CHEER is thrilled to announce the recipient of our 2018 Lifetime Achievement Award: Kimarie Bugg, DNP, RN, MPH, IBCLC, CLC, for her long-standing dedication to breastfeeding and maternal child health equity! Kimarie is the Co-Founder, President/CEO, and Change Leader for Reaching Our Sisters Everywhere (ROSE), a nonprofit developed in 2011 to address breastfeeding inequities in the African-American community. CHEER’s Communities and Hospitals Advancing Maternity Practices (CHAMPS) program has partnered with ROSE since its incipiency in 2014, and has the pleasure to host Kimarie as our Community Engagement Director. Throughout her career, Kimarie has tirelessly served families, trained health care providers, managed programs, advised national efforts, and led the charge for breastfeeding health equity amongst typically underserved communities in the United States. In this, her life exemplifies exactly the kind of work CHEER seeks to uphold! 
 
Regarding her professional vision, Kimarie states that, on the basis of the equity-focused work of Dr. Gail Christopher, “I believe that Truth, Racial Healing and Transformation can take place in marginalized communities, starting with Breastfeeding.” 
 
Kimarie’s passion for her work springs from seeds planted in her youth and early motherhood. As a 12-year-old, Kimarie helped her grandmother, a lay midwife in Arkansas, in the fulfillment of her own life calling. It was that experience, says Kimarie, that gravitated her life’s work towards the support of mothers and infants. Years later, in 1978, after finishing a nursing degree in Texas, Kimarie gave birth to her first children, a set of twins. Despite her commitment towards the natural first-food lifestyle, she struggled to get breastfeeding support from her local hospital and struggled to breastfeed. She “failed miserably” she says, and became determined to learn everything she could about breastfeeding. She didn’t want other mothers to experience the disillusionment with lactation that she had. 
 
“I took a year and I read everything I could get my hands on about breastfeeding. Nurses and doctors I worked with started to call me the breast nurse,” she says. 
 
Early in her career, Kimarie moved to Atlanta, where she has spent the past 30 years promoting breastfeeding support and education, especially amongst African-Americans. She has worked in a pediatric emergency clinic and special care nursery, has been a bedside breastfeeding counselor in a large metropolitan hospital, and has managed perinatal and breastfeeding programs at the state level. Kimarie has served as a technical advisor to Best Start, the US Baby-Friendly Hospital Initiative, and the National Institute for Children’s Health Quality’s Best Fed Beginnings program. She was a founding member and officer of the Georgia Breastfeeding Coalition and the Southeastern Lactation Consultant Association. Kimarie received additional training at Wellstart International, and has traveled throughout the United States and several foreign countries training health care professionals to manage lactation. She combined all these skills and passions during her tenure at Emory University’s School of Medicine as a nurse practitioner. 
 
In 2011, when a budget cut left her without work, Kimarie took the advice of her pastor who said, “you were released for increase,” and founded ROSE, alongside two other women. Since then, not only has Kimarie’s work increased, but the work of ROSE itself has increased from a regional to a national scale. In 2017, ROSE was awarded a $1.1 million grant from the W.K. Kellogg Foundation, which has allowed them to look at breastfeeding disparities at a national level and spread the blueprint of ROSE’s work across the country.
 
ROSE’s vision is for 82% of African-American babies to receive breast milk at birth by 2020, a goal set forth by the Surgeon General of United States. ROSE’s mission is to “address breastfeeding disparities to improve health equity among people of color nationwide through culturally competent training, education, advocacy, and support.” Kimarie and her staff seek to fulfill this vision and mission through a number of strategies and programs, including: their staple “Community Transformers (CTs)” program, which trains mothers with positive breastfeeding experiences to provide peer support to other mothers in their community; participating in health care leadership and policy-making; providing technical assistance to agencies regarding Steps 3 (prenatal breastfeeding education) and 10 (postpartum breastfeeding community support) of the Baby-Friendly Hospital Initiative; creating regional and national initiatives to strengthen community breastfeeding programs, such as breastfeeding clubs and Reaching Our Brothers Everywhere for men; and serving as a resource for health care providers and agencies through interactions and events such as the ROSE Annual Breastfeeding Summit. 
 
