Your Secret Weapon for Breastfeeding Success

From the NPR Morning Edition, June 26, 2017

by Glenni Lorick, IBCLC

Yesterday NPR (National Public Radio) ran a fascinating story about breastfeeding mothers in Namibia. It is really worth taking a few minutes to listen to it.  It turns out that mothers there struggle with breastfeeding just like mothers in the United States do. They get sore nipples; they may have supply problems; they have to learn to breastfeed just like American moms do. However, they have a huge advantage that the vast majority of US moms do not have: a culture of breastfeeding.

The Grandmother Factor

This article explains in detail how the Himba people in the northern desert of Namibia have a culture that makes breastfeeding work. They live in mud huts, and babies are born at home, so there is no separation of mother and baby after birth for medical procedures. Their maternal and infant mortality rates are both high. For every 100,000 births, 265 mothers die, and or every 1000 live births 36 babies die. Obviously, I am not advocating giving birth in a mud hut as a solution to our breastfeeding problems. And even Himba mothers do struggle with learning how to breastfeed.

When 17 year old Bethany had her baby, her mother
supported her and taught her how to breastfeed.

But that is where they have the amazing "Grandmother" factor. Himba mothers actually go in the third trimester of pregnancy to the compound where their own mother lives. The new grandmother sleeps in the hut with mother and baby, even serving as an alarm clock to awaken the new mother and remind her to nurse. The grandmother teaches the new mother how to position the baby, how to help baby get the best latch possible, how to safely sleep with baby, and all the other little details necessary for parenting. The new mother remains with her mother for several months following the birth.

In the US we have a generation of great-grandmothers whose doctors told them that formula was the best way to feed a baby. Their daughters who are now grandmothers likely had no support for breastfeeding from either their mothers or the medical community. This lack of help often spelled lactation failure for that generation of mothers. Those who persisted are able to support their daughters in an amazing way, and usually those daughters benefit from their wisdom.

A grandmother who can help with breastfeeding is a treasure.

But there is another glaring obstacle that mothers in the US face. They are expected to jump right back into the routines of life within days or weeks after giving birth. I have worked with mothers who had to return to work or school as little as 2 weeks after giving birth. They aren't even able to give their bodies time to recover, let alone get breastfeeding well-established. The scant 6 weeks that so many employers deem as "generous" maternity leave is actually the bare minimum to move a mother beyond the post-partum period. Employers who allow 12 weeks are much more in tune with what mother and baby both need.

Another big difference between our culture and the Himba culture is the normalization of breastfeeding within the society. There it is completely expected that mothers will feed babies at the breast. Although there is some supplementation with goat's milk when mothers don't have enough milk, it is not the normal way to feed a baby in that culture. In contrast, new mothers here often feel uncomfortable and embarrassed about breastfeeding their babies with anyone else around. We do not have a breastfeeding culture here where children grow up seeing breastfeeding as the normal method of infant feeding.

Lessons We Can Learn from the Himba People

So how can we take this information and use it to increase breastfeeding success among US mothers? I see several ways in which we can learn from the Himba culture.

Skin-to-skin contact during the early days is
critically important for Mother and Baby.

1. Mothers and babies should NOT be separated at birth for any reason unless there is a genuine medical reason. Many hospitals have implemented policies to protect the Golden Hour because the evidence clearly points to improved outcomes when mothers and babies have this uninterrupted time together immediately after birth until after the first feed. 
2. Mothers and babies should have as much skin-to-skin contact as possible in the early post partum period. Research shows that this elevates hormone levels which increase mother/baby bonding. It also helps milk come in faster and increases the rate of breastfeeding success.
3. Mothers need to go home to somebody who will take care of them as they are learning to care for and feed their babies. This person needs to be supportive of breastfeeding, ideally having breastfed herself. Mothers need several weeks of this encouraging care and support. If a supportive grandmother, sister, aunt or close friend is not available to fill this role, a postpartum doula is an option. A Nurturing Moment actually offers a postpartum support package that provides some of this kind of ongoing support to new moms who don't have a grandmother/sister/friend to help out. It is very interesting to note that in the NPR broadcast yesterday morning they actually mentioned IBCLC's as an alternative for mothers who don't have "the Grandmother factor."

   

   India has a mandated 6 month maternity leave!

