When I submitted my abstract, Counting Every Drop: Navigating Low Milk Supply, for consideration for the American Association of Nurse Practitioners 2015 national conference in New Orleans, I did not expect it to be accepted. Not only was this my first submission to AANP, but the conference presenters are the top of their field, and this topic is very much out of my daily professional expertise. I am surprised and honored to be selected as a podium presenter and to share the knowledge that I researched out of my personal struggles dealing with low-milk supply. Here is a look at my abstract submission:
Brief Bio
Dr. Jaclyn Engelsher is a Psychiatric Mental Health and Family Nurse Practitioner, and is nationally certified in Oriental Medicine. She has over a decade of experience blending allopathic and complementary evidence-based therapies for physical and emotional wellness.
Summarize why the topic is important
Current guidelines recommend exclusive breastfeeding for the first six-months of life, however many women are unable to produce adequate milk to meet this goal. Unlike initial difficulties or short-term factors that impact full supply, those suffering with chronic low-milk supply require a higher level of education, management, and support to increase or maintain production. The purpose of this presentation is to describe genetic, social, and emotional factors that contribute to low milk supply, and provide the practitioner with a summary of evidence-based allopathic and complementary interventions.
Summarize the literature on the subject
A review of the literature demonstrates up to 15% of women experience insufficient lactation, and 4-5% have chronic-low supply. The contributing factors can be categorized into issues of either production or extraction. Breast structure, previous breast surgery, certain medications, and pregnancy or postpartum complications contribute to production issues. Extraction issues may be related to feeding length and frequency, insufficient milk transfer, and incomplete breast emptying. Early detection and intervention with galactagogues, latch correction, and feeding or pumping optimization increase the likelihood of reaching full supply.
Summarize the focus of the presentation, such as management of condition, etc.
This presentation will provide evaluation strategies and review causes of low milk supply, including insufficient glandular tissue, infant lip and posterior tongue tie, postpartum difficulties, hormonal imbalances, diet, and emotional factors. Pharmaceutical, herbal, and food-based galactagogues, and lifestyle interventions such as feeding and pumping regimens, will be presented to help the practitioner identify appropriate management strategies. A list of patient education and peer-support references will be provided.
Describe the implications for practice, policy, education, and/or research
Low-milk supply evaluation and intervention has practice implications for the nurse practitioner specializing in pediatric, women’s-health, family, and mental health care. Differentiating transient from chronic supply issues, and early identification and management are key in choosing the appropriate intervention for the physical and emotional health of mother and baby.
About One DNP
I earned my "terminal practice" degree in nursing from the University of Tennessee Health Sciences Center in a journey of excitement and challenge. It inspired me to advocate for an all encompassing clinical credential rather than continuing the hodgepodge of nonsensical initials. I hope these entries will provide entertainment and insight into the Doctor of Nursing Practice experience, which will soon be the entry standard for all advanced practice nurses.