Guest: Dr. Jean Rhodes - RN, PhD.
Host: Dr. Linda Austin – Psychiatrist
Announcer: Welcome to an MUSC Health Podcast.
Dr. Linda Austin: I am Dr. Linda Austin. I am talking today with Dr. Jean Rhodes, who is a Nurse Practitioner with the Lactation Consultation Services at MUSC. Dr. Rhodes, we talked some about lactation and you mentioned in another podcast that for women who have trouble nursing, there are certain aids or devices that you can suggest that may help, can you describe what some of those devices are?
Dr. Jean Rhodes: Sure. Probably the first device that many women are familiar with is a breast pump. We use breast pumps for several reasons; the first is to draw out a nipple, which may be flat or inverted so that the baby can latch to the nipple and many times just a manual pump is sufficient for that purpose and it only needs to be used several times; however in other cases, it needs to be used more consistently. Breast pumps have a tremendous range in terms of expense and in terms how they operate. There are manual pumps, there are mini electric pumps, there are dual electric pumps, and then there are hospital-grade breast pumps and so we have to evaluate this situation to determine what’s going to be most beneficial. We use breast pumps also for women, who we need to have breast stimulations if the baby is sleepy or the baby is undergoing procedures and not able to breastfeed or the baby is premature and not yet feeding, so a mother may began breast pumping on a regular basis sometimes in those cases and usually needs a higher-quality breast pump. We also use for mothers, who have problems with latch or problems with sore nipples, a device called a silicone nipple shield and it looks likes a little silicone, clear silicone sombrero, goes right over the nipple and so when the baby nurses, the baby is actually nursing on the silicone shield, not directly on the nipple. For moms who have really sore nipples, it can provide an effective barrier to protect the nipple while the baby is nursing until the mother’s soreness is resolved. For other moms, who have flat nipples or inverted nipples, it allows the baby to latch to something and in the process of sucking, that baby may actually pull the nipple out into the shape of the shield, which can be very helpful than in having the baby establish its own latch without. We don’t use the silicone nipple shields very often in the first -- about three days postpartum because during that time, a mother will have milk substance called colostrum. It’s a premilk substance. It’s very thick, very rich, and in small amounts and what we found in our lactation service is that most infants can't create enough suction to be able to draw the colostrum effectively through the nipple shield and into its mouth. So, a baby that’s nursing with a nipple shield during that time may not be getting any milk transfer and so the purpose is to have the baby feed then it may not be appropriate to use right in the beginning; however, there is another device called a supplemental nursing system, which is essentially a container with a little thin tube that is taped right at the end of the nipple and we use these devices when mothers have a low milk supply in the case of a baby in the first few days that needs a nipples shield, but also needs milk flow. We will just put that little tube underneath the nipple shield, the baby will suckle at the breast, the container will have milk in it, either mother’s pumped milk or formula and so the baby will actually get milk while the baby is suckling at the breast using the nipple shield and the supplemental nursing. So, these are some of the devices that we use.
Dr. Linda Austin: It must be very comforting to women who are uncertain about how to nurse if they?ve never done it before if it’s a first baby to have an expert like you to show them how to be successful even if it is actually surprisingly awkward for a lot of women to nurse at first.
Dr. Jean Rhodes: That’s one of the most wonderful things about my job; I love it and everyday when I am helping women on the postpartum unit or in the clinic, it’s a tremendous sense of satisfaction to me to be able to help a woman get a baby to begin breastfeeding in a way that’s comfortable for both of them.
Dr. Linda Austin: Now you are at the Medical University of South Carolina, which is a major medical center, do smaller community hospitals have lactation specialists?
Dr. Jean Rhodes: No, they don’t. Most of the major medical centers in the state do, but the smaller community hospitals don’t do always. In the Charleston area, most of the hospitals have at least one part-time lactation consultant, but out in the community in the smaller cities and towns, they may not.
Dr. Linda Austin: Dr. Rhodes, thank you very much.
Dr. Jean Rhodes: Thank you.
Announcer: If you have any questions about the services or programs offered at the Medical University of South Carolina or if you would like to schedule an appointment with one of our physicians, please call MUSC Health Connection at (843) 792-1414.