4. Our lawmakers need to get serious about providing a minimum of 12-16 weeks maternity leave to employees. As a small business owner, I understand the hardships that can cause, but as a lactation consultant, I see daily the hardships caused by the lack of adequate maternity leave. Research as well as the experiences of mothers and companies in the rest of the world have clearly shown the benefits of making sure that a strong maternal leave policy is implemented across society. 
5. From their earliest days, children need to see breastfeeding as the normal way that babies are fed. Children's books should feature pictures of babies nursing, not getting a bottle. Mothers should try to expose their children to other breastfeeding mothers, explaining that this is how babies are designed to be fed. Science classes at the elementary level should include breastfeeding in their curriculum when children are learning about mammals. At the secondary level, breastfeeding should be included in instruction about reproduction and family planning. A breastfeeding culture is built by one mother and baby at a time normalizing infant feeding at the breast. I am optimistic that together this generation of mothers can make that happen!

We Love Doctors Who Refer to IBCLC's!

The amazing doctoras from Lima who first became IBCLC's.

During the 17 years I've been an IBCLC I've had the privilege of knowing some amazing pediatricians. When we were serving as missionaries in Peru, I was very blessed to know Dra. Sicilia Bellomo, Dra. Milagros Raffo, and Dra. Sara Vega. (In Spanish if the doctor is a female, she's a "doctora.") Each of these amazing pediatricians became IBCLC's during our time in Peru, and I felt so honored to know them and be able to refer mothers to them.

Since we've been back in Huntsville and I've been with A Nurturing Moment, I have discovered that we have many amazing pediatricians here, as well. When a pediatrician or family practitioner recognizes that a baby has a breastfeeding problem he or she isn't equipped to solve, sometimes they just recommend formula. as a quick fix. However, there are some outstanding doctors who are very quick to recommend seeing an IBCLC for professional breastfeeding support, and very slow to recommend formula.

We appreciate the doctors at Cornerstone Pediatrics who refer moms to us.

Yesterday morning I received two calls from the same doctor at Cornerstone Pediatrics asking us to see two different patients.We were able to see both the same day. The first mother just wasn't making enough milk. The doctor had recommended that she see me and try to get breastfeeding fixed before starting formula. Honestly, in this situation many physicians would have wanted the baby on supplements immediately. But he was more concerned about the breastfeeding getting fixed. After I worked with the mother, the doctor and I agreed that she did need to supplement some at the breast to help baby suck more effectively. I was so impressed, however, that he really wanted this mother and baby to breastfeed well!

We were delighted that Huntsville Pediatric Associates actually hired an IBCLC as part of their staff. There are other doctors who refer patients to us from time to time, but we have very regular referrals from Cornerstone. I've  even had Dr. Michael Powell call me about a specific patient. That tells us that these are practices who are truly concerned about their patients breastfeeding successfully. When you are looking for a physician for your baby, be sure to ask how they handle breastfeeding problems. If they aren't quick to refer to an IBCLC, you just might need to look for a different doctor!

Melissa's Story: Why I Do What I Do

By Melissa Florence, MA, IBCLC, RLC

The number one question I get asked is “How in the world did you decide to become a lactation consultant?”  That is a very good question because looking back my goals were to get married, become a nurse/teacher and have 3 children all before I turned 30 (because 30 is old). Ha!  I am now a 35 yr old divorced and single mom to one awesome girl.  It is funny how things change, how we change.  If you know me well then you have heard me say at least once “Everything happens for a reason,” and that is so true. The good and bad happen to us for a reason. So what does this have to do with me? If I had not had my daughter I wouldn’t be where I am today.

Before I had my daughter I had decided to “try” to breastfeed. I had my daughter in September 2003, and breastfeeding went well for a few days then rapidly went downhill. At this time in my life I was going through a divorce, was living with my parents and had very little money. I was a WIC mom. When things started getting rough I called the lactation consultants that I was told to call. I was one week post-partum and had a C-section. I was not supposed to lift more than 10 pounds, nor was I supposed to drive, but I wanted to breastfeed so bad that I ignored all of that --  my child comes first! I set up an appointment and went in. I had $50.00 to my name. The appointment was around thirty minutes, and it cost me $45.00.  Twenty five minutes into the consult my daughter latched and started nursing well! I was ecstatic until the time was up. I asked if I could stay until she finished and was told, “Sure, but it will be another $45.00” which I did not have. I pulled my daughter off (she was screaming), put her in the car seat and walked out. Needless to say we both cried the whole way home.

"Everything happens for a reason." 

