Dextrose oral gel for neonatal hypoglycemia

Dr. Matoq and his team

Dr. Matoq and his team

Unlike most medical students, Amr Matoq, MD, Chief Resident in the Department of Pediatrics at the University of Florida College of Medicine-Jacksonville, says that breastfeeding has been a big part of his education.

Recently, Dr. Matoq was involved with a quality improvement project, Improving In – Hospital Exclusive Breastfeeding Rates (PC-05): The Effect of Delayed Newborn Bath and Oral Dextrose Gel for Hypoglycemia on PC-05. Their in-hospital exclusive breastfeeding rate increased from 20.6 percent to 32.6 percent over 19 months using two simple and cost-effective interventions.

Dr. Matoq and his team concluded that adopting dextrose oral gel as the first line of treatment for neonatal hypoglycemia (low blood sugar) and delaying the newborn bath both increase EBF rates in check with the Joint Commission’s perinatal care core measures.

Out with the old, in with the new

Traditionally, hospitals correct low blood sugar with formula feeds and intravenous glucose/dextrose.

There are several risk factors for developing hypoglycemia including prematurity and babies born to diabetic mothers. Prolonged hypoglycemia can cause seizures and serious brain injury.

Dr. Matoq says that because the health implications can be serious, babies may end up receiving formula because providers aren’t always confident the situation will improve without it.

But there are dangers associated with formula supplementation. The dangers of not breastfeeding are well known too. Further, intravenous glucose administration interrupts bonding time between new families.

Administering dextrose oral gel though allows for a rapid rise in blood sugar without interfering with breastfeeding.

Simple, painless, cost-effective?

Dr. Matoq says that there is no new science behind the gel; it’s simply applied to a different age group which should help its use to be easily adopted into practice. No evidence suggests adverse effects to the infant either.

Dextrose oral gel is affordable. In fact, one study showed that its application came out to about 2 dollars per child.

Another study points out that dextrose oral gel is painless and that the intervention “requires no special expertise or equipment and hence is applicable in almost any birth setting.”

However, Carmela Baeza, MD, IBCLC expresses her concerns regarding dextrose oral gel in a comment to this blog post:

I fear posts such as this one…
The way you present oral dextrose gel makes it seem perfectly safe and totally innocuous. However, it means:
1. someone (you actually say “requires no expertise” – implying that anyone can just stick finger in baby´s mouth) puts their finger in newborn baby´s mouth – not good for oral stimulation
2. a substance that is not colostrum is in baby´s mouth – not good for oral microbiome
3. Mother does not receive breast stimulation, which is sooo necessary in the first few hours after birth to establish a good supply.
4. Message to mother is: your colostrum does not do it.

It is very very rare for mother´s colostrum to not be available. So why not give it to babies?
We´ve started a program in which, if baby has not latched and breastfed (because he cannot or because he is separated from mom) in the first hour – two hours after birth, per protocol someone teaches mother to extract colostrum and the baby gets fed. We are getting colostrum volumes ranging from 15 to 45 ml in that first hand expression. And double bonus: babies with ok glycemia and very empowered moms.

Dr. Matoq confirms that breastfeeding is the most suitable nutrition for babies, but he says he’s most fascinated by the emotional connection that breastfeeding provides for mom and baby.

Expansion of donor human milk program

This year, UF Health Jacksonville expanded its donor human milk program to hypoglycemic infants. Infants who receive human milk spend less time in the hospital and more time bonding with their families.

Not only are mothers happy about the use of donor human milk, Dr. Matoq points out that the staff is “really enthusiastic about it too.”

Dr. Matoq and his team presented their findings from Improving In-Hospital Breastfeeding Rates (PC-05): The Effect of Delayed Newborn Bath and Oral Dextrose Gel for Hypoglycemia on PC-05 at The Academy of Breastfeeding Medicine’s 21st International Meeting in October.

In January, Dr. Matoq will join Healthy Children Project for the 23rd International Breastfeeding Conference in Orlando, Fla. where he will present and discuss his findings.  

To register for the conference, please click here!

* Edited 12/5/16 from original version to include Dr. Baeza’s comment.

