“I did not expect it to be as challenging as it was” - Breastfeeding, Infant Nutrition (Part I)

In this episode, Helen Cai chats with Dr. Chen and Dr. Nardella about the challenges and joys involved with feeding babies through breastfeeding.

=== Outline ===

Chapter 1: Motivation for Learning

Chapter 2: Counseling on benefits of Breastfeeding

Chapter 3: Collecting a history and troubleshooting

Chapter 4: Not all situations are the same

=== Learning Points ===

1. Breastfeeding Pain is Not Normal: While some tenderness may occur in the very early days, ongoing pain, is a sign of a problem.
2. Supply and Demand Basics: Breastfeeding largely operates on supply and demand. Parents need to be encouraged to drain the breast 8 to 12 times in 24 hours to establish an adequate milk supply.
3. Universal Provider Responsibility: All primary care physicians should have a foundational knowledge of common breastfeeding challenges and counseling techniques.
4. Focus on Parent Goals and Informed Decision: Counseling should avoid shaming and move past yes/no questions and use motivational interviewing.

=== Our Expert(s) ===

Deanna Nardella, MD, MHS is a general pediatrician at Yale who completed her pediatrics residency at The Children’s Hospital of Philadelphia and later joined Yale as a National Clinician Scholar, bringing a strong background in infant care and breastfeeding medicine to her work with families.

=== Further Reading ===

1. American Academy of Pediatrics. Policy Statement: Breastfeeding and the Use of Human Milk https://publications.aap.org/pediatrics/article/150/1/e2022057988/188347/Policy-Statement-Breastfeeding-and-the-Use-of?autologincheck=redirected 
2. Academy of Breastfeeding Medicine: links to “Need to Know” videos
   https://www.bfmed.org/need-to-know-videos
3. Institute for the Advancement of Breastfeeding and Lactation Education (IABLE): Offers online CME and eCourses, including a “1 Day Primary Care Breastfeeding Medicine Course for Physicians and Other Providers”
   https://lacted.org/ 
4. Global Health Media Project: Offers free instructional videos on a wide range of breastfeeding topics
   https://globalhealthmedia.org/video/?_topic=breastfeeding&_language=english&~1 
5. E-lactancia: Spanish and English information about compatibility between medications and breastfeeding. https://www.e-lactancia.org/ 
6. Drugs and Lactation Database (LactMed), maintained by the NIH: https://www.ncbi.nlm.nih.gov/books/NBK501922/ 

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts about core primary care topics centered around real patient stories. 

Hosts: Helen Cai

Producers: Helen Cai, Josh Onyango

Logo and Name: Eva Zimmerman

Theme music and Editing: Helen Cai, Josh Onyango

Other background music: Alge, futuremono, Joel Cummins, Schwartzy, Density & Time, The Tower of Light, Asher Fulero, Track Tribe, Penguinmusic, Esther Abrami, the Mini Vandals, Godmode, Quincas Moreira, Nathan Moore, Adam MacDougall, 

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Twitter: @PCarePearls

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