Alyssa Milano and Breastfeeding Shaming

As if moms don’t have enough to worry about – we have a continued attack on public breastfeeding. This is a first world problem – a USA problem. Like so many other “issues,” those trying to build their ratings find something to project their biases and ignorance upon and try to get some controversy going. EVERYONE knows that if we were in a developing nation where Western marketing machinery had not yet ruined the culture and economy, breastfeeding in public would not even be a topic of conversation. Babies do not have any sense of propriety (as some would define it). They just know when they are uncomfortable and want their needs met. A young baby cannot understand that someone’s guilt might be stirred up by their need to be tended to in the same general vicinity as the casual observer.
The idea expressed in this commercial needs to be distributed.

If we are to help mothers reach recommended goals of breastfeeding to at least a year and hopefully to two, we must first help them reach their OWN goals – whatever that length might be! And currently, 80% of moms do NOT meet their own goals – whether to breastfeed 6 weeks or 2 years! Baby-Friendly Breastfeeding Initiatives and other similar programs are a first step to getting moms off right. But beyond that, the community must be engaged to support these moms. Breastfeeding should be welcome wherever it is safe for a mom and baby to be. Workplace and social accommodations must be championed. Ignorance can be cured with education. Disappointment when goals are not met must be met with determination to help the next mom – not try to downplay the goal!

If you are a friend or relative of a breastfeeding mom, do what you can to encourage and support her. Educate yourself and your community. The babies of the world will appreciate your efforts!

Adoptive Breastfeeding

I have a particular heart for adoption. I came from a large family where other children were welcomed. My brothers, sisters and extended family have adopted and now I have an adopted grandchild. If adoption is part of your journey and you would like the experience of breastfeeding, I am here to help. Breastfeeding is a normal part of comforting as well as feeding a baby. There are protocols available on the internet to help with bringing in milk prior to anticipated arrival of your child. My part in helping adoptive moms is to coach, encourage, make adaptions to the plan as needed throughout the process.

If an adoptive mom is not able to attain full milk production, any breastfeeding time is beneficial to both mom and baby. Donor milk or formula can be used with a lactation aid to supplement whatever mom is able to produce. And bottle-feeding can be done in a baby-led way that is more physiologic.  See information on this website.

When to ask for help

Need Help?  When to ask for help….

Baby is older than 3 days old and is still not latching.

Baby is older than 5 days old and mom’s nipples are painful, blistered or cracked.

Baby is 7 days old and you are having to supplement.  Or you feel like your milk has not come in yet.

Baby is not having adequate wets or dirties without having to supplement.   A simple guideline is one wet and one dirty per day of age each day until baby is 5 days old.  After that, 3-5 dirties per day with at least one of them equal to a tablespoonful, plus 6-8 wets. Use diapers with a line that turns blue to help you track wets since babies have very small bladders and it’s easy to miss a wet. 

Baby has not gained back to birth weight by 2 weeks of age.

Baby is wanting to nurse every hour or for more than an hour at a time around the clock.

Mom is tense, exhausted and feels unable to relax while breastfeeding. Persistent neck, back or breast pain.

Mom’s breasts do not soften with breastfeeding and painful lumps remain. If mom has a fever over 101, she should contact her healthcare provider for assistance.

Other situations where help might be needed:

Adoption – induced lactation.  Yes, it is possible to bring milk in and create a breastfeeding relationship between you and your adoptive baby.


What to do till the lactation consultant gets there

Baby refusing the breast?
Milk supply low?
Baby not getting enough?

Remember these 3 things:
1. Feed the baby!
2. Protect your milk supply!
3. Make the breast a happy place!

Feed the baby.The amount a baby needs depends on his or her age and size. Babies between one to 6 months need around 24 ounces of breast milk per day. A 3 day old baby needs at least 4 oz per day, a 5 day old needs 8 oz, etc. A baby who is latching effectively may actually take more than these amounts from your breast. If your baby is under a week old and you believe he or she is not getting enough from direct breastfeeding, try offering small amounts of expressed breast milk by spoon, cup or finger-feeding with a syringe. If your baby is older and requires more than an ounce at a feeding, you may consider using paced bottle-feeding techniques for giving extra milk.

