Karen Wambach, Phd, RN, IBCLC, FILCA, FAAN Becky Spencer, Phd

Karen© Jones Wambach, & Bartlett Learning, PhD, RN, LLC IBCLC, FILCA,© Jones FAAN & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONProfessor NOT FOR SALE OR DISTRIBUTION School of Nursing University of Kansas Kansas City, Kansas, USA © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE ORBecky DISTRIBUTION Spencer, PhD, RN,NOT IBCLCFOR SALE OR DISTRIBUTION Associate Professor College of Nursing © Jones & Bartlett Learning, LLC Texas Woman’s© Jones University & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION Denton,NOT Texas, FOR USA SALE OR DISTRIBUTION

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© Jasper Cole/Getty Images © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALEBrief OR DISTRIBUTION Contents © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Preface xi Acknowledgments xiii © Jones & BartlettContributors Learning, LLC © Jones & Bartlett Learning, LLC xiv NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

SECTION ONE HISTORICAL AND WORK PERSPECTIVES 1 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONChapter 1 The InternationalNOT FOR Board SALE Certified OR DISTRIBUTION Lactation Consultant® (IBCLC®) and the Healthcare Team...... 3

Chapter© Jones 2& BartlettBreastfeeding Learning, LLCand Lactation: Roots and© Jones Wings &. . Bartlett . . . . . Learning,21 LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION SECTION TWO ANATOMIC AND BIOLOGICAL IMPERATIVES 47

© Jones & BartlettChapter Learning, 3 Anatomy LLC and Physiology© of LactationJones & Bartlett . . . . . Learning, ...... LLC. . . . 49 NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Chapter 4 The Composition and Specificity of Human Milk...... 85 Chapter 5 Drug Therapy and Breastfeeding...... 127 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONChapter 6 Viral InfectionsNOT andFOR Breastfeeding SALE OR DISTRIBUTION...... 159

SECTION THREE PRENATAL, PERINATAL, AND POSTNATAL PERIODS 175 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC ChapterNOT FOR 7 SALEPerinatal OR DISTRIBUTION and Intrapartum Care. . . . NOT. . . FOR. . . SALE. . . OR 177DISTRIBUTION Chapter 8 Newborn Assessment...... 215

© Jones & BartlettChapter Learning, 9 Postpartum LLC Care . . . ©. .Jones . . . .& . Bartlett . . . . .Learning, ...... LLC . . .247 NOT FOR SALEChapter OR DISTRIBUTION 10 Breast-Related ProblemsNOT. . .FOR . . .SALE . . . OR. . DISTRIBUTION. . . . 281 Chapter 11 Low Intake in the Breastfed Infant: Maternal © Jones & Bartlett Learning, LLC and Infant© Considerations Jones & Bartlett. . . . Learning,...... LLC . . . 313 NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

iii

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iv Brief Contents

© Jones & Bartlett Learning,Chapter 12LLC Jaundice and the© JonesBreastfed & Bartlett Baby. . . Learning, ...... LLC . 355 NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Chapter 13 Breast Pumps and Other Technologies...... 365 Chapter 14 The Use of Human Milk and Breastfeeding © Jones & inBartlett the Neonatal Learning, Intensive LLC Care Unit...... © . Jones . . . . & Bartlett397 Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Chapter 15 Donor Milk Banking...... 443

SECTION© Jones FOUR & BartlettBEYOND Learning, POSTP LLCARTUM © Jones & Bartlett Learning,469 LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Chapter 16 Maternal Nutrition and Breastfeeding...... 471 Chapter 17 Women’s Health and Breastfeeding ...... 481 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR ChapterDISTRIBUTION 18 Maternal EmploymentNOT FOR and Breastfeeding SALE OR DISTRIBUTION...... 549 Chapter 19 Child Health...... 577

Chapter© Jones 20 & TheBartlett Ill Child: Learning, Breastfeeding LLC Implications . .© .Jones . . . .& . Bartlett . 619 Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION SECTION FIVE SOCIOCULTURAL AND RESEARCH ISSUES 675 © JonesChapter & Bartlett 21 Learning, Research, LLC Theory, and Lactation© Jones. . . .& . Bartlett . . . . .Learning, . . 677 LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Chapter 22 Breastfeeding Education...... 713 Chapter 23 The Cultural Context of Breastfeeding...... 739 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR ChapterDISTRIBUTION 24 The Familial andNOT Social FOR Context of SALE OR Breastfeeding DISTRIBUTION. . . . . 759

Index 787

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© Jasper Cole/Getty Images © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALEContents OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Preface...... xi The Rise of Breastfeeding...... 35 Acknowledgments...... xiii Challenges Going Forward: The Breastfeeding Conundrum...... 38 Contributors ...... xiv © Jones & Bartlett Learning, LLC Summary© . .Jones ...... & . .Bartlett ...... Learning, LLC . 42 NOT FOR SALE OR DISTRIBUTION Key ConceptsNOT .FOR ...... SALE ...... OR . . . . DISTRIBUTION . 43 SECTION ONE Historical and References ...... 43 Work Perspectives 1 © Jones & Bartlett Learning, LLC © JonesSECTION & Bartlett TWO Learning, Anatomic LLC and NOT FOR SALEChapter OR 1 DISTRIBUTION The International Board Certified NOT FOR SALE OR DISTRIBUTIONBiological Lactation Consultant® (IBCLC®) Imperatives 47 and the Healthcare Team...... 3