When CHAMPS began in 2014, Kimarie and ROSE were the ideal partners for our efforts to increase breastfeeding rates in the Southern United Sates. With Kimarie as our Community Engagement Director, CHAMPS has had great success in fulfilling the community portion of our mission as stated in our name: “Communities and Hospitals Advancing Maternity Practices.” ROSE works to develop a broad community network by engaging grassroots breastfeeding supporters, counselors, and community members as part of CHAMPS. Since 2014, ROSE has trained 20-40 CTs per year in locations central to CHAMPS’ work, and they have provided continuing education to some of these CTs. Many of these CTs have started breastfeeding clubs in their communities, and mothers are receiving prenatal and postpartum breastfeeding education and support. ROSE also developed a data collection tool to capture data from ROSE CTs and the work being done in the field. In the past year, to support our Mississippi CHAMPS initiative, ROSE established a ROSE-affiliated chapter in Mississippi and identified a CT Leader in the state. ROSE and CHAMPS have also co-hosted breastfeeding and breastfeeding equity summits for CHAMPS hospital staff. 
 
In addition to her work for ROSE and CHAMPS, Kimarie is currently chair of the nominating committee of the United States Breastfeeding Committee (USBC). She provides training for WIC breastfeeding staff and peer counselors throughout the southeastern states, a position she has proudly held since 2005. Kimarie recently completed a Doctor of Nursing Practice degree through Troy University, where she received the “Best Graduate Research Scholar” award in 2017. Prior to that, she completed a 3-month Community Health Leadership Program fellowship within the Satcher Health Leadership Institute (SHLI) at Morehouse School of Medicine that stressed the best practices to provide for global health equity, and provided the network and understanding to eliminate health disparities through action-oriented projects. In 2016, Kimarie received a Legacy Award from USBC for her 38 years of work in the breastfeeding arena. Kimarie is married to Dr. George W. Bugg, Jr., a neonatologist, and they are the parents of 5 adult children. 
 
Congratulations, Kimarie! CHEER applauds your wonderful career and the impact you have had on countless lives! 
 
ROSE website: Reaching Our Sisters Everywhere, Inc.
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​This week's CHEER Champions of the Week are Yuri Kitayama, Noriko Hiwatashi, and Sanae Iwakami, 3 Japanese professional interpreters who provided simultaneous translation at the recent International Society for Research into Human Milk and Lactation (ISRHML) conference at Shonan Village in Kanagawa, Japan. CHEER Director Anne Merewood nominated them for their energy and patience simultaneously translating their way through 5 days of back-to-back presentations on human milk related topics, from the microbiome to Mississippi CHAMPS. CHAMPS presented on Mississippi's amazing progress on the Baby-Friendly pathway. One lesson we learned from them is that "skin-to-skin" is called "skinship" in Japanese!
 
Each of the interpreters told us about their conference experience:
 
Yuri Kitayama, BA, President of Stage-Y Company and Coordinating Conference Interpreter shared: “We—Sanae, Noriko and myself—are mothers and have experienced breastfeeding in the past. We are simultaneous interpreters deeply involved in scientific and medical conferences and have a keen interest in the subject matter of this meeting.

“Before this conference I thought that human beings were greedy consumers of natural resources not contributing anything to the ecosystem. But this conference taught me that we females are also contributors of a valuable biological resource by producing and secreting human milk, and by doing so enhancing human health. 

“I was most amazed to learn how constitution, volume and other features of human milk are regulated by mothers’ biology and how breast milk is made to be best suited for her human baby. We have seen in other scientific meetings that our gut microbiota is finalized during infancy and is very difficult to change in later life. That is why we need some heroic measures like fecal transplantation for treatment of some diseases related to gut microbiota. And the gut microbiota is the enormous endocrine organ with important functions. If milk is the most important determinant and the original source of gut microbiota of neonates and babies, I would imagine that babies inherit from their mothers either health or ill health not only through genetic or epigenetic mechanisms but also through lactation.

“I have learned in this meeting that we are all connected both horizontally and vertically through milk and lactation; and that the other half of the human race, men, are expected to help make this world a peaceful and healthy place for breastfeeding dyads.”
 
