Author Archive | Robin Kaplan

An Interview with Catherine Watson Genna

Written by Robin Kaplan, M.Ed., IBCLC, Owner of the San Diego Breastfeeding Center, and Co-editor of Lactation Matters

Over the past year, I have had the pleasure of listening to Catherine Watson Genna speak about the topic of an infant’s use of his/her hands while latching.  I constantly share this new information with the breastfeeding mothers I work with and I have seen it completely transform a nursing session from a ‘battle of wills’ to one where the baby latches with ease and grace.  Here’s hoping this information will do the same for you!

Robin:  How do breastfeeding infants typically use their hands while latching?

Catherine: Babies use their hands to help them locate the nipple and define a nice mouthful of breast. You may notice the baby often finds the nipple with his hands and then starts to suck his hands. At this point, many moms
pull the baby’s hands away and he gets upset, because he knew what he was doing. If you encourage mom to wait a few minutes, the baby will move his hand and latch onto the breast where his hand was a moment before.

Robin: How does this hand use help the baby latch?

Catherine: If the baby’s face is not close enough to the breast to find the nipple by feel with her lips and cheeks, she’ll bring her hands into the action. I’ve also seen babies whose faces were close to the breast, but were not in the exact right spot to latch well, move the breast around with their hands until they got just the right ‘mouthful’ lined up. Some babies even push or pull the breast into their mouths, or shape it like we sometimes teach moms to!

Robin:  What techniques should Lactation Consultants and parents use to help facilitate the baby’s hand use while latching?

Catherine: First off, I like to see what the baby will do if we place him or her skin to skin with mom and encourage mom to lean back so gravity supports baby against her body. Most babies find their way to the breast if they are calm enough. If mom has sore nipples, cuddling baby so her arms encircle and ‘hug’ the breast, and her chin and lips touch just below the nipple, lets her find the breast with her mouth and not her hands. Basically the Lactation Consultant should help the mom see how baby is working toward latching and let baby try unless they are getting frustrated or getting in their own way. Sometimes babies do get caught in a ‘reflex loop’ of sucking their hand, moving away, and then sucking their hands again. Moving the baby slightly so his face touches mom’s breast can interrupt this loop and get the baby to move his hands away and look for the breast with his mouth again.

For more detailed information about this topic, please see Catherine Watson Genna’s article in Clinical Lactation, Facilitating Autonomous Seo Company Infant Hand Use During Breastfeeding.

Catherine Watson Genna has been an IBCLC in private practice in NYC since 1992. She has a special interest in the anatomical, genetic and neurological influences on infant sucking skills, and writes and speaks on these topics. She serves as associate editor of Clinical Lactation. Catherine has performed research using ultrasound and cervical auscultation to study sucking and suck:swallow coordination in infants with ankyloglossia. Her clinical photographs have been published in both lay and scholarly venues. She is the author of Supporting Sucking Skills in Breastfeeding Infants (Jones and Bartlett Publishers, 2008 and 2012) and Selecting and Using Breastfeeding Tools (Hale Publishing, 2009).

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Mother to Mother Peer Support in Penang, Malaysia

Written by Debz Christiansen-Lee and Connie Mooi

Penang, Malaysia is hoping to shake things up!

2011 Dec monthly gathering

At the end of 2007, a group of mothers were encouraged, by a local Lactation Consultant, to take advantage of a free, three-day breastfeeding course, given by WABA. Ten of us took part and gained technical knowledge as well as taking part in practical demonstrations.

We were so empowered by our new found knowledge, and I personally couldn’t work out why everyone didn’t know all this anymore, that we decided to form a group to help inform anyone and everyone who would listen.

Penang MMPS Graduates 2007

We named ourselves MMPS (Mother-to-Mother Peer Supporter) and our first meeting was on March 1, 2008. Since then we have met every month on the first Saturday of the month. This is no mean feat as we all give our time and energy voluntarily. Our passion and determination is what keeps the group going.

These meetings are a chance for pregnant ladies and new mothers to meet, share experiences and ask questions or talk about problems, to be answered by all.

We especially encourage pregnant ladies to attend and join our support system. Our core group contains mothers with training and/or experience. We also have a Lactation Consultant as our medical advisor so we hope we can attend to any issues raised. Once in our network, support and advice can be reached so that new mothers do not feel alienated or overwhelmed. We’ve even made visits to hospital, confinement centres and homes to aid new mothers in latching-on methods and generally making the mother feel her struggles will be worth it.