The next few months were spent nursing, pumping, supplementing and popping fenugreek like it was candy. All while going through a divorce, dealing with a newborn that had horrible reflux and a not-so-great latch, who was screaming almost all the time and absolutely could not be put down. So when I say I feel your pain, I really do! I would say that I had the “perfect storm” of things going wrong.  After 4 ½ months I dried up -- no more milk. It was because of the stress I was under. I was devastated, and I was ticked off. Why couldn’t anyone help me? Why was it so hard to find breastfeeding support? I made a decision that “God willing” I would not let what happened to me happen to another mother.

 I was raised in believing that if you have a problem you fix it yourself. That is what I set out to do. I wanted to figure out where I went wrong, learn how to fix it and help other moms in the process.  For the sake of this blog not being 10 pages long I will fast forward a little bit. After much, much research on the internet I learned that not only did the tremendous amount of stress I was under lead to my breastfeeding demise, but the fact that I have hypothyroidism also contributed to my milk troubles. Wow!  During all this time Jesus and I became BFFs. I prayed and talked to him constantly, “Please Lord help me understand why this is happening to me. I know there is a reason.” Little did I know just what God had in store for me!

In 2005 I received my Bachelor's degree; my daughter was 2 years old. In 2008 I became a CLC (Certified Lactation Consultant).  In 2009 when my daughter was 5years old I received my Masters degree in Maternal & Child Health with a focus in lactation. In 2010 I received my IBCLC certification!  I stayed busy! I spent numerous hours away from my daughter going to school. I had many sleepless nights working on my thesis while my wonderful daughter was next to me sound asleep. The three things that got me through all of that were

1. God (remember we were Bffs. We still are…) 

2. My family’s love and support. They helped take of my daughter so that I could pursue my passion.

3. My daughter. I wanted my daughter to see that you CAN do anything that you put your mind to. That no matter what happens, God has always “got your back” and that family ALWAYS helps each other out in times of need. Lastly, I wanted to show my daughter that everything happens for a reason.

God put me through all of this so that I could help YOU!

In 2011 I had the tremendous blessing of becoming a part of A Nurturing Moment, The M.O.M. Foundation and the ministry of helping all moms. It was then that God revealed the reason.

 So here is God’s reason for what I went through, the good and the bad. God put me through all of this so that I could help YOU. He allowed this so that I could help ALL mothers who need breastfeeding support. I went through this so no other mother would go through the pain that I went through, if I can help it.  I am a part of The M.O.M. Foundation because I was that mom who needed help and didn’t have the money to pay for it. If God had not allowed me to get married, have a baby while going through a divorce and struggle to make it all work there is NO way I would be able to do what I do today. 

So, if you need help, I am going to be there for you physically and spiritually. I will help my moms succeed, I will pray for every mother that I work with and I will NEVER turn away a mom because of her inability to pay for my services. Remember, at one time I was “that” mom!  So that is why I do what I do.

You can bless The M.O.M. Foundation tomorrow.

Tomorrow if you go to Woody Anderson Ford and test drive a car they will donate $10.00 to a non-profit of your choice. If you have time tomorrow it would be a blessing to The M.O.M. Foundation if you could do this for us and in turn for the moms that we help everyday. I am truly blessed by God to have the privilege of working with Glenni Lorick, of helping moms, and of showing everyone -- especially my daughter -- that God is good and that “Everything Happens for a Reason”!

IBCLC: The BEST Job in the World!!

I have the BEST job in the world.
Nope, you can't argue with me.
Nope, it doesn't matter how much I don't get paid.
Nope, getting a call at midnight is not a nuisance....
I told you, I have the BEST job in the world.

Here are the top ten reasons why being an IBCLC absolutely rocks!! 

1. Newborn babies smell so sweet and are so soft, and I get to hold them all the time!
2. Seeing a mother go from tears of frustration to tears of relief is priceless.
3. Teaching is a key component of my job, and I love to teach!
4. I have the opportunity to see babies I worked with grow into toddlers, preschoolers and even young adults.
5. The friendships I have built with mothers over the years have enriched my life beyond belief.
6. IBCLC's are an amazing group of people to call colleagues!
7. I get to learn new things all the time as I research conditions that are new to me.
8. God designed the breastfeeding relationship so when I help a mother nurse successfully, I am enabling her to do what her Creator intended her to do.
9. I have the privilege of "weeping with those who weep" - when a mother is struggling I can encourage her. When she is broken-hearted I can pray for her. When she needs affirmation, I can give it.
10. Nothing compares with the amazing privilege of touching the lives of moms and babies every single day.

