Leading Lactation Insights - May 2022

Breast anatomy research image

The May 2022 edition of Medela's monthly newsletter for lactation professionals. Leading Lactation Insights provides monthly updates on the latest breastfeeding research, clinical news, and expert insights for IBCLCs, lactation consultants, and maternal health professionals.

News You Can Use
Tools You Can Use
New Webinars
New Resources

A Great Resource – The United States Breastfeeding Committee

Maria Lennon, MSN, CNM, IBCLC

When looking for a “one-stop shop” for resources on breastfeeding, a good place to start is with the USBC (United States Breastfeeding Committee). The USBC is a non-profit coalition of more than 100 organizations that “support its mission to drive collaborative efforts for policy and practices that create a landscape of breastfeeding support across the United States.”

Resources they offer include:

  • Breastfeeding Support Image Gallery: In collaboration with the CDC, the USBC created a library of free, high-resolution images representing breastfeeding support in various communities across the US. http://www.usbreastfeeding.org/photo-project
  • Breastfeeding Resources for Mothers and Families: This section refers mothers and those with questions to other resources for answers and further reading
  • International Documents Related to Breastfeeding: A collection of classical documents.
  • Monthly Observances and Resources: Webpages with breastfeeding news and resources related to monthly observances in the U.S. May is Asian American and Pacific Islander Heritage Month!
  • Publications and Statements – USBC position statements and other publications
  • Surgeon General’s Call to Action Directory: The Action Directory lists information and guidance on how to connect other organizations working on particular action areas.
  • Webinar Archive Directory: Explore the archives for webinars on training, racial equity, and other topics.
  • Breastfeeding Coalitions Directory: Find a comprehensive list of state, territory, and tribal coalitions.
  • Weekly Wire e-Newsletter: Tidbits of national, international, and local community news published weekly. Do you know that the U.S. Department of Defense recently released a revision to the Joint Travel Regulations to allow service members and civilian employees who are breastfeeding to be reimbursed for the shipment of their breast milk when traveling officially for more than three days? That’s just one bit of news published in the latest Weekly Wire.

In addition to these great resources, the USBC sponsors The National Breastfeeding Conference and Convening, which is held annually and brings together a diverse set of clinical, community, advocacy, and research professionals. The attendees represent those who understand the public health importance of breastfeeding as critical for reducing infant morbidity and mortality, chronic disease, and obesity; decreasing the maternal risk of type 2 diabetes, cardiovascular disease, and breast, ovarian and endometrial cancers. This convening is designed for all who are interested in protecting, promoting, and supporting breastfeeding at the national, state, local, and community levels.

This year, the USBC will hold its National Breastfeeding Conference and Convening online from June 7-9, 2022. The title of the conference is, “Pathfinders: Honoring Lactation Wisdom and Nurturing Innovation”. CERPs and CEUs for Registered Dietitians will be offered. For more information click the link here: http://www.usbreastfeeding.org/p/cm/ld/fid=45.

Visit the USBC website to see all they have to offer. Subscribe for free to the Weekly Wire e-Newsletter and check out membership options for your coalition, if interested.

Safe Handling of Human Milk within Healthcare Facilities

Presented by Caroline Steele, MS, RD, CSP, IBCLC, FAND
Wednesday, May 18

Infant Pain Management: Can We Do Better in 2022?

Presented by Sharyn Gibbins, NP, PhD
Wednesday, June 15

Happy International Day of the Midwife – May 5, 2022

Every year on May 5th, the International Day of the Midwife takes place. This day was made official in 1992, when it was formally launched by the International Confederation of Midwives. Thank you for caring for mothers and babies and getting them off to the best start!

Happy World Maternal Mental Health Day – May 5, 2022

In many countries, as many as 1 in 5 new mothers experiences some type of perinatal mood and anxiety disorder (PMAD). Increasing awareness will drive social change with a goal toward improving the quality of care for women experiencing all types of PMADs, and reducing the stigma of maternal mental illness. Click here to listen to the recorded webinar Maternal Mental Health: What We Know and Where Do We Go From Here? originally presented February 17, 2021 by Jennifer Payne, MD

Happy Nurses Week – May 6-12, 2022

National Nurses Week honors the contributions and sacrifices of nurses and reminds us to thank the medical professionals who help us. Thank you for all that you do to help moms and babies!

