Leading Lactation Insights - December 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.

Tools from the Carolina Global Breastfeeding Institute

Maria Lennon, MSN, CNM, IBCLC

There is a wonderful resource for “all things breastfeeding” and it is located at the University of North Carolina School of Public Health in Chapel Hill, North Carolina. The Carolina Global Breastfeeding Institute (CGBI) is a public health breastfeeding center dedicated to increasing the understanding of and support for breastfeeding and offers a comprehensive program of research, service to the greater community, and education. Their approach prioritizes the reproductive health continuum, an intergenerational approach and the “Three B’s” (Birth, Breastfeeding, and Birth spacing) and includes attention to local, national and global health issues that impact the mother/child dyad.

The best way to find out about all the programs the CGBI offers and the resources available is to peruse the website: https://sph.unc.edu/cgbi/carolina-global-breastfeeding-institute. There you can find out about the variety of programs and trainings they offer. 

Here are a just a few of their initiatives: 

Ready, Set, Baby Prenatal Education Curriculum: This is a tool used for prenatal counseling on lactation and optimal maternity care practices. https://sph.unc.edu/cgbi/resources-ready-set-baby 

Empower Best Practices: A hospital-based quality improvement initiative funded by the Centers for Disease Control and Prevention: 
https://sph.unc.edu/cgbi/empower-training-initiative. A trainer manual has comprehensive training materials to implement skills-based competency in maternity care and breastfeeding. There are also downloadable modules available to assist trainers. 

Breastfeeding-Friendly Child Care Toolkits – to help childcare facilities become more knowledgeable and competent in being supportive and protective of breastfeeding families. https://sph.unc.edu/cgbi/breastfeeding-friendly-child-care 

Maternity Care and Postpartum Handouts for Patients and Staff: https://sph.unc.edu/cgbi/resources-maternity-postpartum 

Responsive Feeding Handouts for use in the US, and Culturally Adaptable Global Responsive Feeding Educational Messages. https://sph.unc.edu/cgbi/responsive-feeding 

Lactation and Infant Feeding in Emergencies (L.I.F.E.): Kit containing key resources to assist in supporting families with infants and young children in providing safe nutrition during emergencies. https://sph.unc.edu/cgbi/cgbi-resources-l-i-f-e-support-basic-kit

Lactation Training: 
The Mary Rose Tully Training Initiative is a two-semester Pathway 2 Lactation Consultant intensive training program which prepares students at the graduate level to become board-certified lactation consultants, https://sph.unc.edu/cgbi/lactation-consultant-training 

RISE Lactation Training Model – Reclaiming, Improving, and Sustaining Equity: a grant-funded project which aims to support the development of self-sustaining lactation consultant training programs at universities and colleges serving communities of color. https://sph.unc.edu/cgbi/rise-lactation-training-model-reclaiming-improving-and-sustaining-equity-2 

Breastfeeding University: Online learning modules which provide evidence-based up-to-date information to help give healthcare and childcare providers a working knowledge of how to support families and help them meet their breastfeeding goals. https://sph.unc.edu/cgbi/breastfeeding-university 

The Carolina Global Breastfeeding Institute has even more to offer those interested in promoting, protecting and supporting breastfeeding in both local and global communities. Check out their website to see the wide variety of programs, initiatives, and toolkits available to the public.


Antenatal Milk Expression: State of Science 

Diane Spatz, PhD, RN-BC, FAAN
Monday, December 5

 

Prenatal Colostrum Expression and Collection: A Creative and Empowering Approach to Enhance Breastfeeding Outcomes 

Staci Gallman, RN, BSN, IBCLC
Wednesday, December 5

 

Improving Mothers’ Own Milk Provision at NICU Discharge: Optimizing Achievement of Secretory Activation and Coming to Volume as Key Strategies 

Paula Meier, PhD., RN
Wednesday, February 15

 

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!