Birmingham CLC provides culturally safe care in her community

unnamedEver since attending her friend’s home birth, Chauntel Norris CBE, CLC of Baobab Birth Collective has been captivated by birth.

“It was amazing!” Norris exclaims. “I was used to seeing birth the way that I had experienced it: In the hospital, on your back, with directed pushing.”

Differently, she witnessed her friend walk around, enjoy snacks, labor in a tub, and set the pace for her birth.

“I had no idea any of these things were even an option and I felt cheated that I didn’t experience them with my births,” Norris says.

Determined to offer women “another way” to have their babies, Norris became a doula.

After attending her first few births, Norris says she decided she needed to complete The Lactation Counselor Training Course.  

“The moms would ask me specific breastfeeding questions and I wasn’t exactly sure how to answer them,” she explains. “I understood the basics but I wanted to be able to adequately assist moms in need.”

Completing the training allows Norris to offer continuous care.

“I’ve already been with [the moms] throughout [their] birth[s] so it makes sense that I help [them] with breastfeeding immediately after,” she says.  “It just flows better.”

Norris and her business partner Danica Davis founded Baobab Birth Collective in Birmingham, Ala. in 2014.

On their website, they point out: “In Tanzania there is a tribe of people who have a tradition of actually giving birth inside the [Baobab] trees whose trunks are huge and sometimes hollow. These trunks offer women a secure and private area to give birth. At Baobab Birth Collective we strive to provide this same security and support while we assist mothers in their journey to give life.”

In addition to offering respectful, evidence-based maternal child healthcare, Norris and her business partner are active in their community.

Norris and Davis co-facilitate a weekly Baby Café breastfeeding support group. Norris also serves as a children’s storyteller at a local library; some of the Baby Café participants attend Norris’s storytimes.

Norris recently received an “Innovative and Cool” grant from the Birmingham Public Library to support a Parenting 101 class to be taught at the library. The series will begin with prenatal and breastfeeding information and is scheduled to begin in early December.

Additionally, Baobab Birth has partnered with a local physician/midwifery office and high school to provide childbirth education to their young mothers.

“Of course a large component of that is breastfeeding education and support,” Norris says.

Group prenatal care is offered during the school day so that the mothers miss less school. Norris reports that partner participation is low, but fathers are always welcome to attend.

She also reports that the young mothers who participate appreciate and value the information presented.

“They all strive to be good parents,” Norris says.  

This summer, Norris and her colleagues plan to once again bring The Lactation Counselor Training Course to Birmingham.

Norris and Davis also have plans to travel to Suriname next summer to provide breastfeeding support in a country with a 2.8 percent exclusive breastfeeding rate.

Recently, Norris spoke at the 2016 Alabama Breastfeeding Summit and attended the Lamaze Conference.

“It has been amazing to see the work that others are doing on national and international levels and it’s encouraged me to set new goals for myself in my current work,” Norris reflects. “I am honored to be in the presence of such amazing women and to learn from them. It’s been great to build relationships, work on national initiatives and really get a feel for what’s happening around the globe with women’s issues.”

When asked what excites her most about the birth and breastfeeding movement in our country, Norris replies:

“I love the fact that women are no longer being passive receivers of health care. We are researching our options and making informed decisions about how we want to birth and feed our babies. Not only that, we’re letting our friends know what we’re learning and informing them too. It’s sisterhood at its best!”

Learn more about Baobab Birth and connect with Norris here.

Certified Lactation Counselor plans Nationwide Nurse-In events

unnamed-2Amber Schwickerath, CLC dreams of working in a maternity hospital so that she can provide early breastfeeding support to new mothers.

Schwickerath realized her passion for helping moms and babies early in her journey as a mother after enduring many common breastfeeding barriers.

“My birth plan did not go as I wanted,” she says. “I had an unexpected c-section after 38 hours of labor.”

While her now two-year-old son Jaxon was in the NICU, medical staff gave him formula. They also provided Schwickerath with a nipple shield.  

“I knew I wouldn’t want to take that everywhere with us,” she remembers. “We worked all night that night to latch without it and the next day we didn’t need it.”

unnamed-1Jaxon was later diagnosed with a tongue and tip lie eventually corrected by a pediatric dentist.