If an IBCLC has made a difference in your life, take a minute to thank her and maybe even leave a comment here for her!

ANM Opens Satellite Offices

Sometimes amazing things happen when you are least expecting them! That's how we feel about the past six weeks here at A Nurturing Moment. We are so excited to be able to offer enhanced IBCLC support to mothers across the Tennessee Valley with the addition of two satellite offices.

Madison Satellite

It seems like it was just a coincidence (although we know it wasn't) that Melissa Florence (one of our IBCLC's) was getting her hair at Studio 106 when the owner Dana Burrows mentioned that she was looking for businesses to rent her upstairs rooms. The wheels began turning, and Melissa just knew that God was giving us this opportunity to better serve our moms in Madison, Harvest and East Limestone.

Melissa went to work transforming a bare upstairs room into a comfortable, welcoming satellite office for A Nurturing Moment. She has begun seeing mothers and babies there and is able to provide breast pump and baby scale rental, as well. She is available for in-home consults, if that is easier for mom and baby. She particularly enjoys coordinating with the pediatricians and family practitioners in Madison so that their patients don't have to come all the way to Huntsville to be seen by a lactation consultant.

The Madison satellite office also serves as a pick-up point for mothers who order diapers, breastfeeding supplies or anything else they need from our Huntsville store. The Mommy milk meet-up breastfeeding support group will meet the second Wednesday of each month at 3:00 pm in Madison. For more information or to schedule an appointment, call 256-658-8206.

Fayetteville Satellite

About the same time that the door was opening for our Madison satellite, we began to see the doors opening for a satellite in Fayetteville, TN,  as well. Dr. Sarah Thelen had contacted us about providing lactation support to her patients in Fayetteville. Meanwhile, Kelly Clements, another one of our IBCLC's who happens to live up that way and whose husband teaches in Fayetteville, said she would be interested in working with Dr. Thelen to make sure those moms and babies got the support they need. Dr. Thelen was happy to make space available in her office for our Fayetteville satellite which is also open by appointment. Kelly will see moms in the office or wherever they need to be seen. Like the Madison satellite, the Fayetteville satellite serves as a pick-up point for items the mothers have purchased through the Huntsville store.

Kelly will be coordinating with a LaLecheLeague leader in Fayetteville to offer a support group for moms in the area, and we will post details on our Facebook page under Events. She also has breast pumps and baby scales available to rent. For more information or to schedule a consult with Kelly, call 256-529-2445.

Congratulations to Our New IBCLC!

We are thrilled to announce that one of our very own employees just passed her IBCLC exam! Kelly Clements is a labor/delivery nurse at Huntsville Hospital who also works at A Nurturing Moment occasionally! With Kelly's new certification, we now have three IBCLC's available to serve you around the clock!

What Is an IBCLC?
That's a great question! An IBCLC is an International Board Certified Lactation Consultant. In order to receive that designation, she (or he -- I do know some male doctors who are IBCLC's, and one male midwife who is) must pass a highly specialized board exam which is given once a year on the last Monday of July.

However, not just anybody can sit for the exam. First a candidate must have a university level educational background in the health sciences. Then she must complete at least 90 hours of education in breastfeeding and human lactation. Finally, she must obtain a specified number of clinical hours in breastfeeding depending upon the pathway to certification she chooses to follow. It is a challenging and rigorous preparation which insures that those who sit for the exam are well prepared.

Why Choose an IBCLC?
Many breastfeeding moms can offer great advice. That's the reason that mother-to-mother support groups like Mommy Milk Meet-up and La Leche League are so helpful. La Leche League leaders receive training that enables them to help most nursing mothers very effectively, but they also know when to refer a mother to an IBCLC. In fact, many La Leche League leaders actually end up becoming IBCLC's.

However, if you want to be certain that you're getting the very best evidence-based information about your specific situation, then you need to see an IBCLC. She is the only health-care professional who has the advanced educational level specific to breastfeeding and human lactation that will enable her to provide the most effective intervention possible.

There are other types of breastfeeding professionals. The Healthy Children Project offers a Certified Lactation Counselor program which actually fulfills half of the required 90 hours in lactation education that is needed for IBCLC certification. This course offers excellent preparation with instructors who are personally committed to seeing students succeed in the field of human lactation. Breastfeeding Support Consultants offers a Breastfeeding Counselor course which provides the full 90+ hours needed to sit for the IBCLC exam.

Both of these breastfeeding professionals are very capable. However, they also realize that there are occasions when they may need to refer a mother to an IBCLC. A critical component of a truly professional practice is recognizing one's limitations and knowing when to refer.

