breastfeeding and lactation medicine

This medical specialty combines breastfeeding, the act of the baby at the breast receiving human milk, and lactation, the process of making human milk to meet the specific needs of families desiring to breastfeed. Physicians, nurse practitioners, and physician assistants provide lactation counseling and medical diagnostic and treatment care for breastfeeding and lactation issues.

There are 130 practices in the US and Canada and another 13 internationally. We are the only Breastfeeding and Lactation practice in Nevada.

Participating in the explosion of varied levels of lactation support in the past 30 years, I find that families can be very confused about what ‘help” they are getting. In a breastfeeding and lactation medicine practice, as a family nurse practitioner, families can be assured of the highest quality of care for their family’s well-being.

Practices that serve the medical needs of the breastfeeding families are on the rise. Often, these practices are led by visionary providers who notice that the physiology and pathology of breastfeeding parents and infants are not being addressed by the medical field.
Rosen-Carole, C. , Breastfeeding 2022.

Some parents know they need support or guidance and/or they were referred, but others ask, “Do I need a consultation?”

Consider these questions:

• What if you did nothing? Would your situation improve or deteriorate?

• Do you need peace of mind or can you go a few more nights wondering?

• Are you at a point in breastfeeding when a limited window of opportunity exists during which gains must be made or they will be lost?

• Do you know if these conditions need to be capitalized on?

• Has something happened that has increased your urgency significantly?

• Do you have a specific plan and are you comfortable with your plan?

• Why does waiting seem reasonable? Would you tell your friend to wait?

Seeking help can be beneficial at various points of your journey. For example:

• "Best practice" is a prenatal consultation and a follow-up visit the first week after birth. Early challenges, such as latching issues, nipple pain, feeding patterns, and behavior, can be addressed

• Milk supply is an ongoing concern. Parents often wonder if “my baby is getting enough”

• Feeding multiples

• Returning to work

• Sleep Training perspectives

• Maintaining supply when away from your baby for work, travel, surgery, or tests

• Medications safety

• Weaning at any time in the nursing journey

• Introducing solid foods

• Bottle or breast refusal

• Oversupply of milk

• Exclusive pumping

Although breastfeeding is portrayed as natural and intuitive, it is not culturally “normal.” Instead, it is a learned behavior requiring guidance, confidence-building, and fine-tuning. We would be honored to join you on your journey.

The priority is the parents’ goals and empowering them to nourish and nurture themselves and their baby. A thorough assessment is performed based on the intake information you provided and the health history of the mom and the baby. This is specific to the dyad but may include an infant oral exam to evaluate for tongue restrictions and the myriad of other oral structure and functional issues that may be interfering with breastfeeding.

To get the most out of our time together, you can expect the following:

Plan on arriving 15 minutes early to allow you to check in and verify your insurance so there are no financial surprises.

Once checked in, I will greet and guide you to our room.

I will address your concerns which may include examining your baby, your breasts, breastfeeding, bottle feeding, and or pumping.

I'll review what has been found with you and make recommendations for a sustainable plan to achieve your goals.

• Your baby who is ready to eat. It’s best if your baby is neither starving nor stuffed. Arrange the earlier feedings so the baby will likely be hungry soon after you arrive. Timing is impossible; try your best.

• You are encouraged to bring your support person/people with you.

• Pieces for the hospital rental pump, NOT the actual pump OR your personal pump and pieces if you are using it.

• Extra diapers, wipes, a change of clothing for baby - just in case.

• You may also be using other equipment, such as nipple shields, Medela 24mm, pacifiers, Haakaa, curves, and catches. Bring them.

• If you have difficulty making all the milk your baby needs, bring the milk you’ve pumped or formula and your bottle.

• An open mind. And pat yourself on the back for seeking assistance. I aim to leave you with a plan to feel empowered and more confident in your breastfeeding journey.

When breastfeeding difficulties occur, the American Academy of Pediatrics recommends that an IBCLC see mothers and babies. The Affordable Care Act allows visits for lactation services before and after birth without a cost share to the mother. As your baby is also seen, weighed, examined there will be a charge for those services which may result in a cost share to you. Please refer to your insurance policy for benefits specific to your plan. If you are without insurance or we are not contracted with your plan, we have self-pay prices available.

A summary and plan with a course of action will be given to the family, including scheduling a follow-up appointment if necessary.