Tribal communities in Michigan use traditional knowledge to tackle modern public health crisis
For every 1,000 Native American babies born in Michigan, more than 14 don’t reach their first birthday. That’s more than triple the infant mortality rate for white babes. But tribal communities in Michigan are working to change that. And they’re doing it, in part, by reviving traditional cultural practices around pregnancy and motherhood.
Around three dozen indigenous women from across Michigan and the Midwest gathered in a classroom at Lake Superior State University campus earlier this spring. International board certified lactation consultant Camie Goldhammer, who is Sisseton-Wahpeton, traveled from her home in Seattle to lead the week-long course that teaches indigenous women how to provide culturally appropriate breastfeeding support for their communities.
The women picked up baby dolls from a table in the center of the room and sorted themselves into pairs for a role-playing exercise. Angie Shinos and Sage Hegdal pulled their chairs back to back. Shinas is a member of the Grand Traverse Band of Ottawa and Chippewa Indians. Hegdal is Mohawk of the Bay of Quinte First Nation in Ontario, Canada.
Shinos picked up a doll in a light blue onesie and a colorful cloth breast that she held to her shirt. She’d be playing the role of a mother struggling to breastfeed her baby. Sage Hegdal played the role of breastfeeding counselor, coaching her over the phone on how to get the baby to latch onto the breast.
This training, hosted by the Intertribal Council of Michigan, is part of a larger push among tribal communities in the state to improve infant and maternal health. And that’s an urgent issue.
The latest state data show the infant mortality rate for Native American babies in Michigan increased around 40 % from 2013 to 2017. It’s important to note that the data set for this population is much smaller than other ethnic groups, so it’s hard to say how significant the jump is in the long-term.
“But any, any jump for us is concerning because it just shows that we're not moving things in the direction that we want,” said Raeanne Madison, who is an enrolled member of the Minnesota Chippewa Tribe, Bois Forte Band.
Madison works in the Maternal and Child Health Department at the Intertribal Council of Michigan. She says there are several factors that contribute to the increased infant mortality rate for Native American babies. They include limited access to health care for people who live in rural areas, discrimination in health care settings, a higher rate of commercial tobacco usage in some tribal communities, and intergenerational trauma.
“So my question is not so much slicing and dicing the data and the numbers. My concern is why is this happening to us, and what we need to do about that,” Madison said.
Madison says babies in tribal communities around the state face a disproportionately high risk of sudden infant death syndrome – or SIDS. It's what's also known sometimes as "crib death" because it typically happens while a baby is asleep.
Black babies, and American Indian and Alaska Native babies, have the highest rate of sleep-related deaths in the state. There are nearly 20 sleep-related deaths of Native American and Alaska Native babies for every 10,000 live births. That’s more than double the rate for white babies.
And that’s where breastfeeding comes in. Research shows that babies who are breastfed for at least two months are half as likely to die from SIDS as babies who switch to formula earlier.
"So we say that every drop of breast milk is, for instance, something that can heal our DNA. We can change our whole course of history by breastfeeding one baby."
The American Academy of Pediatrics recommends that babies be fed only breastmilk for the first six months of life. Not many American women are able to reach that goal – only about 25% overall according to the CDC.
And indigenous women are 50% less likely than white women to make it to six months.
That disparity is what inspired Goldhammer to create the Indigenous Breastfeeding Counselor Training a few years back. She says it was something she’d been thinking about since she started training as a lactation consultant in 2011.
“So, anyhow, thinking about why that was and really coming to the conclusion that it was due to colonialism and racism and the systematic separation of native mothers from their children. That, that was the reason we don’t have breastfeeding as our cultural norm,” Goldhammer said.
In cultures around the world where breastfeeding is still the norm, Goldhammer says, women have all the same problems nursing as they do here.
“But what they have is grandmothers that breastfed and can serve them. And that’s something that we don’t necessarily have as a whole in our communities now,” she explained.
