectively. So Janiya has a lot of credentials. 

Janiya is the program director of the Pathway 2 Human Lactation Training Program at North Carolina A&T State University. She also works for the Women’s and Children’s Center at Cone Health as a perinatal educator researcher, community liaison, and doula services coordinator. In 2015, Janiya created Mahogany Milk Support Group in order to promote, encourage and normalize nursing for Black and Brown families. That same year, Janiya also became the first person of color and non-registered nurse to be hired as a lactation consultant for the hospital system at Cone Health. Janiya is very passionate about creating diversity, equity, and inclusion within the field of lactation to promote better health outcomes for Black and Brown marginalized and underprivileged families because they have the greatest lactation barriers to overcome. Janiya also enjoys spending time with her husband, Brandon, and her four sons, Noah Ellington, Brandon Diggs, Henry Sidney, and Avery Harrison.

Welcome to the podcast Janiya.

Janiya Williams: Thanks so much for having me today, Rebecca.

Rebecca Dekker: We’re so thrilled that you took time out of your busy schedule to join us. I know you’re very busy as a working mom. 

Janiya Williams: Yes. 

Rebecca Dekker: We’d love to hear how you first got started in the field of lactation. Mystique Hargrove, our podcast coordinator at Evidence Based Birth® has been raving about you for a while now, for as long as I’ve known Mystique. And I wanted to hear your personal story. How did you get involved in this career path? Especially because you’re not a registered nurse and many lactation consultants go into the field of nursing first before lactation. 

Janiya Williams: Exactly. I too love Mystique. She is one of my mentees for Pathway 3 into getting into lactation. But I got into lactation and most people of color when we get into birth work, it’s because of an experience that we had with our births. And so that’s exactly what happened to me. In August 2007, I had my first son and right after I had him, the hospital system was going through their baby-friendly process for designation. And with baby friendly they asked that you have representation of the communities that you serve on the walls, in the brochures, in pamphlets, right? And so they said, “Hey, we’re updating our marketing here. And we have not found a Black family who’s breastfeeding yet, would you mind letting us take a photo of you breastfeeding your kid?” And this was like three hours after I had him. So “I’m like, yeah, not a problem. We’ll do it,” and they may come in and I leave the hospital 48 hours later.

About a month after that, I start getting stopped everywhere I would go. And it was other families of color in particularly mothers of color who would come up and say, “Hey, you’re the lady in the breastfeeding photo at the hospital, I need help. Can you answer this question for me?” And so slowly but surely I began to answer their questions. I did go back to the hospital to see what everyone was talking about. And I thought I was going to be like this small picture, it’s this huge picture that was right across from where the nursery used to be because baby-friendly, they got rid of all the nurseries and then it was printed in the actual lactation information that they would give to nursing families at discharge.

And so that’s how I became the face of Black breastfeeding for my community. And I decided that these families needed more concrete answers. And at the time, fast forward, maybe three or four years after that, at the time I was in the process of, okay, want to go back to school, don’t know why I want to go back to school for, and then I was like, let’s go back for lactation so I can give these people evidence-based information.

Rebecca Dekker: Yeah. So just going into the field of lactation, how do you go about doing that? What were your first steps because that sounds like, oh, yeah, I’m just going to go into lactation, but that’s a journey in itself.

Janiya Williams: Yeah, no, really is. So in my background of speech and this is what I love about healthcare professions is you can merge healthcare professions and make it all your own. And so when I was in school for speech, I saw a Modified Barium Swallow and I was like, oh, that is so cool. I need to do this for the rest of my life, but I wanted do it with infants. And I always knew I wanted to work with medically fragile children or in a NICU setting. And so I said, “how can I get to the NICU? Well, let’s combine these two worlds.” So I started looking into how to become a lactation consultant and then they have all the alphabet soup out there and then it’s like all the pathways. And that’s when I had to narrow things down because speech pathology does fall under pathway one because there were three pathways to becoming a lactation consultant.

