We all know breastfeeding is critical for both mothers and babies. Most of us are supporters, advocates, counselors, mothers, grandmothers and just generally breastfeeding cheerleaders! We want to help and sometimes it can be hard to know how to help. In a groundbreaking new article, nine unique elements have been identified as modifiable behaviors that can increase breastfeeding success. We always knew there were things we could do! Now we have clear definitions of what those things are. Truly incredible!
The article was recently published in Acta Paediatrica and you can find it here. The research was an observational study conducted in Masaka, Uganda. It looks at 300 newborns in the postpartum unit as well as 166 infants attending the 6-week postpartum clinic. The research team utilized the Lactation Assessment & Comprehensive Intervention Tool (LAT). A tool chosen because it did not aggregate assessment items and has been validated.
What the research found was that there are nine elements that were significantly related to effective breastfeeding: the infant state and feeding cues pre-feeding, four postitioning elements including tummy-to-mummy, infants arms around the mothers breast, the breast not being held or shaped, and the baby’s head being free of restriction, and three latching elements which include the gape, the baby’s head tilt, and the baby’s lower lip reaching the breast first.
I was delighted to speak briefly with Dr. Anna Blair, the lead author on this remarkable paper to ask her few questions on the research and the findings.
Q: What would you say are the key takeaways from the research?
Dr. Blair: There are certain predicable, easily explained things that parents can do to help their baby breastfeeding effectively, before the baby even touches the breast. We found that having the baby tummy to mummy, for example, really matters. It’s best not to hold the breast. Watch that the head is free of restrictions. There’s been a lot of focus on assessing infants already at the breast, but the pre-feeding behaviors and attaching matter.
Q: Was there anything in the results that surprised you?
Dr Blair: Many of these elements we’ve believed for years – written about in numerous texts by experts – but now we have clear findings from research.
I think it was interesting that the baby’s head being free of restrictions mattered more with the infants in post partum than at the 6 week checkup.
Breasts being held have become such a common practice and this research shows it is negatively associated with effective breastfeeding. I was not surprised by that because there has been some previous research on breast shaping having a negative impact on breastfeeding. But look at the images of people breastfeeding and the instructions from hospitals – they largely include breast holding and shaping , which is so unfortunate.
Q: What has you excited about this research?
Dr. Blair: What we found in this study has easy to follow, straightforward ways to improve breastfeeding effectiveness and feeding and I think that is very exciting.
I hope the article sparks as much excitement for you as it did for me and for the research team. I also hope it sparks lots of conversations in your communities and workplaces around these specific, modifiable behaviors and how it might change our practice and the way we help moms and babies.
Jacopo Tintoretto The Origin of the Milky Way about 1575 Oil on canvas, 149.4 x 168 cm Bought, 1890 NG1313 https://www.nationalgallery.org.uk/paintings/NG1313
“We were thrilled to find that the milk of a Goddess was thought by ancient peoples to be the source of our Galaxy,” Turner-Maffei shares. “This concurs with our view that breastfeeding is a core experience of human life.”
[Jacopo Tintoretto’s beautiful painting, The Origin of the Milky Way, depicts] “the Greek God Zeus (Roman name Jupiter) bringing baby Herakles (Hercules) to suckle at the breast of the sleeping Goddess Hera (Juno), Zeus’s wife. Zeus wants Herakles to receive the milk of a goddess, because it bestows immortal life, and will make Herakles into a god. Zeus anticipates that Hera will not willingly provide her milk to his love child [born to mortal woman Alcmena]. Therefore, he tries to sneak up on her while she is sleeping. However, foreshadowing his adult strength, the baby Herakles attaches forceably to Hera’s breast, awakening her. Hera reacts by pushing the baby off her breast. Her milk spurts forth into the heavens, and creates the stars of what becomes our galaxy, the Milky Way.” (Cadwell & Turner-Maffei, 2004, p. xi)
“The Fontana della Spinacorona is a marble representation of the mythological founder of Naples, the winged siren Parthenope. Legend has it that the siren shot her breast milk onto the flames of the volcano Vesuvius to extinguish the fire. The work bears the Latin inscription Dum Vesevi Syrena Incendia Mulcet: ‘while the siren of Vesuvius calms the flames’…I must point out how absolutely METAL that is!!??? BREASTMILK TO EXTINGUISH THE VOLCANIC FLAMES OF VESUVIUS!!!!…”
She goes on, urging, “Think about that for a minute. We typically think of a postpartum woman as weak, drained, struggling. Here, the nursing mother with fountains of milk shooting from her ample breasts, puts her on par with the gods of the sky and sea. PURE, RAW POWER, que bella!”
