Steps to Successful Breastfeeding with Lela Gregg, Lactation Specialist

MUSC Health Florence Women's Pavilion has received many awards and accolades for its commitment to breastfeeding support. Lela Gregg, a lactation specialist and Baby-Friendly and Safe-Sleep Coordinator, explains the benefits of breastfeeding for both mothers and infants and how MUSC Health supports mothers through the ups and downs of nursing a new baby.

"All the staff give moms [the] informed decision on whether they want to breast or bottle feed. And it's giving them the opportunity, if they want a breastfeed, to have all the resources that they need to be successful at it." — Lela Gregg, Lactation Specialist

Topics Covered in This Show

• Gregg, a mother of five, talks about her journey to becoming a lactation consultant. She was inspired by the support and breastfeeding advice she received when one of her children spent time in the NICU shortly after birth. [00:00:48]
• The benefits of breastfeeding are many for both mom and baby. Gregg says breastfeeding reduces ovarian cancer and breast cancer risk and the chance of developing type 2 diabetes in moms. The nutrition in breast milk is designed especially for infants and Gregg says it not only is an ideal food but it can also lower the risk of sudden infant death syndrome (SIDS) and obesity; protect against other illnesses; and promote healthy development in babies. [00:01:53]
• Before introducing solids, the American Academy of Pediatrics recommends six months of exclusive breastfeeding. Gregg says moms are encouraged to continue breastfeeding for one to two years or longer. To meet any breastfeeding milestones, Gregg encourages setting small goals to make the journey more manageable for new moms. [00:02:57]
• There are some situations when breastfeeding may not be recommended, such as the mother being HIV-positive, if the mother is using illicit drugs, or if the baby has certain conditions such as galactosemia. Resources such as the LactMed app can be used to assess the safety of medications a mother may use during breastfeeding. [00:04:24]
• Mothers are supported in the months following birth by MUSC Health staff. Gregg says challenges often arise when a mother needs to return to work and must pump milk while away. [00:05:33]
• Gregg started a program called Lactation 365 Texts. Every family is able to reach out to Gregg via text as breastfeeding questions arise. She says mothers often need support when transitioning back to work and using a breast pump for the first time. [00:07:10]
• She says more local businesses should consider providing lactation-friendly facilities for employees to accommodate working mothers and that the community at large can help support lactating moms by providing clean and safe areas for pumping and/or breastfeeding. [00:09:57]
• MUSC Health Florence Medical Center has received many accolades for its commitment to breastfeeding support, including the IBCLC Care Award, which recognizes hospitals and community-based facilities that demonstrate their commitment to promoting, protecting and supporting breastfeeding and the lactation consultant profession. [00:11:52]
• Despite her busy career and personal life Gregg finds time every day to care for herself through exercise, meditation and embracing the motto "live, laugh, love."[00:13:17]

Read the Transcript

[00:00:00] Erin Spain, MS: Welcome to Advance with MUSC Health. I'm your host, Erin Spain. This show's mission is to help you find ways to preserve and optimize your health and get the care you need to live well. Today's guest is an expert in guiding new moms to successfully breastfeed their babies during the first days of life and beyond. Lela Gregg is a Baby Friendly and Safe Sleep Coordinator and Lactation Specialist at MUSC Health Florence Medical Center. She joins me today to talk about her work, which has helped MUSC Health Florence Medical Center be recognized by international organizations for its activities that help protect, promote and support breastfeeding. Welcome to the show.

[00:00:47] Lela Gregg, Lactation Specialist: Hello.

[00:00:48] Erin Spain, MS: So share with me a little bit about your background and why you decided to become a lactation specialist.

[00:00:54] Lela Gregg, Lactation Specialist: I'm a mom of five who struggled with breastfeeding, and a nurse, Wanda, really helped me have a successful breastfeeding journey. And when I had my son and he was in NICU she was that nurse and lactation consultant who just really was my guardian angel and made everything better. And I was like, you know what? I want to do that for other moms. So that's why I became a lactation consultant. Because I wanted just to help moms have the best journey that they can with their feeding.

[00:01:19] Erin Spain, MS: Explain the benefits of breastfeeding. I know there are so many.

