Course Module
Lactation and Infant Feeding
Lactation and Infant Feeding - Google Doc
or search for the PDF of this module here.
*NOTE: NMI's Study Group module formatting guidelines specify that students provide the text of each question, followed by a blank line and then their response. Sometimes cutting and pasting from the above pdf version causes formatting issues in your word processing document. If this occurs, please use the Google Doc version of the module to make a copy and save to drive.
Practice Guidelines Guidance
Suggested DVDS
BabyBabyOhBaby: Breastfeeding DVD - Available to borrow from NMI’s Media Library for the cost of return shipping! Also purchasable/streamable here if you want your own copy.
Dr. Jack Newman’s Visual Guide To Breastfeeding DVD - Available to borrow from NMI’s Media Library for the cost of return shipping!
PDF Resources
Lactation and Infant Feeding, Part 1 - Lecture Slides from the Hive Mind with Meredith Mance, CPM.
"The Impact of Tongue Tie and Frenotomy on Breastfeeding: A Call for Broadening the CPM’s Scope of Practice" by Anna Bohler, CPM - Midwifery Matters Magazine, Winter 2015
A Book For Midwives: Breastfeeding section - Hesperian Health Guides
Lactation Education Resources - Parent Handouts (published in many languages)
Online Resources
Websites
A Book For Midwives - Hesperian Health Guides, can view the Breastfeeding section online or view the PDF directly above
Stanford - Professional Education, Breastfeeding, many learning resources, videos, information, and more!
La Leche League - Non-profit organization whose mission is "to help mothers worldwide to breastfeed through mother-to-mother support, encouragement, information, and education, and to promote a better understanding of breastfeeding as an important element in the healthy development of the baby and mother."
The Lactation Network - For IBCLCs
CDC, Racial and Ethnic Disparities in Breastfeeding Initiation — United States, 2019
Academy of Breastfeeding Medicine - https://www.bfmed.org/protocols
USC, MADRES Center for Environmental Health Disparities - https://madres.usc.edu/
How to Become Mother-Friendly, Policies and Procedures for Hospitals, Birth Centers, and Home Birth Services - https://connect.springerpub.com/content/book/978-0-8261-2977-2/chapter/ch01
Asian Birth Collective - https://www.asianbirthcollective.com/
HIV and Body Feeding
HIV and Breastfeeding - Milk Matters: Mothers Expressing for Others
HIV and Breastfeeding - UNICEF
2016 Recommendations for ARV use perinatally - US Office of AIDS Research Advisory Council
HIV and Infant Feeding - World Health Organization (WHO)
Transgender and Body Feeding
Inducing Lactation, Possibilities & Outcomes, Trans Fertility Co.
Chestfeeding Classes, Sound Beginnings Family (dot com)
Transmasculine Individuals’ Experiences with lactation, chestfeeding, and gender identity: a qualitative study - BMC Pregnancy and Childbirth
Trans Women and Breastfeeding: A Personal Interview - blog post by transgender father Trevor MacDonald
Trans Breastfeeding - FAQ
Milk Junkies: Chestfeeding and Parenting Stories from a Trans Dad -Trevor MacDonald’s blog
Black Parents and Body Feeding
The Melanated Mammary Atlas, “Normalizing Brown breasts… improves care for the underserved by broadening the health professional knowledge base in real-time, one image at a time.”
Enhancing Breastfeeding Rates Among African American Women: A Systematic Review
Black Mothers Breastfeeding Association - BMBFA’s goal is to have a national impact on the reduction of racial disparities in breastfeeding success for black families.
Racial Disparities in Access to Maternity Care Practices that Support Breastfeeding - CDC Morbidity and Mortality Weekly Report, August 2014
Racial and Ethnic Disparities in Breastfeeding - article from Breastfeeding Medicine
Barriers to Breastfeeding for Hispanic Mothers - Celia Trigo Besore, from Breastfeeding Medicine Vol. 9 No. 7
Mothers’ Milk: Slavery, Wet Nursing, and Black and White Breastfeeding in the Antebellum South - E. West and R.J. Knight, University of Reading
Distant Echoes of Slavery Affect Black Women’s Attitudes Towards Breastfeeding - by Rose Hoban, North Carolina Health News
Infant Death Rates looking at bedsharing, breastfeeding, SIDS, and poverty disparities - Breastfeeding Medicine
Additional Resources
Book: Feed the Baby: An Inclusive Guide to Nursing, Bottle-Feeding, and Everything In Between Hardcover – August 1, 2023 by Victoria Facelli IBCLC (Author), Shruti Nagaraj MD MPH (Author)
Breastfeeding After Reduction Surgery - Breast Feeding After Breast and Nipple Surgeries (BFAR): Information and support for breastfeeding parents who have had previous reductions, augmentations, or nipples surgeries.
