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We need your INTERNATIONAL perspective!

Written by Amber McCann, IBCLC

In my few short weeks as the new co-editor of Lactation Matters, I have skidded right smack dab into a wall…the wall of realization that my perspective on our profession is overwhelmingly American.  Of course, this is understandable as I was born in a small farming community right smack dab in Middle America.  But, I desire to have a global perspective…to understand just how different life can be for mothers on the other side of the world.  And how similar.

Photo by Tareq Salahuddin via Flickr

So, we need YOU!  This blog is for all of us, IBCLCs from the United States and from Australia and from Japan and from South Africa and from Ireland…and everywhere in between.

We need your STORIES.

We need your PERSPECTIVE.

We need your LEADS to innovative people who are making a difference.

If you know of someone or something that needs profiled here, please comment with how we might get in touch with you.  If there is breaking news in your country, let us know.  If you know of research being conducted or published in your part of the world, reach out so that we can include it here.

I am proud to be an INTERNATIONAL Board Certified Lactation Consultant.  Help us make this blog international as well.

Amber McCann, IBCLC

Amber McCann, IBCLC is a  board certified lactation consultant in private practice with Nourish Breastfeeding Support, just outside if Washington, DC and the co-editor of this blog.  She is particularly interested in connecting with mothers through social media channels and teaching others in her profession to do the same.  In addition to her work here, she has written for a number of other breastfeeding support blogs including The Leaky Boob and Best for Babes and served on the Communications Team for GOLD Conference . When she’s not furiously composing tweets (follow her at@iamambermccann) or updating her Facebook page, she’s probably snuggling with one of her three children or watching terrible reality TV. 

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Clinicians in the Trenches: Kathleen Stahl, RN, IBCLC

I would like to introduce you to Kathleen Stahl, an RN and IBCLC from the Annapolis/Baltimore area.  I first met Kathleen at a local educational meeting and have since had several conversations with her about her unique perspective on breastfeeding support.  As a NICU IBCLC in a hospital that primarily sees an underserved population and with a private practice in a particularly wealthy area, she sees a wide range of perspectives on breastfeeding support.

Can you describe a typical day in your current hospital job?

I work as a lactation consultant in the NICU of a large, Baltimore hospital.  Most of the babies that I see in the NICU are very premature and may not feed by mouth for several weeks or more so, in working with them, I support moms in pumping.  I touch base with any moms who are coming in for feedings but many aren’t able due to transportation issues. I will follow up with moms who are still admitted to the hospital, making sure everything is going well and that they have a breast pump for discharge home. I will also see anyone who is on bed rest prenatally that is high risk to talk about the value of breastfeeding.  I also do consults in the NICU during the day for the babies that are starting to go to breast.

In addition, I do follow up phone calls to track our breastfeeding in the NICU at 1 week, 2 weeks, 6 weeks, 3 months, and 6 months and provide outpatient support as we frequently have preemies going home that are not consistently feeding well at breast and will need to have supplemental expressed milk.  The outpatient consult also gives the mother the confidence and reassurance she needs to wean off of breast milk supplementation to exclusive breastfeeding.  I have found that in this particular NICU setting, private outpatient consultation has been more successful than breastfeeding support group once the babies are  discharged.  Mothers can schedule the time to come in when it works for them. While all the mothers have phones, many do not have cars or computers, so finding the best mode of communication for each mom is vital.

The majority of the time I spend educating mothers on the value of breastfeeding.  It is a very scary and stressful time for these mothers with babies in an intensive care unit.  They are afraid to touch and hold their babies and they are fearful of the monitors.  I spend alot of time just building relationships of trust with them so they feel comfortable talking with me about their breastfeeding concerns.  Since the parents watch the nurses with wide eyes as they measure everything that goes in and out of their babies, it is difficult to get the parents to have the confidence while breastfeeding when they cannot measure exactly how much is going in to the baby.

In the NICU, the challenge is mother and infant separation.  Ideally, I would like to see both parents be able to stay comfortably with their babies.  I feel that there is room for more parent education that would make them more comfortable to help in the care of their babies. The NICU is very intimidating with all of the wires that are attached to the babies and the monitor alarms going off.  It makes parents and family members/visitors very nervous. NICU is a very scary time for families.  It is important in my role to educate and try to help the parents be at ease with their baby.