[00:01:23] Lela Gregg, Lactation Specialist: There are so many. For mom, it lowers her risk for ovarian cancer and breast cancer. And for me, I had a history in my family with ovarian cancer. So that was one thing that inspired me to, like, want to try to breastfeed. It lowers the risk for mothers for type 2 diabetes. For infants, the nutrition it's designed especially for them. It lowers baby's risk for SIDS, Sudden Infant Death Syndrome, obesity, it helps them control the amount that they consume, understand their appetite at a very early stage. Those are just a few benefits.

[00:01:53] Erin Spain, MS: Yes, especially in those early days, what's so special about that early milk?

[00:01:56] Lela Gregg, Lactation Specialist: So, basically, it's like the baby's first immunization into the world. It's full of vitamins, antibodies, everything is just like the first impact. Usually babies start to have the immune system in six weeks. So it's really helping that baby keep that immune system going well.

[00:02:12] Erin Spain, MS: So what is the ideal length of time that babies should receive breast milk? What do you tell moms?

[00:02:18] Lela Gregg, Lactation Specialist: American Academy of Pediatrics recommends six months of exclusive breast milk and that's when foods are introduced and then one year or two years or however long you want to go after that. And I agree with them, but it's a lot of patients that I get, Oh, you know, one year, two years they’re, like, what really like that long? So I try to have them follow their baby's immunization schedule.

So, like a baby usually goes to the doctor at one month, two months, four months, six months. So I say set small goals for yourself. Say you're going to do it for one month, and when you reach that one month mark, do two months, and then when you reach two months, say four months, and then that way it's easier to do, and then by the time you look up, you're like, oh, it's been a year, okay, I, I got this.

[00:02:57] Erin Spain, MS: And for a lot of new moms, especially, this can be so intimidating.

[00:03:01] Lela Gregg, Lactation Specialist: So, we, all the staff, give moms informed decisions whether they want to breast or bottle feed. And it's giving them the opportunity, if they want a breastfeed, to have all the resources that they need to be successful at it. Helping moms make an informed decision.

Some moms may not know that if you breastfeed, it can help you decrease your risk for ovarian cancer and breast cancer. Informing pregnant women like the 10 steps of successful breastfeeding. Initiating breastfeeding within the first hour. So letting the baby kind of do its neurological thing as far as laying on mom and kind of going towards the breast and doing skin to skin. Not giving baby formula unless medically indicated, because if you give a mom formula and it's not medically indicated, it's easy for moms to be like, you know what, my baby doesn't like my breast milk, and it kind of discourages them because, it's easier for them to take a bottle than for them to breastfeed.

Rooming in is another one where baby stays with mom and dad or the family for 24 hours out of the day, so they're with him the whole entire time, and that helps parents learn their feeding cues, like if the baby's hungry, if they're gassy, encouraging them to breastfeed on demand in the beginning. Some parents, they love, they have to have a schedule, but in the beginning it helps their milk supply come in a little bit better, and I tell them, we don't go home with you, so if you want to switch it because that was worked for you and you want to put them on a schedule, that's perfectly fine, but in the beginning it helps their milk come in a lot faster, and it's enough for the baby, support, information when they leave so that they can know what's out in their community so that they can be successful and if they do have any questions who to reach out to.

[00:04:24] Erin Spain, MS: And what about some of the myths or fears that are out there about breastfeeding that you hear, especially from these new moms.

[00:04:31] Lela Gregg, Lactation Specialist: The first one is that breastfeeding is easy because people look at, like, videos and stuff like that and they compare their journey to someone else. And I'm like, it can get there, but it's a lot of work. And I tell everyone if breastfeeding was easy, I wouldn't have a job. And then the other one is that it's painful. Like some women come in and they think, like, "Oh my God, it's going to hurt so I don't want to try it." And I tell everyone, "If you want to try it, try it." It was a quote that I read and I kept it and I share it, and they say "Take it one day at a time, one feeding at a time, and if it clicks, it's worth it. Every bit of breast milk your baby receives is a miracle for them and you." I've seen it a bunch of times. Whether it's one hour, one day, one week, whatever you do, you try. And that's all that is important. I mean, if moms, like, can't breastfeed, they can also chest feed, like they can still stimulate or like let the baby suckle and use them as a pacifier and that's an option too and that promotes bonding as well. So it's not a no, you don't have to, but if they do want to have that bonding with breastfeeding, they can chest feed.