History...... © . .Jones ...... & . .Bartlett ...... Learning, . 4 LLCChapter 3 Anatomy and© Jones & Bartlett Learning, LLC Do IBCLCs Make aNOT Difference? FOR . SALE ...... OR . . . . . DISTRIBUTION ...... 5 PhysiologyNOT of Lactation FOR SALE. . . . OR . . DISTRIBUTION49 Pathways to Become Certified as an IBCLC...... 5 Introduction...... 49 Formal and Continuing Education Programs Mammogenesis...... 49 for IBCLCs and Lactation Support Providers...... 7 Breast Structure ...... 50 Practice-Guiding Documents...... 7 © Jones & Bartlett Learning, LLC Pregnancy© Jones...... & . . Bartlett...... Learning, . . LLC . 54 Ethics...... 8 NOT FOR SALE OR DISTRIBUTION ClinicalNOT Implications: FOR SALE Mother OR. . . . .DISTRIBUTION ...... 63 Legal Issues...... 8 Newborn Oral Development...... 65 Avoid Civil Liability...... 9 Sucking ...... 67 Confidentiality...... 9 Frequency of Feedings...... 72 © Jones & BartlettHospital LactationLearning, Services LLC...... © . 9Jones & Bartlett Learning, LLC Summary...... 73 NOT FOR SALEManaging OR DISTRIBUTIONa Hospital Lactation Service...... NOT . 13 FOR SALE OR DISTRIBUTION Key Concepts...... 74 Orientation and Documentation...... 14 Internet Resources...... 75 Education, Advocacy, and Collaboration...... 14 References ...... 75 Professional Lactation Care and Volunteer Appendix 3-A...... 80 or Paid Peer Counselors© Jones. . . . .& . .Bartlett ...... Learning, . 15 LLC © Jones & Bartlett Learning, LLC References ...... 83 Breastfeeding SupportNOT in FOR the Community SALE OR. . .DISTRIBUTION . . . . 15 NOT FOR SALE OR DISTRIBUTION Summary...... 16 Chapter 4 The Composition and Specificity Key Concepts...... 16 of Human Milk...... 85 References ...... 17 © Jones & Bartlett Learning, LLC Milk Synthesis© Jones and & Maturational Bartlett Learning, LLC ChapterNOT FOR 2 Breastfeeding SALE OR DISTRIBUTION and ChangesNOT. . . FOR...... SALE...... OR . DISTRIBUTION. 86 Lactation: Roots and Wings. . . . . 21 Energy, Volume, and Growth...... 87 Introduction...... 21 Nutritional Values...... 92 Human Evolution: Shared Parenting Bioactive Components ...... 99 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC and Lactation...... 22 The Immune System...... 104 NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION United States Policy ...... 33 Preterm Milk...... 107 v

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vi Contents

Anti-Infective Properties...... 107 © Jones & Bartlett Learning, LLC © JonesSECTION & THREEBartlett Learning,Prenatal, LLC Perinatal, NOT FORImplications SALE OR for ClinicalDISTRIBUTION Practice ...... 114 NOT FOR SALE OR andDISTRIBUTION Postnatal Summary...... 115 Key Concepts...... 115 Periods 175 Acknowledgment...... 116 Chapter 7 Perinatal and Intrapartum Care. . . .177 References ...... ©. . Jones ...... &. . Bartlett. . Learning,116 LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONBreastfeeding Preparation. . . NOT. . . . .FOR . . . . SALE. 177 OR DISTRIBUTION Chapter 5 Drug Therapy Early Feedings...... 178 and Breastfeeding ...... 127 Stressful Births and Other Adverse Practices. . . . . 181 Introduction...... 127 Postbirth Care of the Newborn...... 182 The Alveolar© Jones Subunit & .Bartlett ...... Learning, ...... LLC128 Normal Newborn© Jones Sleep & Bartlett Learning, LLC Drug TransferNOT FORinto Human SALE Milk OR. . . DISTRIBUTION...... 129 and Eating PatternsNOT FOR...... SALE ...... OR . . . DISTRIBUTION183 Calculating Infant Exposure...... 132 Pain Medications...... 185 Effect of Medications on Feeding Positions...... 186 Milk Production ...... 134 The Infant Who Has Not Latched On...... 188 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FORReview SALE of Selected OR DISTRIBUTION Drug Classes...... 137 NOTLate-Preterm FOR SALE Infants OR. . .DISTRIBUTION ...... 193 Illicit Substances...... 149 Feeding Methods...... 194 Radioactive Agents...... 150 Hypoglycemia...... 196 Summary...... 150 Cesarean Birth...... 199 Key Concepts...... © . . .Jones ...... & Bartlett Learning,151 Breast LLC Engorgement...... © . .Jones . . . . & Bartlett199 Learning, LLC References ...... NOT. . . . .FOR . . . . SALE. . . OR DISTRIBUTION151 Breast Edema...... NOT . . . . . FOR SALE200 OR DISTRIBUTION Hand Expression...... 201 Chapter 6 Viral Infections and Clinical Implications...... 202 Breastfeeding...... 159 The Baby-Friendly Hospital Initiative...... 205 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Introduction...... 159 Acknowledgment...... 206 NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Human Immunodeficiency Virus...... 160 Summary...... 206 Herpes Simplex Virus...... 162 Key Concepts...... 206 Varicella-Zoster Virus (Chickenpox/ Varicella/ Internet Resources...... 207 Zoster/Shingles)...... 164 © Jones & Bartlett Learning, LLC © JonesReferences & Bartlett...... Learning, ...... LLC . . . . 208 NOT FORCytomegalovirus SALE OR DISTRIBUTION...... 165 NOTAppendix FOR SALE7-A. . . . . OR. . . . . DISTRIBUTION...... 213 Rubella...... 166 Appendix 7-B...... 214 Hepatitis B...... 166 Hepatitis C...... 168 Chapter 8 Newborn Assessment...... 215 Human T-Cell Lymphotropic© Jones Viruses &. .Bartlett ...... Learning,168 Introduction LLC ...... ©. . .Jones . & Bartlett215 Learning, LLC Arboviruses...... NOT...... FOR SALE OR DISTRIBUTION169 Perinatal History...... NOT . . . . .FOR . . SALE215 OR DISTRIBUTION Ebola Virus...... 170 Gestational Age Assessment...... 215 Implications for Practice...... 170 Indicators of Effective Breastfeeding and Acknowledgments...... 170 Assessment Scales...... 221 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Physical Assessment...... 226 SummaryNOT. . . . .FOR ...... SALE ...... OR . . . . DISTRIBUTION171 NOT FOR SALE OR DISTRIBUTION Key Concepts...... 171 Head...... 232 Internet Resources...... 172 Behavioral Assessment ...... 237 References ...... 172 Neonatal Abstinence Syndrome...... 241 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

