Joey Wahler (Host): They're an important part of a newborn's early development, so we're discussing breastfeeding and colostrum. Our guests, Jessica Albright and Celia Robertson, both are Registered Nurses and Lactation Consultants for Southeast Georgia Health System. This is Health Matters from Southeast Georgia Health System.

Thanks for joining us. I'm Joey Wahler. Jessica, Celia, welcome aboard.

Jessica Albright, RN: Thank you for having us.

Host: Great to have you. So, this is an important topic, of course, and great to have two experts. First, I'm wondering why each of you chose this particular specialty. How about you, Jessica?

Jessica Albright, RN: Breastfeeding is very important to me and I breastfed all four of our children. They were all different experiences, which really opened my eyes up to everything. And during my nursing career, after our third child, I asked my lactation consultant, how do I get your job? And she told me the pathway to take and after our fourth baby came along, I decided I want to do this.

So I started that and found employment in 2011. And began working with a wonderful group of IBCLCs at the hospital I came from, and I love helping mothers and getting them through their journey of breastfeeding.

Host: That's awesome. And so, a situation there where breastfeeding four children moved you toward this as a career. And so, how about you, Celia?

Celia Robertson, RN: Well, I started my nursing career in the neonatal intensive care unit. I worked there for 20 years, in numerous different roles as a bedside nurse, as well as an educator, and then combined those; but I saw the importance of colostrum, breast milk, what we're talking about today, and the breastfeeding and bonding experience for families.

I love working with families, so I went back, I got my IBCLC and became a Lactation Consultant in 2018, so that I could even provide more integrated care for families. And, it's such an important aspect of a baby's health and a mom's health. And so I love working with families, I love working with babies, and I love seeing them succeed in however they choose to feed their family.

 They come in and see us in outpatient. We have a nice outpatient facility with a rocking chair and, kind of a quiet space where we can meet with them and see what's going on and make a plan.

Host: And speaking of which, you led me beautifully into my next question. Celia has mentioned you provide the inpatient support and the outpatient follow up. And so tell us about the events, classes, support groups for mothers in need of that help.

Awesome. So basically one of you got started sort of from the outside looking in, so to speak, and the other was already getting an inside look. So Jessica, back to you and regarding your role, what's a typical workday like for you? I'm sure everyone is a little bit different in its own way, right? It sure is.

We are inpatient in the hospital. And we like to see every breastfeeding mom before they go home. We are there for feedings. We are there to answer a lot of questions and to help them with a strong beginning. The first week or two is a lot to learn your baby and have your baby learn also how to do it.

And we're helping them through that process. We also answer a lot of phone calls. Moms after they are discharged will call us with common questions and we walk them through those and some things to try at home. And then if they are needing assistance, they come in and see us in outpatient. We have a nice outpatient facility with a rocking chair and we have a Kind of a quiet space where we can meet with them and see what's going on and make a plan.

Celia Robertson, RN: Like Jessica said, we have a wonderful outpatient facility to see these moms after they're discharged. And dad's, partners come with mom and baby. So that's a wonderful follow up that Southeast Georgia Health System provides, it's amazing. And then we also have, it's called the Milky Breastfeeding Support Group.

And so that we offer the first and third Wednesday of every month. And it is a wonderful group for new moms, but also moms that have been there for a while. So we have moms that have just had a baby, bring their baby in. We offer them the opportunity to weigh their baby, we can actually, oftentimes we'll help with feedings, and oftentimes we have speakers come, so, professional speakers that come to talk about topics that are interesting to new moms. Also as the babies get older, those moms become more confident in breastfeeding and they are absolutely fabulous support for our new moms.

Host: So it sounds like that covers a little bit of everything beyond just breastfeeding itself. And so how can families sign up to participate there, Celia?

Celia Robertson, RN: So, on Southeast Georgia Health System online, there are, you can sign up for I should say, for the breastfeeding support group. Oftentimes though, moms just show up too and that's totally fine as well. The other as far as we have a lactation warm line we call it and parents can call seven days a week.

If we're not here, they can leave a message and we will call them back. So, oftentimes, like Jessica was saying, we answer lots of questions on the phone, but from there, if they need to be seen, that's when we can book them into outpatient and we try to see them as soon as we possibly can.

Host: That's great. So Jessica, back to you and let's talk about colostrum for a moment. It's a word that I had never even heard when our daughter was about to be born almost two years ago next month. So what is it? When does it come? And why do babies need it?