Happy Mother’s Day – May 8, 2022

We wish all of the mommas out there a very happy mother’s day!

Troubleshooting Videos & Infographic

We received great feedback from the professional community regarding our Pump in Style® with MaxFlow™ Breast Pump. We heard that you wanted more information on how to use and troubleshoot common issues with mom, like you could with Pump in Style Advanced. As a result, we developed four videos focused on LCs and an infographic to address common questions and learnings so you can effectively and efficiently help moms. Click here to access videos, click here to access infographic.

Medela and Expectful Partnership

Medela has partnered with Expectful, a holistic maternal health platform for fertility, pregnancy, and motherhood, to offer breastfeeding and pumping education and discounted access to wellness support to new moms. The two brands share a commitment to improving the motherhood experience through research-backed products that can be trusted to truly make a difference.

According to research recently published in the Journal of Perinatology, regular use of the Expectful app is shown to be associated with an increase in milk supply. The researchers analyzed results from 60 women and, after adjusting for confounders, found an increase in breast milk production of 223.2 mL and in pumping episodes by 0.93 when paired with frequent meditation. Skin-to-skin contact increased 100% among women who meditated seven or more times. Adjusted odds of a clinically significant Edinburgh Postnatal Depression Scale score of > 9 was 0.057 with frequent meditation. Though more research is needed, these initial findings indicate that, for women engaging in frequent meditation, there may be an effect in establishing breast milk supply and reduction of depression symptoms1.

Beginning May 8, in recognition of Mother’s Day, pregnant and postnatal women can enjoy the benefits of this powerful mom-centric partnership when they sign up for Medela Family at www.MedelaFamily.us and download the Expectful app. Through the partnership, Expectful users will have access to Medela’s exclusive breastfeeding and pumping course and lactation experts. Medela Family members will also have access to 30% off an annual membership to Expectful’s wellness app through November 25, 2022.

“As a NICU mom who relied on the Symphony breast pump to feed my newborn son, I’m honored to announce this partnership with Medela,” says Nathalie Walton, CEO and Co-Founder of Expectful. “Our partnership with Medela will allow us to increase access to Expectful and share the science-backed benefits of meditation to increase milk production and lower the risk of postpartum depression with new moms in the Medela Family community.”

Medela is focused on strengthening the support offered to new parents following the introduction of their award-winning Medela Family program, a free mobile app for breastfeeding parents on iOS and Android devices released last year. The app offers a one-stop digital solution to support their personal breastfeeding goals with tracking tools, smart connection to Medela breast pumps, a breast milk management system, personalized articles and advice from certified lactation consultants, and more. Article1

Moral Injury in Lactation Care

Maria Lennon, MSN, CNM, IBCLC

Have you ever observed a patient receive care that may have been substandard or even harmful to a mother, a baby, or a family? How about having to participate in something that was disruptive to a couplet’s breastfeeding or bonding experience? Unfortunately, many perinatal and lactation care givers have experienced this phenomenon, some on an ongoing basis at their places of work, and that is quite disturbing.

As healthcare professionals working with mothers and babies, we are passionate about our professions and being supportive of pregnancy, labor, birth, postpartum and mothers’ experiences feeding their infants. We care deeply. As our patients hurt so we too hurt and may experience severe psychological stress.

Some events that can be considered traumatic in lactation care include witnessing harmful acts, being asked to participate in something that you consider wrong or being unable to provide good care due to restrictive policies, management issues, or inadequate staffing. A few examples include:

  • Having to listen to a person in authority repeatedly give outdated and incorrect information to a mother who is struggling to breastfeed.
  • Working in an environment with policies which are outdated and can interfere with successful breastfeeding.
  • Watching a caregiver touch a mother’s breast without first obtaining her consent.
  • Being instructed to supplement a baby with formula when it is not indicated and despite the mother’s request to exclusively breastfeed.

In an editorial published in Clinical Lactation in 2019, Dr. Kathleen Kendall-Tackett explains that there is an emerging construct in trauma psychology that, until now, has only been used to describe experiences of combat veterans. Some researchers have been looking at it to describe perinatal providers’ experiences. This construct is called moral injury.

Dr. Kendall-Tackett’s editorial is certainly thought-provoking for those of us in the lactation field. There are times when some of us may feel we’re dealing with situations of moral injury. She speaks of providers having to leave the field in order to protect their own mental health. For those who stay, she says, these experiences cause job dissatisfaction and discontent, which can eventually affect patient care.