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Contents vii

Summary...... 242 Summary...... 307 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALEKey Concepts OR DISTRIBUTION...... 242NOT FORKey SALEConcepts OR. . . .DISTRIBUTION ...... 307 References ...... 242 Internet Resources...... 308 Appendix 8-A...... 244 References ...... 308 Appendix 8-B...... 244 Appendix 8-C. . . . ©. . . Jones...... & . . Bartlett Learning,245 LLCChapter 11 Low Intake© Jonesin the Breastfed & Bartlett Infant: Learning, LLC NOT FOR SALE OR DISTRIBUTION MaternalNOT and Infant FOR SALE OR DISTRIBUTION Chapter 9 Postpartum Care ...... 247 Considerations...... 313 Immediate Postbirth Events ...... 247 Introduction...... 313 First Weeks: Principles and Expectations...... 248 © Jones & Bartlett Learning, LLC Global Standards© Jones for & OptimalBartlett Growth: Learning, The LLC Common Problems in the Early Days and Weeks. . . . 249 WHO Child Growth Standards...... 315 NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Supplementation Guidelines and Cautions. . . . 253 The Relationship of Newborn Weight Nipple Pain...... 253 Loss to Onset of Lactogenesis II and Other Engorgement + Milk Stasis = Involution...... 256 Peripartum Risk Factors...... 318 Initial Newborn Weight Loss and Early © Jones & BartlettMilk Supply/Milk Learning, Production LLC ...... 258© Jones & Bartlett Learning, LLC Weight Gain...... 321 NOT FOR SALEBreast OR Massage DISTRIBUTION...... 262NOT FOR SALE OR DISTRIBUTION Low Intake and Low Milk Supply: Definitions Nausea and Other Negative Feelings During and Incidence of Occurrence, Confusing the Milk-Ejection ...... 262 Terminology, Limited Data, and Clothing, Leaking, Bras, and Breast Pads...... 262 Nonstandardized Research...... 322 Infant Concerns . ©. . Jones...... & . Bartlett...... Learning,262 LLCAbnormal Patterns of Growth:© Jones The Baby& Bartlett Learning, LLC Multiple Infants. . .NOT ...... FOR ...... SALE . . . . OR DISTRIBUTION266 Who Appears HealthyNOT. . . . .FOR . . . . .SALE . . . . OR DISTRIBUTION324 Sleeping, SIDS, and Bed-Sharing...... 269 Abnormal Patterns of Growth: The Baby Clinical Implications...... 272 with Obvious Illness...... 335 Summary...... 273 Maternal Considerations: The Mother © Jones & Bartlett Learning, LLC Who ©Appears Jones Healthy & Bartlett...... Learning, ...... LLC335 Key Concepts...... 273 NOT FOR SALE OR DISTRIBUTION MaternalNOT Considerations: FOR SALE Obvious OR DISTRIBUTION Illness...... 340 Internet Resources...... 274 History, Physical Exam, and Differential Diagnosis. . . 340 References ...... 274 Clinical Management...... 340 Chapter 10 Breast-Related Problems. . . . . 281 Special Techniques for Management of © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Introduction...... 281 Low Intake or Low Supply...... 343 NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Nipple Variations ...... 281 Acknowledgment...... 347 Plugged Ducts...... 283 Summary...... 347 Mastitis...... 284 Key Concepts...... 347 Breast Abscess. . . .© . . Jones ...... &. . .Bartlett . . Learning,288 LLCInternet Resources...... © . . .Jones ...... & Bartlett Learning,348 LLC Dermatoses of theNOT Breast FOR. . . . .SALE . . . . . OR. . . . DISTRIBUTION288 References ...... NOT . . . . FOR . . . . .SALE . . OR DISTRIBUTION348 Candidiasis (Thrush)...... 290 Other Breast Pain...... 294 Chapter 12 Jaundice and the Breastfed Milk Blister...... 295 Baby...... 355 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Mammoplasty...... 295 Etiologic and Epidemiologic Overview of NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Breast Lumps and Surgery...... 300 Jaundice...... 355 Galactoceles...... 301 Medical Diagnosis of the Jaundiced Infant. . . . . 357 Fibrocystic Changes of the Breast...... 301 Assessment of Jaundice...... 359 © Jones & BartlettBleeding Learning,from the Breast LLC...... 302© JonesManagement & Bartlett of Learning, Hyperbilirubinemia LLC ...... 360 NOT FOR SALEBreast OR Cancer DISTRIBUTION...... 303NOT FORAcknowledgment SALE OR DISTRIBUTION...... 361 Clinical Implications...... 306 Summary...... 361 Acknowledgment...... 306 Key Concepts...... 362