We have a Facebook site, an email account and a blog. This way we hope ourselves and other mothers can give advice and support in a timelier manner.

Flash Mob

We’ve attended a number of functions, to promote breastfeeding and every year we host a “one-minute simultaneous breastfeeding” event for World Breastfeeding Week (1st to 7th August). In 2011, for WBW we held a “virtual one-minute simultaneous breastfeeding event” via the internet and then later in the year we held a public one.

The reason behind the delay of the public event was that we had been working very hard with the local Government and got backing to launch a new campaign called “Make Penang Breastfeeding Friendly” (MPBF). This has become a parallel, ongoing project, but is one we are proud to know was born from our little MMPS group.

March 2012 Breastfeeding Talk by Dr. Balkees

So what’s the future of MMPS? We hope to continue our monthly gathering and give support to the MPBF project. The most important things for us have always been the same: give information on breastfeeding, offer breastfeeding advice and show support to mothers, mothers-to-be and anyone else who has an open mind(husbands, mothers, mothers-in-law etc).

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The ILCA Conference Scholarship Fund

Written by Glenna Thurston, ILCA Membership Coordinator

San Diego 2011 Conference LT – RT .Cathy Carothers (ILCA Pres) Natalia , Rita , Kathy Parkes (ILCA Treas)

The feeling of being invested in has truly empowered me to move forward in the work that I do.” – Rita Rahayu Omar, BSc, IBCLC, Malaysia

“It was the wind at my back that I needed to overcome all the obstacles in my path.” – Irena Zakarija-Grkovic, MD, IBCLC, Croatia

“I couldn’t believe that other people would make my dream come true.” – Natalia Razakhatskaya, IBCLC, Belarus

These quotes are from some amazing women who are previous ILCA Conference scholarship recipients. Donations from our wonderful ILCA members paved the way for their inspiring and life-changing experiences.

The 2012 Conference is coming up quickly and we want to give as many people as possible the opportunity to attend. If each of ILCA’s more than 6,000 members donated just $5, we could offer over $30,000 in ILCA conference scholarships to women all over the world.

Please take just five minutes today to make a small donation to the ILCA Conference scholarship fund, To make donations, click here  http://www.ilca.org/i4a/ams/amsstore/category.cfm?category_id=17  (If you prefer, you may send a donation to ILCA by check or call 888-452-2478 to donate by phone.) Also, please encourage your colleagues and local Breastfeeding groups to participate in providing this great scholarship opportunity to women like Rita, Irena, and Natalia.

Read below to hear more from scholarship recipients about what the scholarship meant to them.

Thank you,

Glenna Thurston

ILCA Membership Coordinator

“Being a recipient of the ILCA conference scholarship has opened my eyes to the spirit of giving of ILCA members. The humbleness, spirit of sharing, the love, respect of all participants is something I will never forget. In a nutshell, it defines us not just as a professional but as a person. ILCA genuinely cares about the advancement of knowledge. Personally, the feeling of being invested in has truly empowered me to move forward in the work that I do. I believe that when you have people who are willing to help further education, it’s really a blessing…and there will always be a way and you will be lead towards that.” – Rita Rahayu Omar, BSc, IBCLC, Malaysia; 2011 ILCA Conference Scholarship Recipient

“Never before have I felt so special and privileged. It was the wind at my back that I needed to overcome all the obstacles in my path.” – Irena Zakarija-Grkovic, MD, IBCLC, Croatia; 2007 ILCA Conference Scholarship Recipient

“Never hesitate to try such a great opportunity. You deserve it. I couldn’t believe that other people would make my dream come true. I will always appreciate this treasure from my destiny!” – Natallia Razakhatskaya, IBCLC, Belarus; 2011 ILCA Conference Scholarship Recipient

“Given a chance to be at ILCA conference in 2009 made me so grateful and inspired me to initiate more productive programs back in Malaysia. Together with like minded friends we had initiated Malaysian Breastfeeding Peer Counselor program and conducted a Lactation Conference in 2010. These are definitely inspiring more and more breastfeeding programs in our country. Thank you so much.” – Nor Kamariah Mohamad Alwi, Malaysia; 2009 ILCA Conference Scholarship Recipient