[00:05:33] Erin Spain, MS: Are there ever times when a new mom should not breastfeed, such as being on certain medications or having certain medical conditions?

[00:05:41] Lela Gregg, Lactation Specialist: So, if they are HIV positive in the U.S., on any illicit drugs, if a baby has galactosemia, which is the body's ability for the baby to turn galactose, which is a sugar and milk to glucose, which is what they need to do, that for those babies not to because it's more harmful for them. But other than that, no. And then I would tell moms who are on medication, I love the app or you can Google LactMed. If you have any medication that you're taking or anything like that even physicians, myself, we all use that and it'll tell you the effects for your breast milk, effects on the babies, and it even gives studies like if they did anything with it, like how many moms that it affected their breast milk or how it affected the baby.

[00:06:21] Erin Spain, MS: How do you begin preparing new moms who give birth at MUSC Health Florence Medical Center, for breastfeeding? This starts well before birth, is that right?

[00:06:29] Lela Gregg, Lactation Specialist: In the office here, they get a book. And we have a secretary who's amazing, Elisa. She calls everyone who gets the book and tries to go over it, if they answer the phone, and go over benefits of feeding and how they want to feed if they want to breast or bottle. Then, she'll get them in contact with me if they have any questions or concerns. Then she also tells them about two free classes that you can do hybrid, you can do in person or you can do computer and it's breastfeeding and childbirth, and we go over everything there. In the end of that class, they get my cell phone number to text me any questions and concerns that they have, or if they want to set up a private appointment, then they can.

[00:07:03] Erin Spain, MS: And does that appointment happen while they're in the hospital and the days after giving birth or how often do they have access to you?

[00:07:10] Lela Gregg, Lactation Specialist: So I started a program here called Lactation 365 Texts. I knew that there was an issue with moms that could not like get in to see Lactation or do anything like that. So every breastfeeding family gets my cell phone number. They have me 365. It doesn't matter if I'm on vacation or what have you. Like they text me and I'll respond back as quickly as I can. But they have full access.

[00:07:30] Erin Spain, MS: That's incredible. So what are some of the common challenges, And then they're texting you, how do you help them overcome these challenges?

[00:07:38] Lela Gregg, Lactation Specialist: So, some of the challenges are like if they're going back to work, the schedule especially. I have some families that swing shift. Trying to get them to get a comfortable schedule that can go back and forth if they work days or nights. I love the text because I'm able to reach out to patients a lot faster. They're saying my milk supply is going down, Okay, well did your schedule change, you know, did you start a medication, what happened? And it's easier that way than playing phone tag sometimes or trying to find that time of the day to get back with them. But yeah, like those are just a few challenges, but just texting them and they can get in to see me faster. I try to work around the patient's schedule so that it's a little bit more flexible for them.

[00:08:15] Erin Spain, MS: You mentioned the challenges of going back to work because for a lot of moms, that means using a breast pump in order to provide milk for their baby. Talk to me about that journey, switching from exclusively having the baby at the breast to now using a breast pump some of the time.

[00:08:29] Lela Gregg, Lactation Specialist: Quite a few moms have struggled with their milk production because the baby will empty you better than any pump will. I don't care what pump you get. This is just my personal opinion after breastfeeding five and also pumping. The baby empties you better. Pumping, a lot of times the mom's milk supply will go down, especially if they miss a pump you know, it's very different. So talking to them about different techniques. If they can power pump, where you just pump for a little bit longer or get in an extra pumping session in if they can. Those are just some of the ways to try to help them with their journey. I really recommend like a week or two, before you go back to work, try to do your work schedule with pumping. So you can kind of see what may come up, you can't see everything, but it kind of gives you an idea of what your schedule will look like. And so if your milk supply does go down, it's some other stuff that we can do to try to help with that.

[00:09:13] Erin Spain, MS: We've talked a lot about moms or the person who's given birth to the baby, but their partner can also play a really positive role in the breastfeeding journey. Tell me about that.

