Keeping Abreast
The Breastfeeding Project of Rutland County
Addison County Breastfeeding Coalition
In This Issue
Connect with Us on Facebook
What's Cooking Rutland?
Ask Lact-Anna
Comic Relief
Open Access
10 Steps for Nurses
More on Vitamin D
Local Outreach
Baby Showers
Rutland Hospital Updates
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We are a group of professionals and volunteers working as a community resource for breastfeeding information including support and education.  Keep in touch with all our activities via Facebook!

 Quick Links  


Junebug Mother and Child, Inc


The Department of Health - Middlebury Office


VDH Rutland 



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Rutland County
Free, drop-in help for breastfeeding:

La Leche League daytime meeting:
1st Wednesday of the month 10:30-12Noon at Grace Church in Rutland
Call Liz 483-6296
Rutland Regional Breastfeeding Class:
2nd Tuesday of the month
6-8PM at RRMC
Partners welcome!
call 747-3695

VDH/WIC Rutland breastfeeding assistance with Peer Counselor support 
  Call Jill at 786-5111


Promise Lactation Thriving Clinic:
4th Tuesday
of the month 3-5PM at RRMC breastfeeding room weight checks available  
breastfeeding help.  Free
Call Lisa 325-2566
Peer Place
2nd Friday of the month
9:30 -11am at WIC Clinic Rutland. Open to the public. Call Jill at 786-5111
 Peer Place at Mettowee Clinic!
New time and space in West Pawlet  Third Friday of each month 9:30-10:30AM
Open to the public, drop-in breastfeeding help, free
Call Jill at 786-5111


Addison County

Free, drop-in help for breastfeeding:


Nursing Nook:

1st Tuesday of the month 9:30 - 11am at the Baptist Church in Bristol


3rd Wednesday of the month 9:30 - 11am at the Congo Church in Vergennes


4th Tuesday of the month 9:30 - 11am at the Memorial Baptist Church in Middlebury


Jan 25, Feb 8, Mar 29, Apr 12
9:00-11:00am Salisbury Elementary School
Nursing Nook coincides with Addison Parent Child Center playgroups
   Call Gillian 388-5741


La Leche League- Breastfeeding Cafe and Playgroup:
1st Thursday of the month, 10:00am, June Bug Resale Shop, in the Star Mill Building on Park St, 
Call Samantha 382-1589 or JuneBug 388-1055
*Infants/toddlers welcome*


Porter Hospital Breastfeeding Class:
Some Mondays,
February 18th; April 1st; June 10th; August 5th; 
Porter Hospital Conf Room Middlebury
Call 382-3413 to register
*Free with Dr. Dynasaur or Medicaid*


Natural Beginnings:
3rd Tuesday of the month, 11:00 - 1:00 pm, Ilsley Library, Basement Conference Room, Middlebury
Call Vicky Kirby 236-4136
*Free, partners/children welcome*
VDH/WIC Middlebury 
  Call Gillian at 388-5741
breastfeeding assistance with Peer Counselor support
What's Cooking Rutland?
Check out the April episode of
What's Cooking Rutland? on Peg-TV.  Guest hosts from Rutland Area Food and Farm Link talk about using those last goodies in your freezer before the garden season starts!
Issue: 2-13April 2013 

Dear Friends and Supporters, 


We're expanding again!  The spring blooms are encouraging us to reach out, join in, and work harder to bring down the barriers to breastfeeding.  This month read an interview with a WIC Breastfeeding Peer Counselor, updates from the Rutland Regional, and some articles that could impact your clinical practice. 


As the school year winds down, we wind up, readying for World Breastfeeding Week and all of our outdoor Nursing Nooks and Rock and Rest booths.


Care to join us?  Call Jill Corey at 786-5111 or Gillian MacMurtry at 388-5741 for information on our next meetings and opportunities to volunteer!   

Ask Lact-Anna

 Do you have a question about breastfeeding, or is there something you've heard about and want to know whether it's fact or fiction? Here's your opportunity! Ask Lact-Anna! 

"Dear LactAnna,


I gave up breastfeeding my first child after four days because I didn't feel like I was producing enough milk for her. I want to breastfeed my next baby but what if I don't produce enough again?

