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Journal of Human Lactation, Ahead of Print.

Journal of Human Lactation, Ahead of Print.
Background:Prenatal care providers play a central role in breastfeeding outcomes. A survey on obstetricians’ support of breastfeeding was conducted in 1993 in Monroe County, NY. Since the landscape of prenatal care and breastfeeding support has changed significantly in the past 2 decades, we repeated and extended this survey in 2015.Research aim:To determine changes in breastfeeding support by prenatal care providers over a 20 year period.Methods:We sent a 46-item on-line or paper questionnaire to all categories of prenatal care providers identified by an online search. A breastfeeding support score was created based on the prior survey, with a maximum score of 3. One point was awarded for: (1) personally discussing breastfeeding; (2) generally suggesting breastfeeding; and (3) commonly receiving questions from patients. Data were analyzed using Chi-square.Results:We had 164 participants (response rate 80%). More current participants, compared to 1993, reported discussing (97% vs. 86%, p < .001) and recommending (93% vs. 80%, p = .001) breastfeeding. Only 10% of 2015 participants gave infant formula samples, compared with 34% in 1993 (p < .0001). Improvement in the support score was seen, with 98% of current participants having high scores compared to 87% in 1993 (p < .001). Similar numbers reported receiving breastfeeding education, though more reported that the education was inadequate (54% vs. 19%, p < .0001).Conclusion:Breastfeeding support improved significantly over time, even though breastfeeding education has not improved in quality or quantity. Improving education of prenatal care providers may help future providers be more prepared to support breastfeeding.

Journal of Human Lactation, Ahead of Print.
Background:Prenatal care providers play a central role in breastfeeding outcomes. A survey on obstetricians’ support of breastfeeding was conducted in 1993 in Monroe County, NY. Since the landscape of prenatal care and breastfeeding support has changed significantly in the past 2 decades, we repeated and extended this survey in 2015.Research aim:To determine changes in breastfeeding support by prenatal care providers over a 20 year period.Methods:We sent a 46-item on-line or paper questionnaire to all categories of prenatal care providers identified by an online search. A breastfeeding support score was created based on the prior survey, with a maximum score of 3. One point was awarded for: (1) personally discussing breastfeeding; (2) generally suggesting breastfeeding; and (3) commonly receiving questions from patients. Data were analyzed using Chi-square.Results:We had 164 participants (response rate 80%). More current participants, compared to 1993, reported discussing (97% vs. 86%, p < .001) and recommending (93% vs. 80%, p = .001) breastfeeding. Only 10% of 2015 participants gave infant formula samples, compared with 34% in 1993 (p < .0001). Improvement in the support score was seen, with 98% of current participants having high scores compared to 87% in 1993 (p < .001). Similar numbers reported receiving breastfeeding education, though more reported that the education was inadequate (54% vs. 19%, p < .0001).Conclusion:Breastfeeding support improved significantly over time, even though breastfeeding education has not improved in quality or quantity. Improving education of prenatal care providers may help future providers be more prepared to support breastfeeding.