For centuries, indigenous people in North America were forced from their homelands by white settlers. Starting in the late 19th century, the U.S. and Canadian governments started forcibly separating native children from their families. They were sent to off-reservation boarding schools. Speaking their native language or practicing their culture was forbidden. Physical and sexual abuse were not uncommon.
That long history of trauma is still being felt today, says Goldhammer. And it can have a significant impact on native families.
“Bonding or attaching with our babies, being that close to our babies, having our baby be that dependent on us can sometimes be very overwhelming when you have a trauma history that goes back 500 years,” she said.
The work Goldhammer is doing is part of a growing movement for “indigenous birth rights.” And it’s not just about breastfeeding. In Michigan, tribal communities are also reviving traditional practices around pregnancy and postpartum. There’s a focus on improving nutrition by eating traditional foods. Families are reviving traditional ceremonies and practices around how to care for babies and new parents.
And tribal communities are hosting cradleboard building workshops for new parents.
Cradleboards are how Anishinaabe families have carried their babies for centuries. They are made of a piece of wood with a bent sapling handle. Babies are swaddled in what’s known as a moss bag, and then secured to the cradleboard with leather straps woven through holes on either side.
This ancient tradition is actually the foundation for a hugely successful modern public health initiative. In the 1990s, public health advocates and pediatricians began a nationwide push to encourage parents to have their babies sleep on their backs. That campaign led to a dramatic decrease in the number of infants dying from SIDS.
So far, the workshops have sent more than 70 cradleboards to new parents around the state.
“Something that's really profound to me is that ... one year ago you, when you walked into one of our community buildings, you would not have witnessed mothers and families with cradle boards,” said D.
But that’s changing. D is a member of the Sault Ste. Marie Tribe of Chippewa Indians. She and her husband had their first child – a girl – this March. She asked that we use only her first initial to protect her family’s privacy.
Now, D explained, she sees more and more families using cradleboards. It’s not uncommon for her friends to text each other and coordinate bringing their cradleboards to community events.
D’s daughter’s cradleboard is made of a smooth, light wood. Hanging from the handle is a dreamcatcher made of red willow, a cloth bag filled with tobacco, and turquoise beads that reflect the light. Her mossbag, a gift from a friend, is made of a burgundy velvet.
D says you have to be slow and intentional when you are getting your baby ready for the cradleboard. She cooed and gave her daughter little kisses as she tied the bag’s leather ribbons.
“We do it in, like, little steps cause it can't be rushed. She'll yell at you,” D said, smiling.
Her daughter sat snug and secure on the cradleboard, her feet resting on a small piece of wood at the bottom of the board.
“She can, like, rest and then take in the beauty of her cradleboard, and what she has on it, and then look beyond her cradleboard at the world. It’s pretty awesome,” D said.
The next day, D and her husband hosted their families for a traditional Anishinaabe naming ceremony. They celebrated her daughter with plates of berries and fish, in honor of the Bear clan. The family also buried the baby’s placenta in a special spot, close to their home on Lake Superior.
“And they say, wherever you plant that placenta, that, like, grounds your baby to that place," explained D.
The Anishinaabe, like other indigenous people in North America, believe that what happens to them today will go on to impact the next seven generations.
“So we say that things that were experienced by our ancestors many generations ago, we can still be healing from those effects,” Raeanne Madison explained.
But, she says, that’s a good thing. It’s hopeful. Reviving traditional pregnancy and postpartum practices is not just a way to connect to the past. By rooting children in the culture of their ancestors, Madison says, native communities can change what happens to the next seven generations.
“So we say that every drop of breast milk is, for instance, something that can heal our DNA. We can change our whole course of history by breastfeeding one baby.”
A broadcast version of this story misstated how much the infant mortality rate had increased among Native American babies in Michigan between 2013 and 2017. It said nearly 30%. It is actually around 40%. A broadcast version of the story also incorrectly identified Raeanne Madison's tribal affiliation. The error has been corrected above.