Grabosky, Tom. Mothers. 01 Oct 1991. Web. 2024. <https://ark.digitalcommonwealth.org/ark:/50959/8s45wt479>.
Mythology offers powerful and inspiring pieces of lore, but mythsas we have come to know them in modern times, can be powerfully harmful.
This week, Donna Walls RN, BSN, ANLC takes the opportunity to dispel some myths she often encounters in her guest piece titled Breastfeeding Myths and Why They Can Cause Difficulties.
Donna is a frequent contributor to Our Milky Way. You can read her other pieces here.
——
Some breastfeeding myths seem to continue unchecked for decades. It seems no matter how much we teach, preach, beg, educate, cajole and insist, they persist. So, I guess I’m going to take one more swing at setting the record straight and hope we can dispel some of the more common ones.
Myth #1
Some women are just too stressed or ‘high-strung’ to breastfeed. Successful breastfeeding requires relaxation.
Nothing could be further from the truth. We know women have been successfully nursing their babies in highly stressful situations for eons. During times of war, weather disasters, personal crises, physical illness, financial distress, and so on and so on, they continue to make the quantity and quality of milk needed for their babies to thrive.
It would be very difficult for our species to survive if a stressful, anxious situation was all it took for our milk supply to shut down. This applies to widespread situations such as wars as well as individuals’ situations. When a new baby is brought into the family, whether it’s the first or fourth, it’s an adjustment. Changes in lifestyle, activities of daily living , sleep patterns and emotional adjustments…no one escapes without some moments of anxiety. It’s a good thing our bodies are designed to do everything it can to nourish and nurture the next generation.
Truly, prolactin is a wonderful hormone! We know it is responsible for milk production, but it is also actually involved in moderating stress responses in males, females, lactating and non-lactating mammals. In simple terms, it has a stress-reducing, calming effect. Even more amazing is our ability to actually increase our prolactin production in times of acute stress. In one NIH study, the levels of prolactin were significantly increased in women who reported long-term stress and resulting depression. So busting this myth should be easy; not only does stress not reduce milk supply, it can actually increase our levels of milk-producing prolactin and help to calm frayed nerves in the process.
Myth #2
Your milk will “come in” about day 3 or 4 postpartum.
This one could be one of the most harmful, because it’s an all-too-common phrase repeated continuously, everywhere. Unfortunately, new mothers, already worried about not having enough milk, are told this as a routine part of breastfeeding education and can result in mothers becoming discouraged in the first hours and days of breastfeeding. We commonly hear them express their fear of “starving” their newborn. Mothers have milk for the first feeds. We call it colostrum, but it’s milk! They have heard about breasts being so full it hurts, but they don’t see or feel that yet. The perpetuated message is clear but untrue: ‘You really don’t have milk now, but in 3-4 days, your milk will “come in” so don’t worry!’ This confirms moms’ number one concern about not having enough milk.
Truth is, colostrum is produced beginning about halfway through the pregnancy and is present, and designed for, the first feedings. Could it be that because we label it colostrum it is not perceived as milk?
It would be great if we could completely ditch the term “milk coming in”, reassure prenatal and new moms that they DO have milk (albeit called colostrum) available for the first feedings. Could we change our terminology from “milk coming in” to milk changing over to mature milk? Could we change the name of colostrum to “newborn milk” which sends the message that this is indeed milk?
Myth #3
You will need to give up the foods you like while breastfeeding.