Inducing or Re-Inducing Lactation in Birthing and Non-Birthing Parents - Canadian Breastfeeding Foundation
Breastfeeding Complications - Ask Lenore (Lenore Goldfarb, PhD, CCC, IBCLC, ALC, a lactation educator and International Board Certified Lactation Consultant (IBCLC)
Videos
Dr. Jack Newman’s Visual Guide to Breastfeeding
33:25 minutes
Baby 28 hrs old, Baby-Led Mother-Guided Latching
Dr. Jack Newman - BreastFeeding Inc.
Caption (BreastFeeding Inc.):The baby starts searching for the breast. The mother guides him towards the nipple. The baby opens up fairly wide, but the mother does not bring the baby on as well as she could and the baby has a shallow latch. He should have more of the breast in his mouth. The baby is mostly nibbling at first though there is an occasional pause in the movement of the chin (see other videos showing good drinking). The mother starts compressing around 1 minute and 10 seconds, and the baby responds by starting to have pausing-types of sucks that indicate he is getting milk well.
2:51 minutes
Really good drinking
Dr. Jack Newman - BreastFeeding Inc.
Caption (BreastFeeding Inc.): This baby is drinking very well at the breast. The pause in the chin as the baby opens his mouth to the maximum, just before closing his mouth, indicates his mouth is filling up with milk; the longer the pause, the more milk the baby is taking in. Thus, it is obvious that the advice to feed the baby 20 minutes (10 minutes, 30 minutes, whatever) on each makes no sense. A baby who drinks as this baby drinks for 20 minutes on the first side could easily refuse to take the second side since he would be full. Even a shorter period of time drinking as he does could easily fill him up.
Compare this baby to the baby in the "nibbling" video. The baby in the "nibbling" video could easily spend hours on the breast and not get enough. The whole notion of feeding a baby by the clock makes no sense at all. The pause can also be seen in the first few days of life. See the videos of the 2 day old, 28 hour old and 10 hour old babies.
2:00 minutes
2 Day Old
Dr. Jack Newman - BreastFeeding Inc.
Caption (BreastFeeding Inc.): The baby in this video is only 40 hours old. Baby has a pretty good latch. Notice his chin is in the breast, his nose is away from the breast and he covers more of the areola with his lower lip than the upper lip. During the first part of the video, the baby has an occasional pause in the chin, but is mostly “nibbling” without drinking. Mother is using compressions, but not always as we recommend. She should compress while the baby sucks, but does not drink and not while he’s not sucking at all
Compressions at this age (before milk “comes in”), often work only after several series of compressions, unlike later, when the milk supply is greater, when compression usually works immediately. Around 1 minute into the video, the baby starts pulling a little at the breast, becoming impatient with the slow flow. Then, about 1 minute and 14 seconds, the baby starts to drink vigorously, and you can see several pausing type sucks in a row. The mother maintains compression until baby no longer drinks, then releases (at 1 minute 30 seconds). The baby starts sucking again at about 1 minute 37 seconds. Babies who are latched on and hungry will start sucking on their own. No need to tickle their feet or put cold cloths on their foreheads. Babies do not fall asleep at breast because they are tired, but rather because the flow is slow. How to maintain the flow? 1. A good latch 2. Compressions when the baby is sucking but not drinking See the how the baby in the video clip Introducing a lactation aid wakes up and drinks vigorously when the flow of milk increases again. Notice around two minute mark, the compression once again works well.
2:15 minutes
Good Drinking
Dr. Jack Newman - BreastFeeding Inc.
Caption (BreastFeeding Inc.): Note the position of the baby at the breast. Chin in the breast, nose not touching, baby covering more of the areola with the lower lip than the upper. An asymmetric latch. The pause in the chin as the baby sucks means the baby just got a mouth full of milk. The longer the pause, the more milk he got. A baby who drinks like this for 20 minutes straight (for example, we are not recommending feeding by the clock), might not take the other side, he would be full. Timing feedings makes no sense.
0:33 minutes
Nibbling
Dr. Jack Newman - BreastFeeding Inc.
Caption (Breastfeeding Inc.): This baby is eight weeks old and is doing almost no drinking, though very occasionally one sees a short pause in the baby's chin. A baby who breastfeeds only with this type of sucking could stay on the breast for hours and still not get enough milk. Something needs to be done here and if achieving a better latch, using compression doesn’t help, the baby almost certainly needs to be supplemented. The best way to supplement the baby is with a lactation aid at the breast.
Why?
1. Babies learn to breastfeed by breastfeeding
2. Mothers learn to breastfeed by breastfeeding
3. The baby continues breastfeeding and thus continues getting milk from the breast and thus increases the mother's milk production
4. The baby is not likely to refuse to latch on
5. There is much more to breastfeeding than breastmilk, as important as the breastmilk is
See the video clip "Inserting a Lactation Aid"
Visit BreastFeeding Inc.'s website for more videos like the ones above! Note: the breastfeeding video resources included above are also available in French and Spanish.
Chocolate Milk
Series on the state of breastfeeding in Black America
2:37 minutes
Entire series of videos can be accessed here.
An Interview with author Trevor MacDonald
CTV News Channel - Trevor MacDonald discusses his book, "Where's the Mother? Stories from a Transgender Dad" on CTV National News.
3:21 minutes