“I passed my IBCLC exam in 2011 and now I am working in the private hospital as a LC. It is something completely new and unheard here, a special person for breastfeeding support who is not a nurse, midwife or a doctor. Sometimes it is not easy to help mother-baby dyads even when mothers are very motivated to breastfeed, as many Labor and Delivery practices still need improvement and sometimes they just need more encouragement and support. Now I understand how important for me was the University of California San Diego (UCSD) Medical Center Tour. I have now a picture how all this breastfeeding support works in a large hospital. It helps me a lot when I face challenges on my new job.” – Victoria Nesterova, IBCLC, Ukraine; 2011 ILCA Conference Scholarship Recipient

“My scholarship allowed me to attend my first ICLA conference. I would not have been able to attend otherwise, as my family had had many unexpected expenses due to frequent hospitalization of my husband that year, and the hospital for which I worked was unwilling to support any continuing education activities. The conference helped to reinvigorate me, and get me recharged to go back to do my job with new ideas as well as connect with other IBCLCs, with whom I have been able to keep in contact with. In fact, I no longer work for the non-supportive hospital and have a much more fulfilling job as an outpatient consultant with a free-standing pediatrician and working for a more supportive hospital part-time.” – Pam McArthur, RNC, CCM, IBCLC, USA; 2009 ILCA Conference Scholarship Recipient

“What an honor it was to receive this scholarship.  The conference was so informative; also it was so wonderful to be among all the many other people with a goal of gaining knowledge to help breastfeeding Mothers and Babies.” – Judy Swoboda, RNC, IBCLC, TX, USA; 2010 ILCA Conference Scholarship Recipient

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Clinicians in the Trenches – Wendy Wright

Written by Robin Kaplan, M.Ed., IBCLC, Owner of the San Diego Breastfeeding Center and Co-editor of Lactation Matters

Last month, I had the pleasure of interviewing Wendy Wright, MBA, IBCLC, and owner of Lactation Navigation, a business committed to empowering mothers, babies, and employers by easing the transition from maternity leave to work through education, preparation and communication for all issues related to breastfeeding.

Robin: Wendy, tell us about Lactation Navigation.

Wendy: Lactation Navigation serves to help women return to work without weaning. We provide our support through three primary pathways: (1) directly working with employers on breastfeeding policy and breastfeeding support programs, (2) directly supporting new mothers through teleconference education, on-site return to work classes, pump rentals and free community classes offered monthly and (3) training lactation consultants to assist employers and mothers in their specific geographical areas.  I have also begun to explore the iphone to assist women in their return to work – the pump@work iphone application has been available since 2010 and is selling well in the Apple store. 50% of proceeds from sales are donated to the California Breastfeeding Coalition.

Robin: How did you decide to focus on workplace lactation for your business?

Wendy: I worked in the crazy up and down world of biotech marketing for 20 years before becoming an IBCLC. During my biotech employment, I gave birth and breastfed two great children. Maddy – currently 12, breastfed for 18 months during which time I traveled for approximately 40% of each workweek. Teague – now 5, breastfed for four years during my last biotech position and my return to school for the IBCLC. I always knew I would breastfeed and would never allow work to get in the way. As I met more and more mothers, it became obvious that returning to work without weaning was very difficult for many – priorities are often confused, commitment levels are not built initially and employment rights are misunderstood. Once I became an IBCLC, the choice to focus on workplace nursing was straightforward and there were very few experts available on the topic.

Robin: What can we do in our communities to promote better workplace lactation support?

Wendy: I would encourage each lactation consultant to work with their local hospital to offer a back to work breastfeeding course at a reduced rate or for free. This will give women a place to turn and an opportunity to network with other mothers in their same position. Lactation Consultants will benefit by gaining referrals, networks and potential corporate clients. Also, get involved with your local breastfeeding coalition – when back to work legislation or breaches of policy occur in your area, you can be the local expert to assist and promote the appropriate breastfeeding resources and support.

Robin: Where can a woman find out what her rights are as a working, breastfeeding mother?

Wendy: The National Conference of State Legislators summarizes each states’ current breastfeeding laws, it was last updated in May 2011. Also important to review is the National Fair Labor Standards Act (part of the Affordable Care Act). The Act has been amended to provide rest breaks and space for employees who are nursing mothers to express breast milk. The amendment became effective on March 23, 2010 – and where there may be a conflict between federal and state law on a particular issue, the amendment specifically provides that the federal law does not preempt a state law providing greater protections. This is great news for all American women and babies!

Robin: What is the most rewarding aspect of your business?

Wendy: I love listening to success stories once women have returned to work. I learn something from each experience and then can apply the new understanding to helping more women successfully balance work and breastfeeding.