And so Pathway 1 is a recognized health professional. Pathway 2 is an accredited health educational track. And then Pathway 3 is just mentorship. And so as I started looking around for mentors in the area, I found that there was probably one and it’s so funny because now she’s a preceptor from our program, but I wanted to get more of, I guess, an academic experience because at the time the job I worked was giving us money for tuition. So I was like, I’m not going to leave any money on the table. And then when I calculated the hours back, almost nine years ago, when I went back to school for this, it would have taken me forever to get the hours for Pathway 1 in speech when I didn’t work with children, I worked with adults. So that’s how I decided on Pathway 2 to becoming a lactation consultant.

Rebecca Dekker: So Pathway 2 is like an academic program that some universities offer then?

Janiya Williams: Exactly. So there are nine universities that offer this program and then there was some community college that-

Rebecca Dekker: In the United States, there’s nine places you can go to school for that.

Janiya Williams: Yes. And in fact, we’re the only ones in the world who have them.

Rebecca Dekker: Okay. And was there a program near you then?

Janiya Williams: No. Well, not really because the closest program at that time to me was at UNC-Chapel Hill. And just because my children were younger, like babies, I was like, I don’t know. And my husband was in grad school at the same time. I was like I don’t know if this is going to work out with me commuting back and forth. And so I opted for Union Institute & University, which is in Cincinnati, Ohio because they had an online program.

Rebecca Dekker: And tell us then what were some of the challenges you faced at the beginning of your program or throughout the program? How long does this process take to go through an accredited program to become a lactation consultant?

Janiya Williams: Definitely. So it really depends on the program that you’re in and we’ll discuss programs as we move on today. But the program that I went to is a master’s level program, like they give out actual master’s degrees.

Rebecca Dekker: So you have to have a bachelor’s degree to get in?

Janiya Williams: For some program

Rebecca Dekker: For this one.

Janiya Williams: So for this particular program, yes, because they actually gave us master’s degrees in health and wellness with a concentration in human lactation. And now it’s just a master’s in human lactation. But some of the barriers that I faced because it was an online program is trying to ensure that I could get all of my clinical rotations done within the city that I lived in because with hospitals you had to have clinical agreements with these universities. And so here I am trying to get into a field A that was at a hospital system that said you have to be an RN in order to do this and then-

Rebecca Dekker: So a lot of hospitals literally say you can’t practice as a lactation consultant unless you’re a registered nurse?

Janiya Williams: Correct. 

Rebecca Dekker: Okay. So that’s one big barrier right there.

Janiya Williams: That’s a huge barrier, especially when it comes to people of color, because if you’re looking for assistance from us within the realm of lactation, the majority of us do not hold those registered nurse credentials. And so it just so happened that my girlfriend had just become VP of our hospital system. And so I said, “Hey, I’m in this grad program. I need you to let me in for an internship. Can you do this?” 

And so she went and talked to the director of lactation and they said, “Sure, positive, I can work something out” because I pointed out to her, “Hey, I don’t think that you have any people of color who work in lactation in your hospital system. And if you let me in, then you could potentially hire me and we could help change these health disparities that are affecting Black and Brown babies and parents.” And so she thought about it and they allowed me to come in, until this day I’m still really, really good friends with my preceptors because then they became my coworkers. And at the time I was right, there weren’t other people who looked like me working in the hospital system.

Rebecca Dekker: And yet they were caring for people who look like you.

Janiya Williams: Exactly. And so we really did learn from one another, especially with our conversations that we’ve had in light of everything that’s happened in the past year. And most of my preceptors have moved on and they’ve retired, but they still reach out and we still have these conversations because I was the first person of color that they had worked with in their careers in the field of lactation. And they never even thought about, “I’ve never worked with a Black LC before, what is that like? Are the things that I’m saying to families offensive? How can I be better? How can I be more culturally aware and culturally humble?” And so these are still the conversations that I’m having with them to this day.

Rebecca Dekker: Wow. So how long was your particular program then? And how many hours did you have to complete in the clinical site as well? 

Janiya Williams: Yeah. So back then, because it’s like back then, I had to earn 500 clinical hours. Today Pathway 2 is just 300 hours and the program took two and a half years to complete.

Rebecca Dekker: Wow. So not just like a simple workshop or training?

Janiya Williams: Yeah. Definitely. They are doing just the weekend or one of those blitz-type training.

Rebecca Dekker: Yeah. And then what happened next? When you finished that training program and all of your clinical hours, what are the next steps before you can become an IBCLC?