Sincerely, Wondering in Westfield"


Dear Wondering,


This is a great question and let me first applaud you for wanting to give breastfeeding a second try! What you experienced is something many women tell me they have faced before too. I want to first describe the process of lactation and the involvement of hormones. Before the birth of your baby, you have very high levels of various hormones (i.e. estrogen, prolactin) which stimulate your breast tissue to develop and prepare for milk production. From about the fourth month, your breasts produce milk called colostrum. After the delivery of the placenta, there is a chain of events that causes the milk production to increase which many people refer to as "milk coming in." Sometimes, this process takes a few days so you might not feel like your breasts are making milk even though they are and your baby is getting colostrum. After about 3-4 days of nursing, your breasts will start to feel less soft and more firm as your milk changes from colostrum to milk that looks similar to skim milk. During this time, you might feel feverish, tired, and your breasts might feel engorged. The key during the first few days is to breastfeed your baby often because early, frequent, and effective nursing increases a hormone called prolactin, which helps assure an abundant and robust milk supply. The more often you breastfeed your baby from birth, the better your milk supply will be down the road.

There are a few  reasons why a woman's milk might not "come in" until a little later which includes first time mothers, mothers who deliver by Caesarean section (C-section) or mother's experiencing other stress, and rarely, medical factors. Healthy, full-term babies do not need anything more than colostrum during the first 3-4 of days.


Take Away Messages:

  1. Your breasts start producing milk at about 4 months gestation. This is called colostrum and your baby will drink this for the first few days of his life. You may or may not notice leaking during your pregnancy.
  2. Your breasts will increase the volume of milk they produce around 3 or 4 days because your breasts are responding to prolactin, a hormone released every time your baby nurses at your breast.
  3. Your baby needs to breastfeed early, often, and effectively. The more you breastfeed, the more milk your body produces.
  4. Don't give up breastfeeding if you feel your baby isn't getting enough to eat or if you have questions about your milk production. You have lots of people you can call and ask questions of, like your WIC Peer Counselor, a Lactation Consultant, a local La Leche League leader, or your baby's Pediatrician.


Sincerely, Lact-Anna and


Comic Relief 
Clinical Lactation 
  Now Open Access! 
Clinical Lactation, the Official Journal of the United States Lactation Consultant Association is now available to read on line.  Check out all the back issues - book reviews, new research, opinion articles, and clinical practice.

 WIC Breastfeeding Peer Counselor Brooke Hughes-Muse


How long have you been a WIC Breastfeeding Peer Counselor?


I began my training with the PC program in June of 2012 and became a peer in July.


What made you interested in this work?


I am a birth advocate and working with birthing women inevitably led to my interest in promoting breastfeeding. I have four children and breast fed each of them. My oldest is now almost nine and geez, do I wish I had someone to be available for support (and encouragement) back then! I had a hard time with nursing and vowed not only to get help right from the start with any subsequent children, but also to be available to any other new mamas who needed some extra help with breastfeeding. I first heard of this program through the peer who contacted me during one of my pregnancies. She was incredibly helpful and encouraging.


What do you do that you never thought was part of the job?


I am encouraged to keep learning! I thought I would simply be calling and talking with mamas about breastfeeding and the benefits associated with it. Luckily, I'm also encouraged to learn more about breastfeeding through conferences, webinars , and monthly trainings.


Tell me a story about a helping situation.


When I was pregnant with my third child, I was contacted by a Peer Counselor. She sent her bio and then called a few weeks later to follow up. Life was crazy for me at that time and I don't believe we ever connected by phone. But after my baby was born, I had specific issues that I needed help with and my peer was the first person I turned to. I sent her a personal message through Facebook and she guided me through my problem and helped find a solution that worked for me and my baby. My peer and I still talk today about babies, breastfeeding and the WIC PC program!


What are some of the resources you use to help you in your job (written or people or other)?


I use my training manual pretty extensively when I make my calls. I also frequently use the book "The Womanly Art of Breastfeeding" and "The Nursing Mother's Companion". Of course, I also rely on Lisa, one of the more experienced peers in the program, for advice. Our supervisor Jill, is very helpful in any situation in which I ask her for help.