Over the course of a year, Schwickerath overcame mastitis eight times.

“It was not fun, but no matter what we face we want to give our babies what is best for them,” Schwickerath says of breastfeeding.  “I knew it was what was best, so I just kept pushing on.”

At 18 months old, Jaxon self-weaned much to Schwickerath’s dismay.

“Before I knew it, our journey had ended,” she says. “It was very, very sad.”

Although Schwickerath’s breastfeeding journey is over, she has made it possible for other babies to receive human milk.

“I have donated over 1,000 ounces to moms [and babies] in need,” she reports.

What’s more, Schwickerath actively participates in several breastfeeding groups like Breast Friends (run by one of Schwickerath’s support people Sonni Martzahn, RN, IBCLC) and the Iowa Breastfeeding Coalition.

Media attention at the 2016 Nationwide Nurse-In Iowa

Media attention at the 2016 Nationwide Nurse-In Iowa

Schwickerath is co-chair of the North Central Iowa Breastfeeding Coalition, the statewide administrator for Iowa’s Nationwide Nurse-In (NWNI), and the nationwide administrator for Iowa, Arkansas, New Hampshire, and Indiana. Schwickerath volunteers her time to all of these organizations.

Laura Delmonico founded the NWNI in 2014 in an effort to unite “supporters of breastfeeding everywhere” and  “to work towards our common goal: a society in which breastfeeding is celebrated and not shamed!”

Back in April, Schwickerath organized and participated in Iowa’s Nurse-In where participants were asked to cover-up by a Statehouse worker who was concerned that children might see them breastfeeding, Schwickerath reports. She says she remained calm and politely explained their mission with the support of her friends Megan Fairholm and Destiny Nelson. Schwickerath recalls being surprised by the media attention the encounter elicited.

unnamedAn Iowa Department of Administrative Services spokesperson eventually issued an apology that read in part, “The Iowa Department of Administrative Services apologizes for asking women who were breastfeeding in the Iowa Capitol to cover up during a special rally today. The department recognizes it is legal to breastfeed in public places and was in error in asking the women involved to cover up while breastfeeding during the event.”

Despite confrontation during the 2016 Iowa NWNI, Schwickerath says she is already planning for and looking forward to the 2017 nurse-in.

Find out how to get involved with the Nationwide Nurse-In here.

‪#‎PowerToThePeople: An interview with Tamara (Tams) Thompson Moore, CLC

I met Tamara (Tams) Thompson Moore, CLC during my second round of The Lactation Counselor Training Course in May 2015. I was bedazzled by her positive energy that seemed to engulf the classroom. What’s more, she has amazing style and insanely cool penmanship. Her writing looks like typeface! Tams’ day job is in corporate marketing, but she’s passionate about helping families thrive. I’m pleased to share our interview this week on Our Milky Way.

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Source: United States Breastfeeding Committee.

Source: United States Breastfeeding Committee.

Q: How did you become interested in maternal child health?

A: I relocated to Marshall, WI from Chicagoland and was in desperate need of help with my newborn daughter, Jocelyn in 2004. The local WIC agency provided me with some resources for ongoing support, the one that stood out to me was a support group for African American breastfeeding mothers. I joined them and over time, became a peer mentor. My interest grew as I formed close connections with the mothers I met there and as I began to understand more about the parts of our stories that we had in common as well as the differences in our pregnancy, birth, and breastfeeding experiences.

Q: Your day job is in corporate marketing. Does your passion for maternal child health intersect here at all, or are they two different worlds?

A: I would have to say that these are two totally different worlds. I have many, many interests but few passions. While the corporate marketing part of my life gives me a rewarding career, my heart is in helping families thrive.

­Q: What inspired you to take The Lactation Counselor Training Course?

A: Having the opportunity to be a part of a close-knit group as a mother was a life-changing experience for me and motivated me to help the organization when its number of participants fell. I wanted to recruit more mothers but also wanted to assist in providing direct support for mothers who needed help but were unlikely to travel to a health care clinic for a lactation care provider.