Wendy Wright, MBA, IBCLC

Wendy spent 15 years in the biotech industry in the Bay Area and worldwide prior to breaking out on her own and founding Lactation Navigation in 2007. Wendy has a B.S. in Health Services Administration from the University of Arizona and an MBA with a Marketing emphasis from the University of Cincinnati. Wendy’s daughter is twelve and her son is five. Both kids love to swim and enjoy bicycling. She is dreadfully fearful of spiders and enjoys spicy food any time of day. Lactation Navigation allows Wendy to combine skills learned in the corporate setting over the past 15 years with her love of breastfeeding. It allows her to spend time with her children and also with new mothers. It also encourages health and happiness for other families, and brings bottom-line profits to progressive companies.

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Using Text Messaging to Support Breastfeeding in WIC

Written by Maryanne Perrin, MBA, Graduate student in Nutrition Science, and ILCA volunteer

Recently, we talked to a private practice IBCLC and several of her clients about using mobile* phone based text messaging to support breastfeeding.  We’re continuing the exploration of this innovative topic by talking to IBCLCs within the Women, Infants and Children (WIC) program about how they use text messaging to help low-income mothers succeed with breastfeeding. (NOTE: WIC provides nutritional support to over 50% of infants born each year in theUnited   States which means that this federally funded program has a unique opportunity to play a significant role in promoting and supporting breastfeeding.)

The American Red Cross WIC office inSan Diego,California and the Shasta County WIC office in Redding,California both recently began using text messaging within their Breastfeeding Peer Counselor (PC) programs. Jennifer Nolan, Peer Counselor Supervisor and IBCLC (American Red Cross), and Sara Stone, Lead Peer Counselor and IBCLC (ShastaCounty), shared their stories with us…

Getting Started

Shasta County WIC PCs

Both WIC offices received federal grant funding which they used to purchase mobile phones for their Peer counselors (PCs).  American Red Cross has 3 people on the peer counseling team and Shasta County has 8.  When a new mother enrolls in the peer counselor service, each office asks the mother about her communication preferences and no one ever initiates text messaging without first receiving the mother’s approval (depending on an individual’s phone plan, they could potentially incur additional expenses for receiving unwanted text messages).

ShastaCounty also had to request a modification to the contacts database so that “text messaging” was an option for tracking contacts. (Note: they only count the text message as a contact if they get a reply from the mother; unreturned texts are not counted.)  Once the database modifications were made, they became available to other California WIC agencies as well, allowing them to track text messaging use.

A lesson learned in Shasta County was the importance of having an effective phone for text messaging.  Initially they got very basic phones for their PCs, but soon upgraded to phones with full keyboards so that the PCs could be efficient in sending texts.

How Text Messaging Is Used

Both Jennifer and Sara stressed that text messaging is never a starting point for building a relationship with a client, but instead a complementary communication method they use after first establishing face-to-face or phone contact. “We get better participation in our program by using a communication mode that is most comfortable for mothers,” says Jennifer.  Sara echoed this sentiment, describing text messaging as a cultural shift that allows WIC PCs to stay better connected with their clients.  Examples of the types of messages exchanged between PC and mother include:

  • Prenatal contacts that involve inviting the mother to classes or scheduling/confirming appointments
  • Sharing tips about baby’s development and checking in during pregnancy to help build rapport
  • Receiving texts from mother while she is in the hospital to learn about baby’s arrival
  • Asking and answering simple breastfeeding questions or scheduling calls to follow-up on more complicated breastfeeding issues
  • Checking in on postpartum status and sending encourage messages

Why Use Text Messaging?

San Diego WIC office

Text messaging is portable (mobile phones are typically with mothers at home, at work, and in the hospital) and also non-invasive (won’t wake a sleeping baby or interrupt someone during an important meeting at work).  One WIC mother, upon receiving a call from her PC, whispered into the phone, “I’m at work, can you please text me?”

Jennifer says that the majority of their clients use text messaging, and she thinks it has the potential to prolong breastfeeding because it keeps mothers engaged and gets them the information they need (a critical mass of WIC data should allow future analysis of this).  ForShastaCounty, “It’s taken off like wildfire,” says Sara.  Text messaging has grown from 7% of their non face-to-face contacts (phone, email or text) in July 2011, to almost 25% as of February 2012.  Sara’s words of advice to other WIC agencies – “Just jump in and do it!”

Are you using text messaging or alternative technologies in creative ways to promote and support breastfeeding within WIC or other settings (e.g. third-world countries)?  If so, we’d love to hear your story!

