Center for Breastfeeding Medicine Supports Mothers at Cincinnati Children's and Beyond
Ellen Springer, MD
Breastfeeding, while natural, is not always easy. That’s why the Cincinnati Children’s Center for Breastfeeding Medicine (CFBM) is here to support women as they learn the ins and outs of nourishing their babies and grow to understand their bodies.
The CFBM offers clinical consultation for inpatients and outpatients. Inpatient services support the establishment or continuation of breastfeeding during periods of illness and help our babies in the Neonatal Intensive Care Unit, Cardiac Intensive Care Unit and Fetal Care Center get off to a good start. Members of the Breastfeeding Support Service in the Primary Care Clinics help mothers, starting from the newborn appointment throughout the time the mother feeds her infant breast milk. The outpatient Breastfeeding Medicine Clinic specializes in the evaluation and management of breastfeeding problems and provides focused support.
The CBFM staff consists of both physicians, registered nurses and dietitians who, on average, see 8,900 patients a year. All staff members are international board-certified lactation consultants. The lactation team also operates a telephone warmline, which answers questions related to breastfeeding from mothers and community healthcare providers. They receive over 1,000 calls per year.
Breastfeeding Benefits and Challenges
Research shows that breastfeeding improves health outcomes for both the mother and her baby.
When infants are breastfed, they have a reduced risk of infant mortality, SIDS, many infectious diseases, and reduced long-term health conditions, such as obesity, asthma, allergies, diabetes, and some childhood cancers.
When women breastfeed, they have a reduced risk of breast and ovarian cancer, as well as a reduced risk of developing heart disease and diabetes type II.
In addition to the physical benefits of breastfeeding, there is also an important emotional benefit. The act of breastfeeding allows for bonding between mom and baby.
Ellen Springer, MD, and Julie Ware, MD, MPH, two of the center’s outpatient physician lactation consultants, say most patients are seen for two reasons: moms are having trouble getting started or they have a low, or perceived low, milk supply.
“Breastfeeding is a learned skill,” explained Ware. The AAP recommends women should breastfeed exclusively for 6 months and then continue for at least 1 year with the addition of complementary foods. Only 25 percent of moms are still exclusively breastfeeding at 6 months, and only 35 percent are giving any breastmilk at 1 year. “Women who are facing challenges with breastfeeding are not alone, and we are here to help them,” said Ware.
At the CFBM, both mom and baby are evaluated at visits, so our physicians can explore challenges they are facing and create the best plan. The CFBM sees both mom and baby together because breastfeeding takes two and it allows for a deeper understanding of what the barriers are.
“The best part of my job is helping moms reach their breastfeeding goals. There is nothing better than assisting moms through challenges and learning about their success. If there are situations we can’t overcome together, I counsel moms that 'every drop counts.’ They have given their baby a good start in life. At CBFM, we provide encouragement and support,” said Ware.
Julie Ware, MD, MPH
- Breastfeeding is easy. Even though it is natural and babies are born with reflexes for breastfeeding, it takes practice so it works well for both mom and baby. Like learning anything, it gets easier as both become familiar with each other.
- Formula is close to breast milk. While formula manufacturers are trying to get as close to breast milk as they can, breast milk is specifically tailored to each child, which is something formula cannot do.
- I can’t breastfeed when I’m sick or taking medicines. During many illnesses, a child gets protection through breast milk. There are only a few instances where illness and/or medication would result in a recommendation to stop or pause breastfeeding. Your child’s healthcare provider can help guide you.
Tips and Resources
- Figure out why breast milk feeding is important to you. This can help sustain your goal through those harder times. Find out as much as you can before your baby arrives about breast milk and formula feeding so you can make an informed choice.
- Support works. Parents that have support to breastfeed, whether it is family, friends, a breastfeeding group, and/or healthcare provider, are much more likely to meet their own goal for breast milk feeding.
