July 2016
The Human Milk Insights newsletter presents the latest breastfeeding topics and clinical practice
solutions, addresses coding issues challenging the lactation community, features a lactation
service, as well as announces upcoming webinars and conferences.
CONTRIBUTORS
FEATURED STORIES THIS MONTH
Cindy Wagner MS, RD, IBCLC
Education Consultant
Medela, Inc.
Tuscaloosa, AL.
NEWS YOU CAN USE
 Human Milk in the NICU
 Human Milk in the Hospital and
Outpatient Setting
Maria Lennon, MSN, CNM, IBCLC
Nurse-Midwife
Tuba City Regional Health Care Corporation
Tuba City, AZ.
HUMAN MILK WEBINARS
 Fitting Breast Shields: Determining the
Correct Breast Shield Size
Irene M. Zoppi RN, MSN, IBCLC
Clinical Education Specialist
Medela, Inc.
McHenry, IL.
CODING CORNER
 Licensure and Reimbursement, Does it
Matter?
CLINICAL PEARLS IN LACTATION
 Licensure Affects Clinical Practice
SPOTLIGHT ON PRACTICE
 Leah Aldridge, JD, IBCLC, RLC
NEWS YOU CAN USE
HUMAN MILK IN THE NICU
Neonatal Gravity Feeding: What Are The
Challenges?
Sandy Beauman discusses feeding in the NICU
and the challenges with selecting the best
method.
http://blog.neonatalperspectives.com/2016/06/22
/neonatal-gravity-feeding-what-are-thechallenges/
Warming Infant Feeds
To warm or not to warm infant feedings is not
really the question. Obviously, refrigerated milk
is likely to have an impact on the temperature of
a very low birth weight infant, although the
extent of that impact will depend on the
temperature and volume of the milk. However,
what temperature is best for milk delivery
remains without extensive research.
http://blog.neonatalperspectives.com/2016/05/19
/warming-infant-feeds/
NICU Barista’s Guide to Warming Mother’s
Milk
It is clear that the science of human milk feeding
still has many questions to answer. To all the
human milk baristas (moms, nurses, milk
technicians) working our infant lattes day in day
out, thanks for being part of such a sophisticated
craft!
Nine Human Milk Post Resources for NICU
Professionals
We’ve compiled nine popular human milk blogs
from the past twelve months in order to provide
an instant resource to locate infographics,
clinical perspectives, research references, and
more.
http://blog.neonatalperspectives.com/2016/06/17
/9-human-milk-post-resources-for-nicuprofessionals/
HUMAN MILK IN THE HOSPITAL AND
OUTPATIENT SETTING
Article – Antibiotics May Blunt BreastFeeding's Benefits
Early use of antibiotics may dampen some of the
benefits of breastfeeding, a new study suggests.
Researchers found that babies who were
prescribed
antibiotics
while
they
were
breastfeeding or shortly afterward were prone to
infections and obesity.
http://health.usnews.com/healthcare/articles/2016-06-13/antibiotics-may-bluntbreast-feedings-benefits
HUMAN MILK WEBINARS
http://blog.neonatalperspectives.com/2016/05/23
/the-nicu-baristas-guide-to-warming-mothersmilk/
Fitting Breast Shields: Determining
Correct Breast Shield Size
Irene Zoppi, RN, MSN, IBCLC
July 20, 2016 from 1:00-2:00 pm CST
4 Amazing Ways Preterm Human Milk Differs
From Term Human Milk
What makes preterm human milk so special for
these infants who are born too early? How does
a mother’s early birth experience and her own
biology impact her breast milk composition?
There are many answers to those questions.
Today we are focusing on a few specific ways
the human body helps to compensate for an
early birth, and minimize the increased health
risks that come with it, through the advantages
of human milk.
This one-hour webinar will describe the process
of properly fitting breast shields. It includes a
review of the ultrasound work of Dr. Donna
Geddes regarding the anatomy of the lactating
breast and describes how milk removal is
hindered by ill-fitting breast shields.
http://blog.neonatalperspectives.com/2016/05/27
/4-amazing-ways-preterm-human-milk-differsfrom-term-human-milk/
http://www.medelabreastfeedingus.com/forprofessionals/Education/Programs/Detail/654
the
CODING CORNER
Licensure and Reimbursement, Does
it
Matter?
Licensure is an important first step for lactation
consultants getting paid for services they
provide.
The goal of licensure of any health professional
group is to protect the public. Licensure ensures
that an individual provider has met minimal
requirements for practicing the profession and
meets continuing competency standards. In
other words, licensure prevents unqualified
individuals from practicing.
In terms of paying for lactation services,
insurance companies have the responsibility of
protecting health care consumers. The Centers
for Medicaid and Medicare Services (CMS) have
rules which permit only licensed providers to
offer services and get paid. In the US healthcare
system, most private insurance companies
choose to follow the CMS guidelines and only
reimburse practitioners who are licensed. There
are some unlicensed providers who receive
insurance payments, but only very few.
In order for lactation consultants to consistently
be paid for their services, they must first be
recognized by the US healthcare system as
licensed
providers.
Hospitals,
insurance
companies,
health
policy
makers
and
consumers would then view the profession as
they do other regulated allied healthcare
professionals.
Once
licensed,
lactation
consultants would then be eligible for
reimbursement from Medicare/Medicaid and
private insurance companies.
There is no national licensure. It is up to each
individual state to legislate the need for
licensing. To date only two states, Rhode Island
and Georgia, have enacted legislation which
requires that lactation consultants be licensed.