How does your hospital work contrast with your role in private practitioner?

Many of the mothers who have premature babies where I work have not even considered breastfeeding. Many of the pregnancies are not planned. Formula feeding/bottlefeeding is the cultural norm. They are shell shocked to have just given birth to a baby that weighs a little over a pound.  They may not have even planned to breastfeed but just spoke with a neonatologist that told them that breast milk can help save their baby’s life.  Often times there is a cultural barrier…all they know is bottle feeding.  They are afraid of people seeing their breasts and most have had very little prenatal care or none at all.  Due to economic barriers, they come at most once a day and stay for about an hour or two and leave. Some are just stressed from the dire circumstances of their baby’s health and the stress can impede their milk supply.  I spend most of my time talking parents into breastfeeding and how wonderful it is not just for the baby but for them.  Many of these patients have economic stressors like one mother I supported who was back to work 2 weeks after giving birth at a local fast food chain.  Many mothers are single parents and many have poor family support.

Contrast that with the mothers I see in my private practice who want to breastfeed. They have already been educated about the value of breastfeeding not only for the baby but for themselves.  They know they will have a healthier baby and many do not want formula to ever touch their baby’s lips. Many of these parents were breastfed as infants and see formula feeding as a failure. These parents would gladly pump or stand on their heads to breastfeed. These parents are usually higher-income, higher-educated people who have taken the classes and had the prenatal care.  They are usually committed couples who do not have many economic stressors.  Most also don’t have the stressor of an extremely ill child.  These parents have invited me in to assist with their breastfeeding relationship of a healthy child.

These groups are as different as night and day.  Most mothers in the NICU will pump once they are informed of the benefits of human milk for their sick babies.  But they have many social and economic barriers that cause additional stressors to the mother and infant dyad.  Where as in my private practice, there are many fewer barriers to breastfeeding.  These mothers have plenty of support and they see breastfeeding as the cultural/desired norm.

What are the unique challenges of each of these kinds of work?

I wish I could do more for these mothers.  A single mother who has 5 children at home giving birth to a 28 weeker, and her car breaks down…I wish I could find a way to fix her car! Talk about stress and socio-economic factors!  Also, the father of the baby is not involved. How do I meet her needs? Need I say more?  My heart breaks for the disadvantaged families here.

The rewards of seeing healthy babies going out the door.  That is a huge reward!  The biggest reward is the great big smile on a mother’s face when she can tell that the baby is nursing well. Often times, NICU mothers have a hard time exclusive breastfeeding when they go home because they still have to supplement and because they don’t trust that the baby will get enough.  I do test weights so the parents can see what baby is getting.  I have had a mom of twins that is now exclusively breastfeeding because she was coming in for outpatient consults after her babies were in the NICU.  That has been a very rewarding experience for her and me.

I have to say that my private practice support group recharges my soul when I get discouraged working in the NICU.  Those mothers and babies in the NICU have so much working against them, separation, sick baby, having to pump, stress, stress stress.  Nurses that are used to measuring everything going in and going out that are unsure of breastfeeding and inadvertently say the wrong things…parents that stop pumping or don’t want to put baby to breast and I feel like I have failed them…like I have let them down. Then I go to my mother’s support group and look at the 2 year old that is still nursing whose mommy told me he was a failure to thrive 20 months before.  I am encouraged how we worked together and he is a beautiful happy breastfeeding boy!  Or the mom that says she is thinking of weaning and at the end of group says, “Nope, we’re not ready yet”.  I have moms of newborns that are having melt downs and another mother puts her arm around her and tells her not to give up.  I have hope for the next day.

Annapolis Breastfeeding Care,LLC, was formed in January of 2008 by Kathleen Stahl, recognizing the needs of women and infants with the desire to receive services in the privacy and comfort of their own home.  Kathleen provides private home consultations, breastfeeding classes, pump rentals, sales and breastfeeding accessories.  Kathleen has been a registered nurse since 1994 and an International Board Certified Lactation Consultant since 1999.

After years of working in Labor and Delivery, Kathleen decided to dedicate her nursing skills to helping mothers breastfeed.  Kathleen is a strong believer in the many benefits which breastfeeding provides for both mother and baby, and after almost 10 years of working in Lactation departments, helping mothers and listening to their struggles and concerns (and having had two kids of her own!), Kathleen realized that having to travel back and forth to the hospital with a newborn added unnecessary stress to new mothers.  So, in January of 2008 Kathleen started Annapolis Breastfeeding Care, LLC, which offers a wide array of lactation consulting services, geared towards bringing quality lactation services and products to the comfort of one’s home.

