Building a CLC village


Columbus Nationwide Children’s Hospital in Columbus, Ohio has rapidly grown its tribe of lactation care providers with the leadership of NICU lactation educator Stacy Notestine, RN, BSN, IBCLC.

Source: United States Breastfeeding Committee. (Photo by Sara D. Davis)

Three years ago, Notestine and colleagues formed a program modeled after Children’s Hospital of Philadelphia’s (CHOP) lactation program.  The program was designed to be an additional resource to the IBCLC Lactation Team and for the NICU staff to support breastfeeding efforts in the NICU, Notestine explains. Notestine, who oversees the lactation education for more than 800 staff members across the Nationwide Children’s NICU service line, created an eight-hour CE course called Breastfeeding 201: Promoting Breast Milk & Breastfeeding Success. Once completed, participants become known as “NICU Breastfeeding Super Users.”

Six nurses attended their first meeting on main campus in October 2015. Today, there are more than 100 Super Users at Nationwide’s main campus and more than 200 Super Users across the six NICUs in the community.

Over the past three years, Nationwide NICU administration has supported the initiative to grow the number of NICU CLCs and has provided CLC financial scholarship support for NICU nurses to attend the Lactation Counselor Training Course (LCTC). On main campus, NICU nurses receive additional certification pay once they have obtained the CLC credential. Continuing to grow, there are currently 36 NICU nurse CLCs and more NICU nurses are signed up for the upcoming spring LCTC in Columbus.

“The momentum and initiative to continue to grow our CLC NICU village is alive and well in all…of our Nationwide Children’s NICUs,” Notestine says.  “It has been great because the value of this initiative has been fully embraced by administration and the unit managers.”

Notestine admits that taking on her role as educator has been an exciting but challenging one.

“It’s been a tremendous amount of work, but the benefits are paying off,” she explains. “I’m really proud of what we’ve created.”

Not only do families benefit from a host of lactation care providers, but NICU staff have reported increased knowledge and higher self-confidence in their ability to serve families.

Notestine attributes this in part to the accessibility of CLCs. She says it is easier and more efficient for fellow nurses to interact with one another as opposed to having to often wait and consult with a different team of providers, like the well-baby lactation team that is often busy on the well-baby units. Nationwide hosts monthly breastfeeding meetings to foster collaboration and clear communication between all lactation care providers.

Concentrating lactation care within the NICU allows those who have been working with families at the bedside to better personalize their care.

Notestine jokes that thanks to many years of clinical lactation experience she “could probably get a rock to latch”, but says her influence is nothing compared to the NICU nurses who have established intimate and supportive relationships with NICU families day in and day out.

She tells this story as a testament to CLCs’ impact: While working a weekend evening shift when the lactation team was not available, one Nationwide CLC counseled a mother of a 34 weeker who was ready to quit pumping. The mother went on to eventually successfully breastfeed, and the baby was discharged from the NICU exclusively breast milk fed.

“Had it not been for the positive impact of that CLC, who knows if that would have happened,” Notestine comments. “The knowledge and availability of the bedside CLC is so valuable to our NICU population!”

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