Noriko Hiwatashi, Freelance Conference Interpreter shared: “It has been quite interesting and encouraging to work for a conference where the participants were overwhelmingly female, especially when such an occasion is so rare in Japan. We appreciated that many
speakers came to the briefing sessions for us so that we were able to prepare for the simultaneous translation work.” 
 
Sanae Iwakami, BA, Freelance Conference Interpreter shared: “I found the recent ISRHML conference truly multidisciplinary, represented by experts from many different fields from biology to policy as the title of the conference, “Protecting, Promoting and Supporting Breastfeeding from Biology to Policy,” indicates. I have always believed in breastfeeding, but I was reassured of the positive impact it can have on child and maternal health. To achieve this objective, ISRHML has been instrumental in bringing together knowledge from different disciplines and technologies. It was a great privilege and pleasure to work for the conference as an interpreter. I also want to echo the comments of my colleague in thanking the speakers for the briefings they provided.”

Congratulations, Yuri, Noriko, and Sanae! Thank you for these beautiful insights and the wonderful work you do!

​This week’s CHEER Champion of the Week is Talita Ruble, a mother who persevered in breastfeeding her adopted son, Ronin! Talita’s story is truly remarkable and a testament to a mother’s determination and the support of her community, including CHAMPS hospital King’s Daughters Medical Center (KDMC) in Brookhaven, Mississippi. 
 
In January 2018, Talita and her husband met with Ronin’s birth mother for the first time, who asked them in that meeting to be the parents of her baby, who would be born on June 25th. Soon after that meeting, Talita decided to induce lactation. She had heard about induced lactation years before from some ladies in a Catholic infertility support group, who were discussing the article, "How and Why I Induced Lactation,” by Amanda Teixeira. Although Talita and her husband were not pursuing adoption at that time, Talita saved the link to that article. After meeting with Ronin’s birth mother, she reread the article and did more research.
 
“The more I researched it, the more convinced I became that the benefits were worth the effort of inducing lactation,” Talita says.
 
Talita knew her road would not be easy. Induced lactation involves a lot of time pumping with varying results. Yet Talita countered this challenge with realistic goals and beautiful definitions of success.
 
Talita shares: “I pumped for months with nothing but drops not even big enough to save. When it did start, it took a week to get an ounce, then finally 2 days, then 1 day. By June 25th, I was at 3 ounces per day. Unfortunately, my supply never increased. However, I did it, and my goal was to be able to nurse Ronin within 1 hour of birth. Thanks to his birth mom and the hospital staff at KDMC, we did it. Then the most vital goal, nurse him through withdrawals. We made it! Five days of delirium tremens and he was tremor free. After day 5 I had to start supplementing. Luckily, since I started producing a month before he was born, I had a small stash of frozen milk.”
 
Talita credits her success to her various sources of support. She says her husband was her “champion,” and that when she grew tired of pumping and support was hard to find, he kept her focused and reminded her that “every drop mattered.” KDMC Lactation Nurse Lou Ann Wall, RN, IBCLC helped Talita during the induction stage before Ronin was born, during Ronin’s hospital stay, and after discharge when Talita had to start supplementing. 
 
“Thanks to the hospital and Ronin’s birth mom, my husband and I were able to room-in with Ronin,” says Talita. “Once we were back in our own room with the baby, Lou Ann helped me get Ronin latched for the first time and checked in on us regularly.”

Talita and her husband’s room was next door to Ronin’s birth mom’s room. Ronin was put into Talita’s arms outside the operating room door, and she and her husband were able to spend every moment with him from then on, including during a short visit to the nursery for vitals and a short visit to the birth mother’s room for her to see him. Talita is grateful for this unique opportunity for an adoptive mother to have a private room to do skin-to-skin and nurse from the moment of birth. 
 
Talita is also thankful for the support she received from Circle of Moms Baby Café in Brookhaven. She started attending their weekly meetings while still pumping and awaiting Ronin’s arrival. She says the ladies there “cheered her on” through her whole journey and helped normalize breastfeeding for Talita, who had not been around any breastfeeding moms before. Talita perceives more moms in Mississippi talking about and practicing breastfeeding especially in the last few years. 
 
Ronin is 5 months old now and “growing like a weed!” says Talita.
 
Congratulations, Talita, on your amazing journey, and best wishes to you and your family!