Janiya Williams: Yeah. And so a lot of people who are just getting into researching how to become an IBCLC assume that it’s just a real quick training course that someone can take. And then from there they can just take the exam and they move on with becoming a lactation consultant in a hospital system, private practice, or within a health department, but that is not it at all. So again, back then, the exam was only given out in July because the entire world sits for this exam in a one to three-week timeframe. And so with that being said, we finished our program in April and we had to sit for the exam in July, which was great because we were still able to have some of that knowledge and we were able to still apply it to studying etc.

But now with these programs, we’re graduating people in May, but they can’t take the exam until September. So students are freaking out because they’re going, “I’m going to forget everything that I learned. How do I stay abreast and do well on this exam?” In addition to that, it is sometimes financially difficult for individuals to pay for this exam. 

Rebecca Dekker: How much does it typically cost?

Janiya Williams: Well, this year the students told me it was $660 for them to apply for and to take the exam. And then it’s also a very expensive credential to keep up as well, because it’s about $500 for us to recertify every five years within the credential. And so when I talked to aspiring IBCLCs, I let them know straight up upfront, “Hey, this is an expensive credential. It’s expensive to sit for the exam. It’s expensive to do X, Y, and Z, are you in it for the long haul?” Because this is the conversation that no one had with me. And I just had to find out on my own and then I was having to tell my husband who was a grad school student at the same time, “Hey, I found this thing that I want to do and it’s going to run us a pretty penny, so what do you think about it?”

Rebecca Dekker: Yeah. So rather than being surprised about it, it’s important for people to know the costs upfront so they can start to look for ways to pay for it.

Janiya Williams: Oh definitely. Definitely.

Rebecca Dekker: Yeah. And then the exam itself, so you said it’s still offered just once a year?

Janiya Williams: No. It is now offered twice a year. It’s offered in April and then again in September.

Rebecca Dekker: Okay. So to be an international board-certified lactation consultant truly is an international credential, so it’s recognized around the world.

Janiya Williams: Exactly. And so that is something that I always tell people who are aspiring as well, “hey, this isn’t a credential” because with most health credentials, it has to be within the state that you live in. And I’m saying, “hey, you can work anywhere in the world with this.” So these are some of the pluses of getting a very expensive credential.

Rebecca Dekker: And you mentioned alphabet soup and that’s what we talk about in healthcare when there’s a bunch of initials and different ways of going about different professions, but there’s other pathways as well not just IBCLC, but you can get involved in lactation through other ways as well, correct?

Janiya Williams: Correct. And I tell people this too, when we have the conversation about, “hey, I know it’s an expensive credential, you don’t have to become an international board certified lactation consultant because we need all boots on the ground.” There are different levels. And so you can be a certified lactation counselor or a CLC. You can be a peer breastfeeding supporter within the communities with a department program. You could also just be a lactation advocate in your community and you can be that peer-to-peer support person. So those are all the different routes that you could potentially go.

Rebecca Dekker: So we’ve talked about there’s different levels of being involved in lactation. So for you as an IBCLC, what do you love about being part of the field? What are some of your favorite parts?

Janiya Williams: So, some of my favorite parts of being an IBCLC would have to be the fact that I can see, especially within the NICU setting, seeing families go from not being able to do anything except to provide their milk for their babies, to being able to feed their babies at their breasts or their chest, and then those babies graduating and moving on. Another thing that I love about my job is talking to families in the inpatient setting. There have been many times where I’ve gone into an inpatient setting and it’s a family of color and particularly a Black family and no one has ever breastfed before or chestfed before. And I’m going in and I’m explaining all the health benefits and I’m explaining the long-term health benefits for the nurser and the parent. And grandmother’s eyes are this big because they had no idea and just assisting families with their infant feeding journeys because everybody’s infant feeding journey is different.

A lot of people are under the impression that it has to be one way or another. They don’t understand that you can do both and you can be successful at doing both. Or there are times when I need the birthing parent who didn’t have a great breast or chestfeeding experience with the first child and they want to try again, but they’re a little reluctant and they’re able to work with someone who understands and can meet them where they are because patient care for me is really about meeting families where they are and building feeding plans that are really going to work for them. That they’re realistic. And then helping them understand how to keep up their milk supply when they are separated from baby or when they do have to go back to work early, and then just again, seeing their eyes light up like, “Oh, I can do this.” It’s just empowering people.

