Lactation Services and

Breastfeeding Education at Mercy

St. Elizabeth’s Boardman Campus
By: Mary Miller
 Physiology of Lactation

Lactation can be divided into 5 stages:

1. Mammogenesis- Preparation of the breasts for lactation.

2. Lactogenesis- Synthesis and secretion of milk from the breast alveoli.

3. Galactokinesis- Ejection of milk outside the breast.

4. Galactopoiesis- Maintenance of lactation.

 Hormones of Lactation

Estrogen / Progesterone
• From the 24th week of pregnancy, large quantities of estrogen secreted by the placenta and
ovaries cause the ductal system of the breast to grow and branch.
• Levels drop at delivery and remain low for the first several months of breast feeding.

Prolactin
• Produced in and released from the anterior pituitary gland in the brain.
• Stimulates milk production in the mammary glands.

Oxytocin
• Produced in the hypothalamus and released from posterior pituitary gland.
• Releases milk from the breast (Let Down Reflex)
• Helps the uterus to contract down to normal size.
Let Down Reflex
Stages of Breast Milk
 Common Problems in Breastfeeding

• Breast Engorgement
- Cold or warm compresses, warm showers
- Cabbage leaves
- Anti-inflammatory medication
- Breast massage, hand expression.

• Sore/ Cracked Nipples

- Correct breast feeding technique (latch, positioning)
- Lanolin ointment
- Breast shields

• Insufficient Milk Supply

- Increase skin to skin contact
- Increase feeding frequency or pump more often
- Rest, healthy diet, relieve stress
- Herbal remedies ( Fenugreek, Blessed Thistle, Goat’s Rue, Shatavari)
- Prescribed medication ( Metoclopramide)
 Common Problems in Breastfeeding

• Plugged Milk Ducts

- Warm compresses
- loose clothing
- Frequent feedings
- Lecithin (fat emulsifier)

• Mastitis
- Antibiotics for 10-14 days (Cephalexin)
- Breast feed or pump frequently
- Warm compresses before feeding
- Rest and adequate fluid intake
 Nurses Role in Lactation Counseling

• Education as early as possible.

• Assessing the patients knowledge about breastfeeding.

• Guidance on positioning and technique.

• Early correction/ intervention of problems to promote success.

• Promotes feelings of competence and confidence.

• Connecting the mother with other resources for support.

 Education Needed to Become a Lactation Counselor

• Certified Lactation Consultant (ALPP)

- 3 pathways
- RN, APRN, etc. or hold a bachelors degree
- Minimum of 45 hours of education with WHO/ UNICEF
- Proof of mastery of skills
- Can earn Advanced level training with extra courses

• Certified Lactation Consultant (IBCLC)

- Minimum of 95 hours of lactation specific education ( including 5 hours of
communication training).
- 3 pathways
1. Recognized Health Professional- 1000 of clinical lactation hours
2. Comprehensive Accredited Program-300 hours of supervised clinical lactation
experience
3. Mentorship- 500 hours of directly supervised lactation experience

- These trainings need to be completed in 5 years

- Sit for a board exam.
- Maintenance of Certification: CPR/ NRP, 250 hours of practice in lactation, Exam or
Con-ed (Recert. Every 5 years) +Fee
 Lactation Services and Breastfeeding Education

• Breastfeeding assistance for new moms and their newborns.

• Inpatient counseling
• Outpatient education

• Programs offered
- Babykind Virtual Breastfeeding Basics : Virtual Q&A sessions
- Virtual Breastfeeding Support Group: via Zoom
- Breastfeeding Class: In person classes (basics + latch, positioning, complications, pumping/
storing milk)
- Inpatient Consultations
 Lactation Consultant at St. E’s Boardman

Cassandra Campean CLC

• Sat for her boards in September still awaiting her results (IBCLC)
• Degree in Psychology
• Has been a lactation consultant for 20 years and is also a Doula and childbirth educator.
• Used to do home lactation consultation.
 Questions Asked

• How many consultants are employed here? Titles/ education?

- 3 full time, 1 part time.
- 2 are RNs with IBCLC certification, 1 dietician (WIC through Mercy)

• Are there home lactation consultants? If not, how do moms obtain assistance out of hospital?
- No home services. They have to seek outside help through WIC, classes, or online assistance. WIC
offers a peer program of women who have successfully breastfed to help teach others of the same social and
economic status.

• When was this program started?

- Began in the early 1990’s with IBCLC

• Who is the core population most served by your service?

- Really all walks of life. Primarily, Managed Care clients – single mothers. Women who qualify for WIC
services.
 Questions Asked Continued

• How has the Covid 19 pandemic affected your services?

- There were no in person or online classes offered during the pandemic. Inpatient was limited as well.
Internet classes are still not offered due to staffing issues. Only inpatient assistance is happening now.
The parents are only offered a Ymingo app for their electronic devices with instructional videos. 85% of
their patients don’t know about it or download it to use.

• Is there assistance through the hospital system for low income families?
- They are primarily referred to WIC and other local services as well as Medicaid.
 Resources For Information

Mahoning County
• WIC
• Tri-County Breastfeeding Connections

Ohio
• Ohio Department of Health
• WIC
• Ohio Breastfeeding Alliance
- 24 hour hotline: 1-888-588-3423
• Ohio Hospitals.org
- First Steps Breastfeeding Program (10 steps for successful breastfeeding)

Others
• La Leche League
• National Women’s Health and Breastfeeding Helpline
- 9a to 6p, M-F
 Resources

Admin, S. U. (n.d.). The Academy of Lactation Policy and practice. ALPP. Retrieved November
14, 2021, from https://www.alpp.org/certifications/certifications-clc.

Information & Programs. Mahoning County Public Health. (n.d.). Retrieved November 14,
2021, from https://www.mahoninghealth.org/programs/.

Kkovacs. (2021, July 1). IBLCE. Retrieved November 14, 2021, from https://iblce.org/.

Lactation services and breastfeeding education. Mercy Health. (n.d.). Retrieved November 14,
2021, from https://www.mercy.com/health-care-services/maternity-care-birthing-
centers/specialties/lactation-services.

Lowdermilk, D. L., Perry, S. E., Cashion, K., Alden, K. R., & Olshansky, E. F. (2020). Maternity &
Women's Health Care. Elsevier.