Many people who know me well say that I cannot talk about something very long before I start getting the urge to do something about it. Comparing stories I had heard about obstacles to breastfeeding pushed me toward wanting to explore more deeply into statistics among Black African Americans in infant mortality and maternal morbidity. I decided to start my journey into tackling racial disparities in maternal health by gaining more hands on experience in lactation counseling. I had noticed that the Peer Mentor positions with the local WIC agency required the CLC.

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­ Q: How have you been using what you learned in the class?

A: I’ve been using some of what I learned in the class with my clients during prenatal visits in preparing parents to breastfeed their babies and also shortly after birth. I have found that familiarizing parents with methods well before birth really increases their confidence and creates a strong will to continue breastfeeding for a longer duration.

Q: On your Facebook page you write about The Lactation Counselor Training Exam: “There is so much riding on this exam I’m about to take: I believe creating positive change in the community includes the use of my own energy. My hands. My voice. My work. My compassion. My love. Proving that I am competent with a credential doesn’t validate me as an activist, or a person for that matter- but it does seem to make me more visible to those outside of my community. Let me be an instrument of light, peace, hope, and love- but more importantly- let there be ‪#‎PowerToThePeople.” Can you tell me more about what you were feeling when you wrote this?

A: I wrote this thinking about being something like the proverbial sister’s keeper. I saw a need for me to an expand my role not only within the organization but within the community. I observed the ways that mothers were not feeling respected, heard, and served- this drove me to act because the gap between where services are offered and services were needed was blaringly obvious to me. I find myself frustrated with the way healthcare can seem politicized and also how the hierarchy of professionals works like a power structure more than a vehicle toward health equity for all. I felt that my intentions needed to be expressed because I wanted it to be known that I aim to create positive change in the institutions that we use to welcome our future generations in. It’s like that still moment where a group of quiet people hesitate before making a conscious choice to respond. I wanted to break the silence and say “I will.”

Q: How do you network with other birth and lactation professionals in our area? Why is networking important to you?

A: …My networking happens mostly because I am a chatty person, if I’m within earshot of an interesting person, I strike up conversation and we’re exchanging information shortly thereafter. While this is something that I do with everyone, I make a point to encourage Black African Americans and all people of color to consider the lactation profession. With the low amount of diversity among breastfeeding advocates, it’s understandable why there are attitudes among Black African Americans and people of color that breastfeeding is something we don’t do. It’s not normalized because the prominent voices of the narratives aren’t familiar to many of us. I hope that mothers and families who look for advice and services can see mirrors of themselves in providers because lifestyle habits and parenting philosophies that are generational can influence so many things- having providers that understand this concept and can build on that established rapport can be instrumental to success. So many people in African American communities in Wisconsin have been touched by the death of an infant and are getting mixed messages from what they hear and read. Having someone knowledgeable empower them with sound information and practical advice that they can relate to is something we can provide with more CLCs and IBCLCs that are from said communities. I think the prosperity of a community depends on the strengths of its families, therefore the people who serve families have major roles. Proximity matters!

Q:  Please tell me about your doula training with Shafia Monroe.

A: What a life-changing four days that was! Shafia Monroe is more than just a person to me, she symbolizes this resilient spirit of power and ingenuity. She is a champion. The training I received honored the legacy of respected midwives who were pillars before this land was renamed the United States and through the introduction of modern obstetrics. She gave a thorough curriculum of everything I expected like physiology and anatomy but also included cultural aspects that isn’t a component of what the more mainstream certifying organizations offer.

 Q: Please tell me about your involvement with the African American Breastfeeding Alliance.

A: …every 2nd Friday of every month, the circle gathers and I’m always glad to be a part of it. Sometimes the magic happens all on its own when expectant mothers just feel good vibes from nursing mothers and cute little giggles from babies- that’s what makes it priceless. A safe space for sharing, listening, and learning is a powerful thing. I’m also glad to also join forces with the African American Health Network of Dane County in its disease prevention initiative where I will work with mothers who are interested in reducing their child/ren’s risk of diabetes.  

Q: Could you please comment on how you see cultural safety integrated into the work you do and where it needs to be implemented?

