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Table of Contents


	Preface	xi
	Acknowledgments	xiii
PART 1	PROMOTION AND SUPPORT
Chapter 1	Breastfeeding Promotion in the Modern World	3
	Infant Feeding Practices Throughout History	3
	Breastfeeding as an Infant Health Issue	7
	Breastfeeding as a Women’s Health Issue	8
	Cultural Influences on Infant Feeding	9
	Breastfeeding as an Economic Issue	10
	International Breastfeeding Promotion Initiatives	10
	Current Breastfeeding Recommendations	14
	Summary	14
	Chapter 1—At a Glance	14
	References	15
Chapter 2	Lactation Consultants as Part of the Healthcare Team	21
	The Healthcare Team Approach	21
	The Lactation Consulting Profession	21
	Practicing in a Hospital	24
	Practicing in a Health Clinic	25
	Working in a Physician Group	28
	Practicing in Home Health Care	29
	Working in Private Practice	30
	Other Members of the Healthcare Team	34
	The Mother’s Role on the Healthcare Team	39
	Summary	40
	Chapter 2—At a Glance	40
	References	41
Chapter 3	A Sociological Perspective on Breastfeeding Support	43
	Organization of a Society	43
	The Process of Socialization	45
	Social Behavior	49
	Relationships	56
	Knowledge and Culture	58
	Decision Making	60
	Summary	64
	Chapter 3—At a Glance	64
	References	65
Chapter 4	Empowering Women to Breastfeed	69
	Health Consumerism	69
	Adult Learning Approach	72
	Confidence in Breastfeeding	77
	Components of Communication	82
	Humor as a Communication Tool	87
	Summary	90
	Chapter 4—At a Glance	90
	References	90
Chapter 5	Counseling Skills: Learning How to Help Mothers	93
	The Counseling Process	93
	Methods and Skills in Counseling	96
	Counseling Examples	110
	Summary	113
	Chapter 5—At a Glance	114
	References	115
Chapter 6	Client Consultations	115
	Reaching Out through Anticipatory Guidance	115
	Problem Solving with Mothers	120
	Consultation Methods	122
	Elements in a Consultation	123
	Documenting a Feeding	128
	Summary	135
	Chapter 6—At a Glance	136
	References	136
PART 2	THE SCIENCE OF LACTATION
Chapter 7	The Science of Lactation	141
	Anatomy of the Breast	141
	Mammary Growth and Development	146
	Hormonal Impact on Lactation	149
	Milk Synthesis	150
	Milk Ejection Reflex (Letdown)	151
	Variations in Breast Structure and Function	153
	Summary	156
	Chapter 7—At a Glance	157
	References	158
Chapter 8	Maternal Health and Nutrition	161
	Nutrition Education	161
	The Basic Nutrients	163
	Nutrition in Pregnancy and Lactation	170
	Making Healthy Food Choices	172
	Offering Nutrition Suggestions to Mothers	177
	Summary	183
	Chapter 8—At a Glance	183
	References	184
Chapter 9	Properties of Human Milk	187
	Colostrum: the Early Milk	187
	Transition to Mature Milk	188
	Composition of Human Milk	189
	Health Benefits of Human Milk	195
	Differences Between Human Milk and Infant Formula	204
	Summary	212
	Chapter 9—At a Glance	212
	References	214
Chapter 10	Impurities in Human Milk	225
	Medications	225
	Social Toxicants	229
	Breast Implants	235
	Environmental Contaminants	235
	Counseling a Mother About Impurities	237
	Summary	238
	Chapter 10—At a Glance	238
	References	239
PART 3	PRENATAL THROUGH POSTPARTUM
Chapter 11	Prenatal Considerations	245
	The Decision to Breastfeed	245
	Preparation for Breastfeeding	250
	Selecting a Physician or Midwife	256
	Summary	260
	Chapter 11—At a Glance	260
	References	261
Chapter 12	Hospital Practices that Support Breastfeeding	265
	Setting the Stage Prior to Birth	265
	Supportive Labor and Delivery Practices	266
	Creating a Supportive Postpartum Environment	274
	Postpartum Care Plans	281
	Baby-Friendly Hospital Practices	286
	Summary	288
	Chapter 12—At a Glance	288
	References	289
Chapter 13	Infant Assessment and Development	293
	Assessment of the Newborn	293
	Digestion	303
	Infant Communication	308
	Infant Behavior Patterns	311
	Infant Growth	312
	Sleeping Patterns	314
	Crying and Colicky Behavior	317
	Summary	327
	Chapter 13—At a Glance	328
	References	328
Chapter 14	Getting Breastfeeding Started	335
	Getting Ready to Nurse	335
	Beginning the Feeding	337
	Assisting at a Feeding	341
	Breastfeeding Positions	344
	Breastfeeding Multiples	346
	Tandem Nursing	350
	Summary	352
	Chapter 14—At a Glance	353
	References	353
Chapter 15	Infant Attachment and Sucking	355
	Sucking and Suckling	355
	Sucking at the Breast versus a Bottle	357
