Leading Lactation Insights - November 2022

Breast anatomy research image

The Leading Lactation Insights newsletter presents the latest breastfeeding topics and clinical practice solutions, addresses coding issues challenging the lactation community, features a lactation service, and announces upcoming webinars and conferences.

AAP Resource Practice Tools for Healthcare Professionals

Maria Lennon, MSN, CNM, IBCLC

The American Academy of Pediatrics has a list of excellent resources that healthcare professionals will find helpful in caring for their breastfeeding patients.

In the first section, Point of Care Resources, there are links to the National Library of Medicine Drugs and Lactation Database (LactMed), Breastfeeding and Lactation: The Pediatrician’s Guide to Coding and the BiliTool, an online program designed to help clinicians to assess the risks for the development of hyperbilirubinemia or “jaundice” in newborns.

There are resources for best practices: links to The Breastfeeding Friendly Practice, Sample Hospital Breastfeeding Policies for Newborns, Lactation Support Provider (LSP) Descriptors click here, a link to the Infant Risk Center and lists the book, Breastfeeding Telephone Triage and Advice.

There is a section on Resources for Parents - information they can access directly when they have questions or need breastfeeding assistance. They list the National Women’s Health Breastfeeding Helpline, articles from HealthyChildren.org, free short videos in English and Spanish from firstdroplets.org and the many free videos from GlobalHealthMedia.org/.

For information about breastfeeding Basics and Common Concerns, they have a link to the Office on Women’s Health. The AAP also lists a link to the USDA’s WIC program and the breastfeeding services they provide.

Other Breastfeeding Organizations and Non-Profit links include the Academy of Breastfeeding Medicine, Human Milk Banking Association of North America, International Board of Lactation Consultant Examiners, La Leche League International, Lactation Education Accreditation and Approval Review Committee and the United States Breastfeeding Committee (USBC).

The AAP’s Breastfeeding Resource Page also helps professionals be prepared to support breastfeeding families during emergencies or disasters*.

Also available is the Breastfeeding Support and Promotion Speaker’s Kit with ready-made presentations on five different topics to educate anyone who has a role in breastfeeding support and presentation.

These resources can be accessed by clicking here.

*Fact sheet for supporting Breastfeeding in Disasters click here


Transfer of Opioids, Bipolar Meds, and Cannabis into Human Milk 

Presented by Thomas Hale, R.Ph., PhD
Wednesday, November 16

 

2023 Webinar Schedule

2023 Medela Human Milk Clinical Webinar Calendar

The 2023 Human Milk Monthly Clinical Education Webinar Schedule is now available! Download your copy today!

Innovating Practice – Colostrum

Written by Sharyn Gibbins, NNP, PhD

Medela's Innovating Practice Through Research and Evidence - Colostrum Topic

Colostrum is a vital food that is secreted shortly after birth and gradually changes in volume, consistency, components and appearance to transitional milk and mature milk. As the infant’s gastrointestinal tract and immune system develop, colostrum transitions over time to provide fewer immune factors and more calories and nutrients for growth.

This edition of Innovating Practice will explore three articles representative of important themes in the science of colostrum. The overall theme in this edition is: Colostrum is species-specific and changes over time to meet the immunological and nutritional needs of all infants; colostrum is readily available and inexpensive to use; colostrum plays a significant role in maintaining homeostasis at a time of vulnerability associated with prematurity or mode of delivery. Through ongoing analysis of this “liquid gold”, full medicinal, pharmacological and immunological benefits can be achieved. Click here to
read this installment.

Low Dose Dual Cap In-Service

Medela offers a variety of product In-Services that can be used to educate your staff on our products. We are happy to announce our new Low Dose Dual Cap In Service is now available. Click here to register and view the In-Service.

World Prematurity Day – November 17th

World Prematurity Day Purple Ribbon

November 17th is World Prematurity Day. This day is meant to remind us to take a moment to show compassion and support families who are going through the challenges of having a baby who was born premature. We thank all of the healthcare workers who work with these families while helping them care for their precious little one.