A: Cultural safety is not only integrated into the work that I do but also how I live my life. We as people are all prone to forming some type of bias during our lives and it’s very important that we make a conscious decision to reflect on those things that have the potential to influence how we respond to others. I think mindfulness of cultural safety should be a key factor for everyone who works directly with people but unfortunately, that is wishful thinking. Since that is not a realistic expectation, I understand that I have some walls to break down when I work with some people because they are used to being treated with less sensitivity. Sometimes when I explain informed consent in pregnancy and childbirth to clients, the conversation takes turns into other areas where the people realize that they have more options that they realize and can have a more active role in their medical decisions in general. Finding ways to empower people is one way we can reset standards so patients can come to expect that their medical providers will not use language or behavior that is demeaning. There are more studies being published such as ‘It’s The Skin You’re In’ that validate what people of color have been saying for generations, but I hope to see more of the focus on changes on an institutional level rather than more initiatives that focus on what mothers are doing wrong. When we talk about racial disparities in healthcare, there seems to be numerous efforts aimed at how medical consumers need to be more educated or change their habits but not as much attention aimed at eliminating mistreatment and discrimination in clinical settings. We can see billboards that target black African American people to put their babies to sleep on their backs, to participate in cessation programs, and that’s all very good but where are the billboards and public service announcements against being racist at work? The data strongly suggests that it’s happening, but there seems to be less willingness to address it.   

­Q: What is Wisconsin doing really well when it comes to maternal child health? Where do we need to improve?

A: I think Wisconsin’s Birth to Three programs are very beneficial to families. I believe every parent that I have had who participated in those programs had good things to say about the services. I haven’t had personal experience, but I distinctly remember having the school district reach out to me about my little ones who weren’t yet school aged and even childcare providers offer tools for parents to look for key indicators that a child might need screenings. I think early intervention is most important in preventing long term health effects so these are definitely good protocols to follow in my opinion.

I think an area of improvement would be concerning lead testing in Wisconsin. I listened to a public radio show where a local legislator spoke in depth about alarming concerns about lead levels in children found by researchers and it I decided to look into it more. There is a LOT of data, so I can’t share all of it but I will mention that our state is not exactly consistent with the federal regulations set by the CDC for blood lead levels in children and the agencies that intervene are likely missing children who need services because of it. The highest amount of children who tested with elevated blood lead levels are in Milwaukee and Racine. With all that we know about how lead affects the body, parents want to know that our children are not being put at risk. It makes sense to avoid spending millions of dollars on an irreversible health crisis that is linked to behavioral and mental disorders by instead spending funds on eliminating the risks of contamination in the first place- but that is not what’s happening. We shouldn’t have to console ourselves with thoughts about how much worse it is elsewhere or wait for partisan division to end, these children are our future. All of ours. We need more regulations that keep people safe from drinking water that could potentially harm an unborn baby, an infant who feeds on formula, and toddlers whose readings are below the state’s threshold but above the CDC’s.

­ Q: Anything else to add?

A: I have noticed in some conversations that there is a perception that being a lactation counselor and a doula means that I am pro- “natural birth” and anti- formula, so I wanted to address those two things. I recognize that there are very real cultural and institutional pressures that create shame for mothers however, I would suggest that these are not at the core of either; being a doula means supporting the birth that the mother wants- not pushing any personal agenda, just as recommending that mothers offer breastmilk also means that I respect that there are reasons why some do not- bottom line: babies must be fed! I think there is an unfair way maternal choices are hyper scrutinized in our society that assigns guilt needlessly. I think supporting families in reaching their goals is the reward above anything else.

Remembering Lois D.W. Arnold, PhD, MPH, ALC

14481851_10154423867447211_4406283603342166041_oMost of you have already learned of Lois D. W. Arnold’s, PhD, MPH, ALC passing. While our hearts are heavy, we find comfort in the memories we shared with her. Lois’s friends, acquaintances and colleagues have shared these words in her memory.

You can read Dr. Arnold’s professional obituary written by Dr. Karin Cadwell here.

I roomed with Lois during a meeting and though I didn’t know her well we had lots of laughs and good exchange of ideas as we were both so passionate about helping mothers and babies with breastfeeding.

