August is National Breastfeeding Awareness Month; Mothers Now Have a Choice!

When a woman is preparing for the birth a baby, she and her partner face many choices — such as what to name the child and whether to breastfeed or use formula. Breastfeeding offers numerous benefits to babies from providing the nutrition they need for healthy growth and brain development to protection against obesity, asthma and diabetes. Many women intend to breastfeed only to encounter challenges such as lack of milk production or latching issues, which can lead to anxiety, frustration and disappointment among the new mothers. It can also worsen post-partum depression. In some parts of the United States, when mothers face these obstacles, their only option is to abandon their plans of providing breast milk to their infants and feed them formula.

However, that is not the case for some Pennsylvania mothers. For the past three years, mothers in Northwestern/Central Pennsylvania who experience breastfeeding challenges have had a choice. The Penn Highlands Maternal and Child Center, in rural DuBois, Pennsylvania, offers many resources to mothers which even includes supplying donor breast milk to help babies receive a great start in life — while easing mother’s anxiety and frustration.

“Women in this region are very fortunate to have our Maternal and Child Center nearby,” said Suzanne McCullough BSN, RN-NIC, Director of the Penn Highlands Healthcare Neonatal Intensive Care Unit and Apnea-Reflux/Developmental Clinic in DuBois. “For mothers who wish to breastfeed, we provide education, lactation specialists and support groups. In addition, we give them choices, such as the donor milk, that are not typically offered in rural communities,” she added.

According to McCullough, the breast milk supplementation program began in 2019 for premature babies in the Penn Highlands DuBois Neonatal Intensive Care Unit (NICU).

“Often babies in the NICU — especially younger babies who are born at 32 weeks or earlier — may have a hard time feeding directly from the breast because their suck, swallow, breathe pattern may be too weak. Plus, their mothers may not be producing enough milk yet to feed them. The supplemental breastmilk is an alternative to formula.”

At the Maternal and Child Center, 68% of NICU admissions are discharged with breastmilk or breastmilk and formula, which is in line with the national average for NICUs of that size. In addition, 27% of the NICU infants in the Center are exclusively breastfeeding at discharge, which is above the national average for NICUs of that size.

The Milk Bank
Penn Highlands Healthcare partners with Mid-Atlantic Mothers’ Milk Bank, which is located in Pittsburgh, Pennsylvania. Donors pump and store their milk in home freezers. They either deliver the milk to the Pittsburgh facility or send it via a next-day shipping service. At the facility, the milk is thawed and strained into glass flasks. The milk of up to five donors is pooled together. It is then individually packaged and pasteurized. The pasteurization process inactivates pathogens while maintaining the majority of the milk’s bioactive components that support the immune systems of the recipient babies. The milk is then tested for bacteria cultures and a panel of common drugs. Finally, it is tested for calories, protein and carbohydrate content. Processed milk is stored frozen and is distributed by hospital order or prescription only.

Program Expansion
Building on the success of the supplementation program in the NICU, in 2020, the Penn Highlands Maternal and Child Center began providing the breast milk to babies with Neonatal Absence Syndrome (NAS). Babies with NAS are born to mothers who were exposed to drugs during pregnancy. Some substances can be detected in breast milk thus not making it a viable option for the infants.
“NAS babies may need to remain in the hospital for a few weeks after their mothers are discharged because the infants experience gastrointestinal issues,” explained Sharon Shattenberg, RN, BSN, Maternal Child Service Line Director for Penn Highlands Healthcare. “The supplemental breast milk lessens the G-I symptoms, and reduces breakouts on their bottoms from their stools.”

In 2021, Penn Highlands Healthcare expanded its program to include healthy, full-term babies who face breastfeeding issues. In fact, the Maternal and Child Center at Penn Highlands DuBois is one of the few centers offering supplemental breast milk to healthy babies.

Shortly after giving birth, the new mother’s breasts produce colostrum, a thick, rich milk that is high in nutrients. It can take up to four days for the mother’s milk supply to be adequate to nourish the baby. In February 2022, the Maternal and Child Center began offering parents the option of purchasing “bridge milk” from donors to support and sustain their infants until their breast milk “comes in.” To date, the Center has supplied 510 ounces of donor breast milk to 12 families.
Since introducing the supplemental breastmilk program in 2019, the Maternal and Child Center has utilized nearly 10,000 ounces — or 78 gallons of donor milk for its patients. On average, they keep approximately 200 ounces on hand.

A Journey With Experts
Mothers who deliver their babies at the Maternal and Child Center begin their breastfeeding journey with experts. The Center offers four certified lactation counselors and four lactation consultants. All staff members at the Center receive 15 hours of specific education and training on how to help and support parents. In addition, they are required to continue yearly training and competencies.

One of those four lactation consultants is Amanda Baker, CRNP, IBCLC, who works at Penn Highlands Life’s Journey OB/GYN in DuBois, Pennsylvania. Baker provides latch assessments and support to new mothers with their various breastfeeding concerns.

“I tell new moms that there are three main goals for breastfeeding; first, feed the baby; second, protect your milk supply; and finally achieve pain free nursing,” explained Baker.

Shattenberg is proud of the staff at the Maternal and Child Center and the important role they play helping new mothers.

“Not only is our staff skilled, they are patient and put the new mothers at ease as they and their infants begin their breastfeeding journey. It is important that new mothers who struggle with breastfeeding, know that they have choices, and at the Maternal and Child Center at Penn Highlands DuBois, we are here for you,” added Shattenberg.