While false, the lists of no-no foods can be quite extensive. No spicy foods are usually at the top of the list. It makes you wonder about all those babies in cultures that have curry, garlic, and chili peppers as a staple of their diets. Babies in Italy or Mexico aren’t fussier babies than in America or Sweden. Many years of work by Julie Mennella clearly demonstrates that newborns accommodate to the smells and tastes of their culture through exposure to those smells and tastes in the amniotic fluid. Infants learn to like the foods that are normal in their mother’s diet before they are born!
While we are on the subject of foods, another persistent and incorrect myth is that of the need for the “perfect diet” with extra calories to be able to breastfeed. It doesn’t take a lot of research to look at nursing mothers around the world and realize that successful breastfeeding and healthy infants are not reliant on the perfect diet. Women have breastfed in the most dire of circumstances without negative consequences to their babies. The misinformation stating that lactation requires a significant addition of calories, sometimes as many as 1,500/day, to successfully nourish her infant still persists. This can be discouraging to a new mother, anxious to lose pregnancy weight. I think we have all heard concerns expressed that maybe breastfeeding is not the right choice for those wanting or needing to lose postpartum weight. Again, not true. In reality the current CDC recommendation for calories during lactation are an additional 330-400 calories for maternal health, not for milk production. And remember, it’s not just calories but what foods are recommended. Eating a bag of processed chips gives you calories but does not contribute to better maternal health!
Myth #4
Your breasts are too big…too small. Your nipples are flat…too big…too small.
Oh how we love to judge nipples and of course, make sure the mother understands she does not have breasts or nipples that are perfect for breastfeeding. Then we wonder why women struggle in this culture to breastfeed. Maybe because we work so hard to destroy their confidence even before the newborn goes to breast for the very first time.
Care providers take one look and diagnose flat nipples, rarely considering how they actually function. Anatomy 101 reminder! Nipples are erectile, they stretch when stimulated. So when the baby touches the nipple either with their hands or mouth the nipple erects, some a little, some a lot. Sadly, many women compare their nipples to an artificial teat and worry that theirs is not the same, not quite right. Let’s set the record straight, we have the gold standard nipples, the rubber ones are a pathetic imitation!
And consider human infant feeding compared to other mammals. Many other mammals have long, exaggerated teats designed for the offspring to slurp it in and suckle the teat. Human infants breast feed- not nipple feed. Our offspring open their mouths wide and attach to the breast, not just the nipple. Correct latch involves the baby taking in lots of breast tissue. If they are sucking on just the nipple it will cause discomfort and result in inadequate milk transfer. It makes you wonder why we get so “judgy” about nipples! Let me take a moment to reassure you that babies don’t have a pre-set idea of measurements they want in a nipple. No, they want the one attached to their mother.
Nipples too big? I have seen small premies open wide and attach to nipples deemed “too big”. Did we forget to tell the infant that their mouth was not the right size to nurse? Asymmetric latch, with the baby starting nose to nipple, coming to the breast chin and bottom lip first, then bringing their head forward in an “up and over” motion can work like magic for little ones.
So before we start judging nipples and breasts, branding them not quite right, let’s first remember our number one job is to build the mother’s confidence and support their breastfeeding journey.
Myth #5
Drinking a lot of water will help you make more milk.
Another persistent one and untrue. I still read it in books and see it on well-meaning how-to websites which state that if you’re concerned about your milk supply the answer is easy: drink more water. Sometimes the amount can be more than a gallon a day with frustrating results. These results are spending more time in the bathroom and less time with your baby. Sadly, this shortcut skips asking pertinent questions like:
How often are you nursing? The answer should be 10-12 times/24 hours.
What is the baby’s output? The answer should be at least 4 urinations and 4 stools, with the stools changing color to a golden yellow and the urine a pale yellow, by the fourth postpartum day.
What is the baby’s weight gain pattern? It should be no greater weight loss than 7% in the hospital, no further weight loss by day 5 and regaining to birth weight by 14 days.
Have there been changes in the mother’s breasts? Ideally noticing fuller breasts in late pregnancy and breast becoming rounder, fuller, firmer and heavier as the milk composition changes over to mature milk.
Is the baby latching comfortably? Correct latch facilitates optimum milk transfer.
