A conversation with Mary Ellen Galante – Cambridge-based Nurse Midwife and Lactation Expert

Breastfeeding. Just because it’s natural, doesn’t mean it’s easy. For some moms, it’s a breeze. There are no complications, the baby latches well, and everything goes smoothly. For many, many others, it doesn’t work out that way. A number of issues can interfere with breastfeeding success; tongue-tie, problems latching, mastitis, milk supply issues, sore and cracked nipples, or all of the above.

We are 100% supportive of parent choices when it comes to breastfeeding, pumping, or using formula. And we’re here to support moms who want to breastfeed – as much or as little as makes sense for them. That’s why we work with the most highly qualified lactation consultants.

With the coronavirus taking our world by storm, everyone we know is looking for ways to adapt, including virtual breastfeeding instruction. Our providers are so passionate about helping new moms. We talked to one of them, Mary Ellen Galante, RN, CNM, IBCLC, MPH, about how COVID-19 is changing her care as a  Nurse-Midwife and Lactation Consultant.

Could you share a bit about how you are adjusting your business in the wake of the COVID-19 outbreak? 

Though I had previously done some virtual consults (a few clients living overseas referred to me by other clients), I had not had extensive experience providing virtual visits.  At first, after the wave of COVID-19 panic hit in Massachusetts, early to mid-March, there were relatively few calls or emails asking for lactation support. I knew that women were having babies but it appeared that everyone was in shock, really not knowing what to do.  Normally many women are referred to my practice from hospital nurses on discharge, or from their OB or Midwife or pediatrician, but with the social distancing mandates, it seemed that most everyone, neither breastfeeding mothers nor their care providers, were thinking of lactation consultants as a viable option.  Home visits may have seemed a risky prospect for some families. There were also a few others who didn’t think anything of asking for a home visit and didn’t realize that they may be putting a lactation care provider at risk of exposing their families to potential risk. 

So, in the midst of this general confusion, I decided it would be best to offer telehealth visits as my first option for mothers with breastfeeding challenges.  I was already familiar with the Zoom platform, and already had set up a digital EHR platform. I purchased some additional ‘props’ to use in order to demonstrate via video, the use of a nipple shield, and latching using a doll with an open mouth and a realistic-looking silicone breast. Many of my colleagues were also going through similar challenges with the transition so we provided each other with much-needed support and practical tips.  

I have found that I have been able to provide excellent breastfeeding support via telehealth visits. Just this past week, I provided a follow-up telehealth visit to a mother, who had successfully practiced the latching techniques I taught her on the first virtual visit.  She was now breastfeeding without pain, and her damaged nipples were able to heal. “I would never have kept breastfeeding the way I had been going, thank you so much for your help,” she told me at the conclusion of the visit. It was very satisfying. Honestly, I have been surprised how effective I can be even with telehealth visits and what a difference it can make.  I still miss the home visits and the ease of surveying the woman’s own environment to scope out comfortable breastfeeding spots, and understanding in a more complete way what her support system is, and how she is coping.  

Not only are we providing postnatal lactation care but many of us also do prenatal breastfeeding preparation classes as well, all virtually.  

Could you share a bit about your passion for this work and why lactation support (even in the midst of these crazy times) is so important?

Now more than ever women and their families are desperate for postpartum support.  Those earliest weeks and months following the birth of a baby are so challenging in our society that is increasingly fragmented and mobile.  Many families have very limited support as they often live far from close relatives. Our parental leave policies are sorely lacking in comparison with most of Europe, Canada, and Scandinavia.  Many partners have limited paid time off from work (if any). This has made breastfeeding even more difficult, as it is time-intensive, especially in the earliest weeks. Women and their partners find it hard to manage the household (shopping, cooking, and cleaning) and possibly their other children, at the same time that many women are often recovering from major surgery as so many undergo c-section at birth (over 30%).  

Now, with the coronavirus, most women and families I have been helping are bereft of their normal support systems, as grandparents are most often in the high risk category and need to isolate.  Other family members may not be able to travel to come and help, and friends are all practicing social distancing.

Yet, breastfeeding is now more important than ever as a way to protect babies from the virus, and so many other illnesses, both bacterial and viral.  So I am grateful that I can provide women with not only breastfeeding support, but also the emotional support they need in this time of so much anxiety.  

This work is very satisfying in that the breastfeeding relationship can last years and makes a lifetime of difference in positive health outcomes for mother and baby- mother’s health benefits get less attention, but they include reductions in postpartum depression rates, diabetes risk, heart disease, osteoporosis, and breast and ovarian cancer risks. Beyond that, women tell me that they feel powerful as a breastfeeding mother, that they have this unique way to nourish and nurture their babies that is special. 

Women deeply appreciate the help and support I can give them to help them with their breastfeeding challenges at a time in their lives when they feel vulnerable because when breastfeeding is not going well. When they call me, many women are often in tears, feeling guilty, and sad, often blaming themselves for their breastfeeding issues. It is a great privilege to be able to provide them with a combination of emotional and psychological support, along with practical information and techniques to enable them to reach their own goals and feel good about themselves and their mothering skills.  

WellNested’s mission is to help families thrive in the fourth trimester by offering personalized, flexible care. If you’d like to work with Mary Ellen or any of our highly-qualified lactation consultants, reach out to us at hello@bewellnested.com.

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