Have you experienced moral injury in your work? How do you and your colleagues deal with it? It’s a conversation worth having among our colleagues.

Clinical Lactation, 2019, 10(3), http://dx.doi.org/10.1891/2158-0782.10.3.101.

This month's spotlight: Patricia Esposito, RN, MS, IBCLC, LCCE from New York

Patricia Esposito, RN, MS, IBCLC, LCCE, has over 55 years of experience providing high-quality care to patients in the Obstetrical Care Units. She says that taking care of patients has been her passion since she was a little girl, which led to her attending St. Vincent’s Hospital School of Nursing in New York City to become a Registered Nurse. Patricia later obtained her Bachelor’s of Science in Health Administration from St. Joseph College in Patchogue, New York, followed by her Master’s in Health Administration from the New School for Social Research in Manhattan.

During this time, Patricia had four children – all of whom she breastfed. As she welcomed her own babies and worked in an Obstetrical Unit, Patricia’s interest in natural childbirth was sparked. In 1979, she became an ASPO (American Society for Psychoprophylaxis in Obstetrics)-certified Childbirth Educator. This organization later became Lamaze International. Patricia continued to work in the Labor and Delivery Unit while teaching Lamaze classes from her home. She eventually became the Head Nurse at Southside Hospital’s Labor and Delivery Unit in Bay Shore, New York, which consisted of 60 employees and serviced about 3,000 births annually! She recalls not being pleased with the breastfeeding education available and offered at that time to staff and patients and, because of this, Patricia became an IBCLC in 1998. She was also honored by the March of Dimes for her work in the Obstetrical community.

Though Patricia retired from her Head Nurse position in 2009, she remains actively involved with her hospital as a Lactation Consultant. The following year, she began a weekly breastfeeding support group at the hospital, with attendance steadily growing over the years. In 2017, Southside Hospital became an affiliate of Baby Café USA and, in 2021, achieved Baby-Friendly status. Once in-person meetings were cancelled due to the COVID-19 pandemic, Patricia began facilitating the virtual baby café twice weekly. She also teaches a monthly breastfeeding preparation class through the hospital for expectant parents, while continuing to offer childbirth education classes and occasional in-home lactation guidance as requested.

Patricia notes one of her challenges was transitioning into the world of technology due to the onset of COVID and the subsequent need to develop virtual breastfeeding support resources. She says, “I entered the health field in the time of handwritten notes. As electronic charting came into being, I progressed along with it, but I had no knowledge of the workings of Zoom or Microsoft Teams.” Having overcome those early challenges, she says the baby cafes are great because of the convenient accessibility to moms, but that they also lack the hands-on assistance aspect of support when it comes to latching difficulties.

As a result, Patricia says that she would love to see baby cafes transition into a hybrid program, blending convenient virtual meetings for better accessibility with occasional in-person meetings for more interaction and easier hands-on assistance. She also notes that Southside Hospital – now South Shore University Hospital, a member of the Northwell healthcare team – currently has a lactation team of 5 IBCLCs and a majority of their maternal-child health nurses are also CLCs. She credits many innovations in the Obstetrical department over recent years to their lactation coordinator, Wendi Andria MSN, who developed their official lactation program in 2014.

In her free time, Patricia enjoys being outdoors, walking, beaching, boating, kayaking, and paddle-boarding. She loves entertaining friends and family, and misses doing so in recent years due to the COVID-19 pandemic. She says “cherishes the time I spend with my four children, their spouses, and my 10 grandchildren.” Most of all, she says, she is blessed to still be with her high school sweetheart after 55 years of marriage!

Thank you, Patricia, for dedicating your career to caring for moms, babies, and families. Your knowledge of and contributions to this field through the years are greatly appreciated by many!

Thank you to this issue's contributors and writers!

Maria Lennon, MSN, CNM, IBCLC

Nurse-Midwife, Perinatal Education Consultant - Sedona, AZ

Katie McGee, RN, BSN, IBCLC

Education Consultant - Westchester, IL

Kimberly Colburn, BPC

Medela U.S. Medical Education Specialist - McHenry, IL

Megan Quinn

Medela U.S. Corporate Communication Specialist - McHenry, IL

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