Jessica Albright, RN: Colostrum is meant for the newborn. A mother's body starts making this during pregnancy, actually in the first trimester. So it's preparing for the baby early on. And this small, very potent, concentrated milk, we call it liquid gold also, it is intended for our newborn. It is packed with antibodies

that help the baby's immune system. Also proteins, fats, and sugars. So it's everything the baby needs and it coats their inside, their gut health. We talk about that a lot these days. Helps them be prepared for mature milk that will come and change on day three, four, and five. So colostrum is just what the baby needs.

And, the mom's been making that all through pregnancy.

Host: Really amazing. So, Celia, a new trend, relatively speaking, is called harvesting colostrum at the end of pregnancy. And so what is that and what's its benefit?

Celia Robertson, RN: Around 37 weeks, some literature is showing even 36 weeks, moms can start doing hand expression, and collecting that colostrum ahead of time. So the benefits of doing that is it's great practice for moms, so to get them to know their body better and as well as seeing that milk is extremely empowering for moms.

But also on top of that, they can freeze that milk and they can bring it into hospital. It's very beneficial if for some reason your baby, can't eat right away, or you have a separation with your babies, which we see if babies end up needing additional nursery care or NICU care.

You already have that colostrum available to them, and it's exactly what they need at that time. We always say, make sure you talk to your physician first, and get clearance to do that, but it is a wonderful thing that moms can start to do, as long as it's cleared by their physician.

Host: And speaking of which, Jessica, I presume harvesting colostrum is safe, yes?

Jessica Albright, RN: Yes, it is. It actually prepares the mother's body. They get a lot of empowerment. They see this small amount of milk for their baby. And as long as she doesn't have any concern for preterm labor; again, talk to their OBGYN first. It should be perfectly fine.

Host: And naturally, you and yours can answer any questions and offer any help needed when it comes to that as well, right?

Jessica Albright, RN: Yes, sometimes mothers ask us this on the phone, before they deliver and we talk with them one on one about it and the steps of how to do it when they are at home.

Host: So Celia, new moms often wonder why they're not immediately producing milk, and if not, when they will. So at what point should they be concerned? Because, am I right, normally there is no cause for concern.

Celia Robertson, RN: You're right. That's very true. We always ask moms if they had breast changes in pregnancy, that's a good indication that your hormones are on board and things are moving forward. The hand expression ahead of time, like we just talked about, is a very helpful way of helping moms see that they do have colostrum there.

And colostrum's in very small amounts, so it's very, very concentrated. It's full of antibodies for baby, coats the gut. It's the perfect food, but it's in very small amounts because baby's only take in about an ounce in that first 24 hours. Their tummy is the size of a marble in that first 24 hours. So the amounts that they need are very small. And then from there, milk starts to increase around day three to five. Now, if you've had previous pregnancies and breastfed before, sometimes it's right away. Sometimes moms see lots of milk, but generally it's around day three to five.

And so we do a lot of counseling for moms around that because it's one of the biggest concerns we find in hospital, that moms are concerned that they don't have enough. s

Host: So, Jessica, to facilitate that baby latching in the hospital, it's been mentioned. Talk a little bit please about exactly what hand expression is and spooning as well.

Jessica Albright, RN: So, in the first one to two days while baby's learning, mothers can hand express. It's a type of massage really and we talk them through the technique. It's more than just a squeeze. And usually after about two or three minutes, they see their colostrum come out. So if we do that, babies can smell this, they can taste it.

We can put it by their nose, their lips and get them enticed. And they open wide and learn to latch. It's very positive in facilitating the latch technique. And then when the mother sees her colostrum, again, it's very empowering. And, we do this a lot on day one and two, all the babies learning latching.

If you have a sleepy newborn, which is common in the first 24 hours, sometimes we collect some colostrum. We actually give our mamas this little kit. It's a little medicine cup with a tiny little spoon and a little one milliliter syringe. And this is a great way to collect a little puddle, and I tell the moms, it's just a little puddle, we spoon it to the baby, their eyes open, they start to move their mouth and their tongue, and we can help latch them on.

Host: That's great. So, Celia, how about a breast pump? When might that be brought into play?

