Registed Nurses' Association of Ontario

Breastfeeding Best Practice Through Education

Linda McDonald
St. Thomas Elgin General Hospital

The benefits of breastfeeding to both the newborn and its mother are many and of great and life long importance. The St. Thomas/West Elgin Ontario region’s incidence of breastfeeding, however, is below the provincial average, and educated professional lactation support for new mothers is often limited or non-existent. This shortfall has been recognized, and the St. Thomas Elgin General Hospital’s participation in the WHO’s Baby Friendly Initiative (BFI) is part of a plan to rectify this problem. Encouragement from management to apply for an RNAO fellowship was another sign of this commitment.

The fellowship presented a unique opportunity to improve my own practice in this specialized area, and to gain a much greater understanding of both the resources available in the area and how they interconnect.

The fellowship was designed to examine current lactation education best practices through completing an intensive Clinical Lactation Certification course as well as several other workshops and specialty courses. Resources available locally, in-hospital, and in the community were examined in cooperation with professionals from several disciplines. As well, careful study of the application of current best practices in a large regional centre (London), and of current breastfeeding education resources and delivery in the St. Thomas/West Elgin area formed a significant portion of the fellowship hours.

Level 1and Level 2 Breastfeeding Courses were successfully completed. A Lactation Education Resource Clinical Lactation Specialist Certification was successfully attained. A comprehensive overview of lactation education resources available was developed. On a personal level, my understanding of the subject has certainly increased greatly. Combined with a much better understanding of lactation education techniques, my scope of practice and expertise in the area have risen exponentially.

lactation education resources continue to be created and an ongoing resource is now available for the Women and Children’s unit at STEGH. Networking has been established and relationships with area Lactation Consultants and specialists in lactation education across the health care continuum have developed.

Next Steps:
I will pursue IBCLC certification in the spring. I will develop Standards of nursing care for the breastfeeding dyad. I will develop policy and procedures around skin to skin, zero separation, and supplementation guidelines for BFI safe feeding practices following the WHO code. I will continue training to be a BFi champion and educate disciplines that make up our patient care. I hope to establish a peer support group for mothers in hospital so that they can readily access knowledgeable breastfeeding help.

Going into the fellowship, I felt that I had an excellent knowledge base for breastfeeding, but I am truly humbled by the learning opportunities afforded to me by the fellowship. I look forward to sharing my learning and shaping best practice at STEGH. I have acquired lactation counseling skills, and have learned about: medications, galactogues, effects of breast surgeries, how to take a lactation history, how to develop feeding plans for complex and common lactation problems, using lactation aids, where to develop and enrich resources, where to refer for follow up, and much more. I have gained a deep respect and understanding of what lactation consultants accomplish and marvel at the knowledge and responsibility they have and the life long impact it can have. I am thankful for this opportunity to take the best from many LCs and make it my own