What do you see in your future for helping breastfeeding families?


Using what I have learned through this program has made me more confident in my ability to share my knowledge with other people, specifically new mamas. I plan to continue with WIC to reach out to women who may have questions or just need some extra help. Separately, I also work with birthing women who are usually interested in breastfeeding. It is nice to be able to give them the immediate hands-on support that helps encourage their mothering journey.


How does the WIC Breastfeeding Peer Counselor Program help breastfeeding families in your area of the world?


The PC program is a great tool to get to know other women in your area who are pregnant and considering breast feeding. Our local PC program has recently set up a Peer Place Clinic in Pawlet as a means of extra support for the women in our town and the area further from Rutland. Being able to offer support in different locations is a great way to meet and get to know the women in our area. Whether it's your first child or your sixth, extra support is almost always appreciated.


Clinical Lactation 

 A New 10 Steps for Nurses


The intrapartum period is a crucial time for implementing steps to protect, promote, and support breastfeeding. Labor and delivery nurses may be more concerned with the immediate safety of the mother and fetus than with future implications for breastfeeding. The purpose of this article is to review the potential effects that prenatal education and intrapartum practices and interventions have on lactation, and to encourage nurses to thoughtfully consider these effects in their clinical practices. By implementing these recommendations they can better educate the mother, empower her to make informed choices, avoid unnecessary intrusion into the normal birth process, and maximize the potential for meeting her breastfeeding goals.


 Another 10 Steps for Intrapartum Nurses:


1. Assess the mother's knowledge of the benefits of breastfeeding and risks of formula feeding to ensure

informed consent for feeding choice.


2. Assess the mother's knowledge of the impact

analgesia and anesthesia has on labor, the infant, and

the lactation process.


3. Assess the mother's knowledge of, experience with,

and motivation for the use of non-pharmacologic

comfort measures to customize teaching and labor

support to avoid or minimize pharmacologic



4. Encourage ambulation for as long as the laboring

woman is comfortable.


5. Discourage the recumbent position and suggest

frequent position changes for mothers confined to bed.


6. Encourage oral hydration and nourishment, unless

contraindicated, and carefully monitor fluid intake

and output.


7. Place baby immediately on mother's chest, and leave

the baby skin-to-skin to encourage bonding, breastseeking,

and breastfeeding behaviors.


8. Delay routine eye prophylaxis and vitamin K

injections until after the first breastfeeding is



9. Delay the baby bath until after the first breastfeeding.


10. Initiate breast pumping within the first hour if the

infant is transferred to the NICU without the

opportunity for skin-to-skin contact and breastfeeding.


 Read the whole article here.  

More About Vitamin D from The Journal of Human Lactation 

Maternal Vitamin D Supplementation to Meet the Needs of the Breastfed Infant: A Systematic Review.


Source - Oregon Health and Science University, Monmouth, OR, USA.

Maternal vitamin D insufficiency during lactation, related to lack of sun exposure and minimal intake of vitamin D from the diet, contributes to low breast milk vitamin D content and, therefore, infant vitamin D deficiency. The objective of this review was to examine the literature regarding evidence for achieving maternal vitamin D status that promotes sufficient vitamin D transfer from mother to infant exclusively from breast milk. PubMed and CINAHL databases were searched using the terms lactation or breastfeeding or milk, human and vitamin D. The resulting articles were further limited to those written in English, published within the last 10 years, and involving clinical or randomized controlled trials of humans. The search yielded 13 studies, 3 of which provide evidence for maternal intake of vitamin D and the correlation with exclusively breastfed infants' serum 25-hydroxyvitamin D level. A strong positive correlation exists between maternal vitamin D intake during exclusive breastfeeding and infant serum 25-hydroxyvitamin D levels. There is support to conclude that when maternal vitamin D intake is sufficient, vitamin D transfer via breast milk is adequate to meet infant needs. In the reviewed studies, doses up to 10 times the current recommended daily intake of vitamin D were needed to produce sufficient transfer from mother to breastfed infant. Further research is needed to refine the dose and gestational timing of maternal vitamin D supplementation. Due to the high rates of vitamin D deficiency during lactation and the correlations between vitamin D deficiency and multiple diseases, providers should consider monitoring lactating mothers' vitamin D status.