Judith Bole Roepke

I have been in the breastfeeding community since 1973. By then Lois Arnold was already a household name. Our paths crossed at breastfeeding conferences. I knew who she was but I doubt she knew who I was. When I attended a session when she was in the audience I felt I had chosen my session wisely. When I was on the board for the San Jose Mothers’ Milk Bank of Santa Clara County in San Jose California in the early 2000’s we understood how much the work she was doing influenced how we could function.  As a charter member of the Human Milk Banking Association of North America (HMBANA), our standards of processing donated breast milk even then was basis of operation for milk banking organizations. Because of that, even in the days of AIDS and worry about the safety of human milk, we were able to survive as an organization and we were trusted to provide safe milk for the fragile infants we serviced.  When I worked in the mother baby unit and NICU in the mid 2000’s in a hospital in Austin Texas, there was no question of safety of the milk the babies were getting. So many of those fragile infants that thrived to adulthood through the years may not know Lois Arnold’s name, but she likely has a star in her crown for each of them.

Beverly Morgan, IBCLC FILCA

I first came into the lactation world in the early 1980’s, when Lois had already been at work in milk banking for many years. I was in awe of her knowledge and skill.

Lois and I shared a Woods Hole research bond; she had worked at the Marine Biological Lab there for many years as a bench scientist, studying the nervous system of squid and other sea creatures (my husband worked at the neighboring Woods Hole Oceanographic Institution for many years). She often joked that it was wonderful work, dissecting and studying the creatures in the morning, and then cooking them up for lunch! She was incredibly knowledgeable about zoology, and shared many vivid tales, most memorably one about the sex lives of octopus that has scared more than one early adolescent into abstinence.

When I first joined the Healthy Children faculty, I was invited to share a hotel room with Karin Cadwell and Lois Arnold in San Diego during the La Leche League Physician’s conference. It was my first pajama party with such luminaries of lactation. It was love at first site for me with both women. Lois and I lunched together during the conference. After scanning the menu, she tossed it down and declared that she was ordering two desserts, announcing they sounded too good to miss.  Her bravado cinched the deal: I was her fan for life.

Lois was unabashedly Lois. Independent in every sense of the word, she always told it the way she saw it; perspicacity could have been her middle name. A few times I felt the need to interpret her behavior for those not familiar with New England Yankee spirit she embodied: thrifty, a bit gruff, committed to justice for the most vulnerable among us, possessed of a wonderful sense of humor, and an enormous heart that she chose not to wear on her sleeve. She was a treasure, one I’m so honored to have known.

We will all miss Lois dreadfully. May we always remember the brilliance of her mind, the warmth of her heart, and the twinkle in her brilliant eyes!

Cindy Turner-Maffei, MA, ALC, IBCLC

I had the honor of having Dr. Arnold as an instructor for a class I attended at Union Institute and University. I took Human Milk for the Preterm Infant. It was not an easy class by any means but it was one of the classes where I learned the most. Lois pushed me to be a better writer. She pushed me harder because she believed that I could do better. And I came out of that class better for it.

I had many conversations with Lois in email about the non-profit that I am involved with in my hometown. Lois was intrigued by how we operate as we an informal/formal milk bank. While our organization does not pasteurize the donor milk that we get, we do require that our donor moms have lab testing done. Lois was very curious about our protocols and I was happy to share wither more about the organization that I hold very near and dear to my heart.

I enjoyed the class that I had with Lois and my heart breaks for her family as they grieve her passing. She was a great instructor and I am glad that I took her class!

May you rest in peace Lois! Sending much love and prayers to your family.

Brooke Simmons

I met Lois when I took the class for my CLC. Since the class was held in CT, and we both were coming from the Cape, we carpooled. Having no background in maternal health or biology, really no experience except the practical value of breastfeeding both my children, I was eager to learn but also very intimidated by Lois’ towering intelligence. I spent the 3 hour ride asking ignorant questions (probably testing her patience).

Over the next week, as I sat in class, or shared a meal with Lois I also had the good fortune to discover her sense of humor and her generous, true desire to teach.

