Breast Feeding Medicine Program
Concept and Objectives
A physician-directed, comprehensive program, bridging obstetrics and pediatrics, prenatal and postnatal, maternal and infant care, and charged with the responsibility for:
- Clinical Care
- Research
- Education
- Generating community and foundation support
Clinical Care
Goal
- Evaluation and revision of hospital policies and practices to improve the promotion and support of breastfeeding the preterm and term infant.
Objectives
- Increase the initiation and one month post-discharge breastfeeding rates of well newborns born at LPCH.
- In the NICU's and Intermediate Nurseries at all LPCH sites, increase the average 2-week post-partum 24-hour pumped milk volume in pump-dependent mothers.
- Increase the one-month post-discharge breastfeeding rates in premature infants discharged from LPCH and satellite nurseries.
Research
Goal
- Initial research goals will focus on real or perceived impaired milk production as the most common reason cited for early discontinuation of breastfeeding the term infant. This is also true of the preterm infant with the additional challenge of failure to transition the infant from gavage feeding to breastfeeding.
Examples of Specific Aims
- Identification of influential factors (pre-glandular, glandular and post-glandular) of lactogenesis in the pump-dependent mothers of premature infants.
- Evaluation of breastmilk markers, such as breastmilk sodium, for their clinical usefulness in the evaluation of lactogenesis in the pump-dependent mother.
- The relationship of multiple births and parity to milk production.
- The frequency of hypernatremia in newborns admitted for treatment of hyperbilirubinemia in order to document the association of impaired lactogenesis, hypernatremia and hyperbilirubinemia.
- Evaluation of the effects of the manipulation of the fat content in human milk on growth, GE reflux and "colic", including the association of hyperlactation, fat-poor milk and "colicky" behavior.
Education
Goal
- Heighten sense of interest, responsibility and competence of obstetrical and pediatric staff and students in supporting and promoting breastfeeding of the preterm and term infants.
Objectives
- Integrate breastfeeding basics into existing curriculum for students and house staff including at least composition and benefit of human milk, physiology of lactogenesis and physiology of milk transfer in breastfeeding.
- Provide ongoing in-service education in a user-friendly format at multiple locations regarding clinical issues in breastfeeding, including:
- Breastfeeding management of the infant with medical problems such as hypoglycemia, cleft lip/palate and prematurity.
- Breastfeeding management in the mother with medical problems such as HIV, herpes, drug treatment and addiction, and localized breast infection/inflammation.
- Prevention and management of common problems such as impaired production, latch-on and cross-cultural communication.
Community and Foundation Support
Goal
- Enhance awareness, involvement and support for breastfeeding from the general and philanthropic community.
Objectives
- Organize and launch support and education groups for mothers of preterm infants at each LPCH NICU site.
- Solicit opportunities to provide education to community groups on the social, medical and fiscal benefits of proactive intervention to support breastfeeding women.
- Develop partnership with community organizations that provide family support to include breastfeeding education and support techniques.
For more information, please contact Jane Morton, MD