Link to the article

Out and About with The Breastfeeding Coalition of Rutland County!
Green Mountain College Wellness Fair
We had a great time on April 10, chatting with students and faculty at the twice-annual wellness fair at Green Mountain College.  The Breastfeeding Jeopardy game attracted much attention and lots of students learned new things about the science and management of lactation!  Thanks to Middlebury Peer Counselors for lending us the game - we are hot on your trail to make our own!
Baby Showers!



Rutland Regional Medical Center Support for Breastfeeding

  A Note from Kathleen Craig, MSN, RN, CENP, Director of RRMC Women's and Children's Unit



Hospitals and healthcare providers may help or hinder mothers and babies as they begin breastfeeding. The Baby Friendly Hospital Initiative describes the Ten Steps to Successful Breastfeeding, practices that are proven to support breastfeeding. Rutland Regional Medical Center (RRMC) is implementing the Ten Steps in partnership with the Vermont Child Health Improvement Program (VCHIP). VCHIP is working with hospitals all over Vermont to ensure that babies born in Vermont have the best opportunity to breastfeed. Breastfeeding offers the optimal start for a lifetime of good health. Practice changes at RRMC are aimed at improving breastfeeding rates in our community.


One simple step to making breastfeeding the first choice for infant feeding in Rutland County is to remove formula promotion material from patient education information. Providing literature from formula companies has been shown to decrease a mother's confidence in her ability to breastfeed. Patients who choose to bottle feed will receive information specific to their needs, but it is not distributed to all.


At Rutland Women's Healthcare clinic, pregnant women meet with an RN Care Coordinator for an initial visit, and beginning May 1, 2013, at 28 weeks gestation, to provide information about the healthiest choices for pregnancy, birth, and postpartum. Nurses inform women about the benefits of breastfeeding and help identify family and community support for their choices. In 2012, all Birthing Center and Women's and Children's Unit staff completed 16 hours of very specific training to improve breastfeeding support practices in the hospital. Last summer the RRMC website was updated to reflect our new practices.


Lisa Velasquez, an International Board Certified Lactation Consultant (IBCLC), La Leche League leader, and WIC Breastfeeding Peer Counselor is volunteering at RRMC. She rounds on patients in hospital once a month and is available for continued support after discharge. She is at the Women's and Children's Unit every fourth Tuesday from 3-5 PM for drop-in visits, and to facilitate mother-to-mother support for breastfeeding mothers and pregnant women.


RRMC has four Certified Lactation Counselors on staff. CLCs offer breastfeeding classes at the hospital every second Tuesday from 6PM - 8PM. Classes are usually held in Conference Room A of the Leahy Conference Center. A WIC Breastfeeding Peer Counselor often attends these classes to encourage and support. Call 747-3695 to register and find out more about breastfeeding classes.


After delivery, early skin-to-skin contact helps a newborn baby stabilize and get ready for feeding. RRMC nurses and doctors encourage skin-to-skin contact between all mothers and babies for at least an hour immediately after birth, and frequently during the early postpartum period. Birthing Center staff received additional special training to recover mothers from C-section births right in the Birthing Center so baby and mother are not separated after delivery. All these steps are shown to support breastfeeding.


In October 2013, RRMC will host a week-long Certified Lactation Counselor (CLC) course for all those interested in Vermont and surrounding states. An additional six RRMC nurses will receive 45 of hours of education in lactation management. Participants sit for specialty certification after the training. Once they pass the exam, they can use the CLC designation. CLCs continue to receive education in lactation management to maintain the certification. Research has shown that providing staff with this level of education improves breastfeeding rates.


RRMC nurses are tracking breastfeeding outcomes to see if the changes are working to promote breastfeeding, and to improve the likelihood that breastfeeding will continue after discharge. The work of promoting and supporting breastfeeding is part of a plan to improve the overall health of our community, one step at a time.


Happy Spring!

Addison County Breastfeeding Coalition
The Breastfeeding Project of Rutland County