Marsha Walker

Editorial in Clinical Lactation | Early View Meet the Clinical Lactation Editorial Team Walker, Marsha, RN, IBCLC, RLC Clinical Lactation , Oct 2024, DOI: 10.1891/CL-2024-0024 Focus Article Metrics Article usage Cited by Crossref Google Scholar Focus

Objective: Breast pumps have been seen since antiquity and have become a ubiquitous part of breastfeeding. Breast pumps are used for numerous reasons and have become incorporated into law and regulations in the United States. Breast pumps have allowed breastfeeding and lactation to proceed both under normal conditions and with significant challenges. However, the rapid proliferation of breast pumps and their heavy promotion have prompted social criticism regarding whether pumps have displaced the promotion of direct breastfeeding and deflected addressing more pressing social issues such as greater investment in breastfeeding promotion and care and the creation of a national paid family leave policy. Methods: This survey of the history of breast pumps and accompanying concerns utilized historical and current references, U.S. patents, and perusal of government laws and regulations. Results: This history of breast pumps and accompanying concerns highlights the progression of breast pump technology, exposes social criticism of breast pumps, discusses alterations in expressed milk composition, and raises the possibility of altered infant health outcomes from consuming pumped breastmilk. Conclusions: Breast pump use is a necessity for many families and should be balanced against the potential of interfering with the breastfeeding relationship.

The infant formula shortage has dominated the headlines and caused frustration and anxiety among parents who rely on infant formula or specialty formulas to feed their infants or children. The Federal government has taken steps to ease this shortage but has been a major contributor to the problem. Most of the discussion has centered around increasing the formula supply but little has been discussed regarding reducing the demand for infant formula. This commentary explores the background to the infant formula shortage and encourages breastfeeding advocates to speak up and step up to decrease the pervasive creep of infant formula use.

Objective Cesarean deliveries can adversely affect breastfeeding. Alerting clinicians to new interventions may help reduce negative outcomes of cesarean section deliveries on breastfeeding. Methods Discussion of the literature on Enhanced Recovery after Surgery (ERAS) protocols is provided through selected references. Results Use of Enhanced Recovery after Surgery (ERAS) protocols following cesarean births has been shown to enhance patient satisfaction, decrease neonatal complications, and significantly improve breastfeeding rates. Conclusion Clinicians may wish to advocate for the adoption of the ERAS protocols for cesarean births in their hospital setting.

Rationale: Staying current with the burgeoning amount of breastfeeding research can be a daunting task. It is incumbent upon the IBCLC and other lactation care providers to be cognizant of new research and innovations in lactation support.Method: Recent products and findings regarding neonatal jaundice, hypoglycemia, mastitis, and therapeutic taping are presented.Findings: New research findings, techniques, and products have been gathered to augment the provider's knowledge and skill set regarding a broad range of items relevant to clinical lactation practice. Most are affordable options for practitioners and parents, and represent safe and effective options for screening and treatment.

To the Editor I wish to respond to the Clinical Guideline Synopsis on the Baby-Friendly Hospital Initiative (BFHI) by Bass et al, with an alternative approach l

Social media has been alight with descriptions of exclusive breastfeeding being dangerous, resulting in significant and severe negative outcomes in infants whose mothers wished to breastfeed. This backlash has been led by a campaign that uses inflammatory anecdotes and misleading and inaccurate interpretation of research to bolster its assault on breastfeeding. However, poor breastfeeding outcomes can and do happen. The narratives identify areas where clinicians can improve their delivery of care. A closer look at risk factors and interventions may help reduce the risk of poor outcomes and increase the likelihood of mothers meeting their breastfeeding goals.

Mastitis can be an unwelcome and debilitating visitor to breastfeeding mothers. The mammary gland has its own microbiome that can be affected by reduced polymorphonuclear neutrophil recruitment during the first 3 months postpartum, as well as the receipt of antibiotics during the last trimester of pregnancy. This can leave the breast vulnerable to pathologic bacterial overgrowth. Mammary dysbiosis is a process whereby the population of potential pathogens increases at the expense of the normal mammary microbiota. Multiresistance to antibiotics plus tricky evasion techniques engaged in by bacterial agents can result in microbes that are elusive to antibiotic therapy. Therefore, new strategies are needed for the treatment of this threat to continued breastfeeding. Bacteriotherapy, targeting harmless bacteria to displace pathologic organisms, is an emerging therapeutic intervention that uses probiotics instead of antibiotics. Once more high-quality clinical trials of strain-specific probiotics have been conducted, bacteriotherapy may move into mainstream mastitis treatment.