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Lactation consultation service educates new moms by Cindy Abole Public Relations Mothers and their newborns will now have a chance to learn the benefits of breast-feeding thanks to a new program that supports women through MUSC Women’s Services. The addition of this service within the Lowcountry’s only tertiary care hospital provides complete women’s care for South Carolina patients.  Proud papa Johnny Phillips II and MUSC lactation consultant Jeanne Barreira, delight in watching his newborn son, Johnny III, receive nourishment from with his mother, Ivonne Frebres. Since last August, MUSC’s Lactation Service has supported new mothers who receive care at the medical center with formal breast-feeding guidance and support. This service supports mothers and infants in the hospital’s neonatal and pediatric intensive care units, obstetric, medical-surgical and other pediatric patient wards. Care manager Jean Rhodes, R.N., Ph.D., and Jeanne Barreira, R.N., are certified nurse midwives who are also full-time accredited lactation consultants through the International Board of Lactation Consultant Examiners (IBLCE). Both are not only experts in the birthing process and with general women’s health issues, they also provide guidance and expertise for nursing mothers. Three levels of care Their purpose is based on a three-tiered approach to care. Primary is the ability to meet and interact with patients throughout the hospital in an outpatient setting. Secondly, they educate mothers and fathers, patients, staff and health care students about the many benefits of breast-feeding as a natural benefit for an infant’s growth, immunity and development. The final component addresses research. Rhodes began by exploring options for organizing lactation services for the hospital’s postpartum, antipartum and neonatal mothers. For years, Rhodes has informally made the rounds to patients offering guidance to nursing moms as requested or as time and duties warranted. In 2002, Rhodes made a formal proposal to Medical University Hospital administration about providing this as a full-time service. Through this, the team works with staff to organize breast-feeding classes, provide patient consultation and instruction, outpatient support, tracking and management of patient information for a lactation data base. “We want to communicate the many benefits of breast-feeding to more women,” said Rhodes. “Overall, research supports that breast-feeding results in an overall healthier child.  We’re challenged by today’s culture of bottle feeding by promoting something that’s natural and healthy for both mother and child.”  Team of support Also supporting this effort are a team of hospital nurses, nurse managers, physicians,  specialists and hospital administrators. “I’m supportive of this program,” said Lynne Nemeth, R.N., director of care management research and evaluation. “This is an important opportunity for our patients to learn and benefit from the breast-feeding process successfully. It provides a level of support for a new mother that’s the right thing to do.” Rhodes and Barreira are planning to establish an outpatient lactation clinic that will not only provide consult services but will encourage a healthy interaction for nursing moms of different cultures and experiences, according to Rhodes. Nursing benefits For years, health experts have touted the benefits of breast-feeding. The American Academy of Pediatrics, American Academy of Family Physicians and the Department of Health and Human Services support breast-feeding postpartum up to one year for good infant health. Breast-feeding provides the right mix of nutrients and antibodies that a developing baby needs for its immune system. Other benefits include a reduced risk of certain diseases including diabetes, sudden infant death syndrome (SIDS), gastronomic and intestinal diseases not to mention the economic and long-term health benefits for a child. For the mother, there is a reduced risk of breast and ovarian cancers, anemia and osteoporosis. However, the formula industry continues to be thriving and prosperous producing about $1 billion annually. But medical advocates have questioned the safety and benefits of formula milk versus mother’s milk. Lately, Western culture’s acceptance to breast-feeding has been mixed. For all its positive effects, breast-feeding can be labor intensive and time consuming for the mother. Problems with breast-feeding, milk production and continued maternal support can be the difference between a successful or negative experience, according to Rhodes. Limited patient time and lack of new knowledge prevent physicians and some nurses from enlisting in lactation support for new mothers. To offset this, the College of Medicine plans to offer an elective class for students about lactation and breast-feeding. And the service will continue to provide lactation lectures to other MUSC students.  “What we’re striving for is providing consistency in care for our patients,” said Rhodes. “What we provide is education and care in something that probably has been confusing or unknown to today’s mothers. Above all, we will always strive to offer expert advice as to what’s best for the mother.” Research The lactation consultants are assisting neonatologist Carol L. Wagner, M.D., in developing a proposal for a human milk bank. With research funding support from Wagner and other specialists, they are continually discovering and improving their knowledge of the importance of breast milk in an infant’s growth and development.  