NEONATAL PERSPECTIVES BLOG

Honoring Infant Loss Awareness Month in October

Hospital bed image for Neonatal Perspectives blog.

Written by Jess Sember, MSN, RN, IBCLC, CPLC, CCE, SBD

This blog discusses how to help parents with the loss of an infant. In this blog you will find suggestions of some keepsakes you can offer to families as well as information about what to do regarding lactation after loss. Click here to read the blog.

My Perspective About Breastfeeding, By a NICU Nurse and Mom

NICU baby holding mom's finger

Written by Courtney Castillo, RN

As clinicians, not all of us get to be on both sides of the fence - as a nurse in the hospital and as a parent of a baby in the hospital. Courtney has experienced both and she is currently working as a nurse while raising 4 young (and all breastfed!) children. Everyone’s story is unique, but we are proud to recognize common threads and glean inspiration from people like Courtney who share their stories, struggles and successes.
Click here to read the blog.

AAP Resource Practice Tools for Healthcare Professionals

Maria Lennon, MSN, CNM, IBCLC

The American Academy of Pediatrics has a list of excellent resources that healthcare professionals will find helpful in caring for their breastfeeding patients.

In the first section, Point of Care Resources, there are links to the National Library of Medicine Drugs and Lactation Database (LactMed), Breastfeeding and Lactation: The Pediatrician’s Guide to Coding and the BiliTool, an online program designed to help clinicians to assess the risks for the development of hyperbilirubinemia or “jaundice” in newborns.

There are resources for best practices: links to The Breastfeeding Friendly Practice, Sample Hospital Breastfeeding Policies for Newborns, Lactation Support Provider (LSP) Descriptors click here, a link to the Infant Risk Center and lists the book, Breastfeeding Telephone Triage and Advice.

There is a section on Resources for Parents - information they can access directly when they have questions or need breastfeeding assistance. They list the National Women’s Health Breastfeeding Helpline, articles from HealthyChildren.org, free short videos in English and Spanish from firstdroplets.org and the many free videos from GlobalHealthMedia.org/.

For information about breastfeeding Basics and Common Concerns, they have a link to the Office on Women’s Health. The AAP also lists a link to the USDA’s WIC program and the breastfeeding services they provide.

Other Breastfeeding Organizations and Non-Profit links include the Academy of Breastfeeding Medicine, Human Milk Banking Association of North America, International Board of Lactation Consultant Examiners, La Leche League International, Lactation Education Accreditation and Approval Review Committee and the United States Breastfeeding Committee (USBC).

The AAP’s Breastfeeding Resource Page also helps professionals be prepared to support breastfeeding families during emergencies or disasters*.

Also available is the Breastfeeding Support and Promotion Speaker’s Kit with ready-made presentations on five different topics to educate anyone who has a role in breastfeeding support and presentation.

These resources can be accessed by clicking here.

*Fact sheet for supporting Breastfeeding in Disasters click here


Transfer of Opioids, Bipolar Meds, and Cannabis into Human Milk 

Presented by Thomas Hale, R.Ph., PhD
Wednesday, November 16

 

2023 Webinar Schedule

2023 Medela Human Milk Clinical Webinar Calendar

The 2023 Human Milk Monthly Clinical Education Webinar Schedule is now available! Download your copy today!

Innovating Practice – Colostrum

Written by Sharyn Gibbins, NNP, PhD

Medela's Innovating Practice Through Research and Evidence - Colostrum Topic

Colostrum is a vital food that is secreted shortly after birth and gradually changes in volume, consistency, components and appearance to transitional milk and mature milk. As the infant’s gastrointestinal tract and immune system develop, colostrum transitions over time to provide fewer immune factors and more calories and nutrients for growth.

