8 AUTHORS
DEBRA FENTON
Maternity Service Manager
JENNY LESTER
Lactation Specialist
LOUISE STONE
Lactation Specialist
ALLISON VODANOVICH
Lactation Specialist
Lactation Support Service Specialists Annual Update Lactation support service The lactation support service is based in Middlemore Hospital’s maternity wards and community midwifery service, and is delivered by a team of nine midwife and nurse specialists with lactation qualifications and three breastfeeding advocates. The service offers mothers advice on infant feeding and provides intensive assistance to mothers and staff when babies have complications that impede effective breastfeeding. The lactation specialists are available Monday to Friday from 7am to 3:30pm. Further support is given by the breastfeeding advocate team who educate mothers about successful feeding and are available during the day, 7 days a week. Over the past year, the team has worked on various projects and work streams. Some of the main ones are summarised below.
Newborn hypoglycaemia LOUISE STONE, LACTATION SPECIALIST
During 2019, the lactation team provided input into the newly developed Women’s Health Guideline for Management of Newborns at Risk of Hypoglycaemia. Newborn babies with hypoglycaemia are at risk of not effectively establishing breastfeeding, due to complications associated with poor fetal growth, diabetes and other complications during pregnancy. At CM Health, 12 per cent of our pregnant women have diabetes. We also have high numbers of women having late preterm deliveries, so this guideline applies to a considerable number of our babies. Giving dextrose gel to newborn babies with low blood sugar can help protect exclusive breastfeeding. However, a considerable number of our babies still required supplementary feeding with an artificial breast milk substitute to avoid newborn hypoglycaemia. The lactation specialists help staff become familiar with the hypoglycaemia guideline, supporting them with newborns
who meet the criteria in the guideline, and emphasising the measures that protect and preserve breastfeeding.
Transitional care beds in maternity ALISON VODANOVICH, LACTATION SPECIALIST
The introduction of transitional care beds in the maternity wards began in late 2019. This model of care is designed to support babies, mothers and whaanau progressing from the Neonatal Unit. Transitional care babies tend to have been born prematurely or had a more complex medical course. Their mother or caregiver is re-admitted as a boarder on the maternity ward to gain experience in mother-craft and establish feeding before the baby goes home. Babies are often progressing to breastfeeding after having been on nasogastric feeding support. Transitional care provides a collaborative approach to baby’s care between the whaanau and maternity staff, including the lactation support team and neonatal medical staff. Staff promote autonomy for families by helping mothers and whaanau evaluate their infant’s feeding and encouraging other aspects of safe infant care. This model of care has been used for some time in maternity services, but this initiative created an opportunity to formalise the arrangement and dedicate beds for transitional babies. On average, four babies will be transitioning on the maternity wards at Middlemore at any one time. Others area cared for in the primary birthing units. The goal for Middlemore was to have up to eight dedicated transition beds by the end of 2020. However, progress of this model was complicated by visitor restrictions during COVID, compounded by high levels of postnatal acuity experienced on the ward, which required dedicated staff and bed space resources.
Posters developed for COVID-19 Two very useful posters about the benefits of breastfeeding during COVID-19 were developed with the initiative and WOMEN'S HEALTH AND NEWBORN ANNUAL REPORT 2019-2020 131