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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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Breastfeeding and the Working Mother

Written by Diana Cassar-Uhl, IBCLC and La Leche League Leader

We know what the studies say:  mothers who have to separate from their infants to return to the workplace are statistically less successful  (Johnson & Esposito, 2007) at meeting the goal recommended by child health promotion organizations around the globe:  exclusive breastfeeding until around the middle of the baby’s first year, thereafter supplemented with nutritionally sound, complimentary foods while breastfeeding continues through the child’s second year or beyond (World Health Organization, 2002).

This is not a significant issue for IBCLCs outside the United States, in nations where paid maternity leave is normal and expected after a mother has a baby; however, IBCLCs in the U. S. will likely find themselves in the position to counsel and assist mothers who wish to maintain a breastfeeding relationship with their infants after a return to work or school.  Reminding a mother that many mothers before her have been successful in continuing to breastfeed after regular separations from their babies and providing practical suggestions can be valuable.

Direct breastfeeding is best for mother and baby.

This is always my first tenet of support when I’m helping a mother who has to separate from her baby.  Is there any way for the mother to spend more time in her baby’s presence?

  • Can maternity leave be extended, or can the mother return to work on a gradual/partial basis (for example, half days; or back 2 days the first week, 3 days the 2nd week, and so on)?
  • Can the baby be brought to work with his mother?  There are workplaces that have experimented with this option and found it to be a win-win alternative.  The Parenting in the Workplace Institute offers some details.
  • Is the daycare on-site or close enough to mother’s workplace that she can breastfeed her baby during her lunch or other breaks?  Keep in mind that Federal legislation, as part of the Patient Protection and Affordable Care Act supports break time for nursing mothers.
  • Can the baby be brought to visit his mother one or more times during her workday?  Even one breastfeeding session during the separation can make a difference in how much milk continues to be produced long-term.

But I have to travel for my job!

While Transportation Security Administration rules permit a mother to travel with her pumped breastmilk when she is not traveling with her child, a more lactation-friendly alternative is to bring baby along and breastfeed whenever possible – often, this is more frequently than when mother is at her home office.  It has been reported that Julie Andrews, while on location to film The Sound of Music, had her toddler on site with a caregiver.  This was a sensible solution in 1964 and can still work today!

Even if I give my job 75% and my baby 75%, that still adds up to 150% and I’m exhausted!

As an IBCLC, I support a mother in her efforts to breastfeed her baby; this can include practical tips for a new family.

  • If there is a support person at home (baby’s father, mother’s partner, other family member), is he or she in agreement that breastfeeding is the best course of action for mother and baby?  This person and others close to the mother will have a tremendous impact on the choices she makes.
  • Remind the family that when mother is not at work, her #1 priority is to care for the baby; this means everyone must pitch in to care for the mother and the household.
  • Safely sharing sleep with her baby as detailed here can ensure a mother gets some rest (though likely not as much as she desires or needs unless she can modify her work situation or her baby gets older) and meet the nutritional and attachment needs of her baby.

Some breastfeeding is better than no breastfeeding.

If a mother can’t employ the tips shared above and struggles to express enough milk to meet her baby’s needs, remind her that she can still pump what is feasible for her – every drop her baby gets is a precious gift.  She can also continue to enjoy the breastfeeding relationship when she is with her baby, even if he has been partially weaned to commercially-prepared baby milk.

Finding her tribe.

When a breastfeeding mother returns to work, she may feel stuck between two worlds; her heart is with her baby but her mind is on her job.  The other breastfeeding mothers she knows stay home with their babies and the mothers at her workplace weren’t successful at combining employment outside the home with breastfeeding.  If enough of your clientele combines working and breastfeeding, perhaps you can host a monthly discussion group (in the evening, baby required for admission!) where mothers can share their strategies in your presence (and you can moderate comments to ensure everyone leaves with sound information).  If your breastfeeding and employed population is smaller, see if one or two mothers who have been particularly successful at the balancing act might be willing to serve as a resource to other mothers embarking on the journey.

