How Our Breastfeeding Specialists Can Help
We offer lactation services to all parents who give birth at Duke, but if you have a medical issue that needs additional help, you may be referred to an expert in breastfeeding by your obstetrician or pediatrician during your pregnancy or following delivery. Our lactation consultants are part of your care team and coordinate with Duke providers to address potential challenges, such as creating an adequate milk supply for your baby or coping with painful lactation. We can also help you if you are on medication like chemotherapy or have medical conditions that affect breastfeeding such as a previous breast surgery or mastitis, an infection that occurs when the breast tissue becomes inflamed.
Breastfeeding Consultations Before and After Birth
Our lactation consultants identify potential challenges with breastfeeding at all stages of pregnancy so you can be prepared when your baby arrives. We work with you to find safe solutions to begin breastfeeding and bonding that is important to connect with your child.
Prenatal Consultations
If you struggled with milk supply during a past pregnancy or had breast surgery, you may benefit from a prenatal consultation with a lactation consultant. These consultations are offered by appointment at the Duke Family Medicine Center. During your appointment, a lactation consultant will review your health history and discuss a breastfeeding plan to follow when your baby arrives. You will receive educational materials specific to your breastfeeding needs and can use My Duke Health (previously Duke MyChart) to communicate with a lactation consultant during your pregnancy and after you deliver.
When Pregnant with Multiples
If you are pregnant with two or more children, we will meet with you before your expected delivery date to talk about your breastfeeding plans. This allows us to identify any risk factors and discuss potential challenges you may have with breastfeeding, including the complexities of feeding more than one child. A lactation consultant can work with you to identify different techniques that can make it easier to produce additional milk to feed your children. You’ll leave with educational materials about feeding your babies.
Postpartum Consultations
Common issues after birth such as low milk supply or oversupply, nipple pain, or swollen breasts can impact your ability to breastfeed. We evaluate your concerns and provide treatment recommendations to help you and your baby.
Treatments for Milk Supply and Lactation Needs
One or more of the following treatments may be recommended to help you breastfeed during a stay or visit at one of our hospitals or clinics.
Inducing Lactation
Lactation can be induced with medication and through physical techniques such as breast stimulation via feeding, electric breast pumps, and massage. These techniques help induce lactation in the birth parent and in non-gestational parents including parents who adopted a child, used a surrogate, have a partner who is delivering a baby, and are transgender.
Treating Low Milk Supply
A low milk supply can occur when breasts don’t empty effectively or efficiently, or when your baby’s latch does not create enough suction to stimulate milk production. An over- or under-active thyroid or polycystic ovary syndrome can also alter milk supply. Once we diagnose the cause, we may prescribe oral medication to increase your body’s milk production. We can monitor your milk supply with a breast pump or by weighing your baby before and after feeding. Dietary changes and herbal supplements may also be recommended to increase your milk supply.
Pain During Lactation
The way your baby latches for feeding, the fit of an electric pump, nipple spasms, and skin irritation are all common causes of pain during breastfeeding. Clogged ducts and mastitis can also cause pain. We identify the source of your pain and recommend ways to relieve symptoms so you can breastfeed comfortably.
Treatments for Breastfeeding with Medical Conditions
If you or your baby experiences a condition that requires extra care and support, we work with you to find solutions that encourage breastfeeding.
Preterm Delivery
Our prenatal consultations address concerns about your baby’s health and your ability to breastfeed. If you can’t have immediate contact with your child after birth, we help you with techniques such as hand massage to encourage milk supply within hours of delivery. If your child needs intensive care, we work with their providers to identify opportunities for short feeding sessions. These may include a combination of bottle and breastfeeding or alternative feeding methods combined with breastfeeding. When your baby is healthy enough to spend more time with you, we devise a feeding plan to meet your and your baby’s needs.
Babies with Cleft Lip, Cleft Palate, Low Muscle Tone
Children born with a cleft lip and/or palate can have a difficult time creating suction to breastfeed. Breastfeeding can also be difficult for babies with low muscle tone, like those who have Down Syndrome or are born premature. We coordinate with surgeons, speech pathologists, and pediatricians to help you and your child adapt in ways that encourage breastfeeding.
Frenotomy for Tongue Tie
Some babies are born with a “tongue tie,” a piece of tissue that connects the base of their tongue to the floor of their mouth. This can restrict movement of their tongue and make it hard to latch and breastfeed. We may perform a frenotomy to clip the extra tissue. Once healed, your baby can breastfeed normally.
Recurrent Mastitis
It is safe to breastfeed your baby if you have chronic inflammation and pain in your breasts, but it may be uncomfortable to do so. Problems can arise from past breast surgeries, oversupply of milk, clogged ducts, or a combination of issues. Antibiotics help relieve symptoms and make it more comfortable to breastfeed. We will test your milk to find answers and prescribe the right kind of medication that is safe for you and your baby.
Breastfeeding During Cancer Treatment or Surgery
Surgical procedures and most cancer treatments do not prevent you from breastfeeding safely. A prenatal consultation will help you understand your options. We may recommend feeding or pumping around scheduled surgery or cancer treatments including chemotherapy. We also coordinate with your providers to adjust or prescribe medication so it remains safe to breastfeed your baby.