Journal of Human Lactation, Ahead of Print.
Introduction:Childbearing women with primary or secondary Herpes Simplex Virus type 1 infection are at risk of transmitting neonatal herpes infection to their infants; a medical emergency that is associated with high mortality and morbidity. Neonatal herpes infection has been commonly associated with Herpes Simplex Virus type 2, or genital herpes, but can be caused by either subtype and the presentations are indistinguishable. This case describes the course of diagnosis, treatment, and recovery for a mother and infant during a severe maternal and neonatal herpes infection, and how lactation was maintained and breastfeeding re-established. Our children’s hospital coordinated its efforts to assist and monitor this breastfeeding family, and they were able to resume breastfeeding soon after discharge. It is our opinion that it is imperative that mothers receive evidence-based lactation care to maintain their breastfeeding relationship during extended hospital stays.Main Issue:An acutely ill infant was admitted to our urban children’s hospital with severe neonatal herpes infection for a total of 3 weeks. His mother was severely affected on her breasts and she required a brief hospitalization. The mother’s breasts were covered with draining herpetic lesions that required daily dressing changes. However, her lesions were slow to heal, and a wound care consultation was facilitated and her treatment plan was adjusted. We were surprised that she experienced minimal discomfort with pumping and dressing changes. The mother maintained a positive outlook, complied with the plan to express frequently to maintain milk production, and was able to breastfeed again when they both recovered.Management:This mother received immediate support and appropriate pumping equipment from our hospital personnel and was subsequently able to establish and maintain her milk supply. The difficulty in this case was the management of the mother’s extensive herpetic wounds that were slow to heal. A certified wound care specialist was required. Both mother and child recovered from their infections and were able to restart breastfeeding; eventually reaching their goal of breastfeeding for 2 years.Conclusions:Neonatal herpes infection is a potentially fatal disease and maternal child health professionals should have a high suspicion for any ill-appearing newborn with or without a rash. When a breastfeeding infant and mother become infected with Herpes Simplex Virus type 1, it is the responsibility of the healthcare institution to support lactation and the return to breastfeeding rather than recommend cessation of lactation, which is rarely necessary. A multi-disciplinary evidence-based approach to lactation care is essential to preserve lactation during infant hospitalization.

Journal of Human Lactation, Ahead of Print.

Journal of Human Lactation, Ahead of Print.

Journal of Human Lactation, Ahead of Print.

Journal of Human Lactation, Ahead of Print.

Dr. Camara Jones, MD, MPH, PhD, is a public health thought leader and pioneer, known for (among many things) her gift for telling stories that take your understanding of – and ability to break down – structural health inequities to the next level. Have you heard her speak about the cliff of good health yet? […]

We asked IBCLCs from all over world what lactation consultants do and when families should seek their help. WHAT is an IBCLC? An IBCLC is a healthcare professional who specializes in the clinical management of breastfeeding and chestfeeding. As Zoe Faulkner, an IBCLC in the United Kingdom, shared, “IBCLC lactation consultants provide experienced, expert and […]

Journal of Human Lactation, Ahead of Print.

Journal of Human Lactation, Ahead of Print.

No matter your role in lactation, you will find what you need to better ENGAGE with your work at #ILCA19. If YOU provide clinical care… Gain practical skills at our pre-conference Clinical Skills Rotation, on topics including tongue tie, massage, and supporting families after an intensive care stay or emergency. Find clinical skills during our […]

Kangaroo mother care is a comprehensive intervention given for all newborns especially for premature and low birthweight infants. It is the most feasible and preferred intervention for decreasing neonatal morb...

Every year, the Journal of Human Lactation (JHL) hosts a photo contest for the coveted cover spot for the four issues published during the coming year. The annual photo contest is your opportunity to contribute to the journal and highlight your community. JHL is seeking photos illustrating lactation professionals’ education role, which could be an […]

Since 2010, the World Health Organization recommends lifelong antiretroviral treatment for all women living with HIV, and exclusive breastfeeding for six-months followed by breastfeeding until 24-months for al...

The Journal of Human Lactation (JHL) is soliciting manuscripts about ethical issues pertaining to lactation and breastfeeding or chestfeeding for the February 2020 issue. Ethical discussions of these topics have been limited within the professional literature, despite the short- and long-term health benefits of human milk to families and communities’ health and wellbeing. JHL welcomes […]

In India, though breastfeeding is universally practiced, exclusive breastfeeding (EBF) rates in urban informal settlements are low; and health programs face several challenges in promoting EBF. In this study, ...

Breast milk provides nutrition for infants and also contains a variety of bioactive factors that influence the development of the newborn. Human milk is a complex biological fluid that can be separated into di...

Early skin-to-skin contact promotes infant physiologic stability, provides warmth and makes breast milk readily available. Despite the known benefits of early skin-to-skin contact, this practice is not include...