NICU Family Journey Video Series

As part of Medela’s commitment to fight infant mortality and malnutrition and in support of the NICU families, Medela’s three-part video series follows the NICU journey of Ashlee and her baby Natalie while highlighting the importance of human milk in the NICU.

This video series was captured by Fixing Us and recorded at Northside Hospital in Atlanta, Georgia. Medela is honored to share this story and bring visibility to the NICU experience and incredible team of caregivers dedicated to the families in their care. Click the links below to view this video series.

Episode 1 
Episode 2 
Episode 3

Colostrum Feeding and Collection: Protecting the Patient’s Liquid Gold

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

This blog discusses the function of colostrum and purpose of colostrum feeding. It also discusses the importance of capturing every drop and introduces a new solution from Medela to help with collection. Read the blog

Medela Professional YouTube Channel

Did you know Medela has a YouTube channel dedicated to Professionals? This channel is a resource for lactation consultants, midwives, OB staff, NICU staff, and any medical professional with an interest in lactation support. Check it out

Medela Consumer YouTube Channel

Did you know Medela has a YouTube channel dedicated to Professionals? This channel is a resource for lactation consultants, midwives, OB staff, NICU staff, and any medical professional with an interest in lactation support.

Check it out - https://www.youtube.com/medelabreastfeedingusa

Nursing Contact Hours

Are you in need of any Nursing Contact Hours? You can view any of our recorded webinars on our website www.MedelaEducation.com.

Now until December 31 you can use Promo Code AE3MGY and receive $15 off each course you register for, bringing the price down to just $5 per credit hour!

Tools from the Carolina Global Breastfeeding Institute

Maria Lennon, MSN, CNM, IBCLC

There is a wonderful resource for “all things breastfeeding” and it is located at the University of North Carolina School of Public Health in Chapel Hill, North Carolina. The Carolina Global Breastfeeding Institute (CGBI) is a public health breastfeeding center dedicated to increasing the understanding of and support for breastfeeding and offers a comprehensive program of research, service to the greater community, and education. Their approach prioritizes the reproductive health continuum, an intergenerational approach and the “Three B’s” (Birth, Breastfeeding, and Birth spacing) and includes attention to local, national and global health issues that impact the mother/child dyad.

The best way to find out about all the programs the CGBI offers and the resources available is to peruse the website: https://sph.unc.edu/cgbi/carolina-global-breastfeeding-institute. There you can find out about the variety of programs and trainings they offer. 

Here are a just a few of their initiatives: 

Ready, Set, Baby Prenatal Education Curriculum: This is a tool used for prenatal counseling on lactation and optimal maternity care practices. https://sph.unc.edu/cgbi/resources-ready-set-baby 

Empower Best Practices: A hospital-based quality improvement initiative funded by the Centers for Disease Control and Prevention: 
https://sph.unc.edu/cgbi/empower-training-initiative. A trainer manual has comprehensive training materials to implement skills-based competency in maternity care and breastfeeding. There are also downloadable modules available to assist trainers. 

Breastfeeding-Friendly Child Care Toolkits – to help childcare facilities become more knowledgeable and competent in being supportive and protective of breastfeeding families. https://sph.unc.edu/cgbi/breastfeeding-friendly-child-care 

Maternity Care and Postpartum Handouts for Patients and Staff: https://sph.unc.edu/cgbi/resources-maternity-postpartum 

Responsive Feeding Handouts for use in the US, and Culturally Adaptable Global Responsive Feeding Educational Messages. https://sph.unc.edu/cgbi/responsive-feeding 

Lactation and Infant Feeding in Emergencies (L.I.F.E.): Kit containing key resources to assist in supporting families with infants and young children in providing safe nutrition during emergencies. https://sph.unc.edu/cgbi/cgbi-resources-l-i-f-e-support-basic-kit

Lactation Training: 
The Mary Rose Tully Training Initiative is a two-semester Pathway 2 Lactation Consultant intensive training program which prepares students at the graduate level to become board-certified lactation consultants, https://sph.unc.edu/cgbi/lactation-consultant-training 