Rebecca Dekker: Yeah. That was the word I was thinking when you were talking, it sounds like you’re working with people who you see becoming empowered and that must feel incredible. What are some of the challenges you face currently as a lactation consultant? You laugh because I’m sure there are many. 

Janiya Williams: Yeah. I was like, “Oh, where should we start with that?” There are at times where we are getting it as far as people being combative towards the use of human milk from all sides. The birthing person’s family members may say, “hey, you shouldn’t breastfeed the baby or chest feed the baby because you have to go back to work or that’s nasty. That’s something we shouldn’t do.” Or we’ve got partners who think that it’s oversexualizing when parents have to nurse in public. And then there are providers who, especially within NICU, let’s just give the baby infant formula, they’ll get out of here faster. Some even nursing staff members are the same way, dispelling the myth that human milk is not the extreme beneficial source of infant nutrition to providers in the medical community sometimes with medically fragile children. That sometimes is an area where we have issues as a lactation consultant.

Rebecca Dekker: So you still in the NICU still have physicians who think that formula is superior to human milk, even in medically fragile babies?

Janiya Williams: Yes. Unfortunately, yes. And it’s just, wow, we have to-

Rebecca Dekker: It takes a long time to undo. Yeah.

Janiya Williams: Right.

Rebecca Dekker: It takes a long time to undo the harm that’s been done. It sounds like you’re talking about a lot of huge cultural barriers to lactation and how the industry… Gosh, I don’t know, whenever formula became popular, I know my own mom with my older sister was told, well, “formula is the scientific way to feed your baby.” And I think that has taken a long time to go away. And in many cases that still lives with us. 

Janiya Williams: Exactly. 

Rebecca Dekker: Yeah. Especially in the Southeastern part of the United States because I feel like I say that and people from other parts of the country will be like, you’re shamed if you don’t breastfeed or chestfeed your baby here. But in the Southeast where we live it’s very different, you’re definitely part of the majority if you formula feed and it’s very different depending on where you live in the world.

Janiya Williams: Definitely. Definitely with the cultural barrier because formula became really popular right around the Great Depression. And it was, if you could afford formula, then you had a higher social status and if you had to breastfeed, it was very much so looked at as you’re poor and people took that and ran with it like you said, especially in the Southeast. I feel like we’re always last when it comes to things like healthcare and education. If we could just get a little bit more into having these conversations and dispelling these myths and a lot re-education needs to be done. 

Rebecca Dekker: Right. And like you said, with families, that has to be part of the hardest part. You may have the birthing parent who is excited about feeding their baby with human milk but the rest of the family is opposed. That’s still a problem.

Janiya Williams: Oh definitely. I always say that everything that’s in the birth realm is generational because it’s passed down the stories, the myths, and we are the ones who have to combat all of those, especially when we’re in the hospital setting, in those birthing suites.

Rebecca Dekker: Can you tell us about the importance of Black Breastfeeding Week that’s going on right now as this podcast episode is coming out and the barriers of Black community in particular experiences when it comes to lactation and getting support for lactation?

Janiya Williams: Definitely. So Black Breastfeeding Week is something that definitely needs to be highlighted, celebrated. And we hear sometimes, and Mystique and I, we come together to help celebrate Black Breastfeeding Week in our community. And I remember the first time we did one back in 2018 and I had a baby the same week as Black Breastfeeding Week was starting and so I was like, “I need you to go ahead and carry this out for me.” And people said, “well, where’s White Breastfeeding Week? Where is this? Where is that?” And that seems to always be what folks go to when we discuss anything that has to do with a marginalized population. And so this is just a week where we want to highlight the importance of Black families, normalizing, supporting, and educating on the benefits of human milk, nursing in general, and then making sure that we have community support who looks like us because that’s something else that’s missing.

We definitely want to highlight the benefits of breastfeeding and chestfeeding but there are also many benefits to creating more lactation consultants who do identify as Black because I like to call it the mirror-mirror effect. People of color, they tend to receive messages about health better from other people who look like them because there are so many issues as far as the mistrust is concerned within the medical community. So definitely it’s something that we like to celebrate and help spread the word.