This edition of Innovating Practice will explore three articles representative of important themes in the science of colostrum. The overall theme in this edition is: Colostrum is species-specific and changes over time to meet the immunological and nutritional needs of all infants; colostrum is readily available and inexpensive to use; colostrum plays a significant role in maintaining homeostasis at a time of vulnerability associated with prematurity or mode of delivery. Through ongoing analysis of this “liquid gold”, full medicinal, pharmacological and immunological benefits can be achieved. Click here to
read this installment.

Low Dose Dual Cap In-Service

Medela offers a variety of product In-Services that can be used to educate your staff on our products. We are happy to announce our new Low Dose Dual Cap In Service is now available. Click here to register and view the In-Service.

World Prematurity Day – November 17th

World Prematurity Day Purple Ribbon

November 17th is World Prematurity Day. This day is meant to remind us to take a moment to show compassion and support families who are going through the challenges of having a baby who was born premature. We thank all of the healthcare workers who work with these families while helping them care for their precious little one.

NEONATAL PERSPECTIVES BLOG

Honoring Infant Loss Awareness Month in October

Hospital bed image for Neonatal Perspectives blog.

Written by Jess Sember, MSN, RN, IBCLC, CPLC, CCE, SBD

This blog discusses how to help parents with the loss of an infant. In this blog you will find suggestions of some keepsakes you can offer to families as well as information about what to do regarding lactation after loss. Click here to read the blog.

My Perspective About Breastfeeding, By a NICU Nurse and Mom

NICU baby holding mom's finger

Written by Courtney Castillo, RN

As clinicians, not all of us get to be on both sides of the fence - as a nurse in the hospital and as a parent of a baby in the hospital. Courtney has experienced both and she is currently working as a nurse while raising 4 young (and all breastfed!) children. Everyone’s story is unique, but we are proud to recognize common threads and glean inspiration from people like Courtney who share their stories, struggles and successes.
Click here to read the blog.


Clinical Pearls in Lactation

This column is for lactation practitioners to share clinical challenges, successes, observations and pearls of wisdom with colleagues. If your submission is selected for publication in a future issue of Human Milk Insights, you will receive a $25.00 VISA gift card.

submit your pearl

Maternity Care Deserts in the US

Maria Lennon, MSN, CNM, IBCLC

The United States is suffering a crisis in caring for women of childbearing age. Maternal mortality rates are much higher in the US than in other industrialized countries. The evidence is clear that regular prenatal care results in improved outcomes for both mothers and babies. Nearly 7 million women live in counties where there is low or no access to OB care.

The March of Dimes (MOD) has just published the 2022 Maternity Care Deserts Report which explores different aspects of healthcare that affect how and where maternity care is provided in the US. It also confirms that access to maternity care is worsening throughout the country.

What is a Maternity Care Desert? 

Counties in the US which have no hospitals or birth centers offering obstetric care and no OB/GYN physicians or certified nurse midwives to provide OB care are called maternity care deserts.

What does it mean to live in a maternity care desert?

Women may have little access to appropriate preventative, prenatal and postpartum care if they live in counties with few hospitals or birth centers (one or fewer) providing obstetric care, few obstetric providers (fewer than 60 per 10,000 births) or a high proportion of women 18-64 without health insurance (10% or more).

“In the U.S., significant racial and ethnic disparities exist in maternal and infant perinatal outcomes. Disparities are also evident in access to care. Although the majority of women living in maternity care deserts are non-Hispanic White, 12.8 percent of Native American women who gave birth in 2020 lived in maternity care deserts. In 2020, one in 4 Native American babies (26.7%) were born in areas of limited or no access to maternity care services. Additionally, 1 in 6 Black babies (16.3%) were born in areas of limited or no access to maternity care services.”

There is a lack of equity in quality maternal care. Prior to childbirth, racial and ethnic disparities in maternity care exist. One in four Native American women (24.2%) and 1 in 5 Black women (20.1%) did not receive adequate prenatal care in 2020, compared to only 1 in 10 White women (9.9%).

