Written by NPWH Board Member Tamera G. Borchardt, Lt Col, USAF, NC, DNP, WHNP-BC, and Amanda J. Anderson, Maj, USAF, NC, MS, ACNS-BC
August was officially declared National Breastfeeding Month in 2011 by the United States Breastfeeding Committee. Every year, groups including the World Health Organization, UNICEF, La Leche League, MomsRising, and a host of others promote the benefits of breastfeeding and encourage women to breastfeed throughout their child’s first six months. Thanks to these efforts, far more information, tools, and resources about breastfeeding are available, and advocacy is better than ever. WHNPs have a key role to play in supporting women as they consider breastfeeding.
What WHNP’s Need to Know
WHNPs are often the first-line providers for new pregnancies, fertility, and conception counseling. It’s crucial to have an early discussion about the benefits of breastfeeding so that mothers have time to research, take classes, ask questions, and make an educated decision about what’s best for her and her baby. WHNPs have the knowledge and experience to make this conversation as comforting and informative as any other about women’s health concerns.
Information to discuss includes:
Benefits to Mothers:
- Recover faster from delivery; fewer complications; fewer maternal deaths
- Decreased risk factors for breast and ovarian cancer
- Decreased risk factors for Type 2 diabetes
Benefits to Babies – Decreased Risk Factors of:
- Ear Infections
- Diarrhea and vomiting
- Respiratory Infections
- Sudden Infant Death syndrome (SIDS)
- Type 2 diabetes
- Decreased childhood hunger/world hunger
- Decreased sick time and lost wages
- Environmentally friendly (decreasing cans, bottles, and trash created with bottle feeding)
Know What to Ask and Who Can Help
In just a brief conversation with your patient, you can work together to figure out what resources she has access to and how they can help to make nursing go smoothly. It’s good to keep a list of these resources in your facility or area, including lactation consultants, breastfeeding classes, WIC services, local La Leche league, and/or new parent support programs. It’s also important to know whether your clinic can assist with breast pumps and other equipment.
Here are some questions you can ask to help your patient make a plan:
- To what extent does your insurance cover pumps and equipment?
- Where would be best to pump when you’re back at work? Does your workplace have a designated breast pumping room?
- Are you planning to take maternity leave after delivery? This can help with bonding and developing a breastfeeding routine.
If your patient is a working mother, she may need time to get comfortable with a breast pump.
Laura Atkinson, a lactation consultant at Wright Patterson AFB, says breastfeeding success can be dependent on the provider reengaging with mom at her follow-up post-partum visit, and then again after she returns to work. These are good times to check in and talk about any difficulties or barriers to breastfeeding they might be experiencing, and to help your patient with a plan to address them so they can continue to breastfeed, if possible. Keep in mind that it’s unwise to order or suggest a breast pump at the first sign of difficulty – sometimes all it takes is adjusting positions while breastfeeding to dramatically improve the experience for a mother.
The number one reason why mothers often give up breastfeeding after facing difficulties is a lack of support from a healthcare provider. WHNPs are in an excellent position to make a difference for these women by reassuring patients that they can be successful with the right knowledge, support from family, and plenty of patience. It’s important to remind patients that breastfeeding is a learned technique – being unable to breastfeed effortlessly the first time is not a weakness. And while the evidence does suggest breastfeeding is best, we need to listen and support our patients with whatever feeding decision they make.
First-hand Experience from a Working/Breastfeeding Mom
To wrap up this blog, Active Duty Air Force Nurse Major Amanda Anderson shares her personal experience with breastfeeding and the uniqueness she experienced with each birth.
I have been able to breastfeed both of my children until they were 10 months (baby #1) and 6 months (baby #2). Both of those experiences were completely different. With my first baby we were discharged from the hospital with little to no education about how to breastfeed and what to expect. I had this idea that breastfeeding would just “happen” and that my baby and I would have this symbiotic, natural experience. However, upon discharge we were not successful, and wound up back in the hospital – she had jaundice. Her bilirubin levels had increased to a critical level. When asked about her feeding habits, I naively responded that she was on the breast “all the time” so I thought she was getting exactly what she needed.
Looking back on that experience, I underestimated the work that goes into establishing that special bond with your child. After my baby received the medical treatment she needed and nutrition (pumped breastmilk and formula) I was able to reinitiate the breastfeeding relationship and successfully breastfed her until she was 10 months old.
My experience with my second child was very different. She was a healthy baby and we had a successful latch within the first hour of life. However, after about another hour of life her clinical picture worsened. She started to have an increase in respirations, her oxygen sats dropped, and she was becoming more lethargic and “floppy”. She was transported to the local children’s hospital to receive proper medical care and non-invasive oxygen therapy. We were in the NICU for a week, with a diagnosis of Transient Tachypnea of the Newborn and eventually jaundice. During those first few days of life, we were unable to establish that breastfeeding relationship because of her respiratory compromise. Thankfully, with the help of a lactation consultant and my support system, I was able to pump on a regular basis and provide her with the nutrition she needed. We also supplemented with formula until my breast milk came in. She received her feeds through an OG tube, and we began breastfeeding when she no longer required oxygen. We were successful for 6 months.
The intent of sharing my experiences with breastfeeding is to show that the relationship can look different between a mother and their child and that is okay. We are all trying our best to give our babies what they need: nutrition. Whether that’s exclusively breastfeeding, breastfeeding with supplementing, formula, exclusively pumping, whatever… it’s fine. Everyone’s story is different and so is their breastfeeding relationship.
- The General Surgeons Call to Action to Support Breastfeeding 2011. Available at https://www.cdc.gov/breastfeeding/resources/calltoaction.htm;. Accessed Aug 15, 2019
- National Breastfeeding Month 2019. Available at http://www.usbreastfeeding.org/nbm19;. Accessed Aug 12, 2019.
- World Breastfeeding Week 2019. Available at https://www.who.int/news-room/events/detail/2019/08/01/default-calendar/world-breastfeeding-week-2019;. Accessed Aug 12, 2019.
- Making the decision to breastfeed. Available at https://www.womenshealth.gov/breastfeeding/making-decision-breastfeed;. Accessed Aug 12, 2019.