New mom Sarah Rogers Spaulding (L) with Anya Koutras, MD, (R) family medicine physician and board-certified lactation consultant and twins Kinslee (R) and Cooper (L)!

New mom Sarah Rogers Spaulding (L) with Anya Koutras, MD, (R) family medicine physician and board-certified lactation consultant and twins Kinlee (R) and Cooper (L)!

World Breastfeeding Week takes place August 1-7, 2014, and highlights the importance of increasing and sustaining the protection, promotion, and support of breastfeeding. the University of Vermont Medical Center’s new Newborn/Lactation Clinic helps mothers understand how to breastfeed in a healthy and sustainable way. To learn more or to schedule an appointment, please call 802-847-8200.

Today, although 75 percent of women start out breastfeeding, only 25 percent are exclusively breastfeeding when a baby is six months old. Breastfeeding remains an important act of personal connection and critical step in a child’s healthy development. Guidelines from the CDC and prominent physician organizations recommend that mothers breastfeed in the first six months of a baby’s life. There is also evidence that breastfeeding is linked to long-term health benefits for mother and baby.

We spoke with new mom Sarah Rogers Spaulding about why she breastfeeds and with Anya Koutras, MD, family medicine physician and board-certified lactation consultant, about why breastfeeding is an important practice for women to continue.

Why is breastfeeding relevant in our modern world?

Anya Koutras: Breastfeeding has so many long-term health benefits for mothers and babies. Exclusive breastfeeding is associated with reduced respiratory and gastrointestinal infections in the newborn; reduced lifetime risk of obesity, diabetes and heart disease in children; and reduced risk of childhood cancers, inflammatory bowel disease, and allergies in children. For premature babies, the significant reduction in necrotizing enterocolitis and respiratory distress from breastmilk may be life-saving. For women, there is greater success to return to pre-pregnancy weight; lower lifetime risk of heart disease, obesity and diabetes; and reduced risk of breast, uterine, and ovarian cancers.

To enjoy these benefits, we recommend that moms exclusively breastfeed until six months, followed by continued breastfeeding with appropriate solids until at least 12 months and beyond as mutually desired. These guidelines are endorsed by the World Health Organization, UNICEF, CDC, American Academy of Pediatricians, and the American Academy of Family Physicians. As a mother, I feel very fortunate to have been able to breastfeed my children and grateful for the health benefits I was able to impart on them and myself. I was amazed by the wonderful bonding experience this turned out to be with each of my daughters and am grateful that I was able to continue breastfeeding as well as pump for each of them after returning to work.

Tell us more about the bonding experience.

Sarah Rogers Spaulding: For a new mom, those moments when you sit down or lay down to nurse your child are some of the few moments that you as a mom get to relax and reflect on your day and on your baby.  Personally, I relish this relaxing time.  Often, my older child grabs a few books, sits next to me, and we read stories together while our new babies – twins — enjoy the voices of mom and big sister. This gives us the ability to bond as a family. I had a rough start breastfeeding my two younger children. I fought hard to get them to breastfeed, establish my milk supply, and continue to work to maintain my supply while returning to work. It’s a little like putting in all the hours of training for a marathon, then enjoying the glory of setting a personal record — except I find the satisfaction of breastfeeding above and beyond that single moment of glory because it impacts my children’s health for life.

What are the challenges for mothers who want to breastfeed?

Sarah Rogers Spaulding: I had difficulties with having my new babies latch because they were tongue-tied and lip-tied. One of my babies was not eating and not gaining weight, and we were very concerned about his health.  I had successfully nursed our older child, but did not know why these two babies were so much more difficult, until I worked with a lactation consultant to determine why the babies could not get a sufficient latch.  The poor latch was causing discomfort and the babies were not getting the nutrients they needed. Breastfeeding is supposed to be a comfortable and enjoyable experience. New mothers and veteran mothers alike benefit from continued education about breastfeeding because every baby is different and each baby can have different problems to be addressed.  That is why education is so important and resources like the breastfeeding clinic at the UVM Medical Center and working with a lactation consultant, as I did, are so helpful.  I am proud to say that with their help I have not had to supplement formula for any of my babies.

Anya Koutras: Breastfeeding can be challenging in those first few weeks. With the right support and resources it can steadily improve. For moms who continue to have nipple pain or babies who continue to not latch on well or fail to gain weight, it’s important to get a lactation consult early. Tips to improve breastfeeding success for those first few days to weeks include: early skin to skin after birth, rooming in to notice feeding cues of baby, and prenatal, birthing, and breastfeeding classes before baby arrives. Also, early follow-up with the newborn’s provider – within 72 hours after hospital discharge – and consideration of a lactation consult for all moms, especially first-time moms.

Tell us about the new Newborn/Lactation Clinic at the UVM Medical Center. What can moms expect?

Anya Koutras: Our new clinic opened in June and it is a central referral location for moms across Vermont. We see patients with nipple pain, poor milk production, poor latch, poor weight gain in the newborn, cleft palate, tongue tie, cleft palate, Raynaud’s, and more. The clinic is located at the Children’s Specialty Center at the University of Vermont Children’s Hospital at the University of Vermont Medical Center. My colleagues and I are trained, board-certified lactation consultants who can meet with moms individually to discuss problems and develop solutions. Molly Rideout, MD, and Rebecca Goodman, MD, both pediatricians and board-certified lactation consultants, are also available. The clinic is open for appointments on Fridays. In addition to typical breastfeeding issues, we also have babies who come through the hospital with a lot of different health issues so it’s an ideal place to house our clinic.

What are some lessons learned that you would like to share?

Sarah Rogers Spaulding: Don’t give up and seek professional help immediately – even if you’re a veteran mom. A lactation consultant can identify the many reasons why a baby may not be latching well, different ways to help improve milk supply, and different styles of latching. I have had a different experience and different challenges with each of my three children. It was the lactation consultants who were able to address each scenario with the best results. Also, talk to your employer about federal regulations. Returning to work should not be an added stress.  As a mom you should be able to return to work and still feel that you can provide for your baby, or babies. These federal guidelines help moms return to work and continue to have the ability to exclusively breastfeed, by being allowed to pump at work. My employer provides a “Reflection Room,” a calming environment with comfortable seating that us nursing moms are allowed to use for breast pumping. That’s important for moms who are heading back to work.

Anya Koutras: I agree with Sarah, do seek help early. You should also know that federal regulations support breastfeeding moms. This includes reasonable break times at work and health insurance benefits. A breastfeeding-friendly office is very important. All you need are a room with a simple sign, a comfortable chair, and water, or even a place to change your baby to create a welcoming space.

Where can moms find resources and support mothers for breastfeeding?

Anya Koutras: I would recommend the resources at the Vermont Department of Health and the CDC to moms as well as online resources including, KellyMom (for patients and providers), the La Leche League (for peer support and information),, and mobile apps like LactMed (to look up use of medication with breastfeeding) and BFGuide (great general resources for patients and providers).On Facebook, local moms can find support at the Chittenden County Breastfeeding Coalition Facebook Page.


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