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UrduNancy McDaniel, a registered nurse and an international board certified lactation consultant at Penn State Health Children’s Hospital, calls herself a cheerleader for breastfeeding moms. “We’re here to make sure new moms can get to where they want to be with their infant — breastfeeding with ease and confidence,” she said.
Lactation specialists receive specialized education and training to assist mothers with establishing and sustaining breastfeeding, even in the midst of difficulties and medical conditions that might otherwise derail the effort.
Prenatal support
Ideally, breastfeeding support and education should start early, well before the baby is born, McDaniel said.
Tara Schmid, a nurse educator and an international board certified lactation consultant at Penn State Health St. Joseph Medical Center, agreed.
“We’ll reach out to our prenatal moms to ask if they’ve thought about how they’re going to feed their baby,” Schmid said. “If these moms have any medical issues that they know about, anything that could potentially cause problems with breast feeding — like a previous breast augmentation or reduction, or polycystic ovarian syndrome — we can discuss and plan ahead so they’re better prepared when they have their baby.”
One familiar roadblock McDaniel and Schmid face with prenatal patients is emotional: fear.
“They’ve heard horror stories about how much it hurts to breastfeed,” Schmid said. “I explain to them that when a mom feels pain while breastfeeding, it’s actually an important signal that the baby isn’t latched properly. We tell pregnant women that while they can expect tenderness the first week because of hormonal changes, breastfeeding shouldn’t hurt.”
While early education is key to providing a foundation of support for future breastfeeding, lactation consultants really step up to the plate once the baby arrives.
Early and ongoing support
“The most immediate problem typically is getting the newborn to latch on properly,” Schmid said. Lactation consultants work with moms with breast positioning to help the infant get a good latch. Meanwhile, “the infant is learning to coordinate their suck-swallow-breathe pattern,” she said.
In the first hours and days of breastfeeding, mothers often worry their infant isn’t getting enough to eat.
“Moms who bottle feed can say, ‘I just fed my baby two ounces.’ But breastfeeding moms don’t have that easy measurement for reassurance,” McDaniel said. “We tell them to trust nature. And for further peace of mind, we remind them that what goes in must come out, so they should watch their baby’s pee and poop.”
Hospitals provide breastfeeding moms with a booklet that gives them a table of how many bowel movements a newborn should have in a day. McDaniel also recommends that moms download a free app that they can use to make a record.
The role of a lactation consultant continues after the mom leaves the hospital with her newborn.
“I’m there for them as long as they want me,” McDaniel said. “I am a phone call away whenever they need me.” She said she sees new moms most often within the first two weeks postpartum — whether or not they delivered at a Penn State Health medical center. “It’s not always a one-and-done visit,” she said. “I’ve followed up with some families in person five, six times and then had additional phone consultations to reassure them.”
Common concerns that arise in the first few days and weeks postpartum include sore, cracked and sometimes bleeding nipples that most often result from a shallow latch, Schmid said. Complications can include clogged ducts and mastitis — an inflammation of breast tissue that may require antibiotics to treat. Women should call their doctor if they experience any symptoms, including pain, swelling, warmth or redness in the breast, or a fever.
Both McDaniel and Schmid want moms to know breastfeeding difficulties aren’t uncommon and to seek help from a lactation consultant.
“We see the moms who’ve been asking themselves, ‘Am I the only person who’s struggling with this?’ McDaniel said. “And I keep telling them, if you were the only person with this problem, I would not have this job.”
Related content:
- The Medical Minute: Information, support can lead to breastfeeding success
- Mom and baby sleeping in same room associated with less sleep, unsafe sleep habits
The Medical Minute is a weekly health news feature produced by Penn State Health. Articles feature the expertise of faculty, physicians and staff, and are designed to offer timely, relevant health information of interest to a broad audience.