Rebecca Dekker: Yeah. And I think a lot of people aren’t aware of the roots of the disparities. They may know that Black families are less likely to breastfeed. Could you talk a little bit about the history behind that and how that became a disparity because it’s a part of history that is still present with us today. 

Janiya Williams: Definitely. And this just goes back to cultural reasons. We know that when we remove socioeconomic status, educational status, Black babies still have the lowest breastfeeding rates and it’s a combination of things and we’re still trying to unravel it as Black breastfeeding researchers. And we know that some of it comes from wet nursing from slavery because we knew that if you were a slave who was nursing, you would have to nurse your master’s child before you could nurse your own. And then that would mean that your own child would be more fragile, sicker, and then that took on that Black children are inferior because they’re sicker, they’re weaker, they’re not as strong. And then we have a lot of Black families who have to return to work early. They don’t have time where they can actually express their milk.

They work jobs where there’s nowhere to store their milk and little to no maternity leave at all. So that too is another barrier. In addition to just all of the societal things that we face too, especially as Black people who identify as women, there are many, many hurdles that we have to jump and climb. I say all the time that it is definitely hard to be a Black birthing person who identifies as a woman, especially if you work in a professional setting because the expectation is so high. And there is a lot of pressure when you come back to work and you’re having to pump and you’re having to stay on top of your game with your work and making sure that no one’s ever able to say, “oh, well, you can’t do this anymore because you just had a baby and then you’re going to breastfeed on top of that, who do you think you are?” 

And so just making sure that families have a village of support around them is really what we need to be working towards as well as creating more lactation support folks who look like us that can help us try to balance out what does a pumping plan look like, things like that.

Rebecca Dekker: Yeah. So there’s a whole web of factors including negative connotations from slavery and then current barriers. And you mentioned having lactation support that looks like you, do you happen to know what percentage of lactation consultants are Black?

Janiya Williams: So we suspect as far as just the IBCLC is concerned because the credentialing body does not keep track of race or ethnicity, but they ask us for this information when we sit to take the exam, because I think-

Rebecca Dekker: So they have it but they don’t report it.

Janiya Williams: Right, because it’s an issue. So we believe that less than 1.5% to 2% of us identify as Black or African-American in the field of lactation.

Rebecca Dekker: In the United States?

Janiya Williams: In the United States. Yes.

Rebecca Dekker: Okay. So there’s a huge barrier somewhere in there that prevents Black people from becoming lactation counselors and consultants definitely. So tell us what action you took because it sounds like you’re very passionate about this in solving this problem. Can you tell us how you started your own Pathway 2 Lactation Program and what that experience was like and what does this look like today?

Janiya Williams: Yeah. So back in 2017, we discussed at the beginning that I also ran a breastfeeding support group for families of color called Mahogany Milk. There is another one close by to me I’m in Greensboro, North Carolina in Charlotte, North Carolina called the Queen City Cocoa BEANS. And we were all at a breastfeeding conference in Chapel Hill back in 2017. And this was the first time that we all finally got to meet each other and we were sitting at lunch and we said, how can we make more lactation consultants of color and then make sure that we’re able to place these individuals into realms where they would definitely get jobs that can help reach the broader spectrum of the community. 

So at this conference, the Pathway 2 Program that I was talking about earlier, North Carolina, Chapel Hill, they were one of the hosts. And so we sat down with their program director the following day and we talked about, “okay, so we know you have this Pathway 2 Program but what does this look like if the community were to step in? And we were to join forces with historically Black colleges and universities” because we knew that there were HBCU or HBCUs, that there were HBCUs located in each of our major cities.

And we started having these conversations early on and she said, “Well, let me see what I can do on my end to assist with this.” And about two years later, we were able to secure grant funding from the Kellogg Foundation through Chapel Hill and then Chapel Hill gave us startup monies for the first year of our programs and North Carolina A&T State University, I’m an alumna of that university. And we love to give back to our universities if you’ve ever met someone who attended an HBCU and then A&T is also the largest HBCU in the nation. So I started talking with different departments, program areas, and I said, “I’m trying to make more lactation consultants of color. I didn’t necessarily want to go into a program area or a nursing department.” 

