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Welcome to your news source for all things related to advocating for and growing the IBCLC® profession in the US!

Follow us as we share news from the field of of lactation-related policy, legislation, and hot topics you most want to explore. Join us at NLCA.us.
Volume 2
April 2022
We exist to empower and advocate for holders of the IBCLC® credential in the marketplace, in legislation and in policy. Our vision is to advance health by ensuring access to care by persons holding the IBCLC® credential. 
 
Advocacy in Action:  
We have been busy!

NLCA was instrumental in acquiring an Occupational Code Assignment for the IBCLC® from the US Department of Labor/Employment and Training Administration through the O*NET program, the nation’s primary source of occupational information. O*NET assigned the IBCLC® the following occupational code: 

Healthcare Diagnosing or Treating Practitioners, All Other, assigned to O*NET-SOC Code: 29-1299.00
 
The code assignment helps provide clarity regarding lactation personnel to employers, insurers, policy makers, and the healthcare system. The O*NET classification may help secure jobs and positively position the IBCLC® as an occupation associated with a career path that enables the holder of the credential to earn a livelihood.
 
Clarity among lactation personnel as delineated by the O*NET occupational code is congruent with the recent recommendations from the Women’s Preventive Services Initiative (WPSI). The WPSI is a federally supported collaborative program led by The American College of Obstetricians and Gynecologists (ACOG) to review and recommend updates to the current Women’s Preventive Services Guidelines. NLCA’s comments were instrumental to the WPSI definition of lactation personnel as follows:
 
Clinical lactation professionals providing clinical care include, but are not limited to, licensed lactation consultants, the IBCLC®, certified midwives, certified nurse-midwives, certified professional midwives, nurses, physician assistants, nurse practitioners, and physicians. Lactation personnel providing counseling, education or peer support include lactation counselors/breastfeeding educators and peer supporters. See https://www.womenspreventivehealth.org/recommendations/breastfeeding-services-and-supplies/
 

As advancing holders of the IBCLC® credential is one of NLCA’s prime goals, it is hoped that the O*NET and WPSI guidance on role clarity provide one more step in enhancing the profession.
Postpartum Care for Up to One Year
The Agency for Healthcare Research and Quality (AHRQ) issued a call for comments on its review to assess healthcare strategies for the postpartum period. The goal of the review is to conduct a systematic review of research to inform clinical guidance for strategies to manage postpartum care for up to one year after delivery. The review will provide strength of evidence tables for important outcomes during the postpartum period and include breastfeeding intention, initiation, duration, and exclusivity. See https://effectivehealthcare.ahrq.gov/products/postpartum-care-one-year/protocol
 
NLCA submitted comments emphasizing consideration be given to how lactation during the postpartum period enhances health and decreases the risk of many diseases and conditions such as cardiovascular disease, stroke, death from cardiovascular disease, type 2 diabetes, and reproductive cancers (breast, ovarian, endometrial). NLCA’s comments also included a request for role delineation of lactation personnel be included during the evidence review process. 

Meet the Board 

Each month, we will introduce to you a different NLCA Board Member. Our board is made up of current and former Board Members of ILCA®, USLCA, IBLCE®, HMBANA, Baby-Friendly USA and many state breastfeeding coalitions. We are current and former Editors of the Journal Clinical Lactation, members of the Editorial Review Board of the Journal of Human Lactation and authors of numerous journal manuscripts and textbooks. We are attorneys, APNs, RNs, Dietitians, University Faculty Members and LLL leaders and we are all holders of IBCLC® certification.
Teresa R. McCullen 

Teresa is an IBCLC® certified Lactation Consultant who holds a Bachelor of Science in Biology. She has over 30 years of distinguished experience in the field of lactation. Teresa is currently the Lactation Consultant and Childbirth Educator at the Augusta University Medical Center. She also simultaneously serves as: Vice President of the Georgia Breastfeeding Coalition, Board Member of the Southeastern Lactation Consultant Association (SELCA) and Trainer for the Georgia Chapter AAP's EPIC® Breastfeeding Program.

Teresa brings a wealth of experience to the National Lactation Consultant Alliance Board as a founding member and currently serves as its secretary. She is a dedicated family advocate and educator who has worked closely with breastfeeding mothers and their families throughout her career. Notably, she has served as a La Leche League Leader in 6 states across the country— Alaska, Georgia, Oregon, Tennessee, Texas, and Washington. Teresa and her husband of 46 years, Michael, are the proud parents of 5 fabulous children and grandparents of six adorable grandchildren, ages 17 to 18 months—and each one of their children and grandchildren were/are breastfed.
Update on the Georgia Litigation
While Goliath may have slain David in the Georgia courts regarding the challenge to IBCLC® licensure in the state, it is our understanding that the Georgia Secretary of State has filed a Notice of Appeal of the trial court decision in the case of Jackson v Raffensperger. The Secretary will continue to accept and process license applications while this matter is pending. For background information, to understand what happened, and to sort fact from fiction click here.    

Use of Glucose Gel for Newborn Hypoglycemia

The use of 40% glucose gel for treating newborn hypoglycemia has been incorporated into many hospital protocols and expert guidelines. Gel use has been associated with reduced NICU admission and increased exclusive breastfeeding rates. However, not all studies reported successful resolution of hypoglycemia in some infants treated with the glucose gel. One reason for the mixed outcomes could be the inconsistency of the glucose dosage found in the commercial tubes of gel typically used in hospitals. Typical hospital tubes of 40% gel are intended for adults with diabetes. Aliquots taken from the top, middle, and bottom of the tubes showed up to 81% variation in glucose concentration depending on where in the tube the gel was extracted. These adult preparations also contain flavorings, colorings, and preservatives with unknown effects on the infant gut microbiome. Authors of the studies recommend, single use, prefilled syringes of a custom newborn dose containing limited additives.

Solimano A, Kwan E, Osiovich H, Dyer R, Elango R. Dextrose gels for neonatal transitional hypoglycemia: What are we giving our babies? Paediatr Child Health. 2019 May;24(2):115-118.
Stanzo K, Kumar V, Chiruvolu A, Cipher DJ. How Much Glucose Is in the Gel Used to Treat Neonatal Hypoglycemia? J Obstet Gynecol Neonatal Nurs. 2022 Mar;51(2):218-224.
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