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viii Contents

Internet Resources...... 362 Discharge Planning for Postdischarge © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Breastfeeding...... 426 NOT FORReferences SALE . OR. . . .DISTRIBUTION ...... 362 NOT FOR SALE OR DISTRIBUTION Postdischarge Breastfeeding Management. . . . 428 Chapter 13 Breast Pumps and Other Acknowledgment...... 429 Technologies...... 365 Summary...... 429 © Jones & Bartlett Learning,Key LLC Concepts...... © . . . Jones & Bartlett429 Learning, LLC What Mothers Want...... 367 NOT FOR SALE OR DISTRIBUTIONInternet Resources...... NOT . . . . . FOR SALE430 OR DISTRIBUTION Breast Pumps...... 368 References ...... 430 Pump Comparisons...... 370 Appendix 14-A...... 440 Simultaneous and/or Sequential Pumping. . . . . 374 Flanges©. . .Jones ...... & . . Bartlett ...... Learning, LLC375 Chapter 15 ©Donor Jones Milk & Banking Bartlett. . Learning, . . . . . 443 LLC ContaminationNOT FOR of Breast SALE Pumps OR and DISTRIBUTION Expressed Introduction. .NOT ...... FOR . . . . . SALE ...... OR DISTRIBUTION443 Breastmilk...... 376 Use of Donor Milk...... 443 Cleaning Pumps...... 376 History of Donor Milk Banking...... 445 Maternal Concerns, Emotions, and Education Donor Milk Today...... 447 © Jones &Needs Bartlett...... Learning, ...... LLC...... 377 © Jones & Bartlett Learning, LLC Safety...... 452 NOT FORWhen SALE Pumps OR Cause DISTRIBUTION Problems...... 378 NOT FOR SALE OR DISTRIBUTION Availability...... 453 Sample Guidelines for Pump Selection...... 378 Milk Banking Procedures...... 453 Common Pumping Problems...... 379 Informed Decision Making...... 456 Nipple Shields...... 381 © Jones & Bartlett Learning,Wet-Nursing, LLC Informal Sharing, ©and Jones & Bartlett Learning, LLC Breast Shells...... NOT . . . . .FOR . . . . SALE. . OR DISTRIBUTION385 Sale of Milk...... NOT. . . . .FOR . . . SALE456 OR DISTRIBUTION Feeding-Tube Devices...... 387 For-Profit and Not-for-Profit Milk Banking ...... 458 Summary...... 389 Research Findings on Donor Milk...... 458 Key Concepts...... 389 Selected Case Studies ...... 460 Internet© Resources Jones & for Bartlett Mothers .Learning, ...... LLC392 A Tribute to Mary© Jones Rose Tully & Bartlett...... Learning, . 462 LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Publications...... 392 Summary...... 462 Resources for Healthcare Providers...... 392 Key Concepts...... 462 References ...... 392 Internet Resources...... 463 © Jones & Bartlett Learning, LLC © JonesReferences & Bartlett...... Learning, ...... LLC . . . . 463 Appendix 15-A...... 467 NOT FORChapter SALE 14 OR The DISTRIBUTION Use of Human Milk and NOT FOR SALE OR DISTRIBUTION References ...... 467 Breastfeeding in the Neonatal Intensive Care Unit...... 397 SECTION FOUR Beyond Introduction...... © . .Jones ...... & Bartlett Learning,397 LLC Postpartum© Jones & Bartlett469 Learning, LLC Informed Decision: HumanNOT Milk FOR as a MedicalSALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Intervention...... 398 Chapter 16 Maternal Nutrition Mothers of Preterm Infants ...... 400 and Breastfeeding ...... 471 Rates of Breastfeeding Initiation and Duration. . . 401 © Jones & Bartlett Learning, LLC Introduction. ©. . .Jones ...... & . .Bartlett ...... Learning,471 LLC Evidence-Based Lactation Support Services. . . . . 402 NOT FOR SALE OR DISTRIBUTION General NutritionalNOT FORAssessment SALE of ORthe LactatingDISTRIBUTION Initiation and Maintenance of Milk Supply. . . . . 404 Mother or Parent...... 471 Maintaining Maternal Milk Volume...... 407 General Dietary Guidelines During Lactation. . . . 472 Human Milk Management...... 409 Calorie Restriction and Exercise...... 475 © JonesOptimization & Bartlett of Learning, Human Milk LLC for Feeding...... 412 © JonesSpecial Circumstances& Bartlett Learning, That May Influence LLC NOT FORMethods SALE of ORMilk DISTRIBUTIONDelivery...... 414 NOTDietary FOR NeedsSALE During OR DISTRIBUTION Lactation ...... 475 Nonnutritive Sucking at the Breast...... 416 Nutrient–Drug Interactions in Lactating Measuring Milk Transfer...... 421 Mothers and Parents...... 477

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Contents ix

Key Concepts...... 479 Summary...... 570 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALEReferences OR DISTRIBUTION...... 479NOT FORKey SALEConcepts OR. . . .DISTRIBUTION ...... 570 Chapter 17 Women’s Health and Internet Resources...... 571 Breastfeeding...... 481 References ...... 572 Chapter 19 Child Health...... 577 Postpartum Health© andJones Care .& . . .Bartlett ...... Learning,481 LLC © Jones & Bartlett Learning, LLC Lactation, Fertility,NOT Sexuality, FOR and SALE OR DISTRIBUTIONDevelopmental OutcomesNOT FOR SALE OR DISTRIBUTION Contraception...... 483 and Infant Feeding...... 577 Fertility...... 484 Oxytocin and Breastfeeding ...... 581 Postpartum Well-Being and Sexual Health . . . . . 490 Growth and Development...... 581 Women’s© Jones Health & Bartlett Across the Learning, Childbearing LLC Years. . . . 495 Theories© of Jones Development & Bartlett...... Learning, ...... LLC585 AcuteNOT Illnesses FOR SALE and Infections OR DISTRIBUTION...... 509 Clinical NOTImplications FOR .SALE ...... OR . . .DISTRIBUTION ...... 595 Chronic Illnesses...... 514 Immunizations...... 596 Mood Disorders During Lactation...... 522 Car Seat Safety...... 600 Autoimmune Diseases...... 526 Vitamin D and Rickets ...... 600 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALEPhysically OR ChallengedDISTRIBUTION Mothers...... 530NOT FORDental SALE Health OR and DISTRIBUTION Orofacial Development. . . . . 601 Sensory Challenged Mothers...... 533 Solid Foods...... 603 Epilepsy (Seizure Disorders)...... 533 Obesity...... 607 Surgery...... 534 Long-Term Breastfeeding...... 609 Transplants. . . . .© . . Jones ...... & . .Bartlett . . . . . Learning,535 LLCWeaning ...... © . .Jones ...... & . .Bartlett . Learning,609 LLC Donating Blood . NOT. . . . . FOR . . . . .SALE . . . . . OR. . DISTRIBUTION535 Implications for PracticeNOT. . . . .FOR . . . . .SALE . . . . OR DISTRIBUTION610 The Impact of Maternal Illness and Acknowledgment...... 610 Hospitalization...... 535 Summary...... 610 Acknowledgment...... 536 Key Concepts...... 610 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Summary...... 536 Internet Resources...... 611 NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Key Concepts...... 536 References ...... 611 Internet Resources...... 538 References ...... 538 Chapter 20 The Ill Child: Breastfeeding © Jones & BartlettChapter Learning,18 Maternal LLC Employment © Jones & BartlettImplications Learning,. .LLC ...... 619 NOT FOR SALE OR DISTRIBUTIONand Breastfeeding ...... 549NOT FORTeam SALE Care for OR the DISTRIBUTION Child with Feeding Difficulties...... 619 Introduction...... 549 Feeding Behaviors of the Ill Infant/Child...... 620 Historical Perspective and Statistics on Maternal Employment ...... 549 What to Do If Weight Gain Is Inadequate...... 621 © Jones & Bartlett Learning, LLCPain Management Concerns© Jones...... & . . .Bartlett . . Learning,625 LLC The Effect of WorkNOT on Breastfeeding FOR SALE. . .OR . . .DISTRIBUTION . . 550 NOT FOR SALE OR DISTRIBUTION Facilitators and Barriers to Breastfeeding Breastfeeding Care of the Hospitalized in the Workplace...... 551 Infant...... 625 Individual Strategies to Manage Perioperative Care of the Breastfeeding Infant/Child...... 627 ©Breastfeeding Jones & Bartlett and Work Learning,...... LLC. . . . 552 © Jones & Bartlett Learning, LLC Emergency Room...... 627 SpecialNOT FOR Issues SALERelated ORto Returning DISTRIBUTION to Work. . . . . 555 NOT FOR SALE OR DISTRIBUTION Workplace Strategies to Support Care of Children with Selected Conditions. . . . . 628 Breastfeeding and Work...... 560 Alterations in Neurologic Functioning...... 634 Community Strategies to Support Breastfeeding Congenital Heart Disease...... 639 © Jones & Bartlettand Work Learning,...... LLC ...... 565© JonesOral/Facial & Bartlett Anomalies Learning,...... LLC ...... 641 NOT FOR SALENational OR and DISTRIBUTION Global Strategies in Promoting NOT FORGastrointestinal SALE OR AnomaliesDISTRIBUTION and and Supporting Breastfeeding...... 566 Disorders...... 646 Clinical Implications...... 569 Metabolic Dysfunction ...... 651