* Other terms used around the world including cell phone, cellular phone, and hand phone.

By Maryanne Perrin

MBA, Graduate student in Nutrition Science, and ILCA volunteer

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Implications of Obesity in Breastfeeding Women – A Follow-Up

Lactation Matters would like to thank all of our readers who left comments about the Implications of Obesity in Breastfeeding Women article.  Your comments clearly raised some very important issues about how we, as lactation consultants, should use research articles to guide our practices.  Fortuitously one of our guest bloggers, Jennie Bever Babendure, has significant research experience with cellular and animal models of obesity.  She has graciously offered her insight into understanding this research article and its relevance to our practice.  Again, we thank you for your thoughtful comments about this research study and the conversation it helped to create.

 

Response by Jennie Bever Babendure, PhD, IBCLC (email: jennie.bever@gmail.com)

“In light of the advice given to speak with mothers about the impact of a high fat diet on lactation, it’s important to point out that feeding rats high fat chow (which is also higher calorie) is a way researchers induce obesity in rats. This was done 6 weeks before the rats got pregnant, so they were already obese before pregnancy and lactation.

As a result, this study cannot separate the effects of a high fat diet during pregnancy and lactation from the effects of preexisting maternal obesity.  Had the 2 sets of rats consumed the same amount of calories on low or high fat diet, we might be able to draw conclusions about dietary fat’s impact on lactation in rats. However, the rats fed a high fat diet consumed more calories and were obese before they even became pregnant. As such, this study does not provide sufficient evidence to recommend that human mothers consume low fat diets when pregnant or lactating to improve lactation outcomes.

As this study was written for the research community, I don’t think the authors made a point to clarify that they were using high fat feeding primarily to study the impact of obesity, not necessarily dietary fat content, on lactation.  In the interest of evidence-based practice, I felt it was important to make this distinction.  This study doesn’t demonstrate that consuming a diet with a higher percentage of fat during pregnancy and lactation leads to lactation problems in humans, but rather suggests that preexisting diet-induced obesity leads to delayed onset of full lactation, and changes in the mammary gland in rats.”

 

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Implications of Obesity in Breastfeeding Women

Written by Crystal Karges, DTR, CLEC

With the growing concern of obesity in the United States, the implications for breastfeeding women are not completely understood. The frequency of obesity of adult women in the United States, particularly of those women who are considered to be within the reproductive age (20-39 years old), is increasing rapidly. A recent study has analyzed how a high fat diet may alter lactation outcomes, revealing possible complications for mothers who consume high-fat diets during pregnancy or who are overweight or obese.

Several studies have demonstrated the negative effects of obesity on various physiological pathways. Such outcomes resulting from excessive weight gain during pregnancy include increased risk of developing breast cancer, increased birth weights in offspring, augmented probability of developing obesity or metabolic syndrome in their lifetime, development of gestational diabetes, and the possibility of delayed lactogenesis (failure to lactate for more than 72 hours postpartum). This is particularly important for the breastfeeding mother, as delayed onset of lactogenesis has also been correlated with overall shorter duration of breastfeeding. While it has been determined that obesity is a contributing factor to the interference of normal lactation cycles in mothers, the mechanisms within mammary glands that trigger delay of lactogenesis are yet to be understood.

In this recent study by Hernandez et al, the possible mechanisms by which high fat diets effect lactation outcomes were explored on rodent models. These researchers discovered that the mammary glands of rats ingesting a high fat diet had a significant reduction in the number of intact alveolar units within the mammary glands, which are critical for lactogenesis to occur normally. Additionally, it was also concluded from this study that within the mammary gland itself, there was a decline in genes corresponding with the uptake of glucose and development of milk proteins (an essential step for the synthesis of lactose), along with the increase in genes linked with the inflammatory process (a response activated by obesity). Based on these results, authors were able to determine that the consumption of a high-fat diet inhibits the normal functional ability of mammary parenchymal tissue, hindering its capability of manufacturing and secreting milk.

This information would be relevant to discussing with patients/clients in the prenatal period, particularly in encouraging pregnant mothers to consume a relatively low-fat diet with the goal of optimizing initiation and long-term duration of breastfeeding.

How does this information affect your scope of practice as a Lactation Consultant?

To be directed to the original study, please continue reading here.

