Lactation Consultants Are Resource for Families, Staff
By Lisa Schuller BSN, IBCLC, RN and Mary Jo Butler BSN, IBCLC, RN
Breast milk, the optimal nutrition for infants, provides protection from infection and may enhance the infant’s immune system. Long-term benefits may include decreasing the risk of Type I and Type II diabetes, childhood cancer, allergies and obesity. Benefits for the mother include minimizing maternal blood loss at delivery and decreasing future risk of breast and ovarian cancer.
St. Louis Children’s Hospital is seeing an increase in the number of breast-fed infants. Currently, 83 percent of mothers in the Newborn ICU are initiating breast-feeding or providing breast milk for their infant. Initiation of breast-feeding or providing breast milk for infants less than or equal to 1,500 grams is 94 percent. Ninety-four percent of mothers with infants weighing less than or equal to 1,500 grams either breast feed or provide breast milk.
To support breast-feeding, --in 2002 the Newborn ICU established a lactation program with one lactation consultant. Currently, two full-time lactation consultants provide coverage throughout St. Louis Children’s Hospital.
In the Newborn ICU, establishing early communication with the mother gives the consultant a chance to discuss breast-feeding benefits, family history and resources available. The lactation consultant initially meets with the mother about feeding preference and screens for the rare contraindications to breast-feeding. The mother is then able to make an informed decision about the method of feeding her infant. Including the family is important because studies indicate that mothers will breast-feed longer and be more successful at breast-feeding if there is a strong support system available to them at home.
The main focus of the lactation consultant is to be a resource for the mother, enabling her to achieve her breast-feeding goals. Once a mother decides to either breast-feed, supply expressed breast milk via a bottle or both, a plan is developed to support her decision. This plan, along with continued encouragement and support, includes:
- Skin-to-skin holding
- Nuzzling at the breast
- Nonnutritive “practice” breast-feeding
- Nutritive breast-feeding
Skin-to-skin holding, nuzzling and nonnutritive breast-feeding help emotionally with breast-feeding success and give the mother confidence in knowing her baby’s cues and handling her baby at the breast. Nuzzling and nonnutritive breast-feeding are done after the mother has emptied her breast with a breast pump.
Besides seeing families in the Newborn ICU, the lactation consultant may see inpatient families with diagnosis such as hyperbilirubinemia, slow weight gain or dehydration. These are usually newborns admitted the first few days to several weeks of life. Families are scared and need reassurance and emotional support along with breast-feeding education.
Consults may also be ordered for older infants if the mother is pumping for the first time or has breast-feeding questions. In a collaborative effort to assess an infant’s ongoing breast-feeding needs, a lactation consultant and speech therapist may continue to follow a family in outpatient Therapy Services.
At discharge, families receive community resources, and the mother is encouraged to call if issues continue or new issues arise. Resources include pump rental or purchase information, a breast-feeding book, and a breast-feeding and pumping teaching tool.
Staff education is also provided to ensure a supportive breast-feeding environment for both inpatient and outpatient families. Initiatives include house-wide in-services on pumping and storage of breast milk and strategies to help mothers with breast-feeding issues.
The lactation consultant role at the hospital is unique in that it is exclusively dedicated to supporting breast-feeding. The consultants provide advanced clinical lactation knowledge, support and compassion during a family’s vulnerable time.
Lisa Schuller may be contacted at 314.454.4648 or lms2298@bjc.org; MaryJo Butler may be contacted at 314.454.3797 or mjb8813@bjc.org.