Turn your frustration into advocacy!

If you’ve seen too many overwhelmed mothers give up breastfeeding because the “otherhood” complicates new motherhood, take action.  In her Call to Action to Support Breastfeeding, U. S. Surgeon General Regina Benjamin encourages us to “work toward establishing paid maternity leave for all employed mothers” (United States Department of Health and Human Services, 2011).  A letter to your elected officials at every level will keep this issue on the table.  Breastfeeding protects the health of babies and their mothers; we are called to protect breastfeeding in any way we can.

Johnston, M. L. & Esposito, N. (2007).  Barriers and facilitators for breastfeeding among working women in the United States.  Journal of Obstetric, Gynecologic, & Neonatal Nursing, 36: 9–20.  doi: 10.1111/j.1552-6909.2006.00109.x

United States Department of Health and Human Services, Office of the Surgeon General. (2011). The Surgeon General’s Call to Action to Support Breastfeeding.  Washington, D. C.

World Health Organization. (2002). Global strategy on infant and young child feeding. 

Diana Cassar-Uhl, IBCLC and La Leche League Leader, enjoys writing to share breastfeeding information with mothers and those who support them.  In addition to her frequent contributions to La Leche League International’s publication Breastfeeding Today, Diana blogs about normalizing breastfeeding in American culture at http://DianaIBCLC.com and has been a guest blogger at Best for Babes and The Leaky Boob.  Diana can be found lecturing at breastfeeding education events around the United States.  She is pursuing a Master of Public Health, and upon graduation hopes to work in public service as an advisor to policymakers in maternal/child health and nutrition.  Mother to three breastfed children, Diana has served as a clarinetist on active military (Army) duty in the West Point Band since 1995.

If you want to link to Diana’s Breastfeeding Today article on breastfeeding and working, (mothers are the target audience) it’s here.

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THE MANY BENEFITS OF ATTENDING AN ILCA CONFERENCE OR HOW NILS BERGMAN ENDED UP IN CROATIA AND SLOVENIA

Irena Zakarija-Grković, MD, FRACGP, IBCLC, is a GP and passionate breastfeeding advocate from Melbourne, Australia who moved to Split, Croatia in 2004 with her husband and three children. Irena now works at the University of Split School of Medicine where she is involved in teaching and research. Irena is a founding member of the National Breastfeeding Committee, a BFHI educator, president of the Croatian Association of Lactation Consultants, 80-hour breastfeeding course provider, former IBLCE coordinator for Croatia and an active member of ILCA (volunteer member of Scholarship Committee and Multilingual Committee)and ABM. She also conducts breastfeeding classes for expectant parents, does some private practice as a lactation consultant and is the author of several chapters in Croatian on breastfeeding . Irena loves what she does and tries hard to infect others with her enthusiasm for breastfeeding.

Back in 2007, I was a fortunate recipient of an ILCA scholarship and so, thanks to the generosity of numerous friends of ILCA, I was able to attend my first ILCA Conference, held in San Diego, California.

It was an exhilarating experience and among the many interesting talks I attended, the one that stood out was the talk given by Nils Bergman, on the importance of skin-to-skin contact for brain growth. After the presentation I struck up a conversation with Nils and soon found out that Nils traveled to Europe regularly to visit family in Sweden. Immediately, the thought of Nils visiting Croatia came to mind but seemed too farfetched to mention at the time, so I left San Diego with some lovely memories and lots of useful information and resources.

Upon returning to Split, I realised that unless I tried to bring top experts to Croatia the likelihood of my colleagues hearing about the latest recommendations in the field of breastfeeding medicine was minimal, and hence I set about making plans on how to bring the exciting world of evidence-based breastfeeding medicine to Croatia. This wouldn’t have been possible without collaborating with neighbouring Slovenia, specifically the Slovenian Association of Lactation Consultants and UNICEF in Slovenia. Together we’ve brought several renowned speakers to our neck of the woods over the years and by doing so have raised the awareness of the importance of breastfeeding. This, in addition to organizing an annual 80-hour breastfeeding course for health professionals (5 years running) and getting the IBLCE exam translated into Croatian and offered in Split (since 2009), has brought the number of certified lactation consultants in Croatia from one in 2007 to 21 in 2011!

