Not long ago, Lillian Scott, MS, CCC-SLP, CLC, a Speech Language Pathologist at Baptist Health in Lexington, Ky., saw a mother and her four month old baby for feeding difficulties including maternal breast and nipple pain. Scott reports that the mother sought out help from other community lactation specialists; still, her pain continued.
“It came as a challenge to me,” Scott begins. If this mother has already sought out information and support, why does she still have lesions on her breasts? She wondered.
Ultimately, Scott discovered that the baby latched shallowly onto the breast, so she worked with the couplet to find a more comfortable position. In the meantime, Scott knew she needed to tend to the mother’s sores; that’s when she consulted a specialist from the wound care team at Baptist. The wound specialist suggested the mother keep the lesions moist, rather than attempt to keep them mostly dry as she had been doing. Eventually the mother healed, and she and her baby went on to breastfeed comfortably.
Scott’s recollection exemplifies wonderfully the importance of creative problem solving, collaboration and interdisciplinary teamwork within maternal child health care, all methods Scott has embraced in her journey to serve families.
Before becoming interested in lactation and breastfeeding, Scott was a special education teacher where she focused on the various needs of children when things don’t go as planned in school. When she became a speech pathologist and transitioned to work in the NICU with Amber Valentine, MS, CCC-SLP, BCS-S, IBCLC as her mentor, she started to question infant feeding methods for fragile babies and mothers when things don’t go as planned after birth.
Her work today focuses on helping Baptist Health transform and evolve its NICU to reflect the latest evidence in health care improvement, like adopting a team-based and allied health approach.
Scott often consults research coming out of The University of North Carolina at Chapel Hill and follows the work of Louisa Ferrara, a pediatric speech and swallowing disorder specialist at Winthrop University Hospital.
She works to change NICU culture by engaging in positive conversations with her co-workers and sharing education opportunities.
Scott presented at ROSE’s 6th Annual Breastfeeding Summit: Health Equity Through Breastfeeding, where she reviewed the challenges presented when mothers and babies endure traumatic separation after birth. She talked about what to do when breastfeeding isn’t appropriate due to babies’ skill level. Skin-to-skin is almost always first on the list, because it regulates body temperature and respiration rates, naturally sedates mother and child, among a slew of other benefits.
When babies advance and begin to show feeding cues but still might not be able to sustain a full feed, recreational nursing– where baby engages in non-nutritive sucking– is encouraged. Mothers then pump to ‘empty’ the breast. This practice allows bonding between mother and child to continue, and prompts mothers’ bodies to continue to produce milk.
As baby continues to rehabilitate and demonstrates readiness to breastfeed entirely, usually sometime between 32 and 37 weeks gestation when the the suck-swallow-breath pattern and respiratory stability begin to mature, Scott encourages more frequent feedings.
After completing The Lactation Counselor Training Course, Scott says she gained new perspective on feeding difficulties. While her work once focused on the infant, Scott says she gained appreciation for understanding the mother too.
“I was mind-blown all week,” she says. “Why didn’t I have this education before?”
As she works toward becoming an IBCLC, Scott completed The Milk Mob Community Breastfeeding Supporter training.
“I love The Milk Mob and having access to the resources to better help my clients,” she says.
Scott also celebrates inclusion in her practice as an Ally to the LGBTQ community, officially credentialed through OutCare Health, a nonprofit dedicated to providing cultural knowledge to medical and other care providers. Tomorrow, Scott will present about breastfeeding at the University of Louisville which will be recorded and included on OutCare Health’s website as part of its evolving health certificate.
In March 2018, Scott and colleagues will present about breast wound care at a state language pathology conference.