So we started talking to the child development program area and they accepted our proposal. And so we have the second HBCU with a Pathway 2 Program, the JCSU, Johnson C. Smith University in Charlotte. They started their program a year before ours. So they’re the only private HBCU to have this program in North Carolina. A&T is the only public institution to have this program. And both of us are now continuing on matriculating with other classes and cohorts. We just graduated our first cohort in May of this year with 11 students. We were in fact, the largest graduate certificate program on campus. And we are gearing towards starting up our second cohort in the next few weeks. So we’re very excited.

Rebecca Dekker: That’s so amazing. 

Janiya Williams: Thank you. Thank you. Thank you.

Rebecca Dekker: I just am so excited for you. And that just seems like a wonderful model that other HBCUs could follow to meet this need. 

Janiya Williams: Definitely.

Rebecca Dekker: Yeah. So you said you have your second cohort starting right now?

Janiya Williams: Second cohort is starting as soon as the university is up again. So the third week, in fact, the week before this podcast interview will air is when we will start with our second cohort. And we’ve got all of the major healthcare systems involved this year, as far as precepting our students and our students did so well last year in the clinical setting that we had these same hospital systems and then other areas reaching out to us seeing if they could hire our students before they had even sat to take the exam, which they will do this September.

Rebecca Dekker: Wow. So they’re actually getting job offers before they graduate.

Janiya Williams: They’re getting job offers early. Yes. Definitely. 

Rebecca Dekker: Yes. And how many people do you anticipate being in this second cohort of students? 

Janiya Williams: Our second cohort of students, and I think that we’re going to see this across the board in academia, it’s smaller than our first cohort because of financial barriers due to COVID. So we only have seven students this year, but I’m hoping that we’re able to keep increasing after this. One of the major barriers, because we had about 52 interested or prospective students on our list and as we began accepting applications, most of them in their essays would tell us that their barrier was how they were going to pay for, if we have scholarships available, if there were grants available, work study, etc. So those are the things that the program is currently in the process of working on to make sure that we’re able to assist students financially. Again, remember one of the barriers for Black people entering this field is financial. And so we’re wanting to help carry some of that burden for our students.

Rebecca Dekker: Do you have any ideas or things you have been brainstorming and that might not be put into action yet because I seems like that would be a similar problem other programs could run into.

Janiya Williams: Definitely. And then remember with our first year we were grant-funded only. And with COVID a lot of universities said, hey, we’re not accepting any new programs because this was before the program was built into the actual university system. A&T being a larger university, they were able to embed the program into the university. So we don’t have to worry now about, okay, how are we going to keep our program financially afloat? Now we’re able to direct all of our attention to how can we help with keeping students in the program. So we’ve come up with a few-

Rebecca Dekker: So retention. 

Janiya Williams: Yes. So we’ve come up with a few ideas. We are collaborating with the North Carolina Breastfeeding Coalition as far as a work study position is concerned. And so this person would just work in the prenatal sites and when they’re, of course, not in their clinical hours, and then the coalition will assist them with some of their tuition.

We’ve also tossed around a few other ideas with our local health departments. And then just some of the birth workers who have access to those who were in philanthropy. They’re trying to assist us with making sure that the students have everything that they need because it’s not just the tuition, the students also have to pay for things like lab coats, liability insurance-

Rebecca Dekker: Child care. 

Janiya Williams: Oh yeah! That too. And then a lot of our students are… In fact, all of our students last year, except for one and this year, except for one, work full time. And these programs are very difficult to do because we’re asking our students to take nine credit hours each semester of graduate work. In addition to that one to two, eight-hour clinical days a week. So they’re having to balance all of these things for a whole year.

Rebecca Dekker: Wow. So having as much support as possible financially is important for them so they don’t have to work full-time if at all possible.

Janiya Williams: Exactly.

Rebecca Dekker: Yeah. Are there any other projects you’d like to share with our audience that you’re currently working on?

Janiya Williams: Yes. So in September, our program is launching a community-based clinic in conjunction with our local hospital system. And so we’re very excited about that because the students will be able to get the outpatient experience that they really did not have last year due to COVID. And then in addition to that, we’re placed right in what we call our Women’s Med Center and it’s like an all-encompassing center for women’s health care. And you can do your prenatal visits, just your regular visits there. They’ve got mental health, pelvic floor therapy, there’s a food pantry, and there’s lactation. And we said, “hey, what about community-based lactation where people can see other people of color doing this too, and we can support them.” And so they said, “Yeah, that’s a great idea. You guys come on in, you can help us with classes. You can help us with support groups and you can do outpatient.”