More states will likely follow suit but the process
is a long one and takes a lot of work.
Contact your state’s professional lactation
consultant organization to see what efforts are
being made in the area where you practice.
More information can be found on the United
States Lactation Consultant Association’s
website: www.uslca.org.
CLINICAL PEARLS IN
LACTATION
This column is for lactation practitioners to
share clinical problems and successes,
observations, and pearls with colleagues. To
share a clinical pearl, submit it here.
Licensure Affects Clinical Practice
Professional licensing is an issue that directly
affects every lactation consultant in clinical
practice.
As healthcare professionals specializing in the
clinical management of breastfeeding, LCs have
long been committed to helping mothers meet
their individual breastfeeding goals, increasing
access to lactation services, increasing the
breastfeeding initiation and duration rates and
improving health outcomes. Your specialized
knowledge and skills have prepared you to
provide a professional standard of care, based on
clinical evidence and research.
State licensing….
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Delineates who can legally use the title
lactation consultant, thereby preventing
unqualified persons from practicing.
Increases credibility with other members of
the healthcare team and assists consumers,
colleagues, hospitals and insurers in
identifying and accessing qualified lactation
practitioners.
Protects mothers and babies by ensuring
they will receive quality care by a
practitioner who has met minimum
requirements and exhibits competence in
practice standards.
Fully integrates lactation consultants into the
US healthcare system and allows for
appropriate
billing,
coding
and
reimbursement.
Sets standards and provides a regulatory
framework to which practitioners are
accountable.
If you’re a lactation consultant, you may find it
helpful to research the topic of licensure and
determine the pros and cons related to your
clinical practice. For more information, visit the
United States Lactation Consultant Association at
www.uslca.org.
SPOTLIGHT ON PRACTICE
This month we are spotlighting Leah Aldridge, JD, IBCLC, RLC, founder and co-principal of
ABC-Atlanta Breastfeeding Consultants, LLC.
July 1st is an historic day for lactation care in Georgia. HB 649, the Georgia Lactation
Consultant Practice Act, signed into law on April 26, 2016 becomes effective on July 1, 2016.
This law makes Georgia the second state, after Rhode Island, to license lactation consultants.
Licensure increases mothers’ ability to obtain clinical lactation care and helps ensure the
healthiest possible start in life for Georgia’s babies. Since most insurance companies will only
pay for the services of licensed healthcare professionals, licensure opens the door for mothers
with private and public insurance to receive lactation services covered by their insurance
providers. The tireless, five-year journey that led to this legislation was directed by the passion
and dedication of Leah Aldridge, wife, breastfeeding mother of three young children, lawyer, and
champion of public policy to improve maternal and infant health outcomes.
Leah’s knowledge and passion for breastfeeding as well as her desire to assist in the welfare of
others was established as a young girl witnessing her mother’s efforts in supporting other
mothers with breastfeeding. In 1963, Nancy Stanton developed the first La Leche League
International (LLLI) chapter in Florida and later served on the LLLI board. For many years,
Nancy led League meetings in her home providing breastfeeding encouragement, information,
and education to mothers. Leah witnessed her mother’s loving support of young mothers with
their breastfeeding efforts. After earning a BA in English from the University of Virginia and a
law degree from Emory University, Leah practiced in the area of corporate healthcare for many
years with an Atlanta-based law firm. Since ‘retiring’ from practicing law, Leah’s interest in
assisting breastfeeding mothers and infants and healthcare policy has surfaced. She remains
an active member of LLLI and continues actively leading mother-to-mother support groups in
Atlanta. An IBCLC since 2010, Leah is the co-principal of Atlanta Breastfeeding Consultants,
LLC providing evidence-based lactation support, consultations, prenatal instruction and care in
an office setting with in-home consultation opportunities. For many years, Leah has served on
the Board of ‘Healthy Mothers, Healthy Babies Coalition of Georgia, Inc.’ a non-profit agency
that serves as Georgia’s voice for improved maternal and infant health outcomes and access to
healthcare. Leah currently serves as the agency’s president.
Leah views lactation licensure as a relevant, current and hot topic. The goal of the Surgeon
General’s Call to Action to Support Breastfeeding (2011), Action 11, ‘Ensure access to services
provided by Internationally Board Certified Lactation Consultants’ for all breastfeeding women is
not being realized. One step the Surgeon General recommended was licensure for IBCLCs as
there are insufficient IBCLCs to meet the lactation needs of all mothers. In Georgia, for
example, there are currently 364 IBCLCs, far below the number necessary to provide
appropriate care. Leah is actively working in Georgia to increase opportunities for other
clinicians within the lactation community to continue the journey in achieving the IBCLC status, if
they desire. She also looks to the future where all women, whether insured through private
insurance or Medicaid, have access to quality clinical lactation care and services.
Leah appreciates the excitement and momentous opportunity offered by the implementation of
this legislation. But the real test for Leah will be how this relates ultimately to the breastfeeding
initiation and duration rates for mums and babies in Georgia, “Come see me in five years and
let’s see where the breastfeeding metrics are for Georgia. That will be the real test of this
legislation.” Leah’s dedication and commitment to the cause of IBCLC licensure is driven by her
passion to improve maternal and infant health. What a great testament to the amazing lessons
Leah learned from her mother. Let’s hope Leah realizes her dream of increasing breastfeeding
initiation and duration for all women in the state of Georgia.
This column is for lactation practitioners and facilities who wish to acknowledge the work of
others. We invite you to submit suggested practitioners or facilities you would like to spotlight. If
you have a suggestion, submit it here.