Shortcut answers like “just drink more water, eat oatmeal cookies, or drink lactation tea” bypass the need for assessment and can ultimately lead to poor outcomes for the newborn. Rather than setting arbitrary amounts of water, encourage mothers to drink enough to quench her thirst. Some research even shows drinking too much water can actually decrease milk production.
Myth #6
Breastfeeding is hard and difficult to learn.
Perhaps the saddest of the myths is that breastfeeding is so hard that your chances of success are really quite low. Breastfeeding is NOT difficult nor is it hard to do. Let me clarify: There can be difficult situations that arise but the vast majority of “problems” are generated by a hospital system or other systemic issues that are not designed to foster successful breastfeeding. Systems that separate mothers and their newborns might be the biggest reason for difficulties. When the newborn is immediately removed for the “experts” to tend to the baby, the message is that we can do a better job of caring for your newborn than you can, not the confidence- building care that supports breastfeeding. When newborns are housed in nurseries and brought out for scheduled feedings, the innate communication between mother and baby is interrupted. This exquisite communication is the foundation of breastfeeding as the newborn signals their needs and the mother’s body responds to provide the nutrition, nurturing and protection all newborns need and deserve.
Other practices that can reduce the chances of successful breastfeeding are:
-not encouraging skin to skin in the first hours and days after birth
-promoting a strict feeding schedule rather than teaching responsive feeding
-covering the newborn’s hands with mittens, denying them the use of their hand-to-mouth activities
-swaddling tightly and restricting their movements
– nursery housing so the mother “can get her rest” rather than talking with her about how to rest and sleep in the first days and weeks after birth
-allowing a brightly lit, noisy environment in the patient room rather than a calming, quiet environment for rest
-not honoring the magical connection between mother and baby
There are many other myths, of course but hopefully, with time, research and education, we can continue to support breastfeeding families with sound, evidence-based information and early and continued support for all families.
Cadwell, K. et al. The Pocket Guide to Lactation Management. Jones and Bartlett Publishers,Inc. Fourth Edition. June, 2021.
CDCAP. CDC.gov. Breastfeeding. Maternal Diet. National Agricultural Library. NAI.USDA.gov
Kent, J. et al. Int. J. Environ. Res. Nipple Pain in Breastfeeding Mothers: Incidence, Causes and TreatmentsPublic Health 2015, 12, 12247-12263; doi:10.3390/ijerph121012247
In May 2016, Stephanie Hutchinson (then Carroll), MBA, BS, IBCLC and a few of her colleagues launched the Appalachian Breastfeeding Network (ABN), “dreaming that one day [Appalachian] parents would have the access to lactation care that they deserve.”
In just one year, the network grew to 11 states and 250 members. By the time the organization was five years-old, the network grew “to over 600 members across all 13 states in Appalachia – and beyond!” Today, ABM “continues to grow in its membership, its capacity, and its visibility.” [Retrieved from: https://www.appalachianbreastfeedingnetwork.org/abn-board.html]
Then
When Our Milky Way first featured Hutchinson in 2017, she said that the exponential growth was not expected, but also not surprising.
“There was absolutely no organization that grouped Appalachia as a culture, together, to make an impact for change,” she said.
and now.
Almost a decade later, Hutchinson serves as the President of ABN and Administrator of their 24-Hour Breastfeeding Hotline. She also works in private practice as the owner of Rainbow Mountain Lactation, is an instructor and administrative assistant/media manager for Lactation Education Consultants.
This year, ABN will host its first cohort of Appalachian LATCH (Lactation at the Center of Healthcare) Leaders which is their train-the trainer program. With grant funding provided by Gallia American Community Fund of the Foundation for Appalachian Ohio (FAO) and the I’m a Child of Appalachia Fund®, they will offer 20 scholarships for registration to the course.
Many years ago, before the birth of her daughters, Hutchinson shared that she never anticipated doing the work she’s been engaged in, but as we often say, “All roads lead to breastfeeding.” Now, reflecting on the most significant change she’s noticed in maternal child health in the last decade, Hutchinson says, “As a member of the LGBTQ+ community, I have noticed more inclusivity in education and support for all families. I am happy to see such wonderful changes to include everyone who is lactating.”