Citation: Hernandez LL, Grayson BE, Yadav E, Seeley RJ, Horseman ND (2012) High Fat Diet Alters Lactation Outcomes: Possible Involvement of Inflammatory and Serotonergic Pathways. PLoS ONE 7(3): e32598. doi:10.1371/journal.pone.0032598

Crystal Karges, DTR, CLEC

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Can a Change in Pediatric Office Policy Begin to Change the Culture of Infant Feeding?

Written by Jennie Bever Babendure, PhD, IBCLC

In the February issue of Breastfeeding Medicine, Ann M. Witt and her colleagues analyze the impact of integrating lactation consultants into a pediatric practice1.  Although providing referral to or in-office lactation services if requested is not a new idea, what makes this study unique is the systematic change made to schedule ALL breastfeeding newborns with a lactation consultant for their first pediatric office visit.

How did this work?  At the time of the study, the American Academy of Pediatrics (AAP) policy dictated that all healthy term breastfeeding infants be seen at the pediatric office within 3-5 days of hospital discharge2.  In 2009, the study practice changed their policy to routinely schedule these visits with an in-office IBCLC precepted by a physician.  IBCLC’s spent 45-60 minutes with the patient, then discussed the history and breastfeeding evaluation with an available physician who spent about 5 minutes in the room evaluating the patient and deciding on a treatment plan.   Follow up phone calls and in-person visits were scheduled, as well as a routine visit with the primary physician at 2 weeks of age.  More than 45% of patients had multiple visits with a practice IBCLC, and a limited survey indicated high maternal satisfaction with the new policy.  IBCLC’s were employed 4 hours a day 5 days a week in the practice to meet the need for these visits and follow up.  As the physician evaluated the patient at the 3-5 day visit, it was reimbursed as a general medical visit, which sufficiently covered IBCLC salaries.

How did this impact breastfeeding?  In 2007, all infants were seen in the office by 2 weeks of age unless jaundice or weight gain problems were identified in the hospital.  The practice employed an RN, IBCLC 3 days a week to provide phone support for breastfeeding problems as well as in-person consultations.   When researchers compared infant feeding method  in retrospective chart review between 2007 and 2009 patients, they found that non-formula feeding (breastfeeding) went up by 10-15% at all time points from 2-9 months, demonstrating a significant increase in breastfeeding intensity following the intervention.

When I first read this study, I was struck by the brilliant simplicity of this idea.  By integrating lactation consultants into the existing medical structure, mothers and babies got automatic breastfeeding help and follow-up, and physicians could follow AAP policy and monitor jaundice and weight gain as well have a large influence on the on-going health of their patients with minimal input of time or cost and no additional formal training.  As I continued to think about this study, I realized that this policy has a much broader impact.  By making this systematic change to their office policy, they have changed the culture of infant feeding in their practice.  Routinely scheduling the first office visit with an IBCLC sends a strong message to patients.  It says:  “Your physicians know you want to breastfeed, and feel breastfeeding is so important to your child’s health that we will do everything we can to help you through the challenges.”

I can’t help but imagine the impact if all pediatric practices were to adopt this model.  Would these actions speak louder than our words?  Would they whisper or shout: Breastfeeding is a public health issue3, we’re here to help you make it happen.

1.  Witt AM SS, Mason MJ, Flocke SA., Source1 Department of Family Medicine CWRU, Cleveland, Ohio. Integrating routine lactation consultant support into a pediatric practice. Breastfeeding Medicine 2012;7(1):38-42.

2.  BREASTFEEDING SO. Breastfeeding and the Use of Human Milk. Pediatrics 2005;115(2):496-506.

3.  BREASTFEEDING SO. Breastfeeding and the Use of Human Milk. Pediatrics 2012;129(3):e827-e841.

Jennie Bever Babendure, PhD, IBCLC

I am a mother of 2 active boys and an Assistant Research Professor in the College of Nursing and Health Innovation at Arizona State University. As breastfeeding researcher, I am constantly scanning the literature for articles that guide my research and inform my clinical practice. One of my goals is to increase the evidence base of our profession as lactation consultants. I feel it is important for lactation professionals to be aware of and contribute to breastfeeding research, especially when so much of it is fascinating! As an ongoing contributor to Lactation Matters, it is my hope that you will find the articles I highlight as interesting and informative as I do, and that you will use them to guide you in the important work of lactation professionals and breastfeeding advocates.

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What Private Practice Lactation Consultants Do For Fun!