So we’re doing that. And then in conjunction with the UNC hospital system and then the program within child development and the lactation program in the institution, we are joining forces to create a certification or a training class on post-birth warning signs. And so we’re going to train early childhood education individuals as well as their family members creating the village that we talk about all the time. This is like their fourth-trimester project. 

And then we have The Melanated Mammary Atlas with Nekisha Killings from Linus Lactation. We are one of her partners for creating the Atlas since we will have access to individuals in the community who are typically going to be probably people of color coming to us because we know that the current Breastfeeding Atlas that we have, there are a lack of images in there who reflect Black and Brown families, because what may show up red on somebody with lighter skin, it’s going to show what purple or maybe blue and people with deeply pigmented skin. And so oftentimes we go misdiagnosed and so we’re like, let’s just get on the bandwagon and assist from all avenues and areas. So those are the things that we’re working on right now within the program.

Rebecca Dekker: Those projects sounds so exciting. It sounds like there’s a group effort it’s not just you.

Janiya Williams: Right.

Rebecca Dekker: Is there anybody you want to give a shoutout to or credit to because it sounds like there’s multiple people involved…Obviously you’re doing amazing work but I get the feeling that you have recruited a community around you. 

Janiya Williams: I have. I have definitely recruited a community around me and I always get nervous when it’s like who do you want to shout out? Because then I’ll forget-

Rebecca Dekker: I’m sorry. Yeah. You know what? If you forget someone just email us and we’ll add them in the show notes.

Janiya Williams: So I’m like, “Oh, I hope you add someone.” So it’s really the entire Child Development Program area within North Carolina A&T State University. We also have someone from the nutrition department who is very closely affiliated with us. And then we have a researcher who is a part of another team in Boston who primarily focuses on DEI in infants to adolescents. We have a child development lab that is essentially like a learning center/childcare center on campus and we are collaborating with them on creating this certification. So all of the workers over there and then the program director and that person’s admin.

And then addition to that, just the different clinical sites that we have like Cone and Novant Health, everyone from their directors, especially the preceptors who are there assisting our students with making sure that they’re learning what they’re supposed to in the clinical realm. So those are all the people that I would like to shout out. Again, I was like, I’m not saying names. I don’t want to forget everybody, it’s easier for me to do that.

And then last but not least the people involved in public health within our communities and particularly the Alamance County Health Department and the Guilford County Health Departments. And just like the Black breastfeeding support systems that we have already. I used so many of the Black and Brown IBCLCs to assist me with guests lecturing last year because I can’t teach students every single aspect of human lactation. So what I did was I talked to my colleagues, who’ve become friends and we support each other, of course, over the years, and I said, “What is your area of expertise?” Well, I already knew their area of expertise and asked them to come and guest lecture. And I know that I had over 20 of them come and do it and just give their time to those students. So those are the people that I want to shout out.

Rebecca Dekker: Yeah. So it’s definitely a community effort. And it sounds like you really found a home for this at North Carolina A&T State University. So it’s like really exciting that it’s becoming the hub of so much positive action. So we want to celebrate you and just thank you Janiya for everything you’re doing for our families in your community. And thank you for coming on the podcast to share your experiences. Is there any way that our listeners can follow you or your program?

Janiya Williams: Yeah. So we do not have a social media account for our actual program, but they can follow North Carolina A&T State University on all of the major social media platforms because we do have a person who will post what’s going on with our program on there. And if they want to follow me personally, they can follow me on my Instagram and my Twitter and that’s at janiyawilliams, just Janiya Williams, I’m not very fancy. And really just thank you for having us on Rebecca today at Evidence Based Birth®, I always say we, because I feel like I’m speaking for myself as well as all the people who back me because I am not a one man show at all. I could not do it without the support of others.

Rebecca Dekker: Yeah. Thank you so much Janiya for coming on the podcast. And for those of you who want to learn more about Black Breastfeeding Week I encourage you go to Blackbreastfeedingweek.org to learn more about the founders of the movement and the story behind that week. Thank you so much Janiya.

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