The establishment of a human milk bank (currently only six in the country) will benefit high risk newborns. Wagner is a fellow with the Academy of Breastfeeding Medicine, an international professional organization that promotes and support breast-feeding and human lactation. Since 1994, she has conducted research on the effects and benefits of human growth factors in human breast milk. Borrowing from lacto-engineering developed for the modern dairy industry, the facility plans to have the ability to receive milk donations, process, analyze and prepare human milk for premature infants. “All of this is possible thanks to people like Jean Rhodes and a critical core of medical staff supporters who share the same vision to work well with each other to make this service preeminent throughout the medical center,” Wagner said. Progress in breast pump technology, equipment and other devices have continually improved. The service also offers mothers the Medela Symphony Pump, a hospital grade breast pump for rental. Other pumps are available to purchase. By providing top quality devices backed by reliable expertise more women will embrace breast-feeding as a healthy way to bond and nurture their child.  “Although we know we’ll eventually run into obstacles, we feel blessed because we’ve come a long way in making this a reality,” Rhodes said. MUSC Breast-feeding Programs Free breast-feeding class for parents from 6 to 8 p.m. Aug. 28 and Oct. 30. To register, call 792-5300. Lactation Consultation—Available by consult or appointment. Lactation Line 792-0780; Jeanne Barreira, and Jean Rhodes, both certified nurse midwives and board certified as lactation consultants. Medela Pump Rental and Sales—Best pricing and service in town. MUSC Consultation Service, 792-0780. Breast-feeding Myths After a year, breast milk loses its nutritional value. False. Breast milk continues to provide perfect nutrition as long as the mother continues to breast-fed. It always contains valuable nutrients, hormones and immune agents. You can’t get pregnant if you are breast-feeding. False. Breast-feeding can help delay ovulation and pregnancy, especially if a woman is exclusively breast-feeding, but women can and do get pregnant while nursing. If you truly do not wish to become pregnant, it is wise to use a reliable form of birth control.   NNICU continues to benefit from new service   For 14 years, Neonatal Intensive Care (NNICU) nurse Theresa Koprowski, R.N., has been the reference person when it came to guiding mothers and staff about the benefits of breast-feeding for high-risk newborns. The NNICU has been longtime supporters to the practice. “It’s the best gift a mother can give to her baby,” said Koprowski, a certified breast-feeding counselor and herself a mother of three. “For pre-term babies, there are no expectations. But all of us share the same goal: to send a mother home with a baby that’s healthy.” Based upon their size, weight and condition, premature babies are sometimes too sick to nurse from a breast or bottle making it difficult to eat and thrive. Koprowski and other nurses find time to discuss feeding options early-on with new moms, including breast-feeding. Moms of premature babies are encouraged to pump breast milk within 24-hours. The nutrient-rich colostrum or early milk is like gold to these growing infants, she said. Smaller infants are fed tiny amounts of breast milk through a small feeding tube to stimulate the gut and see if they can tolerate breast milk. These trophic feeds are started and if tolerated can be gradually advanced by increasing the amount given to the baby everyday.  Koprowski and the lactation consultant work as a team helping nursing mothers wade through breast-feeding difficulties from pumping and storage to finding a comfortable position for baby while nursing.  NNICU moms are encouraged to pump milk for as long as they are able. But like many working moms, the challenge of returning to work after six weeks or sooner maybe the greatest factor for mothers to consider when it comes to their choice to nurse. Many non-committed mothers will try breast-feeding for trial periods of two weeks or more. But once they see their baby’s progress, they often change their minds, Koprowski said. “You don’t have to necessarily experience breast-feeding to understand it,” Koprowski said, who helps instruct its fundamentals with fathers and other supporters. The staff is continually involved with education through in-service training based upon reading, discussion, understanding of a woman’s physiology, infant development, eating and nutrition. They also have learned the values of multidisciplinary interaction with other specialists from physicians, occupational and respiratory therapists. “We’re pleased that they can be able to devote their specific time and expertise to our mothers and other patients.”   Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to petersnd@musc.edu or catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Community Press at 849-1778.