Skin to skin in the OR

unnamedNot long after I spoke with Dr. Rebecca Rudesill, MD, CLC for Our Milky Way, she was on her way to perform a planned c-section. Cesarean births, especially without labor, have the potential to cause breastfeeding difficulty. Concerned that I might be disappointed with her response, I reluctantly asked if Dr. Rudesill offered her patients the opportunity to go skin to skin after surgery.

“Of course!” she answered without hesitation. Just like that. No ifs, ands, or buts about it.

The hospital where Dr. Rudesill practices is not Baby-Friendly designated. Even so, Dr. Rudesill makes sure all of her healthy patients have the opportunity for early, uninterrupted skin to skin contact in the OR.

Babies born by c-section with early skin-to-skin care are two times more likely to be exclusively breastfeeding at three to six months, compared to babies who receive routine hospital care. [Retrieved from: http://evidencebasedbirth.com/the-evidence-for-skin-to-skin-care-after-a-cesarean/ ] Skin to skin care is beneficial for all babies, regardless of infant feeding choice.

Like most physicians, Dr. Rudesill received little lactation and breastfeeding education in medical school.

“I remember one question on one test in med school about breastfeeding,” Dr. Rudesill says. “I had no exposure other than basic breast is best messaging.”

Ultimately, when patients came to see her with questions and concerns, Dr. Rudesill couldn’t properly help them. This frustrated her.

So, she attended ABM’s What Every Physician Needs to Know About Breastfeeding. Although the information was sound, Dr. Rudesill searched for more.

Her enthusiasm to help mothers was only deepened when she became a mother herself and struggled with breastfeeding. With better-than-average breastfeeding knowledge and a support system in place, Dr. Rudesill found herself exclusively pumping for a year.

In February 2014, Dr. Rudesill completed The Lactation Counselor Training Course which gave her the practical lactation training she had been looking for. She says she often reminds herself to praise the mother and “meet them where they’re at.”

“It’s about providing support,” she says.

Dr. Rudesill’s patients face most of the same Booby Traps women face across the nation, including the fact that many women haven’t ever seen a mother and child breastfeed.

“When I talk to my patients I say, ‘We wouldn’t expect you to ride a bike if you’ve never seen it done, but we expect you to breastfeed a baby even though you’ve never seen it,’” Dr. Rudesill says of our culture.

As an OB/GYN, Dr. Rudesill cares for women throughout their entire life span.

“I talk to my patients about breastfeeding more than most people,” she laughs.

She includes talk of breastfeeding before her patients become mothers, and after they have been for a while.

“[Breastfeeding] is something that impacts your health for the rest of your life,” she explains.

Her conversations with patients don’t always revolve around breastfeeding, but she hopes that by including it in some, breastfeeding knowledge will percolate through her community.

“Maybe that grandma who hears that breastfeeding [normalizes] the risk for cancer will be more likely to help her daughter breastfeed,” Dr. Rudesill offers an example.

To further help her patients, Dr. Rudesill plans to complete Healthy Children’s Advanced Lactation Consultant (ALC) Certification course alongside her colleague Dr. Kristina Lehman, MD, CLC.

Dr. Rudesill and Dr. Lehman are in the process of creating a pediatric/obstetric collaborative where two breastfeeding support groups will be offered in their community; one with basic breastfeeding information and the other focused on breastfeeding for the working mother.

Additionally, Dr. Rudesill provides lactation and breastfeeding education for residents and her peers.

Despite the important, dedicated work Dr. Rudesill is doing, she acknowledges that culture shifts take time. She explains that nursing education is a key component to changing breastfeeding culture in the hospital, but the budget for nursing education is often limited.

In nearly a decade of work, Dr. Rudesill has witnessed noteworthy changes within maternal child health, like the push to prevent first-time c-sections and prevention of preterm delivery. Positive change within the birth culture will without a doubt influence better breastfeeding outcomes.

“We still have tons of room for growth,” Dr. Rudesill says.

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