Protect your milk supply. Breast milk production is controlled by hormones in the beginning, but soon switches to local control. This means the more milk is removed from the breast, the more completely drained, the more it will produce in the next hour. When a baby is not effectively removing milk, this tells the breast that it is making too much. Using hand-expression and/or a rental-grade breast pump after feedings may be necessary to protect or build a supply until baby is able to empty the breast more easily. Research has shown that mothers who have effective breast drainage in the first three days (that is defined as 30 breastfeeds or hands-on pumping episodes in 72 hours) have twice as much milk at 10 days after delivery.

Make the breast a happy place. Keep baby skin to skin as much as possible. Baby should be between mom’s breasts, head facing to one side. Mom should be positioned comfortably, propped up with firm pillows with her back and arms supported. Breastfeeding is more than providing milk for your baby – it is setting up a relationship that starts out as meeting a physical need and transitions to meeting an emotional need between mother and child.

All breastfeeding techniques or assistive techniques should include these three concepts.

How to get help

Contact by email, text or phone call (See contact page for that information) Give a little history of your issue.   We will set up an appointment according to your needs and my availability. I will respond to your contact request as soon as I am available.  We use an electronic health record system and information and consent forms are obtained before the first visit.  All appointments are conducted during daylight hours with limited availability on weekends. Please see other posts for more helpful information.

What happens in a home lactation consult?

Before a consultation appointment, you will be asked to sign a consent for care, privacy and financial responsibility acknowledgement form.  The link is available under the documents tab above for you to download, complete and email back. If this does not work for you, please contact me and I will email you the form directly. I have recently switched to an encrypted, secure electronic documentation system to enable timely communication with you and your care providers. I will send you an access link to that system once our appointment is confirmed.

  1. I will obtain a history of your prenatal, birthing and breastfeeding situation up till the day of the consult. I will ask for pre and post consult pain levels. This history form is also available as a download under the documents tab. If possible, print this out and complete prior to our visit.
  2. I will do a physical assessment of your breasts and your baby.
  3. I will do before breastfeeding weights of baby or babies without and with diaper.
  4. I will do a digital suck assessment of baby sometime during the consult as needed.
  5. I will ask you to breastfeed the baby and will observe how the baby latches, your comfort level, etc. When observing the baby at breast, I will be looking for specific functional clues to any breastfeeding difficulty’s source. These clues will help us together to design a workable feeding plan. I will weigh the baby at intervals to determine accurately milk transfer with a scale sensitive to 2 grams.
  6. As the consultation proceeds, I will make suggestions as needed for increased comfort for you and baby and increasing milk transfer, as needed. This may involve special positioning, use of extra support devices, feeding aids, etc.
  7. At the close of the consult, I will provide you with a verbal and written plan of care going forward.
  8. I will provide a written report of the consult to your healthcare providers as appropriate with the information you have given me.
  9. After the consultation, I will provide continued email or text support for 2 weeks.
  10. If I think that further treatment or assessment is required by other healthcare professionals, I will tell you at the time of the consultation and also relay this to your healthcare provider.
  11. If follow-up consultation is required with me, those services will be provided at a reduced rate.

What is different about a home lactation consultation?  

  1. We will use whatever furniture and pillows you have in your home to modify the environment.   If you need something to improve your situation, I will help you figure out what that might be.
  2. You do not have to pre-register etc.  A physician’s order is not required for a home visit, although I will communicate with your healthcare provider about the visit and my findings.
  3. Visits can take the time needed to thoroughly assess your situation. Please allow at least an hour and a half for our time together. Visits CAN last up to 2.5 hours which includes history-taking, care-planning, and pumping as well as feeding the baby. There is no additional charge for this time.
  4. I do not sell or rent equipment or supplies.  If these are needed for your continued care, you will need to purchase those elsewhere. I will provide a “shopping list” for your support person, if needed.


If you would like a home consult findjanehelpsopcropped out more here.