And the most helpful lesson she has learned along the way is to say ‘no’.
“This has probably been my hardest lesson learned, but there is only one of me and I know I cannot do all the things,” she reflects. “It’s okay to refer out to someone else, say no to a speaking gig, not go to every conference possible, and take care of myself. Once I learned this hard lesson, I noticed I am able to give more to my clients and my own family…I know that I am not the lactation consultant for every person and humbling yourself to collaborate with others will help your practice tremendously.”
Photo by Elijah Mears on Unsplash
Looking forward, Hutchinson says: “In 10 years, I hope Appalachian Breastfeeding Network has been able to grow enough to fit more into our budget and reach more parents, especially in those areas with little to no lactation support. It is my vision to duplicate our hotline and make it sustainable and available to anyone, anytime, for as long as possible. On a personal front, I hope to see my kids happy and thriving as adults and live out our empty nester lives.”
Many of our Our Milky Way interviewees launch into their advocacy for
healthy infant feeding after they’ve endured personal situations with their
own babies. This is not Crystal Grask’s, CLC origin story into the world
of breastfeeding though. Now the mother of a darling little one, Grask
serves as a Red Cross volunteer lactation counselor at Naval Base Rota
in Spain, but her road to breastfeeding started before becoming a
mother.
We’re pumped to feature this interview with Grask this week on Our Milky Way.
On discovering her passion for maternal child health…
I had really no insight into maternal child health until I found myself
interviewing for the Communications Coordinator position with the Rocky
Mountain Children’s Health Foundation and Mothers’ Milk Bank. Once I
obtained the role, I started working directly with Laraine Lockhart-
Borman, the then director of the milk bank…her staff… Donor Relations
Coordinators, Certified Lactation Educators, Doulas and more. I found
myself immersed in a totally new world and was soaking up the
knowledge like a sponge. Everyday I learned something new about
breastfeeding, donating human milk, or lactation and the impact these
things have on the mother-baby dyads and the families we served.
As I learned…I found myself becoming more and more passionate about
helping moms, babies and families have successful happy starts in life.
Through the RMCHF and MMB I learned about the the Lactation
Counselor Training Course (LCTC), learned about the importance of
breastfeeding, saw firsthand the impact donating and receiving donor
human milk had on mother-baby dyads and families, and was able to
observe and glean insight into dozens of parents’ feeding journeys
through the Foundation’s programming and milk bank’s weekly Baby
Cafe pregnancy and postpartum moms groups.
On completing the LCTC…
… Life happened, and I was unable to take the course during my tenure
at the [RMCHF], but the passion didn’t go away. It continued to blossom. I moved to Washington State where the course wasn’t offered,
but I remained passionate and steadfast in my desires using my
previous knowledge about breastfeeding/lactation to help providers (OBs
and Pediatricians) communicate with their patients about breastfeeding. I
knew I still wanted to work in this realm, and decided that once I was
able to obtain my CLC certification, I would like to pursue a private
practice.
In 2020, the course became virtual, which allowed me to start my
training! I started in December of 2020, and soon after, we moved to
Spain with the Navy. It was there I finished my training, in June of 2021. I
loved the virtual nature of the training and found – even when I was an
ocean away – I could tune in, interact during office hours, and complete
the course with ease. I really appreciated that!
On her own breastfeeding journey…
Flash forward five years… I found myself breastfeeding my daughter,
Julieanne, and having a rough journey. We started off feeding well,
resolving minor latch issues right off the bat. However, despite having a
small but adequate supply, she struggled to gain weight. Our pediatrician
immediately suggested formula supplementation, and I struggled with
that suggestion. My husband was a huge supporter of breastfeeding,
and also felt like there wasn’t a huge need to supplement. I was able to
reach out to prior colleagues… for observations, but neither of them
could find anything truly amiss. My daughter latches well and has always
been very healthy, but didn’t gain weight well no matter how much or
what we were feeding her. We discovered she has a very high
metabolism and strong passion for eating, so I found myself feeding
round the clock, triple feeding for a few weeks, and eventually settling
into a combo-feeding routine. While it wasn’t my picture perfect image of
how our breastfeeding journey would go, I am proud to say we’re still
largely breastfeeding and she’s gained a significant amount of weight.