This year, for WBW, the Croatian Association of Lactation Consultants (CALC) was honoured to welcome Nils Bergman to Croatia. My dream had come true- thanks to Nils’s trust in me, his generosity of spirit, and to the support of my Croatian and Slovenian colleagues. Nils’s tour started off with a two-day visit to sunny Split where he was run off his feet meeting the media, giving talks to health professionals and demonstrating to mothers and staff at the University of Split Neonatal Unit how to practice kangaroo mother care.

The latter was the highlight of Nils’s visit because it brought home the importance of placing the baby in its proper environment, the beauty of which brought tears to the eyes of all present. For some mothers with babies in the Neonatal Unit, it was the first time they had held their children. The media were so impressed with what Nils had to say on the topic of caring for premature babies that he made the midday news and was featured on four other TV programs!

  Next, Nils spoke in Zagreb, the capital of Croatia, to a full house at the Hospital of the Holy Spirit and was then whisked off to Lasko, in Slovenia, where he was an eagerly awaited speaker at the Slovenian breastfeeding symposium.

Despite all the work involved in organising Nils’s visit, it was well worth the effort and has brought hope, joy and revelation to all those he met. Thanks Nils and good luck with all of your endeavours in promoting kangaroo mother care!

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Malaysian Breastfeeding Peer Counselor Program

Mother-to-Mother Support has been identified as one of the key factors contributing to the success rate of prolonged breastfeeding, or at least exclusive breastfeeding in the first 6 months. In recent years, more and more evidence has arisen on the effectiveness and impact of peer counseling support. In 2003, D’Souza and Garcia found that:

  • •peer support as a stand-alone intervention is very likely to increase breastfeeding initiation rates among low-income women who express the wish to breastfeed;
    •support from a mother experienced in breastfeeding, complemented by professional services, is very likely to increase the duration of breastfeeding; and
    •peer volunteers are particularly beneficial in mediating between low income mothers and healthcare professionals.

Latest statistics reveal that the Malaysian Exclusive Breastfeeding rate at 4 months is 19%, while at 6 months is only 14.5% (Salim et al, 2006), and this is far below the global rate, which is about 38% EBF at 6months (Moccia P, 2008). If we focus on the  local trend alone, exclusive breastfeeding rates over the past ten years have plummeted, from  29% at 4 months (1996), despite huge efforts to promote the Baby-Friendly Hospital Initiative and having higher initiation rates.

OBJECTIVES & GOALS
This project is focused on building capacity of breastfeeding counselors in Malaysia in order to sustain exclusive breastfeeding for 6 months, and continued breastfeeding with appropriate complementary foods up to 2 years and beyond. This project will go beyond the hospital setting, as it extends the circle of breastfeeding support, involving training of peer counselors among mothers and other non-medical personnel.

SusuIbu.com has been empowered by UNICEF to carry out a project called Malaysian Breastfeeding Peer Counselor Program. UNICEF initially funded the program that comprised of Train the Trainers, running the peer counselor training in 5 regions, and monitoring the overall project until the end of 2010. The project successfully trained 16 participants whom were trained by LLLI Leaders and program adapted from the Peer Counselling Program of LLLI. These 16 individuals are now functioning as Peer Counselor Program Administrators (PCPA) and Working Committee for this program. A nationwide training program for Peer Counselors was successfully conducted throughout 2010, comprised of existing breastfeeding support groups or mother-to-mother support individuals, who would benefit tremendously from the formal skills obtained from the training.

CURRENT SCENARIO IN MALAYSIA
In Malaysia there has been an on-going effort  to create a more effective Mother-to-Mother Support Group framework among the local mothers, but a more systematic and coordinated effort is needed to strengthen it. The Malaysian Ministry of Health is most supportive of breastfeeding, but its focus has largely been around hospital practices rather than support in the communities. All government hospitals in Malaysia are accredited as Baby-Friendly Hospitals and are continuously assessed as per requirements of the UNICEF/WHO Baby-Friendly Hospital Initiative. Since this initiative was introduced in 1993,  121 hospitals  have been accredited as  Baby-Friendly Hospitals (2004).

However, it was revealed that one of the major causes of Baby-Friendly Hospitals failing their reassessment was Step 10,  “Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.” . In the current practice, breastfeeding support groups would be formed by hospital nurses, rather than the community. This adds strain to the workload of the healthcare professionals, without adequately meeting the needs of mother support. Furthermore, mothers are normally discharged from hospitals only 1 or 2 days after delivery. Thus, not much support activities can be done within the hospital’s set up.