Written by Robin Kaplan, M.Ed., IBCLC, Owner of the San Diego Breastfeeding Center, and Co-editor of Lactation Matters

Four and a half years ago, I attended my first International Lactation Consultant Association (ILCA) conference in Las Vegas.  I was a lactation educator and had just enrolled in the University of California San Diego (UCSD) Lactation Consultant program, to start that upcoming fall.  As a non-RN in San Diego, CA, I knew I would have to start my own private practice once I was board-certified, but had absolutely NO idea how I was going to accomplish that, or even where to begin.  Glancing through the agenda, I stumbled upon the title: Special Interest Group: Lactation Consultants in Private Practice.  Attending that session truly changed my life, both professionally and personally.  It was there that I found camaraderie and first heard about the Lactation Consultant in Private Practice (LCinPP) workshop.

The LCinPP conference takes place every February in Philadelphia, PA.  It was first started in 1988, by Kay Hoover and Chris Mulford, to provide support for the private practice lactation consultant.  Over the past 24 years it has grown considerably, welcoming newcomers, advanced practitioners, and experts alike, from all over the world, to learn, discuss, and share about private practice life.  And, wow, do these ladies know to have fun!

The 2012 LCinPP conference

An ecstatic buzz was in the air as the LCinPP conference began on Friday night.  Old friends embraced as newcomers introduced themselves to one another.  Shrieks of laughter could be heard throughout the atrium of the hotel.  We eventually settled into ice breakers and the ever-popular slide show of photos of our offices, clinics, messy desks, and car trunks stuffed to the brim with in-home consultation supplies.  We also enjoyed a beautiful cake honoring all we do for mothers and babies!

Saturday and Sunday’s agendas included an array of clinical sessions and ‘down and dirty’ private practice How-To’s.  The list of speakers looked like a ‘Who’s Who’ in lactation: Catherine Watson Genna, Liz Brooks, Kay Hoover, and Diane Wiessinger to just name a few.  We learned about the Breastfeeding Center for Greater Washington, an incredible community resource in Washington D.C., run by Pat Shelly.  Diana Cassar-Uhl shared her knowledge about breastfeeding and hypoplasia.  That is just to mention a few!

At lunch both days, some of us engaged in table conversations on topics such as electronic charting, starting a non-profit, and social media.  Others shared stories with their colleagues and caught up with friends.  Saturday night most of us ventured into the city to indulge in a bit of Philadelphia’s finest restaurants.  Our group’s final stop was a candy store, called Shane Confectionary, which was intricately decorated like an old apothecary shop, lined with glass jars filled with every candy imaginable!  It was so easy to stay true to our Nestle ban!

While the education and information shared at the LCinPP conference was top quality, the ONE thing that completely sets this conference apart from the others is its intimate nature.  As a new IBCLC, I admit to being somewhat intimidated by the sages in our profession.  I mean, what can I possibly offer to or share with them that they don’t already know?  Amazingly, this is not the case, nor the feel, at LCinPP.  Throughout the conference, you will find lactation consultants who have practiced for 20 years sitting next to and sharing stories with brand new IBCLCs.  Experts in our field will spend an hour learning about Facebook from the newest social media guru in our practice.  There is a sense that we are all here for the same reason: to learn from one another, both clinically and professionally , so that we can better serve the mothers and babies we see every day.   And it’s never much of a surprise to see these ladies let loose and throw their bras around the conference room!  I can’t wait to go back next February!

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Why Beyonce Nursing in Public is So Significant

Written by Robin Kaplan, M.Ed., IBCLC, Owner of San Diego Breastfeeding Center and Co-Editor of Lactation Matters

Last week I came across an extremely well-written article by Kimberly Seals Allers of MochaManual.com, called Dear White Women: Beyonce is OUR Breastfeeding Moment. Please Step Aside.  In her article, Kimberly discussed her disappointment with the media coverage of Beyonce, one of the most iconic and popular African American women at this current time, nursing in public.  While this was a wonderful moment for all breastfeeding advocates, it truly was a significant event for African American women, who have statistically had low breastfeeding initiation and duration rates.  Here is my interview with Kimberly Sears Allers.

Kimberly Seals Allers and her children

Robin: Why is Beyonce breastfeeding in public so significant for the African American community?

Kimberly: Beyonce breastfeeding in public is particularly significant for our community because we just haven’t had as many high profile African American celebrities come out and support breastfeeding. Like it or not, role models matter. Celebrities can help create a lifestyle cache and trendiness, particularly among young women, that helps broaden our ideas about who breastfeeds in the black community. When you look at the high infant mortality rate among African American infants, and we know how critical breastfeeding is to saving these babies lives and reducing their risks of respiratory infections and childhood obesity, the possibly the power of one highly-visible black celebrity breastfeeding could potentially save one more infant, and help one more baby become a healthier child is significant beyond words for me.