Celia Robertson, RN: Well, a breast pump, we oftentimes you don't need an electric pump in those first few days. Providing lots of skin to skin, feeding baby frequently, 8 to 12 times a day, that's really all you need. Now, sometimes moms want to pump, and so we bring them a hand pump, but generally in the first couple days, hand pumping is more for stimulation of the breast, if baby's not coming to the breast, and then hand expression, like Jessica just talked about, is a much more effective way of getting the colostrum.

Now, the other time that moms might need to pump is if they are separated from their baby because of medical reasons. And so if they can't feed their babies at that point in time, we do get them pumping around the six hour mark after birth, and then they're going to be pumping every three hours, and that is to build their milk supply so that they have that stimulation that normally baby would be giving.

Host: A few other things. First, we're talking so far about moms, and rightfully so, of course. But let's get the dads a little attention here. Jessica, how can a new father help a mom during breastfeeding?

Jessica Albright, RN: That's a great question. First of all, having dad be supportive of breastfeeding is number one. If that's what is best for baby and mom's choosing to do that, having dad support her. There's little things he can be helpful with, undressing the baby, we mentioned skin to skin. And he can undress the baby, help wake the baby while the mom's getting herself ready with some pillows and getting comfortable in the bed.

He can also provide her with a snack. Our breastfeeding moms are really hungry, and rightly so. They are getting that milk supply established, providing for their baby, so a snack, water. Is she comfortable once they get in their feeding position? Does she need another pillow? Those little things matter. It is a partnership, and letting them know those little things, also being a gauge of have you had too many visitors in the room? Maybe we need to ask our families to step out and give us this time to learn breastfeeding.

Host: So the bottom line there is dads, just do something to be helpful, right? Don't just sit there and watch the ball game while all this is going on around you, right? So for both of you, I can't help but wonder, what does it mean to you personally to interact with moms and babies and help the community in such an important way? How about you, Jessica?

Jessica Albright, RN: I've always had such joy in seeing a mom reach her breastfeeding goal, and being a part of that, especially when I have the opportunity to have somebody come back in and see us, and I see them in the beginning of their journey and seeing their success, is very fulfilling, knowing that I've helped encourage her, and I think that's just where I, I find such joy in that, and our community needs that.

This is a specialty. And mothers need support. Somebody gave me support years ago with my children, and I also like to pay it forward and just to continue that.

Host: Celia your thoughts as well because really what Jessica's pointing out there is moms can't do it without you guys, right?

Celia Robertson, RN: Well, they can. We're a help. We definitely are a help. And, I love that part of it. I love, like Jessica said, I breastfed my two girls. And I had help, and oftentimes that little bit of support, sometimes it's a little bit of support, sometimes it's a little bit more support, and we're there for it, because it's all about empowering families, having them feel successful, and, I just love it.

I love working with babies and families. I've done it my whole career, and I love providing them with my experiences in working in NICU and working with moms and babies, throughout my career, but also I learn from them as well. So, I love that Southeast Georgia Health System provides this for our new families.

Host: And speaking of providing, Celia, let me ask you as well. Congratulations are in order. The Lactation Department recently earning the 2023 IBCLC Care Award for implementation of the Milky Weigh. Weigh as in W-E-I-G-H. So, what is that and how did you earn that great distinction?

Celia Robertson, RN: Well, full disclosure, I wasn't here when they won it. So, I got to, now partake in it. And it's wonderful. Like we talked about, it is our wonderful support group. Fully deserve to win an award on it because it really has brought a lot of moms and the community together and it continues to grow, which we're excited about.

And, Jessica, I'm gonna, I'm gonna defer to you on that because you were an instrumental part of building that.

Jessica Albright, RN: So during COVID, a lot of support groups that facilities, hospitals were offering had to come to a halt. And after COVID restrictions were lifted, it was very important to us to restart our group and let the families of the community know that SGHS finds this important and part of their breastfeeding journey.

So we reestablished and we tried to think of some creative ideas to bring moms in and what do they need and it really took off. So this award was for reimplementation and building that community support group.

Host: Congratulations again on that. Folks, we trust you're now more familiar with breastfeeding and colostrum. You heard from both our guests. They call it liquid gold. Jessica Albright and Celia Robertson, thanks so much again and keep up all your great work.

Jessica Albright, RN: Thank you so much. Thank you.

Host: Absolutely. And for more information, please visit sghs.org/breastfeeding. If you found this podcast helpful, please do share it on your social media. I'm Joey Wahler. And thanks so much again for being part of Health Matters from Southeast Georgia Health System.