Photo by Taylor Marie Photography
I hope to help moms receive the support I lacked in the immediate
postpartum. With consistent help and follow-up observations, perhaps
we wouldn’t have needed to supplement. I want to be that resource for other moms, to help them feel validated, encouraged to meet their goals,
and support them no matter what their feeding choices are.
On landing her volunteer CLC position at the naval base…
One of the first things I noticed after arriving at Naval Base Rota was the
multitude of pregnant women around. We were still living in COVID
times, and I quickly learned while there was support for moms to
breastfeed from a command standpoint, there were not many staff or
programs available to support the station’s breastfeeding dyads either in
hospital or at home postpartum. I knew I could help bridge this gap.
After exploring a few different avenues, I found I was able to sign up with
the Red Cross as a volunteer CLC at the Navy Medicine Readiness and
Training Command Rota (Naval Hospital Rota) Maternal Child Infant
ward! This role gives me the unique opportunity to help moms within
hours after delivering her baby, and help these dyads and families start
their feeding journeys feeling confident and supported.
On a typical day in this role…
I come in, check in with the nurse on duty or head nurse for a rundown
of our patients to learn about their delivery(ies), their baby, their current
health situation, and how feeding has been going thus far. I also ask if
mom/family has presented them with any concerns/questions about
feeding thus far, so I can be as prepared as possible when I first meet
with a mom.
After ensuring I have all the information/resources ready, I go meet with
the mom/baby dyad/ family. While in their room, we talk about how mom
is doing, I meet their new little one, and we go over how their feeling
about feeding thus far. I often provide latch assessments, and observe
feedings while in the room as well. Sometimes, during this, we’ll be in a
more relaxed setting, and mom will ask questions about any concerns
she has for when she goes home, which I answer or refer her to her
provider or the base’s Visiting Nurse if it’s a subject outside of my scope.
Once my initial visit is over, I will make a follow up plan with mom if
desired, then input notes and do any supplemental research for her. At
my follow up visit (usually that day or the next) I will give her any
resources we discussed and provide answers to her questions.
In the LCTC, we focused a lot on listening to mom, hearing her story and
using that, her experience and her health history to guide our
counseling. I think I use that often to meet moms where they are and
give them the care they deserve. I also find I’m teaching the asymmetric
latch often, even to second and third time moms! I also cover hand
expression and storage guidelines often. We get a lot of questions
around pumping and building a stash of milk for returning to work,
especially for active duty moms.
I have also started seeing postpartum patients in the hospital’s OBGYN clinic.
On unique challenges…
Grask at Rota Breastfeeding Week 2023 presenting topics like skin-to-skin and hand expression
I think there is a strong desire to help breastfeeding moms here, but
there is an apparent lack of resources, especially for postpartum moms.
The community has one Visiting Nurse who is a rockstar seeing many
moms daily, but she’s unfortunately the only one able to do so at the
moment. To help bridge this gap, I’ve gained approval to have a small
business, Asbury Breastfeeding Counseling, and am offering my
services to moms in the community in addition to my work as a
volunteer. I’m also working with the Visiting Nurse and hospital MCI
leads to host monthly breastfeeding courses at the hospital, promote the
existing pregnancy and postpartum support groups, and soon will be
offering a BYOBB (Bring Your Own Baby and Breastfeed) class at the
hospital for new moms to learn the various positions they can breastfeed
their babies in and be available to answer any questions/troubleshoot
any feeding/latch issues in person.
We also hosted Rota Breastfeeding Week helping educate the
community here on what is available for new moms and showcasing the
various lactation spaces. We also had a latch on nursing event.
On goals for next year…
Over the next year, I hope to reach more moms and families to help
them feed successfully… I know this community’s resources are slim. I hope to establish these classes and have imparted education to staff so
when I ultimately transition out of this station, I know I am leaving moms
with supportive providers who can help her achieve her goals.