- Get help and get it early. There are many sources and types of breastfeeding help available in the Greater Cincinnati area. Some resources our CFBM provides include: -- Cincinnati Children’s Warmline: 513-636-2326 -- Global Health Media: Attaching Your Baby at the Breast -- Ohio Department of Health's free, 24-hour Breastfeeding Hotline- 888-588-3423 -- The Southwest Ohio Breastfeeding Coalition: Help & Support
Empowering Women to Breastfeed in Our Local Community
“As providers, we must show cultural humility with our patients. Moms from diverse cultures may have a different view on infant feeding and need culturally competent support,” explained Ware.
Our CFBM is constantly searching for ways to improve cultural competency.
To improve cultural awareness and increase breastfeeding rates in communities, the CFBM helped to launch All Moms Empowered to Nurse (AMEN). AMEN aims to break down barriers to breastfeeding and bring moms together for friendship and learning in a supportive environment. This program was so successful in Avondale, it expanded to Price Hill. Virtual meetings, added at the start of the COVID-19 pandemic, have seen great success as they allow busy moms to join from wherever they are.
Although breastfeeding in public is protected by Ohio, Indiana, and Kentucky law, some moms do not feel that our culture supports this practice. Our state breastfeeding coalition, the Ohio Breastfeeding Alliance (OBA), has developed tools and resources to use if a mom is ever asked to leave a public place because she is breastfeeding. “Once more mothers are breastfeeding successfully in our community, we will hopefully have a change in the culture so that more mothers will be comfortable breastfeeding in public,” said Ware.
The CFBM is continually looking for ways to broaden their reach and improve their care through education and research.
A lactation consultant’s education is essential for growth and required to keep certification current. Our CFBM team attends multiple presentations, conferences, and even hosts events to further education on breastfeeding. They are also working on research studies and projects, which include the following:
Rapid Cycle Improvement Collaborative (RCIC) project--Led by Sheela Geraghty,MD, MS, co-director, Center for Breastfeeding Medicine, the goal of this project is to provide remote breastfeeding support to all mothers of newborns in the Pediatric Primary Care Clinic.
The team was able to show that they could contact mothers through texting. The team then had a reliable contact number for the mothers and could call them to discuss any breastfeeding issues they were having.
Improving Exclusive Breastfeeding at Discharge Project--Laura Ward, MD, co-director, Center for Breastfeeding Medicine, leads this project, that works with area birth hospitals to increase the rates of exclusive breastfeeding at discharge.
Investigating Community Gaps in Breastfeeding: from Discharge to First Visit Project--Ware and a multidisciplinary team of prenatal, pediatric clinic providers and hospital providers aim to increase the number of babies who are still receiving any mother’s milk at the first visit to our three primary care clinics.
“As providers, we must show cultural humility with our patients.” -- Julie Ware, MD, MPH
Remaining Open Amidst COVID-19
The work at CFBM is so hands-on that it was deemed essential during the height of the COVID-19 pandemic. “While following all COVID-19 safety precautions, we were able to stay open and see and support all patients that came to us. This is a feeling of accomplishment for the CFBM because we feel as though every woman who was breastfeeding and needed support received it,” said Ellen Springer, MD.
The CFBM and the Division of Hematology have launched a study to explore the effects of the COVID-19 vaccine in breastfeeding women. The Antibody Detection of Vaccine-Associated Secretory Effects (ADVISE) study is examining the milk and serum of moms who have received the COVID-19 vaccine. Our research team will follow moms for one year to understand the lasting effects in hopes of learning new and helpful information. For more information email: ADVISEstudy@cchmc.org
There are many questions about the effects of the COVID-19 virus and vaccine on breastfeeding mothers. The CFBM offers guidance based on national health organization recommendations.
Given low rates of transmission of respiratory viruses through breast milk, the World Health Organization states that mothers with COVID-19 can breastfeed. A mother with confirmed COVID-19 or who is asymptomatic for COVID-19 should take all possible precautions to avoid spreading the virus to her infant, including washing her hands before touching the infant and wearing a face mask, if possible, while breastfeeding.
There is no current medical or scientific evidence to support the recommendation either way of breastfeeding while vaccinated for COVID-19. In the absence of science, we are not able to advise whether you should take the vaccine or not. The AAP says it is "not likely" that any harm would come to the child/Infant. However, you would need to balance the risk of contracting COVID and spreading it to your infant vs. the risk of the vaccine.