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Lactastrophe

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You have seen it, a mother who runs into every problem possible as she attempts to begin breastfeeding.  One problem is solved, another one pops up.  How do these lactastrophies happen?

Usually it is related to a series of unwitting and unintentional circumstances during the newborn period in the hospital.

Perhaps it was no skin-to-skin contact immediately after birth

Or no initial feeding during the first hour after birth

Or separation of mom and baby for the initial bath, routine newborn care, or temperature stabilization

It could be a sleepy and sluggish baby due to maternal anesthesia during labor and/or surgical delivery

Maybe it was a lot of intrusions from visitors, cell phones or care providers interrupting the privacy of mom and baby

Maybe it was separation with the baby in the nursery so mom could sleep

Or a bottle of formula due to the infant’s excessive weight loss

Sometimes it is excessive IV fluids during labor causing both pathological engorgement and excessive infant weight loss

Sometimes is it a poor latch that leads to cracked nipples that leads to mastitis

Or a pacifier used to calm a baby when all he really wanted was to be held and fed

Perhaps to mother requests formula feeding due her misperception she has “no milk “ and  then her baby learns to prefer the bottle nipple

Or the mother’s confidence is shattered in her ability to breastfeed by inconsistent or even incorrect advice from her nurse or physician

We can stop this from cascading into a lactastrophe by getting mom and baby together right from the beginning, avoiding separations and the need for supplementation.  If we as a team of health care workers get most of this right, we can help avoid the next problem. 

But if many of these events occur, it is a lactastrophe waiting to happen!

Thank you to Alison Stube MD for coining the term lactastrophe and for inspiring this blog.

Vergie Hughes has a long history of experience in Maternal Child Health including labor and delivery, post-partum and pediatrics, and for the past 25 years she has been involved in lactation management. Ms. Hughes has a BSN from Pacific Lutheran University and a MS from Georgetown University. She has been a board certified lactation consultant since 1985. At Georgetown University Hospital, she was the director of the Human Milk Bank. She created and developed the National Capitol Lactation Center and the one week Lactation Consultant Training Program. This course has trained more than 4,000 Lactation Consultants since its inception in 1990.


She has been a private practice lactation consultant and business owner, and operated her own lactation center, Washington’s Families First. Lactation Education Resources On-Line is her website, offering training to professionals and information to parents as well. Ms. Hughes has served on the International Board of Lactation Consultant Examiners and has served on the IBLCE exam writing committee. Her first love is teaching and that is exemplified by the creativity of the courses she has developed. A series of courses “The In-patient Breastfeeding Specialist,” "The Out-patient Breastfeeding Specialist” and “The NICU Breastfeeding Specialist” are all designed to advance the lactation management skills of nurses at the bedside. She regularly teaches skills to labor and delivery nurses and just recently developed the course “Towards Exclusive Breastfeeding.”


Ms. Hughes is the program director and content manager for all of the on-line Lactation Education Resources courses. Ms. Hughes was recently honored with a “lifetime achievement award” as Fellow of the International Lactation Consultant Association (FILCA).

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Guest Wednesday, 22 November 2017