According to the current Project Manager, Puan Nor Kamariah Mohamad Alwi, “Many mothers are interested to participate in these activities and are willing to support each other. However, there has been inadequate training done for this group of mothers who aspire to become Peer Supporters/Counselors.  In the current situation, these mothers have had to be included in hospital’s lactation management training which is largely meant for the hospital set-up and staff. It has been noted then that the hospital training given may not be  relevant to the mother-to-mother support needs. For instance,  participants who underwent  this training did not receive any proper guidelines on how to operate as peer counselors yet Mother Support particularly peer counseling has shown to be a most effective intervention in supporting breastfeeding. Furthermore, the peer counselors’ activities are not being monitored by any party.”

FUTURE PLANS

We realise that there is still a long way to go, but the awareness on MBFPC, and importance of mother-to-mother support, is on the rise among the public in Malaysia. In 2010, 145 Peer Counselors completed their training.  As of Sept 2011, 84 Peer Couselors completed their training. For 2012, we will focus on strengthening the skills of the currently trained peer counselors in our group. We realise that we will need help to empower our members further so that they can contribute better to the community in the future. Other than securing future funding to ensure sustainability, we hope to create links with other global groups as we believe we all share a common goal. There is an unspoken universal language of love that we share and that is – Breastfeeding!

For more information regarding the program, please visit www.mbfpc.org

———————————————–
Nurturing Concepts Sdn Bhd (NCSB)
Nurturing Concepts Sdn Bhd is a company founded by individuals and professionals who share a common mission which is to protect,  promote and support breastfeeding. NCSB operates 2 reputable entities:
1. Moms Little Ones – known as the Breastfeeding & Natural Parenting Store that purely focuses on producing and selling high quality breastfeeding and parenting range of products.
2. Susuibu.com – known as the Breastfeeding Support Centre that focuses on providing quality breastfeeding consultation services, education and training to the healthcare workers and the public. The popular online community forum “Mother-to-Mother” Support group now has more than 20,000 members worldwide and is recognised by The Ministry of Health Malaysia and WABA (World Alliance for Breastfeeding Action. The World Alliance for Breastfeeding Action (WABA) is a global network of individuals & organisations concerned with the protection, promotion & support of breastfeeding. We are proud to be a WABA endorser.

CONTACT
Nor Kamariah Mohamad Alwi, IBCLC
Lactation Consultant
Project Manager, Malaysian BFPC

+603-89254614 (Tel)
+603-89254615 (Fax)
pm@mbfpc.org

Malaysian Breastfeeding Peer Counselor Website – www.mbfpc.org

Article by: Rita Rahayu Omar, BSc, CISA, IBCLC
CEO, www.thenurturing.com

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Thank You!

The editorial staff of Lactation Matters and ILCA would like to take a moment to thank you.  Our first week in the blogosphere has been tremendous, full of excitement and new challenges.  We are sincerely grateful for the outpouring of support that we have received with the launch of this blog.  In one week we had over 2,000 visits and a number of wonderful commenters encouraging us along.  This blog has been created for all of you, to create an ongoing source of community and support for our fellow LC’s.

At times it can be hard to remember how small the world really is, and how connected we are.  While the facilities that we practice at may be different, we are all working towards the same mission.  Our goal with Lactation Matters is create a safe and informative place that LC’s can gather and never feel alone in their profession again.

Quite an ambitious goal that we’ve set for ourselves, to ensure that this blog stays current and meeting your needs we want to encourage you to submit questions, comments, suggestions, and thoughts to lactationmatters@gmail.com.  This blog is your blog and we want to make sure that Lactation Consultants and healthcare professionals working with breastfeeding mothers around the world are having their voices heard.  Stand as one, be united, and let us know what is happening in your own community.

We look forward to what the future holds for our ‘baby’ blog and watching how all of you connect and interact with us.

Again, thank you for subscribing, reading, and sharing. Stay tuned for some exciting posts next week and a poll coming your way this Friday!

Robin Kaplan, M.Ed., IBCLC, Lactation Matters Editor

Decalie Brown, RN, CM, CFHN, IBCLC, ILCA Director of Marketing

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