Referring back to the definition of innovation in Week 11, the last two blogs of this semester will flesh out some aspects of time, place, and actors in the policy landscape of private arrangement milk-sharing. In shifting the focus to the phenomenon of PAMS as a grassroots innovation, the definition will refocus a bit as well. Per Smith and colleagues (2014), a grass roots innovation as opposed to an innovation specifically of health policy movements “seek innovation processes that are socially inclusive towards local communities in terms of the knowledge, processes and outcomes involved (pg. 2)”. Specific to social movements, Smith and colleagues further note that innovation from grass roots movements frequently result from dissenting voices with regard to some aspect of current hegemony, thus requiring practices and visions unique from those of main stream organized innovation. Grass roots innovation also has the distinction of engage local communities from the outset in instances where innovation began outside the immediate community, thus generating from inside specific communities and moving outward (Smith et al., 2014).
This distinction from innovation as previously discussed sets the stage to discuss sustaining innovation in the specific context of PAMS. Firstly in discussing aspects of time and timing this week as they relate to scope of PAMS as a social movement of innovation in allocating human milk. Part II of this topic will focus on the people and places of the PAMS innovation movement and their critical role in sustaining the practice. Longest (2010) discusses factors pertinent to the environment from which innovation springs – 1) diverse health related problem, 2) development of possible solutions, and 3) dynamic political circumstances related to each and both. Further discussion of these factors also indicates that a characteristic of bureaucracy essential for successful innovation of policy is longevity.
Time and Timing of PAMS Innovation
Sharing of milk between families in communities is not a novel practice. From the origins of human kind, infants were fostered at the breast or on the milk of donors in times of need. The agelessness of the practice has somewhat clouded the appreciation of the exceptional alignment of events and technology at the time of PAMS gaining a foothold. Lactation and breastfeeding were only just beginning to gain some of the momentum in 2010 that we now enjoy. The many health risks to formula feeding and “booby traps” obstructing the goals of breastfeeding dyads created an environment of varied health problems families were attempting to avoid or minimize through the provision of human milk. Social media was still booming, and the reputation of Facebook as a fairly grassroots idea had not yet tarnished. Families were beginning to find comfort and support in virtual communities to support like minded parenting and lifestyle decisions. The age of “going viral” was upon the interwebs. Information access was expanding horizons of what low infrastructure and budget organizations were capable of building.
At this point, Eats On Feets was a single page in Central Arizona. Quickly it became several pages run by close knit volunteers. From there it was grown to dozens of pages all over the globe. Then the network had a philosophical rift, resulting in the original network and the newly spun off Human Milk 4 Human Babies. This in a span of months. Now there were well over 100 pages where families were connecting for PAMS, and two large networks of volunteer page administrators spending hours and hours of their own time supporting and building their local networks. Now, coming up on 4 years later, there are several more milk-sharing networks, all still founded on the original model of donated time, and dedication to local communities. To balance the interests of discussion while maintaining brevity, only Eats on Feets and Human Milk 4 Human Babies will be discussed in any specific detail.
Scope of PAMS
With respect to PAMS, I will use scope as “breadth, depth, and potential capacity”. This entire social movement began as the simple passing along of a request for milk of a single recipient needing a short term arrangement. In that capacity, the mother of the movement, Shell Walker, had no more scope of involvement than passing on a request. With the founding of the original page, that scope expanded to include a general philosophy about the sharing of human milk. When many pages began the early foundations of a network, a concerted effort was made to provide guidance for families that were not familiar with the practicalities of milk-sharing. Significant effort was made to ensure that information provided was evidence based and updated regularly. This is a very dedicated scope in the sense of breadth and depth. As a solution to the varied health concerns of the diverse participants, such a resource for PAMS is essential to the community.
Human Milk 4 Human Babies is less inclined toward resource, but far more dedicated to areas believed to be essential to social normalization of the practice. These activities include a significant presence in the media, social blogging, and a larger network. From the standpoint of scope, this is a potential capacity focus more so than an introverted depth and breadth. Both networks serve the community in the same fundamental way, enabling exchange of milk, but do so with individualized focus.
The practice as a whole is bounded in scope only by the energies of the volunteers within the network and the needs of families. Social media has enabled these networks to secure local volunteers to operate and maintain the pages, thus adding creative and energetic capacity rather than depleting a finite amount from a static number of volunteers and facilitators. The longevity and dedication of network founders has sustained the practice and enable local communities to reach out to a greater global community in times of challenge.
It is difficult even with the best of information, intention, and available resources to generate health policy for a well defined population and practice in a way that does not need frequent correction to minimize the detrimental effects that may or may not have been foreseeable when policy was enacted (Longest, 2010). Considering the significant work still needed to describe participants and participation, policy generation at this time is premature. Considering the nature of human milk as discussed in previous posts and elaborated on through commentary by Elizabeth Brooks, it is not even clear that human milk allocation will benefit from direct policy oversight. The innovative spirit of this social movement seeking to fill a void left by insufficient support for lactation and ensuring human milk is available to all babies may not be able to continue to adapt as a global community supporting local specifics of practice with direct oversight. Where then would that leave families who have come to rely on one another to facilitate their infant feeding decisions?
Longest, B. B. (2010). Health policymaking in the United States (5th Ed.). Chicago, IL: Health Administration Press.
Smith, A., Fressoli, M., & Thomas, H. (2014). Grassroots innovation movements: Challenges and contributions. Journal of Cleaner Production, 63, 114. doi:10.1016/j.jclepro.2012.12.025