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x Contents

Allergies...... 657 Teaching Strategies...... 730 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FORFood SALE Intolerance OR DISTRIBUTION...... 658 NOTEducational FOR SALE Materials OR. . DISTRIBUTION ...... 732 Neonatal Abstinence Syndrome...... 659 Summary...... 734 Psychosocial Concerns...... 659 Key Concepts...... 734 Acknowledgment...... 663 Resources...... 735 Summary...... © . . .Jones . . . . . & Bartlett Learning,663 References LLC ...... © . .Jones . . . . . & Bartlett735 Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Key Concepts...... 663 Chapter 23 The Cultural Context Internet Resources...... 664 of Breastfeeding...... 739 References ...... 664 Introduction...... 739 © Jones & Bartlett Learning, LLC The Dominant© Culture Jones. . .& . . Bartlett ...... Learning,. . 740 LLC SECTIONNOT FIVE FOR SALESociocultural OR DISTRIBUTION and EthnocentrismNOT Versus FOR Relativism SALE and OR DISTRIBUTION Research Issues 675 Cultural Sensitivity...... 741 Cultural Competence...... 741 Assessing Cultural Practices...... 742 © JonesChapter & Bartlett 21 Research, Learning, Theory, LLC and © Jones & Bartlett Learning, LLC Language Barriers...... 744 NOT FOR SALE ORLactation DISTRIBUTION...... 677 NOT FOR SALE OR DISTRIBUTION The Effects of Culture on Breastfeeding...... 745 Introduction...... 677 Colostrum Discarding, Prelacteal Feeding, Theories Related to Lactation Practice...... 677 and Timely Initiation of Breastfeeding...... 748 Origins of Research Methodologies...... 681 © Jones & Bartlett Learning,Maternal LLC Foods...... © . . Jones . . . . & Bartlett751 Learning, LLC Types of Research Methods...... 682 NOT FOR SALE OR DISTRIBUTIONWeaning ...... NOT . . . . .FOR . . SALE753 OR DISTRIBUTION Elements of Research...... 687 Implications for Practice...... 754 Application of Methods Summary...... 755 to Qualitative Approaches...... 693 Key Concepts...... 755 Application of Methods © Jones & Bartlett Learning, LLC Internet Resources© Jones...... & . . .Bartlett ...... Learning,755 LLC to QuantitativeNOT FOR Approaches SALE OR. . .DISTRIBUTION ...... 695 NOT FOR SALE OR DISTRIBUTION Data Analysis...... 699 References ...... 756 Evaluating Research for Use in Practice...... 703 Chapter 24 The Familial and Social Context Using Research in Clinical Practice...... 705 of Breastfeeding...... 759 © JonesSummary & Bartlett...... Learning, ...... LLC . . . 706 © Jones & Bartlett Learning, LLC Family Forms and Functions...... 759 NOT FORKey SALEConcepts OR. . . .DISTRIBUTION ...... 707 NOT FOR SALE OR DISTRIBUTION Family Theory ...... 760 Internet Resources...... 708 Social Factors That Influence Breastfeeding . . . . . 760 References ...... 708 Fathers...... 763 Chapter 22 Breastfeeding© Jones Education & Bartlett. . . . . Learning,713 The LLC Adolescent Mother...... © . . .Jones . . . . . & Bartlett767 Learning, LLC Introduction...... NOT ...... FOR . . . SALE OR DISTRIBUTION713 The Adoptive Mother and FamilyNOT. . . FOR. . . . .SALE . . 769 OR DISTRIBUTION Factors Creating the Need for Breastfeeding The Low-Income Family...... 770 and Lactation Education...... 713 Breastfeeding During Pregnancy and The Changing Landscape of Breastfeeding Tandem Nursing...... 775 Education© Jones. . . . .& . .Bartlett ...... Learning, ...... LLC714 The Downside© of Jones Family &Experience Bartlett. . . Learning,. . . . . 776 LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Breastfeeding Programs for Healthcare Summary...... 780 Professionals ...... 718 Key Concepts...... 780 The Breastfeeding Team...... 720 Internet Resources...... 780 © JonesParent & Bartlett Education Learning,...... LLC...... 723 © JonesOther Resources & Bartlett. . . . . Learning, ...... LLC . . 780 NOT FORAdult SALE Learning OR Principles DISTRIBUTION NOTReferences FOR SALE...... OR . . .DISTRIBUTION ...... 781 and Education...... 727 Curriculum Development...... 729 Index...... 787

