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Improving community health through breastfeeding research

For MCN’s Carla Pohl (DNP, APRN-CNM), breastfeeding research comes at the intersection of midwifery and public health. Breastfeeding brings significant health advantages for both the mother and child, and it can help families save money when caring for young children. The number one reason people stop? They think the babies don’t want it or that they don’t have enough milk.

That’s why Pohl conducts research on how to support breastfeeding mothers. For Pohl, the best part about being a midwife is being able to take care of individual patients. “We’re interested in prevention, and we work individually with patients to teach them how to care for themselves.” Pohl also works in public health, which means she has to think about how to get people in McLean County more invested in prevention, too. This involves physical activity, nutrition, access to a dentist, and refraining from smoking.

Carla Pohl

Associate Professor Carla Pohl

In a recent study, Pohl collaborated with MCN’s Denise Hammer (DNP-RNC-NIC); former MCN instructor Peggy Jacobs (DNP-CNM); Lucinda Edgren-Gebhradt and Karen Shinville, lactation consultants at Carle BroMenn Medical Center; and Rachel Borton (PhD-FNP), a former MCN Ph.D. student who leads the FNP program at Bradley University. The study offered support for breastfeeding mothers by providing access to a peer counselor as well as breastfeeding support via text messaging.

According to Pohl, CDC data tells us that in the United States, about 86-90 percent of new mothers choose to breastfeed. After four weeks, though, this goes down to 45-50 percent. “When you listen to women,” says Pohl, “those first two weeks are extremely difficult. Breastfeeding is complicated. Some babies take to it and are off to the races, but for a lot of babies, it takes more work to get them to breastfeed.”

For first-time moms, the pressure is even higher. “They’re nervous about being a new mom, then they’re also worried that the baby isn’t getting enough milk. When you’re breastfeeding, it’s hard to know if they’re getting enough milk, and you’re also learning the baby’s feeding cues. It’s a lot for a new mother.”

In the first two weeks of giving birth, mothers have access to a lactation consultant in the hospital. Then, the first postpartum checkup is at four weeks. In between then, and at home, she’s on her own, which is where most women decide to stop breastfeeding. “For some reason, women don’t usually call the lactation consultant during that time,” said Pohl. “We found that when reaching out, it doesn’t matter what you text. We thought we’d have to do a lot of teaching, but that wasn’t the case. It wasn’t that they had problems, necessarily. They could just say, ‘Oh, this isn’t going right.’”

Pohl’s research found that just offering support during that two-week window was essential to helping mothers continue breastfeeding. “It’s not the message itself,” said Pohl, “but the human contact and reassurance.” When mothers felt connected and supported, they were more likely to continue breastfeeding or reach out to a lactation consultant.

Text-blasting isn’t new. “WIC [Women, Infants and Children] started texting mothers in Oklahoma in 2004, and they text McLean County mothers as well,” said Pohl. “According to WIC, this practice has increased their contacts, and they’ve found that people are more likely to call in.”

At MCN, Rachel Borton has been interviewing mothers living in rural areas. Overwhelmingly, mothers report needing encouragement more than anything else. “They get it from the health department, but not as much at the hospital,” said Pohl. “So when we reach out to them, we hear back, ‘Thanks. That really helps.’” The personal connection—and the individual follow-up—helps mothers get the care and support they need.

Breastfeeding research is a critical component to improving public health and supporting families in our communities.

 

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