Lactation Consultants' Role in Infant Airway Protection
A lactation consultant (LC) is a professional breastfeeding expert who is qualified to provide education and consultation in all aspects of routine and special circumstance breastfeeding to the mother/infant dyad (couple) and to other health professionals. Special circumstance breastfeeding might include situations that require more than the normal amount of help to achieve a successful breastfeeding relationship. This includes, among other problems, infants who are premature, have birth defects or are ill, and mothers who are ill or have handicaps. Mothers may have sore nipples, too much or too little milk, breast pain, or infections. Babies may be fussy, not gaining well or failing to thrive. LCs can help teach correct breastfeeding skills prenatally, post-partum in the hospital, and as private practitioners from the time the dyad leave the hospital until weaning. Some dyads leave the hospital still experiencing breastfeeding problems. Some experience problems at a later time. The LC also helps when there is no apparent problem other than the fact that the breastfeeding and care of the baby are not going well. Breastfeeding and infant care are not simple tasks, and there is a tremendous need for professional support.
The LC is trained to act independently in developing a treatment plan for each specific breastfeeding situation. At the same time, she recognizes that the mother/infant dyad must remain under the medical care of the attending physician. A team approach between the MD and the LC is taken in order for the mother and infant to receive optimum care.
How can a mother know who is a qualified breastfeeding expert? Ask questions e.g. What is your training? How many years of experience do you have? How frequently have you worked with the problem(s) I’m experiencing? Many LCs, for example, have little or no successful personal experience with a baby who has a cleft palate, or cardiac problems, or a mother who wants to induce lactation, but may have years of experience with latch and positioning problems. Successful experience means that the baby was fed at the breast until problems were corrected and then transitioned to breastfeeding without tools. Just as another physician’s counsel would be sought if not satisfied with the first, keep looking for a more experienced LC if the first can’t solve your specific problem(s). Another key is to seek an LC who has IBCLC (International Board Certified Lactation Consultant) behind her name. This designation insures that the LC has fulfilled specific educational requirements and passed a standardized exam that has been given in over 105 countries. In fact, lactation consulting is the first profession to have a standardized exam world-wide. We have set the standards for how to accomplish this feat.
The very best way that a mother can help her child avoid future airway problems is to establish a solid, strong breastfeeding relationship with her newborn and then continue breastfeeding – ideally until the child self-weans. This natural weaning occurs at different times with different children. The most typical age for self-weaning is when the child is 2 plus years old in a developed country, but longer in a traditional society - in a culture supportive of breastfeeding. Unfortunately, the USA is not yet a breastfeeding supportive country. The World Health Organization (WHO) recommends breastfeeding for a MINIMUM of 2 years. Breastfeeding until the baby self-weans translates into many months of using the oral anatomy correctly.
Why is breastfeeding so key to avoiding the need for orthodontia, ear nose and throat problems or the need for myofunctional therapy? The answer: a baby’s oral anatomy has to be used correctly to remove sufficient milk from its mother’s breasts for appropriate growth. If milk isn’t removed, the mother’s body doesn’t know to make more. When used correctly, all the muscles of the oral anatomy become stronger and correctly positioned. For example, the palate is widened by breastfeeding as the tongue rolls against the roof of the mouth in a repeating wave-like pattern…many, many times each breastfeeding session , which is repeated many times per 24 hours, per week, per month and per year. The same is true of helping to insure that the teeth will come in in good position. The cheek muscles develop properly which is why breastfed babies cheeks are so pinchable. They look like chipmunk cheeks. Research has shown that it is also the correct use of the oral anatomy during suck and swallow that protects the ears & airway, thus breastfed babies have statistically far fewer ear and respiratory infections. Research has also shown that breastmilk delivered from a bottle does not protect the ears or airway the same way. The delivery system does make a difference. Extensive research has shown that children who were breastfed for many months to years have less need for orthodontia. And it’s dose related. That means, the longer the baby is breastfed, the less need statistically for orthodontia. Myofunctional therapists have shared with me that their patients, with their many oral anatomy problems, were never long term breastfed and most were never breastfed at all. (personal communication)
When a healthy baby is positioned, latched and sucking correctly at breast, the baby’s airway is correctly supported, positioned and used. Proprioception is the feeling of where the individual, including the oral anatomy, is in space. We become habituated to how we use our bodies, whether we use them correctly or incorrectly. Patterns, whether correct or incorrect, continue even into child and adulthood. One example of what can cause a baby to have problems sucking is a tongue or lip tie. If the anatomical issue is identified and corrected surgically (usually very minor surgery), followed by some suck training to correct the incorrect pattern of suck the baby is already used to (babies can habituate to an incorrect suck even in utero), breastfeeding, with all its health benefits, can continue problem free. The sooner a problem is addressed, the easier it is to correct. So the younger the baby is when well-trained LC help is utilized, the faster the problem can be solved.
Why is it so important to succeed at breastfeeding? Because research has shown that the health of the baby and mother are positively affected for the rest of their lives. Just one of those benefits is that the baby’s oral anatomy is positioned correctly, thus its airway is also protected. Most important to know is that almost all breastfeeding problems are solvable with the mothers determination and work, and a knowledgeable, caring lactation consultant.