RISE Lactation Training Model – Reclaiming, Improving, and Sustaining Equity: a grant-funded project which aims to support the development of self-sustaining lactation consultant training programs at universities and colleges serving communities of color. https://sph.unc.edu/cgbi/rise-lactation-training-model-reclaiming-improving-and-sustaining-equity-2 

Breastfeeding University: Online learning modules which provide evidence-based up-to-date information to help give healthcare and childcare providers a working knowledge of how to support families and help them meet their breastfeeding goals. https://sph.unc.edu/cgbi/breastfeeding-university 

The Carolina Global Breastfeeding Institute has even more to offer those interested in promoting, protecting and supporting breastfeeding in both local and global communities. Check out their website to see the wide variety of programs, initiatives, and toolkits available to the public.


Antenatal Milk Expression: State of Science 

Diane Spatz, PhD, RN-BC, FAAN
Monday, December 5

 

Prenatal Colostrum Expression and Collection: A Creative and Empowering Approach to Enhance Breastfeeding Outcomes 

Staci Gallman, RN, BSN, IBCLC
Wednesday, December 5

 

Improving Mothers’ Own Milk Provision at NICU Discharge: Optimizing Achievement of Secretory Activation and Coming to Volume as Key Strategies 

Paula Meier, PhD., RN
Wednesday, February 15

 

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!

NICU Family Journey Video Series

As part of Medela’s commitment to fight infant mortality and malnutrition and in support of the NICU families, Medela’s three-part video series follows the NICU journey of Ashlee and her baby Natalie while highlighting the importance of human milk in the NICU.

This video series was captured by Fixing Us and recorded at Northside Hospital in Atlanta, Georgia. Medela is honored to share this story and bring visibility to the NICU experience and incredible team of caregivers dedicated to the families in their care. Click the links below to view this video series.

Episode 1 
Episode 2 
Episode 3

Colostrum Feeding and Collection: Protecting the Patient’s Liquid Gold

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

This blog discusses the function of colostrum and purpose of colostrum feeding. It also discusses the importance of capturing every drop and introduces a new solution from Medela to help with collection. Read the blog

Medela Professional YouTube Channel

Did you know Medela has a YouTube channel dedicated to Professionals? This channel is a resource for lactation consultants, midwives, OB staff, NICU staff, and any medical professional with an interest in lactation support. Check it out

Medela Consumer YouTube Channel

Did you know Medela has a YouTube channel dedicated to Professionals? This channel is a resource for lactation consultants, midwives, OB staff, NICU staff, and any medical professional with an interest in lactation support.

Check it out - https://www.youtube.com/medelabreastfeedingusa

Nursing Contact Hours

Are you in need of any Nursing Contact Hours? You can view any of our recorded webinars on our website www.MedelaEducation.com.

Now until December 31 you can use Promo Code AE3MGY and receive $15 off each course you register for, bringing the price down to just $5 per credit hour!


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

Breastfeeding Decreases Maternal Mortality

Maria Lennon, MSN, CNM, IBCLC

In recent years, research has shown us that, for mothers, breastfeeding reduces the risk of several morbidities. It is now widely accepted that breastfeeding decreases the risk of developing Type 2 Diabetes Mellitus, hypertension, cardiovascular disease and breast, endometrial and ovarian cancers. However, its association with mortality has not been well-studied. 

In a recent study published in the Lancet involving 166,708 women who had given birth, researchers found that a longer lifetime breastfeeding duration was associated with a lower risk of all-cause mortality in later life. These women were from two large cohorts of female nurses in the United States (U.S.) from the Nurses' Health Study (1986-2016) and the Nurses' Health Study II (1989-2019) who experienced at least one pregnancy lasting at least six months across their reproductive lifespans.

