Tag Archives | Marsha Walker

Meet Me in St. Louis: USLCA’s Upcoming Conference

After a long, cold winter, St. Louis, MO is preparing for spring’s cherry blossoms, Cardinals baseball, and USLCA inaugural conference Gateway to Excellence!

USLCA has put together a fabulous line up of speakers including inspiring veterans and innovative newcomers for this May 3-5 event at the historic Union Station Hotel.  With seven plenary sessions and seven different tracks for concurrent sessions, there is something for every lactation professional.  The greatest challenge will be deciding which sessions to attend, so I suggest coming with friends and sharing what you learn over refreshments in one of the many local establishments.

For example…

marshawalkerMarsha Walker, RN, IBCLC will warm the crowd with the opening plenary session “The State of Breastfeeding in the US: We’ve Come a Long Way with ‘Miles To Go Before We Sleep.’”  Marsha, an internationally acclaimed speaker and author, sits on the Board of Directors of USLCA, Baby Friendly USA, Massachusetts Breastfeeding Coalition, and Best for Babes. She represents USLCA to the US Department of Agriculture’s Breastfeeding Promotion Consortium and represents NABA to the US Breastfeeding Committee. She is the co-chair of the Ban the Bags campaign, a national effort to eliminate the hospital distribution of formula company discharge bags.

cathyCatherine Watson Genna BS, IBCLC, will be speaking on Reflux, GERD, and Breastfeeding.

Cathy has been in private practice in New York City since 1992, and currently addresses health care professionals all over the world on her specialty area helping medically challenged mothers and babies to breastfeed.  Her lively presentations are enhanced by her widely published clinical photographs.  Cathy has authored numerous publications and also serves as Associate Editor for the United States Lactation Consultant Association journal Clinical Lactation.

haleThomas Hale, PhD, one of the world’s leading authorities in the use of medications in breastfeeding women,  will enlighten the crowd with “How to Evaluate Drug Usage in Breastfeeding Mothers.”

Tom is the founder and director of the Infant Risk Center, a national  call center for pregnant and breastfeeding mothers. He is a well known international lecturer in the pharmacology of lactation and is  the author of five books including: Medications and Mothers’ Milk, the top-selling drug reference manual.

Liz Brooks (1)Elizabeth Brooks, JD, IBCLC, FILCA,  will draw from her legal background with her boundless energy and humor to bring us the timely,   “Who’s Your Daddy…Mommy, Surrogate or Donor? Modern Families and Lactation.”

With plain language and humor, Liz helps keep us honest as she offers explains pragmatic tips and ethical perspectives that can immediately be used in daily practice.

Liz is the President of the International Lactation Consultant Association (ILCA), serves on the Board of Directors for the United States Breastfeeding Committee (USBC), and works with breastfeeding families both in private practice and the hospital setting.

Sound interesting?  There are still more plenary sessions from the National Breastfeeding Center’s Dr. Todd Wolynn, infant oral motor specialists Robin Glass & Lynn Wolf, and The Joint Commission’s Celeste Milton.


The plenary sessions are compelling enough to click the registration tab right now, but wait!  There is more!  The concurrent session tracks have something for everyone.  Is your hospital pursuing Baby-Friendly status?  Got it!  Finding exclusive breastfeeding elusive?  Got a track on that, too.  Advocacy, community, preterm infants, and WIC, check, check, check, and check.  There is also the Mosaic- the assortment pack of timely topics.

Gateway to Excellence will let you network with speakers, authors, and peers, learn cutting edge skills, see what new tools and texts exhibitors have to offer, and come away refreshed and energized with knowledge you can immediately put into action.

So what do you do now?  REGISTER, of course.  Bring friends.  Click here for more information and to register.  See you in St. Louis!


URGENT ACTION NEEDED in the United States

By Marsha Walker, RN, IBCLC, USLCA Director of Public Policy

USLCAMany mothers need breastfeeding help, but cannot access the level of care that they need.

Even though the Affordable Care Act requires breastfeeding support, it does not specify the provider that best fulfills this mandate. Many insurers will not credential IBCLCs nor maintain IBCLC networks because IBCLCs are not licensed. Breastfeeding care becomes more fragmented and deferred to providers who may not have the training or expertise to handle complex lactation situations. This means that many breastfeeding women are without the care they need, when they need it the most.

Your voice is needed.

The Department of Health and Human Services (HHS) is creating rules for insurance companies in the individual and small group markets under the new health care law. As part of this effort, they will take comments from the public about what services insurance companies must cover. Use this opportunity to tell HHS that mothers should have access to IBCLCs, that insurers should cover the services of the IBCLC, and that all breastfeeding mothers deserve access to IBCLCs, not just those who can afford it.