	Latching the Baby	359
	Milk Transfer	361
	Problems with Latch	361
	Problems with Sucking	364
	Summary	368
	Chapter 15—At a Glance	368
	References	369
Chapter 16	Breastfeeding in the Early Weeks	373
	Commitment to Breastfeed	373
	Establishing Milk Production	377
	Leaking	380
	Nipple Soreness	381
	Engorgement	392
	Plugged Ducts	396
	Milk Blister or Milk Bleb	397
	Mastitis	398
	Summary	403
	Chapter 16—At a Glance	403
	References	404
Chapter 17	Breastfeeding Beyond the First Month	409
	Patterns of Growth in a Breastfed Baby	409
	Infant Development	410
	Breastfeeding an Older Baby	417
	Sustaining Breastfeeding Beyond 1 Year	420
	Nourishment Away from the Breast	422
	Weaning	429
	Summary	433
	Chapter 17—At a Glance	433
	References	433
Chapter 18	Problems with Milk Production and Transfer	437
	Perception of Insufficient Milk Production	437
	Mothers at Risk for Low Milk Production	439
	Concerns About Infant Growth	440
	Summary	447
	Chapter 18—At a Glance	447
	References	447
PART 4	SPECIAL CARE
Chapter 19	Changes in the Family	451
	Acquiring the Parental Role	451
	Becoming a Mother	451
	Becoming a Father	455
	Changes in Family Relationships	461
	Sibling Reactions and Adjustments	463
	Summary	470
	Chapter 19—At a Glance	470
	References	470
Chapter 20	Special Counseling Circumstances	475
	Mother’s Lifestyle	475
	Opposition to Breastfeeding	476
	Low-Income Mothers	480
	Single Mothers	482
	Teen Mothers	482
	Cultural Competence in Helping Mothers	486
	Mother-to-Mother Support Groups	490
	Summary	491
	Chapter 20—At a Glance	492
	References	492
Chapter 21	Breastfeeding Techniques and Devices	497
	Breastfeeding Techniques	497
	Breastfeeding Devices	499
	Digital Techniques	506
	Milk Expression	507
	Alternative Feeding Methods	515
	Summary	524
	Chapter 21—At a Glance	524
	References	524
Chapter 22	Temporary Breastfeeding Situations	529
	Hyperbilirubinemia (Jaundice)	529
	Delayed Onset of Breastfeeding	538
	Relactation	539
	Nursing an Adopted Baby	541
	Breastfeeding during Emergencies	543
	Baby Losing Interest in Breastfeeding	546
	Baby Prefers One Breast	548
	Summary	548
	Chapter 22—At a Glance	548
	References	549
Chapter 23	High-Risk Infants	553
	Prolonged Hospitalization of the High-Risk Infant	553
	Preterm Infant	562
	Other Babies Not Born at Term	569
	Counseling a Mother Whose Baby has Died	572
	Summary	574
	Chapter 23—At a Glance	575
	References	575
Chapter 24	When Breastfeeding is Interrupted	579
	Managing Breastfeeding through a Separation	579
	Short-Term Separations	581
	Supporting Working Mothers	585
	The Breastfeeding-Friendly Workplace	591
	Summary	594
	Chapter 24—At a Glance	594
	References	595
Chapter 25	Long-Term Maternal and Infant Conditions	599
	Special Maternal Health Conditions	599
	Special Infant Health Conditions	615
	Summary	627
	Chapter 25—At a Glance	627
	References	628
PART 5	ROLE OF THE IBCLC
Chapter 26	Professional Considerations	637
	Acquiring the Role of Lactation Consultant	637
	Preparing for the Profession	639
	Professional Practice	641
	Code of Ethics	642
	Legal Considerations	643
	Developing Resources	646
	Promoting Your Services	647
	Educating the Healthcare Team	650
	Maturing through Experience	652
	Avoiding Professional Burnout	654
	Summary	656
	Chapter 26—At a Glance	656
	References	657
Chapter 27	Critical Reading and Review of Research	661
	Online Journals	662
	Types of Articles in Scientific Journals	662
	Structure of a Scientific Article	663
	Critical Reading of a Scientific Article	665
	Practicing Critical Reading Skills	679
	Summary	690
	Chapter 27—At a Glance	691
Chapter 28	Breastfeeding Promotion and Change	693
	Strong Leadership	694
	Increasing Self-Confidence	696
	Increasing Assertiveness	697
	Becoming a Change Agent	697
	Beginning the Process of Change	707
	Turning the Tide in Breastfeeding Promotion	711
	Summary	723
	Chapter 28—At a Glance	723
	References	724
	Glossary	729
	APPENDICES
Appendix A	Code of Ethics for International Board Certified Lactation Consultants	749
Appendix B	Scope of IBCLC Practice	751
Appendix C	Standards of Practice for Lactation Consultants	753
Appendix D	Clinical Competencies for IBCLC Practice	755
Appendix E	Baby Feeding Requirements	759
Appendix F	WHO Weight Charts	761
Appendix G	Spanish Breastfeeding Glossary	765
Appendix H	Professional Resources	769
	Index	775