How Do I Know if Someone is an IBCLC?
There are a couple of ways to verify that you are working with an IBCLC. You can go to the IBCLC registry and look for her last name. Or you can ask to see her IBCLC card. All IBCLC's have a laminated card that identifies them with their name, IBCLC number and certification expiration date. If someone claims to be a lactation counselor, ask her where she received her training - she should have a card or certificate verifying her claim.

Be very careful about accepting breastfeeding advice from someone who claims to be a lactation counselor but is unable to substantiate her claim in some way. We have seen cases where mothers were actually given very inaccurate information by someone claiming to be a lactation counselor. Recently we heard from a mother who actually quit breastfeeding because of the advice she had been given by one of these "pseudo-lactation counselors." So if you are at all unsure about a person's credentials, ask for proof! When you come into A Nurturing Moment, Glenni, Melissa and Kelly will all be happy to show you our cards!

Action Step 11: Access to IBCLC's

Photo courtesy of the IBLCE website.

This is our final blog in our World Breastfeeding Month series of articles. Today's action step is so important for nursing mothers. Although community support groups like La Leche League offer an incredible opportunity for mothers to get breastfeeding help, sometimes an IBCLC is really the key to helping a mom overcome a breastfeeding problem.
This information comes from page 48 of the Surgeon General's Call to Action to Support Breastfeeding.



Action 11. Ensure access to services provided by International Board Certified Lactation Consultants.

International Board Certiied Lactation Consultants (IBCLCs) are the only health care professionals certified in lactation care. They have specific clinical expertise and training in the clinical management of complex problems with lactation. Better access to the care provided by IBCLCs can be achieved by accepting them as core members of the health care team and creating opportunities to prepare and train more IBCLCs from racial and ethnic minority groups that are currently not well represented in this profession.

Implementation Strategies 

Include support for lactation as an essential medical service for pregnant women, breastfeeding mothers, and children. Third party payers typically define a standard package of health benefits for women and children. Including standard coverage for IBCLC's as “covered providers” when they perform services within the scope of their certification would ensure that mothers and children have access to these services through insurance maternity benefits. Federally funded health benefit programs, such as Medicaid, the Children’s Health Insurance Programs, Tricare, and the Federal Employee Health Benefit program, could serve as models for such a standard benefit package.

Provide reimbursement for IBCLC's independent of their having other professional certification or licensure. The taxonomy for health care clinicians defines qualifications of clinicians to be reimbursed. One option for reimbursement would be to place certified lactation consultants within the category of “nursing service related providers,” and specifying the nature of care they provide would allow for reimbursement of IBCLC's without requiring that they are also registered nurses. Alternatively, developing state licensure of lactation consultants could help to achieve the same purpose.

Work to increase the number of racial and ethnic minority IBCLCs to better mirror the U.S. population. Racial and ethnic minority communities tend to be underserved by lactation consultants. More students from these communities could be trained in human lactation to increase careers in lactation consultation. Area Health Education Centers could be encouraged to establish community-based training sites in lactation services.

Getting Involved

A Nurturing Moment is actively involved in a program to provide IBCLC's for area doctor's offices. Many pediatric and obstetric practices around the country routinely employ the services of IBCLC's for their patients, and it is our hope that this trend will extend to the Tennessee Valley. One of our long-term goals with our non-profit, The MOM Foundation, is to mentor minority women who would aspire to a career in lactation. At present, however, we are more focused on developing peer counselors in economically disadvantaged areas who will be able to encourage breastfeeding in their own neighborhoods.

Because we have two IBCLC's on staff, we are usually able to see mothers the same day they call for help. We deeply appreciate the many doctors who routinely refer patients to us, and are thankful that they view us as part of the health-care team. We are careful to keep communication open with the referring physician because we recognize the team nature of our efforts to serve moms and babies.

Action Step 8: Continuity of Care

This is the third in our series of articles based on the the Surgeon General's Call to Action to Support Breastfeeding. The U.S. Breastfeeding Committee has suggested a specific focus for each day of August. Today we're actually looking at the focus from Wednesday.  The text below comes from Pages 45-46 of the Surgeon General's document.

Action 8. Develop systems to guarantee continuity of skilled support for lactation between hospitals and health care settings in the community. 