We’ve made a lot of progress – but there’s still more to be done. Send in your comments at HERE. Comments are due by 5:00 PM Eastern time on December 26, 2012. The entire proposed rule can be found HERE.

The US Lactation Consultant Association is working hard to assure that IBCLC services are available to all women. Thank you for all you do to ensure women have access to quality, affordable health care. Your letter needs to be brief as the portal allows only 2000 characters. You can cut and paste the following sample letter into the comment portal HERE.

Please state that insurance companies must cover the services of the International Board Certified Lactation Consultant (IBCLC) in the maternal and newborn section of the Essential Health Benefits (EHB). IBCLCs are allied health professionals certified through a rigorous credentialing process who possess the requisite skills to manage common and complex lactation management issues. Too many breastfeeding mothers lack access to the level of care that they need, resulting in fragmented care deferred to providers who may not have the training or expertise to handle complex lactation situations. See http://massbreastfeeding.org/landscape/ for a guide to lactation qualifications. This drives up the cost of and increases the number of health claims due to increased infant illnesses and conditions preventable by successful breastfeeding. Services of IBCLCs result lower health care costs to insurers. The U.S. Surgeon General included in the 2011 Call to Action to Support Breastfeeding, the specific recommendation to provide reimbursement for IBCLCs independent of their having other professional certification or licensure. The Centers for Disease Control and Prevention use the IBCLC as a metric in its determination of the adequacy of breastfeeding support in its annual Breastfeeding Report Card. 

State required benefits should include IBCLC services to improve the quality and value of the coverage that is available for EHB. Please include coverage of IBCLC services under Sec. 147.150 Coverage of essential health benefits. Beginning in 2014, all non grandfathered health insurance coverage in the individual and small group markets, Medicaid benchmark and benchmark-equivalent plans, and Basic Health Programs (if applicable) will be required to cover essential health benefits. I strongly encourage Secretary Sebelius to expressly declare in the text of the final rule that health plans specifically state that coverage will be available for IBCLC services.

Thank you for helping USLCA with their advocacy efforts to bring increased access to lactation care for mothers, babies, and their families.


World Breastfeeding Week: Massachusetts, USA Hospitals Go Bag Free

By Marsha Walker, RN, IBCLC

Massachusetts is now the second state in the US, behind Rhode Island, to have had all of its maternity hospitals eliminate the practice of distributing formula company discharge bags. Ban the Bags is a campaign that began in 2006 to rid hospitals of the practice of distributing formula company discharge bags or other discharge gifts to mothers when leaving the hospital. It was started after efforts in Massachusetts failed to insert regulations regarding such a ban into our hospital perinatal regulations. Ban the Bags, the Massachusetts Breastfeeding Coalition, and the MotherBaby Summit have all encouraged hospitals to eliminate this practice through letter writing, education of hospital management at summits designed just for them, and downright shamed them into doing it in order to get off the list of hospitals we kept who continued engaging in this practice. The list of hospitals who continued to give out these bags was displayed on the MotherBaby Summit website and was placed on a large poster board and displayed annually at the Massachusetts Breastfeeding Coalition’s yearly conference. Ban the Bags answered many e-mails with suggestions, references, and approaches to help individuals get the bags removed from their hospital.

Ban the Bags found that many hospitals did not really care about the effect of formula bags on breastfeeding but responded when told that it was a breech of medical ethics, was in opposition to the hospital’s own mission and vision, and was no different than unethical arrangements with pharmaceutical companies. We encouraged people to contact their hospital Ethics Committee for an opinion on a practice that promoted the use of a potentially hazardous product and how this related to the ethical principles of “first do no harm” and the obligation of health care providers to act in the best interest of their patient. We counseled people to contact the hospital’s Corporate Compliance Department to report how these bags were a conflict of interest, especially since HIPAA defines them as a form of marketing. We recommended that people contact the hospital’s Risk Management Department to inform them that because the hospital had no stock control there was no method to contact patients who had received the bags if there was a recall of the formula. Such a recall occurred in 2006 when one company’s bags were recalled due to the defective packaging of formula inside which resulted in a vitamin C deficiency. Also, the powdered version of formula is not sterile and the hospital could be handing out and liable for a product contaminated with Chronobacter sakazakii. Mothers were never instructed by the hospital in how to safely prepare the powdered formula that they were essentially marketing for formula manufacturers. Eliminating the bags was a fairly easy way to increase the hospital’s score on the mPINC survey.

Ban the Bags advocates toss bag into the original location of the Boston Tea Party!