Julie Allen Hamilton

I have known Lois Arnold since 1992. I was part of the original WellStart team from Illinois. In 1993 I started the dedicated Lactation program at my Hospital. HSHS St. John’s Hospital in Springfield Illinois.

Our Hospital became the 12th hospital in the nation to become Baby Friendly Certified in 1998. We were the first in Illinois.

Lois Arnold used to come to our facility to teach the CLC course. She was knowledgeable, kind, and well received by all the participants over the many years she taught at our hospital.

We will miss her smiles, exciting stories and her love of mothers and their babies.

Janet Tolley RNC-OB, BAN, IBCLC

My memory of Lois comes from her introduction story…..after having her daughter, Katy, Lois found herself having “enough milk to feed an army!” Her sister Hannah, a Pediatric Nurse Practitioner, suggested that she look for a milk bank and Lois found Hawaii Mother’s Milk. At first a donor, she began to drive around Oahu as a volunteer milk collector, Katy on one hip, cooler on the other. The milk bank community provided friendship and an opportunity to blossom that her academic career in zoology never did. She wrote the newsletter, processed milk and took on more and more of the management. Of course her superb intellect became engaged and she enrolled in the MPH program at the University of Hawaii writing every possible paper and doing every possible project on breastfeeding and the wonders of human milk.

Lois sat and passed the first IBCLC exam in 1985 in Georgetown and recertified multiple times. Moving closer to her childhood home, family and friends in the late 1980’s, Lois organized the US and Canadian milk banks (those that hadn’t shut down in the AIDS scare) into the Human Milk Banking Association of North America and became its first volunteer executive director. She tirelessly wrote articles, researched and advocated on behalf of milk banking including convening meetings with the FDA  and OSHA to set the standards for milk banks that have endured until today.

In the 1990s, Lois joined the Healthy Children faculty  and set a goal of teaching in 50 states. One of my favorite memories was teaching with her in Montana one week and driving across Wyoming to teaching in Nebraska the next week. We spent time in Yellowstone where her knowledge of geology, flora and fauna was impressive. She, of course, has planned our trip to the minute to maximize the pleasure of exploring our great country. Lois loved to travel and our trips together to China, Russia, Romania, Cuba, Latvia, Sweden, the UK, Denmark, Egypt and more were always made more fabulous by her thoughtful pre-travel work and post-travel scrapbooks. The Chinese Minister of Health deemed her “The Mother of Milk Banking” and that’s a good description.

Lois’s PhD dissertation on policy related to human milk, asked the question, “where does human milk and milk banking belong in the realm of governmental policy?” She later re-wrote and added to her thesis for the book, Human Milk in the NICU.

As a colleague, we remember Lois as a tireless worker, an intellect of the highest caliber, a teammate. As a teacher, Lois was dedicated to presenting the highest level of evidence and content integrity. As a friend, her consideration and loyalty will always be remembered.

Karin Cadwell, PhD, RN, FAAN, IBCLC, ANLC

I was still pretty new [as a member of the Healthy Children faculty] and trying to figure out all the paperwork- seemed overwhelming at first. Not wanting to admit I was confused I finally asked her a simple question, I think about how she seemed to have a great system of doing daily paperwork. Lois was tickled that the newbie was so interested in her “system”. At dinner we talked about and wrote down a day by day schedule for paperwork, which was really helpful and we had a great “bonding moment”- many more followed.  I had great respect for her accomplishments, I was in the presence of the Mother of modern human milk banking, now I was in the presence of a friend.

Donna Walls, RN, BSN, ICCE, IBCLC, ANLC

Lois was my favorite and most respected professor at UIU. We’d email each other with small talk when I was her student. She told me of her daughter and how she was married to a Navy pilot. I myself was Air Force so we shared that military connection. I was living in Guam at the time and she had lived in Hawaii; both tropical islands surrounded by beautiful seas. Lois pushed me to write the best darn papers I possibly could and to not give anything less than my best! Lois taught me that I was much more capable than I gave myself credit for. She was tough & I loved it!! Lois will be greatly missed. Her legacy will carry on in the world of lactation and within the hearts of so many.

Kirsten Roberts, CLC