[00:09:23] Lela Gregg, Lactation Specialist: Yes, they can help with washing equipment, help with routines, encouragement. Let me tell you, the encouraging thing is the biggest thing. If you notice that they're tired and you say, okay, you breastfed the baby, take the baby away for a little bit and let them get some rest. Like really working together as a team. I mean that's anyone. My sister have helped, my grandmother when she was alive she helped. So it's just having that extra support person just to be there to encourage you and to like, be able to give you some time when it's needed.

[00:09:51] Erin Spain, MS: And what about workplaces or stores, businesses in the community? How can they help support lactating moms?

[00:09:57] Lela Gregg, Lactation Specialist: I would love to see more businesses have safe, clean areas for moms to be able to pump or breastfeed if they're out. You don't really see it a lot. Letting them have a flexible schedule so that they can go and pump for their babies. I have a few patients that I have to call their job and see like, Hey do you have somewhere, not a closet, to where it's like with dust and everything else? Or I have patients that are pumping in their car, like they need somewhere safe. And so, if more businesses in the community could provide that, then that would be great.

[00:10:25] Erin Spain, MS: What about milk banks? Are there opportunities for mothers to donate their milk or is there opportunities for mothers who can't breastfeed to be able to get donor milk?

[00:10:35] Lela Gregg, Lactation Specialist: Yeah, there's an opportunity for mothers who want to donate their breast milk. MUSC Charleston has a depot site there where they can donate. and we're trying to get one here at this location and have the requirements and everything, on our website.

[00:10:49] Erin Spain, MS: There's a lot of items out there in the baby world. A lot of products that people try to sell. But are there any items that you think are worth it for lactating moms to invest in, in order to have the most successful journey?

[00:11:01] Lela Gregg, Lactation Specialist: When it comes to pumps, I've tried multiple ones and it varies on mom's nipple sizes, but the one thing that I do love and I will hand down promote this is the Haakaa, it catches your breast milk if you're leaking. It's a silicone, they call it a manual breast pump, but I call it a milk collector. Looks like a bottle that kind of has an open lid that suctions to your breast. And so while you're breastfeeding on one side, whatever's leaking, it goes into this silicone bottle. And that's why I like it. Cause it just, you can collect milk while you're breastfeeding.

[00:11:37] Erin Spain, MS: You mentioned the text program that you have and all the advocacy work that you do on behalf of your patients. This has led to some recognition. MUSC Health Florence Medical Center has received a lot of recognition for being a baby friendly hospital and for its excellence in lactation care. Tell me about these accolades.

[00:11:52] Lela Gregg, Lactation Specialist: We have the IBCLC Care Award for lactation care the Lactation 365 Text was recognized in that, and then Safe Sleep which I'm a huge advocate for because in South Carolina, six babies die a month from unsafe sleep. So we want to get those numbers down. And we were gold in that. And we got the U. S. News & World Report for Best Maternity Care. But the biggest honor that I have is being the choice for our community. A lot of moms will come up and say, or text me, like, "Hey, my friend told us about MUSC team, and we want to come there, we want your help." That is my biggest honor. That's why I do what I do, because, if you're not making your patients or community happy, then what are you doing it for?

[00:12:32] Erin Spain, MS: So, as we wrap up today, the question we ask everyone who comes on the show is, what do you do to optimize your health and live well?

[00:12:40] Lela Gregg, Lactation Specialist: With five children, I am constantly running around and it's basketball, volleyball, it's soccer. It's something I'm so happy I'm out of dance right now. But I moved my elliptical in my room because I was like, yeah, I'm going to make sure I get on today. So I try to at least exercise 30 minutes a day, like whether it's walking or doing the elliptical. Meditation is key for me. Exercising and trying to get my water in and meditation is like three key things for me. And I live by the motto, live, laugh, love. I try to live my best life, love as much as I possibly can, especially with my wonderful family and try to laugh at least once a day.

[00:13:17] Erin Spain, MS: Sounds like good advice to live by. Well, thank you so much, Lela Gregg, for coming on the show and telling us about this incredible programming that is happening at MUSC Health Florence Medical Center and all the work you're doing for moms. We appreciate it.

[00:13:31] Lela Gregg, Lactation Specialist: Thank you so much, Erin, I appreciate you.

[00:13:34] Erin Spain, MS: For more information on this podcast, check out advance.muschealth.org.