Some favorite breastfeeding stories…
While working at the Mothers’ Milk Bank, I was able to sit in on several
Baby Cafe postpartum support groups. During a few of these groups, I
met a parenting duo and their little one. No matter what they did, this
mom struggled to make enough for her little one, but desperately wanted
to make breastfeeding work. I listened and observed them for weeks,
learning from their interactions as a couple, parents and individuals and
gleaning insights from the [lactation care provider] helping them.
Ultimately, I believe they began to feed with donor milk and formula, but
it was their journey and the persevering passion to help their baby and
family thrive that left an impression on me.
Here in Rota, I have been lucky enough to see a few of the moms I’ve
helped in early days several months postpartum. Two such dyads come
to mind. One was a new mom, baby born a couple weeks early had had
an ample supply of milk. Due to her baby’s early arrival, the baby was
transferred to a Spanish hospital where they received formula instead of
her breast milk. I saw her about five days postpartum and her milk
supply had fully come in but the baby was fussy and struggled to latch.
We worked on several techniques, including skin-to-skin care, cross-
cradle and football holds, asymmetric latch and also discussed ways to
pump/store milk. I was worried as this mom seemed to be ready to give
up quickly, but I ran into her six months postpartum and her once small
baby was now thriving on breast milk! It was a beautiful thing to see and
she is still breastfeeding.
In January, I served the family who had the first baby of the year. The
parents were first time parents, and had no idea what to expect or how
to navigate breastfeeding now their arrival had made her debut. Mom
and I worked on recognizing feeding cues, latching, promoting skin-to-
skin care, using dad for support, and discussed various ways to pump– hand express, manual, double-electric, wearables, to help her build a
supply later on. Soon after I had my own baby, I ran into this mom at a
moms group and found breastfeeding was going well for her! Her little
one was steadily gaining weight and she felt confident in her feeding
routine and encouraged by the support she had received early on. I was
elated at this update and so happy to see them thrive.
Personally, breastfeeding hasn’t been as easy as I’d like, but when I feed
it is the most wonderful, almost indescribable feeling. One of my favorite
stories I have is from my early postpartum days. I had been hanging out
skin-to-skin with her on the couch and accidentally fallen asleep. A little
while later I awoke — to a baby suckling on my breast! I had heard and
known about a baby’s natural instinct to find the breast, but I hadn’t expected her to seek it out and find it on her own when she was so new
to the world. Now she giggles whenever she sees my breast and is
especially excited for boob food time!
CRP also attended the Renaissance Expeditionary Magnet School Back to School Carnival and the Downtown Castle Rock Concert Under the Lights where they set up a lactation station.
Their work is supported by a grant through the Tri-County Health Department. Westover has been working alongside Susan Howk, a breastfeeding policy specialist, to create their policies and lactation spaces through a six-point plan which includes policy, staff and provider training, patient education, environment, evaluation and sustainability, and continuity of care.
The grant has funded things like a chair, end tables, a hospital-grade multi user breast pump and kits, a stuffed animal nursing dog with her puppies for siblings to play with, and a lactation scale for weighted feeds.
Westover displays the breastfeeding friendly employer certificate in March 2022 standing in their first lactation space.
Their lactation space started in one of their smallest exam rooms, but has recently graduated to one of their larger exam rooms, which is now near the end of its renovation. Westover notes that the space also functions for newborn and young baby visits.
Westover reports that CRP owners since November 2021 Drs. Anderson and Bouchillon have been highly supportive of the breastfeeding-friendly changes.
Prior to the implementation of their lactation policies, Westover says their office “was not lactation friendly at all.” She describes stacks of formula in plain view.
“It gave the impression that we were promoting formula,” she comments.
Gift bags for patients were also riddled with formula-promotions, so the team phased out the branded materials and replaced them for non-branded, breastfeeding-friendly items.
Now, Westover and her colleague Sydney Gruenhaupt RN-BSN, CLC see breastfeeding dyads weekly for office visits; whereas they once had to refer out. Of mothers’ main concerns are poor weight gain and uncomfortable or painful latch.
Westover and her colleagues will be out and about again this fall where they’ll craft their lactation tent at events like Oktoberfest and the town of Castle Rock Spooktacular Halloween celebration.
“[It’s] really wonderful because we are able to promote [to] the whole community,” Westover shares.