Hospitals were concerned that they would have to pay for formula, as the formula companies fought hard to prevent the disappearance of this lucrative and inexpensive marketing tactic. We have found that this was not actually true, as manufacturers did not remove their product from the hospital which represented essentially a captive audience. Companies know that well over 95% of mothers continue to use the brand of formula given to their infant in the hospital. Why would a formula company give up this potent marketing advantage? We heard how terrible it would be for poor mothers who could not receive this “gift.” Of course there is only enough formula in the bag for about a week or so worth of feedings, just enough to reduce a mother’s milk supply and accustom the infant to the bottle. Detractors complained that we were “forcing” mothers to breastfeed or removing their choice of infant feeding methods. Mothers decide how they wish to feed their infants well before entering the hospital. Bags have no effect on feeding decisions, they have only one purpose, which is to cause a breastfeeding mother to use formula and create a customer/market where none existed before. We have found that when hospitals remove the bags, they show up in community pediatric and obstetric offices, clinics, and even in ultrasound departments. Make sure to ask that all of these entities cease distributing formula company materials, as this works directly to counteract your efforts in the hospital.

Ban the Bags at www.Banthebags.org has many helpful recommendations on approaching the elimination of this practice. I am happy to help and you can email me at Marshalact@gmail.com.

Marsha Walker is a registered nurse and international board certified lactation consultant. She maintained a large clinical practice at a major HMO in Massachusetts, is a published author and an international speaker. Consulting with hospitals, providing in-service presentations, speaking at conferences and workshops and advocating for breastfeeding at the state and federal levels occupy her professional time. She is currently a member of the board of directors of the Massachusetts Breastfeeding Coalition, Baby Friendly USA, Best for Babes Foundation, and the US Lactation Consultant Association (USLCA). She is a past president of the International Lactation Consultant Association (ILCA).


Speaker Profile: Marsha Walker, RN, IBCLC

During the weeks leading up to the 2012 ILCA Conference, we will be highlighting a number of conference speakers.  Watch this space every Friday for more profiles.

Marsha Walker, RN, IBCLC

Photo used with permission from Hale Publishing

Marsha is a registered nurse and international board certified lactation consultant. She has been assisting breastfeeding families in hospital, clinic, and home settings since 1976. Marsha is the executive director of the National Alliance for Breastfeeding Advocacy: Research, Education, and Legal Branch (NABA REAL). As such, she advocates for breastfeeding at the state and federal levels. She served as a vice president of the International Lactation Consultant Association (ILCA) from 1990-1994 and in 1999 as president of ILCA. She is a board member of the Massachusetts Breastfeeding Coalition, the United States Lactation Consultant Association (USLCA), and Baby Friendly USA, ILCA’s representative to the USDA’s Breastfeeding Promotion Consortium, and NABA REAL’s representative to the US Breastfeeding Committee. Marsha is an international speaker, and an author of numerous publications including ones on the hazards of infant formula use and Code issues in the US.

Her publications include:

You can hear Marsha speak on Friday, July 27 from 10:15-11:15 on the topic “Pumps and Pumping Protocols: What we know, What we don’t know, and What we wish we knew”.

ILCA looks forward to welcoming Marsha Walker.


ILCA Conference 2011 – Reflections

I absolutely love going to ILCA conferences!  While San Diego was quite a treat with its gorgeous weather and fabulous beaches, even the heat of San Antonio and Las Vegas couldn’t diminish the way an ILCA conference re-energizes and makes me feel so proud to be a part of this valuable profession.

Planning my trip to ILCA 2011 was not too challenging, since I live about 10 minutes from where the conference was hosted.  Yet, I still had to juggle clients and my son’s 6th birthday to make it to all of my favorite sessions.  It was so worth it!

The week before the conference, I started to create my ‘plan of attack.’  Which sessions would I attend Thursday through Sunday?  Would I finally learn how to deal with those flat heads and stiff necks?  Is pumping really out of hand?  Where would I meet my friends and colleagues that I met at previous conferences?  Would I have time to peruse the exhibition hall?

I started the conference by attending the Wednesday Clinical Rotations and the rumors from past conferences were all true: What an amazing experience!  It was like having a private session with my favorite experts in the field.  Alison Hazelbaker went through her entire Assessment Tool for Lingual Frenulum Function.  Marsha Walker was so lovely I could just listen to her speak for hours and hours.  The day just flew by!

Thursday through Sunday was a whirlwind, but so many of the things I learned and people I met have influenced my daily practice as a lactation consultant.  At the poster session I met Lenore Goldfarb, who since then has been helping me with a client who is inducing lactation with her adopted son.  I have now mentioned Jane Morton’s video on Hand Expression at least twice a week with new clients and prenatal breastfeeding students.  I have shown samples of the Danish Wool breast pads to several clients with Reynaud’s.  I finally met my fellow marketing committee members face to face for the first time.  I have stayed connected with colleagues I met during lunch and breaks over Facebook and email, which allows us to further our conversations and support one another.