A few of the findings in the MOD report:

  • In just 2 years, there has been a five percent increase in counties that have less maternity access. 
  • In maternity care deserts alone, there are approximately 2.2 million women of childbearing age and almost 150,000 babies affected.
  • In those 2 years, there has been a two percent increase in counties that are maternity care deserts since the 2020 report. That’s an additional 1,119 counties and 15,933 women with no available maternity care.

Do you live in a Maternity Care Desert?

To find out whether you live in a maternity care desert, the March of Dimes has an interactive map that can be accessed by clicking here.

Another very helpful tool provides a more comprehensive picture of the maternity care desert locations, as well the relationship between maternity care deserts and issues of race/ethnicity, income status, and health outcome disparities among women of childbearing age. “This map can be used by federal, state, local, academic, and other stakeholders to aid in the identification, education, and resource allocation necessary to combat the maternal health crisis affecting women and children in the United States.”

https://www2.deloitte.com/us/en/pages/life-sciences-and-health-care/articles/march-of-dimes-maternity-care-deserts-dashboard.html.

For more information and to read the full report click here.


Spotlight on Practice

This column is for lactation practitioners and facilities who wish to acknowledge the work of others. We invite you to submit suggested practitioners or facilities you would like to spotlight. If you have a suggestion, email education@medela.com.

send a nomination


This month we are spotlighting Heather Shelley, BSN, RN, LDEM, IBCLC

Megan Quinn

Heather Shelley is a nurse and IBCLC who originally hails from Canada, but now practices out of Lehi, Utah. She became interested in healthcare as a profession in part due to her father, who was a paramedic and often shared various stories from his work. Heather also notes that her interest in healthcare was already brewing when she was just ten years old as her parents were preparing her for the birth of a younger sibling. She says, “They asked me what I wanted brought home from the hospital after the birth. I asked for the placenta, but they didn’t actually bring it home and I was very disappointed!” Heather also mentions that she became committed to improving the birth experience for parents after the birth of her own son. This led to her attending the Midwives College of Utah and graduating as a midwife in 2009. Her career as a midwife has taken her across the globe, from Indonesia and Ecuador to Haiti, the Dominican Republic and back to Utah, where she currently practices.

Heather shares that she struggled to breastfeed her own children and, years later while helping with lactation at a hospital, opted to get her lactation consultant certification. She then went on to become an IBCLC in 2021 as a way to most optimally help families wanting to breastfeed. Currently, Heather owns the Birthing Your Way birth center. Here, she helps parents deliver their babies, completes postpartum visits and lactation consultations, and teaches nursing and midwifery students “as a way to create more people in the healthcare field that are passionate about improving the journey of parents.” Heather shares that Birthing Your Way is extremely Baby-Friendly and follows the guidelines of the Baby-Friendly USA initiative, including supporting immediate skin-to-skin contact, honoring the golden hour, establishing breastfeeding, and refraining from offering formula, pacifiers, or bottles to clients.

Heather says that current professional challenges she regularly encounters include working with insurances for families who are resistant or unable to pay out of pocket. She also notes an overall lack of awareness surrounding available resources to the public and the importance of better promoting these resources for families in need.

Outside of work, Heather shares that traveling is her passion. She also enjoys crystal hunting in the Andes Mountains and says, “we drive up, pull to the side of the road, and just dig. The crystals are right there.” She notes that, in the last year, she has visited Ecuador several times with the goal of eventually creating a birth center there.



Thank you to this issue's contributors!

Maria Lennon, MSN, CNM, IBCLC

Nurse-Midwife, Perinatal Education Consultant - Sedona, AZ

Katie McGee, RN, BSN, IBCLC

Education Consultant - Westchester, IL

Kim Colburn, BPC

Medela U.S. Medical Education Specialist

Megan Quinn

Medela U.S. Corporate Communication Specialist

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