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© Jasper Cole/Getty Images © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALEPreface OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION his book is dedicated In this sixth edition, I welcome Becky Spencer as to Dr. Janice (Jan) the new coeditor of Breastfeeding and Human Lacta- Riordan, the found- tion. Becky comes to the coeditor position from Texas © Jones & Bartlett Learning,Ting editor LLCof Breastfeed- Woman’s© JonesUniversity & BartlettSchool of Learning, Nursing, where LLC she NOT FOR SALE OR ingDISTRIBUTION and Human Lactation was recentlyNOT promotedFOR SALE to associate OR DISTRIBUTION professor. Becky and pioneer in the field of teaches in the master’s and doctoral programs at TWU human lactation and the and conducts breastfeeding research, with a focus on lactation consultant pro- disparities in breastfeeding, especially among African fession. Jan passed away American women. Becky’s expertise in qualitative © Jones & Bartlett Learning, LLCon September 17, 2018.© I,Jones research & Bartlett and excellent Learning, writing LLC and editing skills (ex- NOT FOR SALE OR DISTRIBUTIONlike many others, miss NOTher FORhibited SALE in the OR recently DISTRIBUTION published Core Curriculum for very much, but I am eter- Interdisciplinary Lactation Care) will serve her well in nally grateful to her for her longtime mentoring and the her role. Welcome, Becky! opportunity to serve as an author and editor of Breast- Changes to this Sixth Edition are once again plenti- feeding and Human© JonesLactation &. JanBartlett was an Learning,extraordin- LLCful and, it is hoped, useful© toJones our readers. & Bartlett We now Learning, have LLC ary scholar who abundantlyNOT FOR gave SALE to the OR lactation DISTRIBUTION and 24 chapters in the book; weNOT have FOR included SALE again OR a chap DISTRIBUTIONter breastfeeding clinical, education, and research com- on maternal nutrition in breastfeeding, auth ored by munity, both nationally and internationally. Profession- Alicia Simpson. Extensive changes and revisions were ally, she was a nurse, an international board-certified made to some chapters while fewer revisions/changes lactation consultant (IBCLC), a nurse educator, and a were made to others. We are fort unate that the evidence breastfeeding© Jones & researcher Bartlett with Learning, a specialty LLC in instrument underlying© Jones the science & Bartlett of breastfeeding Learning, and human LLC lac- developmentNOT FOR andSALE testing. OR She DISTRIBUTION was a prolific author, pub- tation continuesNOT FOR to grow, SALE and OR we haveDISTRIBUTION done our best to lishing many books and papers in several outstanding include such evidence in the chapters. We welcome sev- peer-reviewed journals, including the Journal of Ob- eral new contributors to the book; many took on chap- stetric, Gynecologic and Neonatal Nursing (JOGNN) ters authored by Dr. Riordan and retiring authors or © Jones & Bartlettand the JournalLearning, of Human LLC Lactation. Jan was a fierce© Jones joined & Bartlett existing seniorLearning, authors. LLC Our goal was to include NOT FOR SALEbreastfeeding OR DISTRIBUTION advocate and professional whose effortsNOT FORknowledgeable SALE OR experts, DISTRIBUTION and we believe we have done so. were widely demonstrated through La Leche League; Since the last edition of the book, advances were Wichita State University, where she taught in the School again made in the promotion of and support for of Nursing for 23 years and established the Janice M. breastfeeding in the United States. Following in the Riordan Distinguished Professorship in Maternal Child footsteps of the Best Fed Beginnings program, the Health; the International© Jones Lactation & Bartlett Consultant Learning, Associ- LLCEMPower hospital-based© qualityJones improvement & Bartlett initiaLearning,- LLC ation, where she ledNOT the researchFOR SALE committee OR andDISTRIBUTION served tive was implemented betweenNOT FOR September SALE 2014OR DISTRIBUTIONand on the ILCA board of directors; and the International September 2018 to focus on maternity care practices Board of Lactation Consultant Examiners, as a found- leading to Baby-Friendly designation. Implemented ing member of this important credentialing organiza- in partnership with the Carolina Global Breastfeeding tion.© Jones Her beliefs & Bartlett and values Learning, related to breastfeeding LLC and Institute© andJones Population & Bartlett Health Learning, Improvement LLC Part- lactationNOT FOR stemmed SALE from OR her DISTRIBUTION nursing background as well ners andNOT with FOR guidance SALE from OR Baby-Friendly DISTRIBUTION USA, the as her personal experiences as a mother of six children. Centers for Disease Control and Prevention–funded We miss you, Jan, and your love of the lactation and initiative included 91 hospitals in 23 states and led to breastfeeding discipline will live on for years to come the designation of 66 new Baby-Friendly hospitals. in Breastfeeding and Human Lactation, the classic evi- As lactation care providers, educators, and re- © Jones & Bartlettdence-based Learning, bible of lactation LLC and breastfeeding. © Jonessearchers, & Bartlett we haveLearning, an obligation LLC to do our part in NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