Image from Wikipedia

Upon discharge from their stay in the hospital, many mothers are unable to find and receive skilled breastfeeding support. Mothers often are left on their own to identify resources to help with questions and problems they may have with breastfeeding. Furthermore, hospitals, clinicians in the community, and community organizations typically lack systems to help connect mothers to skilled persons who can offer support for breastfeeding. Ideally, there would be a system to ensure that breastfeeding mothers and their infants would receive skilled support with lactation from informed and available health care teams. Hospitals, primary care clinicians, and community organizations share responsibility for creating such systems.

Implementation Strategies 
Create comprehensive statewide networks for home- or clinic-based follow-up care to be provided to every newborn in the state. Follow-up support for breastfeeding needs to be integrated into home visitation and postpartum care programs. Staff training in breastfeeding management would be fundamental to this care.

Establish partnerships for integrated and continuous follow-up care after discharge from the hospital. Communities often provide a variety of resources to help breastfeeding mothers, including peer support networks, breastfeeding clinics, lactation consultants, and support groups. Health care systems can ensure that their patients are informed about such resources and can facilitate connections to these resources. They can also help to strengthen or create these programs.

Establish and implement policies and programs to ensure that participants in WIC have services in place before discharge from the hospital. Community partners and key stakeholders, such as hospitals, lactation consultants, and other clinicians, can work with WIC to establish continuity of care for WIC participants who breastfeed their infants. In addition, WIC state agencies can collaborate with state hospital associations to identify key barriers to the provision of WIC services within the hospital setting. WIC state agencies and hospitals can partner to establish policies to ensure that WIC participants receive in-hospital
education and support for breastfeeding, including identiication of a WIC peer counselor and scheduling of follow-up support for breastfeeding by WIC staf in the community.

Getting Involved

We try to work as closely as we can with our local hospitals and physicians.  We deliver rental breastpumps to patients in their hospital rooms at Crestwood Hospital. Our Postpartum Support program is a tremendous resource for new mothers who don't have family nearby to help them after baby is born.

Our Bosom Buddies program is specifically designed to help WIC moms by providing them nursing bras. Furthermore, our sliding scale for lactation consultation services in our office ensures that no mother who needs help will ever be refused it due to her inability to pay for an IBCLC.

Action 10: Basic Breastfeeding Support from Health Care Providers

This is the second article in our series about the Surgeon General's Call to Action for Breastfeeding Promotion. Today we're focusing on an action step that we can actually help with significantly.

Action 10. Include basic support for breastfeeding as a standard of care for midwives, obstetricians, family physicians, nurse practitioners, and pediatricians. 

Photo courtesy of the IBLCE   

Midwives, obstetricians, family physicians, nurse practitioners, and pediatricians provide care that supports their patients’ interests and health needs, including breastfeeding. Their full support of breastfeeding may be limited by the use of  practices that unintentionally and unnecessarily interfere with breastfeeding. These practices directly affect mothers’ and babies’ abilities to start and continue breastfeeding.

Implementation Strategies 

Define standards for clinical practice that will ensure continuity of care for pregnant women and mother-baby pairs in the first four weeks of life. The standard of care should include actions that are important for the promotion and support of breastfeeding, including providing prenatal counseling on feeding decisions, setting accountability standards for postpartum follow-up care, monitoring neonatal weight gain, and establishing referral mechanisms for skilled lactation care. Models should be established to integrate assistance with breastfeeding into routine practice settings.

 Conduct analyses and disseminate their findings on the comparative efectiveness of different models for integrating skilled lactation support into settings where midwives, obstetricians, family physicians, nurse practitioners, and pediatricians practice. Skilled lactation support may be provided by trained physicians, by lactation consultants affiliated with a physician practice, through stand-alone clinics, or by referrals. Models of care differ in the degree to which care is provided for all breastfeeding mothers to prevent difficulties and the extent to which care is provided for women already having problems. Identification of best practices and optimal care models is needed.

Getting Involved

We are blessed to live in an area where excellent health-care is available. Many pediatricians are quick to refer mothers to lactation consultants for breastfeeding support. We regularly get calls from their offices requesting consultations for their patients. However, some pediatricians are still quick to suggest that mother's supplement unnecessarily or even stop nursing altogether. Whereas some ob/gyn's are extremely supportive of their breastfeeding patients, others are dismissive at best. 

In many parts of the country lactation consultants are an integral part of the pediatric practice. Therefore, we have designed a program especially for our local doctors to give them the benefit of having a lactation consultant available without having to hire another staff member. Our LC in Your Office program allows even the smallest pediatric or family practice to provide professional breastfeeding support to their patients in the privacy of their office.