Robin: In your opinion, how could this media event been covered more appropriately?

Kimberly: For years I have been writing that black mothers are absent from the mainstream “mommy” conversation in this country and it seems our invisibility has carried over with this instance. The media was, for the most part, negligent by not connecting the dots between Beyonce as a black woman breastfeeding an African American child–both of whom are statistically less likely to breastfeed or be breastfed, and highlighting the particular significance for black women who have had historically low breastfeeding rates for over 40 years. This was also a rare, and unfortunately missed, opportunity for those who speak for the breastfeeding movement to connect those dots for them and millions of others. When we have the opportunity for a national microphone, I believe we have to hold our own leaders and the media accountable for thinking about all the issues and looking at these news events from all angles.

Robin: How can lactation consultants better support African American breastfeeding women in our communities?

Kimberly: The most important thing is to understand the cultural nuances of breastfeeding for an African American woman. Breastfeeding is not about simplistic messaging that breast is best; we know that and want that. But many of us are first generation breastfeeders with little or no multi-generational support. Help us with the how. Studies show that our male partners, grandmas, aunties and extended family members have a greater influence on our decision and breastfeeding duration than other women… so target the whole family. Understand the power of media stereotypes, our own internal stereotypes about who breastfeeds in our community, the residual effects of our breastfeeding experiences during slavery, and the role of aggressive infant formula marketing. Educate us so that when our mother or grandmother question if the baby is getting enough, we have an educated answer. Empower us to have more confidence in our bodies and our ability to “do this” even if, and especially if, we don’t have much social support. Having a broader understanding of what this woman is dealing with, beyond the latch issue, a lactation consultant may actually be there to assist, which can mean so much in terms of true support.

Robin: Now, please tell us all about your new project, Black Breastfeeding 360°.

Kimberly: I’m so excited about this! For years, I’ve been frustrated by the superficial news coverage of breastfeeding issues in our community. There is always reporting of the low statistics, with little or no insight into the complexities I previously mentioned or the lack of role models or the lack of social support. So I created Black Breastfeeding 360° as an online content library for media professionals to get everything they need to know on the full spectrum of the black breastfeeding experience. And I created BB360° as a place for women, mothers, and fathers to learn, share and hear the breastfeeding experiences of others. BB360° features articles and commentaries that any media outlet can use for research or download for free use in their publication.  It features audio and video clips of real mothers, fathers and grandparents talking about their true thoughts and feelings about breastfeeding, and it features practical tips and resources specifically written for any black woman nursing her child or even thinking about it. I was supported to create BB360° through my Food & Community Fellowship with the Institute of Agriculture and Trade Policy, funded by the Kellogg Foundation, and I’m so grateful. It’s my baby and I’m breastfeeding it, so I know it will be healthy and robust.

Kimberly Seals Allers is a leading voice on African American motherhood,  author of The Mocha Manual™ series of books and founder of www.MochaManual.com, a parenting and lifestyle destination and blog for African American moms and moms-to-be. An award-winning journalist, Kimberly is also a popular public speaker and consultant on the mom of color market, and fiercely committed to reducing the high infant and maternal mortality rates and increasing the low breastfeeding rates in the African American community.

In 2011, Kimberly was named an IATP Food and Community Fellow, funded by the Kellogg Foundation, with a mandate to increase awareness and reducing the barriers to access to “the first food”—breast milk, in vulnerable communities.

In addition to her popular blog on MochaManual.com, Kimberly blogs about the African American parenting experience for Babycenter’s Momformation.com and is a regular commentator for Essence.com and LiftetimeMoms.com.

Her first book, The Mocha Manual to a Fabulous Pregnancy (Amistad/HarperCollins) a hip, funny and informative pregnancy guidebook for women of color, put her on the map as a pregnancy and parenting expert with real-deal insights. The book was nominated for an NAACP Image Award and later turned into The Mocha Manual to a Fabulous Pregnancy DVD, available at Walmart.com. Her book series also includes The Mocha Manual to Turning Your Passion into Profit, and The Mocha Manual to Military Life—A Savvy Guide for Girlfriends, Wives and Female Service Members.

A graduate of New York University and Columbia University Graduate School of Journalism, Kimberly is a divorced mom of two who lives in Queens, New York.

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