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xii Preface

© Jonesenhancing & Bartlett support Learning, for breastfeeding LLC mothers. We © Jonescontext &of Bartlettbreastfeeding Learning, past and LLC present as well as hope that our book provides the evidence and infor- visions for the future. NOT FOR SALE OR DISTRIBUTION NOT FORmation SALE on practicalOR DISTRIBUTION application of that evidence in Section 2 focuses on basic anatomic and biologic support of breastfeeding mothers. imperatives of lactation. Clinical application of tech- Birth practices affect lactation. Thus, this edition niques must be based on a clear understanding of the again contains considerable content on obstetric is- relationships among form, function, and biological sues, especially the importance© Jones of & skin-to-skin Bartlett Learning, care constructs. LLC Researchers continue© Jones to find & and Bartlett validate Learning, LLC and keeping mothers andNOT babies FOR together SALE 24 OR hours DISTRIBUTION a the amazing properties in humanNOT milk, FOR as SALE described OR DISTRIBUTION day during the birth hospitalization. Maternity prac- in the newly named Chapter 4, “The Composition and tices and obstetric intervention that impact breast- Specificity of Human Milk.” feeding have retained considerable attention from Section 3 remains the clinical heart of the book professional© Jones healthcare & Bartlett organizations. Learning, This LLC is good and describes© the Jones basics &of Bartlettwhat to do, Learning, when to do LLC it, news for efforts to support breastfeeding initiation and and how to do it when one assists the lactating mother. NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION continuation. Examples include the American College Section 3 thus centers on the perinatal period in the of Obstetrics and Gynecology Committee Opinion birth setting and concerns during the postpartum #756, Optimizing Support for Breastfeeding as Part of period following the family’s return home—notably, Obstetric Practice, and the Association of Women’s breast problems, neonatal jaundice, and infant weight © JonesHealth, & Bartlett Obstetric Learning, and Neonatal LLC Nurses Practice Brief © Jonesgain. This & Bartlett section Learning,also addresses LLC special needs of NOT FOR#4, SALEBreastfeeding OR DISTRIBUTION Recommendations for Women Who NOTpreterm FOR and SALE ill babies OR andDISTRIBUTION their mothers, and it pres- Receive Medication-Assisted Treatment for Opioid Use ents a critical evaluation of breastfeeding devices and Disorders. recommends how and when they can be most appro- As is true of earlier editions, the sixth edition of priately used. It concludes with a review of the devel- this text has a clear clinical© Jones focus. Nearly& Bartlett every Learning,chap- opment LLC and current activities ©of humanJones milk & Bartlett banking. Learning, LLC ter contains a clinical implications section. Important The first part of Section 4 focuses on the mother: NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION concepts discussed in chapters are summarized at the mother’s health and returning to work. The top- the end of each chapter—a feature that makes study- ics then turn to the infant’s health and special health ing easier. Throughout the book are new references needs. The techniques of infant assessment are ex- deemed by the authors to be the most important from plained and demonstrated with photographs. the vastly© Jones expanded & Bartlettresearch andLearning, clinical literature.LLC Section 5© begins Jones with & a Bartlett careful look Learning, at research— LLC Some olderNOT references—whichFOR SALE OR introducedDISTRIBUTION then-new how it is conducted,NOT FOR why ongoingSALE ORresearch DISTRIBUTION is needed, ideas that are now accepted common knowledge— how research findings can be applied in clinical set- have been removed to make room for the new. tings, and what theories are related to lactation prac- Section 1 contrasts the past and present relative tice. The principles of education, the cornerstone of to breastfeeding and the International Board Cer- clinical practice, are explored next. The book con- © Jonestified & Bartlett Lactation Learning, Consultant LLC (IBCLC)®. Chapter 1 © Jonescludes with & Bartlett chapters onLearning, culture’s effect LLC on breastfeed- NOT FORconcentrates SALE OR on DISTRIBUTIONthe work of the present-day IBCLC NOTing FORand the SALE sociological OR DISTRIBUTION context of the breastfeeding and the healthcare team who support lactation and family functions. breastfeeding, and it addresses work-related issues of To avoid linguistic confusion, the book uses the lactation consulting, such as staffing. Chapter 2, with following conventions: The masculine pronoun is used its new title, “Breastfeeding© Jones and & Lactation: Bartlett RootsLearning, to LLC denote the infant or child throughout© Jones &the Bartlett text as a Learning, LLC and Wings,” presents aNOT historical FOR context SALE of OR breast DISTRIBUTION- matter of convenience to distinguishNOT FOR the childSALE from OR DISTRIBUTION feeding within the greater context of infant feeding the breastfeeding mother; nurses, lactation consult- practices. Paige Hall Smith and Ellen Chetwynd are ants, and other healthcare workers are referred to by new authors of this chapter and have eloquently in- feminine pronouns, although we recognize that men cluded an international focus and a sociocultural serve in all healthcare professions. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

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© Jasper Cole/Getty Images © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALEAcknowledgments OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION We are grateful to all current and past researchers and editorship; and currently, Texas Woman’s University, clinicians for providing the foundation for our breast- Denton, Texas. feeding knowledge and to those institutions that en- Finally, we would like to thank our families for couraged© Jones and & supportedBartlett Learning,us in writing LLC the book over their help© Jonesand encouragement & Bartlett over Learning, the years: LLC theNOT years: FOR the SALEUniversity OR of DISTRIBUTION Kansas School of Nursing TheNOT Wambach FOR family:SALE Bill;OR Jackie, DISTRIBUTION Brian, and Bri- in Kansas City, Kansas; the Wichita State University anne; and Nathan, Sugar, Logan, and Samantha. School of Nursing during the years of Jan Riordan’s The Spencer Family: Phil, Erin, Owen, and Nathan.

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© Jasper Cole/Getty Images © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FORContributors SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Teresa E . Baker, MD, FACOG Jolynn Dowling, MSN, APRN, NNP-BC, IBCLC Professor Associate Educator, Janice M. Riordan Distinguished Department of Obstetrics and Gynecology Professorship in Maternal Child Health Texas Tech© Jones University & Bartlett Health Sciences Learning, Center LLC School of Nursing© Jones & Bartlett Learning, LLC Amarillo,NOT Texas, FOR USA SALE OR DISTRIBUTION Wichita State NOTUniversity FOR SALE OR DISTRIBUTION Wichita, Kansas, USA Suzanne Bentley, DNP, CNM, APRN, IBCLC Clinical Nurse Specialist Valerie J . Flaherman, MD, MPH, IBCLC The University of Kansas Health System Associate Professor of Pediatrics © JonesKansas & Bartlett City, Kansas, Learning, USA LLC © JonesAssociate & Professor Bartlett of Learning, Epidemiology LLC and Biostatistics NOT FOR SALE OR DISTRIBUTION NOTUniversity FOR SALE of California, OR DISTRIBUTION San Francisco Elizabeth C . Brooks, JD, IBCLC, FILCA San Francisco, California, USA Private Practice Lactation Consultant Wyndmoor, Pennsylvania, USA Jimi Francis, BS, MS, PhD, IBCLC, RLC, RDN, LD Assistant Professor Caroline J . Chantry, MD © Jones & Bartlett Learning,Health LLC and Kinesiology © Jones & Bartlett Learning, LLC Professor Emerita NOT FOR SALE OR DISTRIBUTIONUniversity of Texas at Tyler NOT FOR SALE OR DISTRIBUTION Clinical Pediatrics Tyler, Texas, USA University of California Davis HEALTH Sacramento, California, USA Catherine Watson Genna, BS, IBCLC Private Lactation Consultant Practice Ellen Chetwynd,© Jones PhD, & MPH, Bartlett BSN, IBCLC Learning, LLC New York, New© JonesYork, USA & Bartlett Learning, LLC Research Scientist NOT FOR SALE OR DISTRIBUTION Thomas W . Hale,NOT PhD FOR SALE OR DISTRIBUTION Center for Women’s Health & Wellness School of Health and Human Sciences, UNC University Distinguished Professor Greensboro Department of Pediatrics Greensboro, North Carolina, USA Texas Tech University Health Sciences Center © Jonesand & Bartlett Learning, LLC © JonesAmarillo, & Texas, Bartlett USA Learning, LLC NOT FORResearch SALE Scientist OR DISTRIBUTION of Clinical Lactation NOTKay FORHoover, SALE MEd, IBCLC, OR FILCA DISTRIBUTION Department of Food, Bioprocessing and Nutrition Lactation Consultant Sciences Riddle Hospital North Carolina State University Media, Pennsylvania, USA Raleigh, North Carolina, USA © Jones & Bartlett Learning,Frances LLC Jones, RN, MSN, IBCLC © Jones & Bartlett Learning, LLC Eva Chevreux, MS, APRN, IBCLCNOT FOR SALE OR DISTRIBUTIONCoordinator, Lactation ServicesNOT and FOR SALE OR DISTRIBUTION Family Nurse Practitioner Provincial Milk Bank Department of Pediatrics BC Women’s Hospital and Health Centre The University of Kansas Health System Vancouver, British Columbia, CA Kansas© City, Jones Kansas, & BartlettUSA Learning, LLC © Jones & Bartlett Learning, LLC Laura R . Kair, MD, MAS, FABM NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Jabina Coleman, LSW, MSW, IBCLC Assistant Professor, Clinical Pediatrics LIFE House Lactation and Perinatal Medical Director, Well Newborn Care Services, LLC University of California, Davis Philadelphia, Pennsylvania, USA Sacramento, California, USA © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