The energy at an ILCA conference is colossal!  The amount of knowledge I obtain in those 4-5 days is immeasurable!  When I leave an ICLA conference I feel smarter, revitalized, invigorated, and supported.  And I can’t wait for the next conference to arrive.  Stay tuned for exciting information about ILCA2012 in Orlando, Florida.

Now it’s your turn to share:

What was your favorite part about ILCA2011?

Who was your favorite speaker? 

What feedback would you like to share?

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


Summary of the Surgeon General’s Call to Action to Support Breastfeeding

On January 20, 2011, Surgeon General Regina M. Benjamin issued a “The Surgeon General’s Call to Action to Support Breastfeeding,” outlining steps that can be taken to remove many of the challenges faced by women who want to breastfeed their babies. The Surgeon General identified 20 evidence-based actions that are needed, including establishing worksite policies and programs that are supportive to employees who are breastfeeding, implementing maternity care practices in hospitals and birthing facilities that do not sabotage breastfeeding, reducing marketing of infant formula products, and ensuring access to services provided by International Board Certified Lactation Consultants (IBCLCs). The Call to Action asks six segments of society to step forward and take responsibility for removing breastfeeding barriers within each of their respective spheres of influence.The twenty action steps within the six categories have numerous suggested implementation strategies.

Mothers and their Families: recognizes the need for mothers to be informed by their health care providers of the importance of breastfeeding, and that health care providers support mothers in their efforts to breastfeed.
Communities: asks for community-based support for breastfeeding mothers from public health programs, including the provision of peer counseling support, and around the clock breastfeeding support from community organizations. Manufacturers of infant formula should be held accountable for marketing their products within the guidelines of the International Code of Marketing of Breastmilk Substitutes and health care providers should not serve as advertisers of infant formula.
Health Care: requests that hospitals accelerate their efforts to achieve the Baby-Friendly designation, ensure access to skilled, professional lactation care services following hospital discharge, provide training in lactation care in undergraduate and graduate educational programs for health professionals, encourage insurers to reimburse for services provided by IBCLCs, and increase availability of banked donor milk.
Employment: calls for paid maternity leave, the establishment of lactation support programs by employers, and the adoption of child care standards that support breastfeeding mothers.
Research and Surveillance: identifies the need for new research regarding the most effective ways to increase breastfeeding rates among populations with low rates, conduct analyses of the cost effectiveness of breastfeeding, and provide a better evidence base for making clinical decisions in challenging situations.
Public Health Infrastructure: urges the creation of a federal interagency work group on breastfeeding, and increasing the capacity of the United States Breastfeeding Committee and affiliated state coalitions.

The Call to Action represents a significant tool for use in validation of the importance of both breastfeeding and the role that the IBCLC plays in assuring that all mothers and infants receive the level of lactation care and services that they need. The document can be used in numerous ways to improve access to evidence-based care in the hospital, to provide post discharge lactation care in the community, and in settings where mothers experience the most difficult challenges to breastfeeding, such as the workplace. The Call to Action functions as a guide or roadmap for those wishing to make changes, as it places the responsibility for breastfeeding improvement on all the segments of society that interact with mothers or who have an influence on how lactation support is provided. It provides suggestions on how best to reduce barriers, and challenges health care providers, institutions, organizations, agencies, the Government, employers, and insurers to all do their part to see that mothers and infants receive the support to which they are entitled.

Action 11 specifically recommends, “Ensure access to services provided by International Board Certified Lactation Consultants.” It goes on to ask that IBCLCs be designated as “covered providers” and that reimbursement should be provided independent of licensure. Adherence to these recommendations will go a long way in reducing disparities and providing access to care that can be financially out of reach for mothers when insurers refuse reimbursement for lactation care and services provided by IBCLCs. Use this document to your advantage, whether you work in a hospital, clinic, agency, or private practice. There is so much room for improvement that we should make sure that we have all of the tools at our disposal in our work to help mother and babies breastfeed. To obtain copies of the Call to Action see:


Summary http://www.surgeongeneral.gov/topics/breastfeeding/executivesummary.pdf

MarshaWalker, RN, IBCLC

Marsha Walker has worked with breastfeeding mothers since 1976, first as a volunteer counselor with Nursing Mothers Counsel in California and eventually as the Director of the Breastfeeding Support Program at Harvard Pilgrim Health, a large HMO in Massachusetts. Much of her time is currently spent advocating for breastfeeding on the state and federal levels. She is the executive director of the National Alliance for Breastfeeding Advocacy (NABA) which is the organization that monitors the Code in the US. Marsha also sits on the Board of Directors Baby Friendly USA, Massachusetts Breastfeeding Coalition, and Best for Babes. She represent USLCA to the US Department of Agriculture’s Breastfeeding Promotion Consortium and represent NABA to the US Breastfeeding Committee.


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