My 35 Year Career in Breastfeeding Support

Breastfeeding is a relationship. It is not just a choice and must be honored and supported as much as possible.

Lactation care begins with the idea that breastfeeding is the natural step after birth: as natural as dessert after a meal. It is what babies and mothers were meant to do. When there is an interruption in that natural progression, questions must be asked. Is there a lack of desire, determination or direction that creates the barriers? Are these barriers coming from within the nursing pair or from without? Most difficulties can be overcome, but it takes the three items of desire, determination and direction to overcome them. My job as a health care professional is to assist your family to overcome any barriers or obstacles to breastfeeding. It’s too important to both mom and baby to not make the effort to give them the physical and relational benefits that breastfeeding provides

My story

I started out as a little girl wanting to be a nurse. While in nursing school, I became pregnant with my first child. I breastfed her as I returned to school and graduated when she was a little over a year old in 1972. This experience inspired me to turn my attention to Maternal-Child Nursing. My first job was as a labor and delivery nurse. I often helped mothers with breastfeeding. I saw the importance of education and information in the quality of a family’s birthing experience. I became a Childbirth Educator and served mothers in my community in that capacity while simultaneously working in L&D. I certified as an ASPO Lamaze Childbirth educator and started classes in Macon, Georgia and Dayton, Ohio in the following years.

In 1986, the hospital where I worked, West Side Hospital, decided to build a NICU and recognized that lactation support was vital in order for mothers to be able to provide breast milk for these fragile babies. I was chosen to participate in the education program that was available at the time with the goal of becoming an IBCLC – International Board Certified Lactation Consultant. I became certified when my fourth child was 2 weeks old.

My career since then has included numerous courses and seminars and conferences to learn more about the special needs of breastfeeding mothers and babies. In 1989, I started preparing adoptive moms for induced lactation and have enjoyed this aspect of lactation care ever since. The interesting thing about adoptive mothers is this: a mom who has never been pregnant can make milk! With that realization and vision, I find I can encourage moms who HAVE delivered, that they too can overcome whatever obstacles encountered to have a happy, satisfying breastfeeding relationship with their baby!

Over the course of my career I have worked with cleft palate and lip babies, Down’s babies, premature babies, babies with torticollis and tongue and lip-ties, moms with inadequate breast tissue, low milk supply, inverted nipples, badly damaged nipples, mastitis, plugged ducts and even cancer. I did my best to help make their breastfeeding experience as meaningful and rich as possible.

In the beginning, lactation consultants leaned heavily on the knowledge gathered by our fore-mothers – the La Leche League moms who first recognized the need for a medical arm of lactation advocacy. Over the past nearly 30 years, the knowledge base has expanded with high quality research, a professional organization, International certification, and recognition that the field of lactation care is a specialty in its own right. The tools we have today combined with a better understanding of the natural instincts that every mother and baby possess have helped bring together the art and science of breastfeeding to overcome problems that were once thought impossible to solve.

Other areas of lactation care where I have served:

In addition to one-on-one consultations for individuals I have served in the following areas:
• Coordinator of Lactation Services at Centennial Women’s Hospital for 25 years
• President of Tennessee Lactation Consultants Association for 2 years
• Committee chairman for Tennessee Perinatal Quality Initiative Breastfeeding Task Force for Centennial Medical Center –Improving Exclusive Breastfeeding in the Hospital
• Writer/lecturer for various breastfeeding education courses for nurses

Today, I am retired from over 30 years at Centennial Medical Center plus 13 years of mostly maternal and child nursing prior to this hospital. I opened my limited private home visit lactation service with the goal of  extending my experience into the home and along the way provide education and mentorship in the community.

Update:  I have enjoyed working with moms in their own environments since I opened my part-time practice in 2016.  It has been an interesting journey with many challenging situations. As of December 31, 2021, all clients will be referred to Chelsea Carver, IBCLC. Thank you to all the moms who have chosen to use my services and the hundreds of moms who have used the resources I have provided on this website.

Welcome to Hope Breastfeeding Support.

If you are interested in engaging lactation services find out more here.