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Contributors xv

Mary Koehn, PhD, APRN, FACCE Paige Hall Smith, MSPH, PhD © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Associate Education Professor Professor, Public Health Education NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION School of Medicine Director, Center for Women’s Health & Wellness University of Kansas, Wichita School of Health and Human Sciences Wichita, Kansas, USA University of North Carolina, Greensboro and Greensboro, North Carolina, USA © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Associate Professor Emerita Linda J . Smith, MPH, IBCLC, FACCE, FILCA, FAAN School of NursingNOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Owner and Director Wichita State University Bright Future Lactation Resource Centre, Ltd. Wichita, Kansas, USA Dayton, Ohio, USA Rebecca Mannel, MPH, IBCLC, FILCA Diane L . Spatz, PhD, RN, FAAN Clinical© Jones Assistant & Bartlett Professor Learning, LLC © Jones & Bartlett Learning, LLC Professor of Perinatal Nursing and Helen M. Shearer DepartmentNOT FOR of SALE Obstetrics OR andDISTRIBUTION Gynecology NOT FOR SALE OR DISTRIBUTION Professor of Nutrition University of Oklahoma Health Sciences Center School of Nursing Oklahoma City, Oklahoma, USA University of Pennsylvania Barbara Morrison, PhD, RN, NM, FNP, CKC, IBCLC and © Jones & BartlettFounder Learning,& CEO, DrBarbCNM, LLC LLC © JonesNurse & Bartlett Researcher Learning, and Manager LLC of the Lactation NOT FOR SALETraverse OR City, DISTRIBUTION Michigan, USA NOT FORProgram SALE OR DISTRIBUTION Children’s Hospital of Philadelphia Sallie Page-Goertz, MN, APRN, IBCLC, FILCA Philadelphia, Pennsylvania, USA Clinical Associate Professor Department of Pediatrics Becky Spencer, PhD, RN, IBCLC School of Medicine© Jones & Bartlett Learning, LLCAssociate Professor © Jones & Bartlett Learning, LLC University of KansasNOT FOR SALE OR DISTRIBUTIONCollege of Nursing NOT FOR SALE OR DISTRIBUTION Kansas City, Kansas, USA Texas Woman’s University Denton, Texas, USA Wilaiporn Rojjanasrirat, PhD, RNC, IBCLC Marsha Walker, RN, IBCLC Professor, Director of Research and Scholarship School© Jones of Nursing & Bartlett Learning, LLC Executive© JonesDirector & Bartlett Learning, LLC GracelandNOT FOR University SALE OR DISTRIBUTION NationalNOT Alliance FOR for SALE Breastfeeding OR DISTRIBUTION Advocacy Independence, Missouri, USA Weston, Massachusetts, USA Hilary Rowe, BSc (Pharm), PharmD, ACPR Jenny Walters, MPH, IBCLC Clinical Pharmacy Specialist, Maternal Fetal Lactation Consultant © Jones & BartlettMedicine Learning, LLC © JonesThe & BartlettUniversity Learning, of Kansas Health LLC System NOT FOR SALENeonatal OR andDISTRIBUTION Pediatric Pharmacy NOT FORKansas SALE City, OR Kansas, DISTRIBUTION USA Surrey Memorial Hospital, Fraser Karen Wambach, PhD, RN, IBCLC, FILCA, FAAN Health Authority Professor, Director PhD Program, Co-Coordinator Surrey, British Columbia, CA BSN Honors Program School of Nursing Elizabeth P . Schlaudecker,© Jones MD, MPH & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC University of Kansas Assistant ProfessorNOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Kansas City, Kansas, USA Pediatrics Division of Infectious Diseases, Global Alice Li Ching Wang, BSC (Pharm), ACPR Health Center Clinical Pharmacist Cincinnati© Jones Children’s& Bartlett Hospital Learning, Medical LLC Center Surrey ©Memorial Jones Hospital,& Bartlett Fraser Learning, Health LLC Cincinnati,NOT FOR Ohio, SALE USA OR DISTRIBUTION Surrey,NOT British FOR Columbia, SALE CA OR DISTRIBUTION Alicia Simpson, MS, RD, IBCLC, LD Elaine Webber, DNP, PPCNP-BC, IBCLC Executive Director, Lead Dietician, and Lactation Associate Clinical Professor Consultant School of Nursing © Jones & BartlettPea Pod NutritionLearning, and LLC Lactation Support © JonesUniversity & Bartlett of Detroit Learning, Mercy LLC NOT FOR SALEAtlanta, OR Georgia, DISTRIBUTION USA NOT FORDetroit, SALE Michigan, OR DISTRIBUTION USA

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