“The pooled multivariable-adjusted hazard ratios of all-cause mortality were 0.95 (95% CI: 0.92 to 0.98), 0.94 (95% CI: 0.91 to 0.98), 0.93 (95% CI: 0.90 to 0.97), and 0.93 (95% CI: 0.89 to 0.97), respectively, for women reporting lifetime total breastfeeding duration of 4-6, 7-11, 12-23, and ≥24 months, compared to women who breastfed for ≤3 months over their reproductive lifespan. Cause-specific analysis showed a similar pattern of non-linear inverse associations between lifetime total breastfeeding duration and CVD and cancer mortality (both p-values for non-linearity <0.01).”

This inverse association between longer breastfeeding duration and decreased mortality risk is biologically plausible when one considers the physiological changes of pregnancy such as additional fat accumulation essential for optimal fetal development and in anticipation of lactation. This additional adipose tissue results in increased visceral fat, insulin resistance, insulin production and circulating high lipid levels which could lead to an elevated risk of cardiovascular disease and cancer, and eventually to mortality. Studies in animals have shown that breastfeeding plays an important role in mobilizing stored fat, reestablishing glucose homeostasis, regulating insulin secretion and promoting lipid metabolism after birth. Observational studies suggest that breastfeeding is associated with improved glucose metabolism, and pancreatic beta-cell function, greater postpartum weight loss and risk of metabolic diseases. All these findings suggest that breastfeeding “plays a critical role in ‘resetting’ maternal metabolism by increasing metabolic expenditure.” This reduces the maternal risk of developing cardiovascular disease and cancer which decreases the risk of mortality in later life. 

The authors suggest that these results boost the evidence of the lifelong benefits of breastfeeding for mothers. Thus, policymakers and social communities should promote, support and protect breastfeeding. Healthcare professionals must do the same, especially in high-risk populations with low breastfeeding initiation.


Reference:
Wang YX, Arvizu M, Rich-Edwards JW, Manson JE, Wang L, Missmer SA, Chavarro JE. Breastfeeding duration and subsequent risk of mortality among US women: A prospective

.


Medela spotlighting Allegra Gatti Zemel, RN, IBCLC

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 Allegra Gatti Zemel, RN, IBCLC

Megan Quinn

Allegra Gatti Zemel is a Registered Nurse and IBCLC with nearly 20 years of experience in Maternal and Child Health in the hospital setting and beyond. Originally from Los Angeles, California, Allegra currently works at Greenwich Hospital in Greenwich, Connecticut on the maternity unit, within the lactation department, where she helps mothers of preterm and term infants initiate and maintain breastfeeding, educates new families on their feeding choices, coordinates postpartum lactation assessments, and serves as an RN. 

Allegra shares that she pursued healthcare as a profession because “science fascinates me and caring for people comes from my core as a person. My career has connected me with so many wonderful people and great families.” She decided to become an IBCLC while working in Maternal Child Care after welcoming her first child and finding her own breastfeeding experience “extremely foreign and challenging” at that time. Today, Allegra strives to educate and empower women, families, providers, and babies in fulfilling their feeding goals and desires. She performs in-home consultations to make feeding as comfortable and enjoyable as possible, and also provides education services as well as hospital visits and rounding to help set new families up for breastfeeding success – however they may define that. She has published a variety of blog articles and contributed expert content to a number of blogs and websites. 

Though Allegra shares that her current hospital is not yet Baby-Friendly, she notes that it does “work hard to support women to achieve their feeding goals” and would welcome more education about Baby-Friendly techniques to be disseminated if full designation is not currently possible. She says that current professional challenges include the amount of support that new families often require to initiate and maintain breastfeeding, noting that “as an IBCLC, I can only do so much. It takes a village, including obstetric providers and institutions, pediatricians, supportive families, and embraced babies.” As a result, Allegra has worked to help educate the larger healthcare community about lactation and feeding practices. She has presented breastfeeding research and data to her hospital’s maternity staff and previously developed and edited a perinatal teaching curriculum for The Parent Collective in New York and Connecticut.

In her free time, Allegra enjoys traveling and exploring nature with her family, friends, and trailblazing Tibetan Terrier. Thank you for your continued dedication to helping babies and families get the best possible start in life!


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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