‘MILCCC’ is an acronym for Mothers’ and Infants’ lactation/Breastfeeding Care Centre Chennai. The ‘MILCC’ Centre is the first of its kind in Chennai and perhaps in the whole of India. MILCC functions as a division of SMRTHI HEALTHCARE.
MILCC Centre is the brainchild of Dr. & Mrs. Subramanian and a lactation consultant, Dr. Padmini Balagopal. Dr.Padmini Balagopal, a Registered Dietitian, Diabetes Educator and a Board-Certified Lactation Consultant (IBCLC), was the state Nutritionist in Delaware, USA in the dept. of Residents’ Protection. She has also been involved in community education in the field of preventive health.
Human milk is a species-specific first food that also helps the newborn develop a strong immune system to fight the many infections he/she will face. Studies have shown that babies fed human milk may have a higher I.Q than babies fed artificial formulas. Importantly, breastfeeding has been touted as a strong preventive factor in chronic diseases such as Diabetes Mellitus, cardiovascular disease, obesity and even in some cancers.
1. What is the need for a specialized centre for lactation?
Breast feeding is considered as a natural right of the newborn and as an instinct and duty of the mother. However every mother who has nursed her child would tell us how the initial period when she first tried to feed her child, was a stressful experience and how she needed guidance. With rising nuclear families, guidance is unavailable to many mothers. Also with rising number of sick newborns surviving, these newborns need to be re-established on breast feeds after their initial stay in NICU. This requires special techniques. Thus MILCCC is meant to provide assistance to mothers who are unable to establish lactation by themselves.
2. How does and when does the process of counseling/help start? Is it recommended for all pregnant women? Does it start with prenatal counseling or post delivery?
Ideally a pregnant mother is educated in the antenatal period itself. She is taught the physiology of lactation and basic know-how on breast feeding. She is mentally prepared to breast feed her baby. However only after the baby is born does the mother actually have a hands-on experience. Thus the practical aspects are taught. The antenatal counseling can be done by any health care worker in contact with the pregnant lady- including the OB-GYN, nurse, child birth specialist or lactation consultants.
3. What happens during a typical session?
Let’s see as to what happens at MILCCC. In a typical session- the initial history is taken, so as to evaluate the problem. An examination of the breast is done to evaluate any anatomical problem, sore nipple etc is done. Then the feeding technique is evaluated. Then the infant’s sucking-swallow reflex and coordination is checked. Once evaluated, corrective actions are demonstrated and explained to the mother. For example, if it is the faulty holding of the baby and faulty latch then the mother is taught appropriate technique of holding the baby. If it is associated with inappropriate sucking by the baby due to bottle feeding then finger training the baby to suck is done. A typical session would usually last for 1 hour. Some time 3-4 hours too.
4. Who are all involved? Is it just the woman or the entire family?
We encourage the family to participate in the process. This helps in them being supportive to the mother. This empowers other family member (especially the husband) to be a part of the solution. When sessions are for a single patient the husband is also allowed to be a part of the consult. However when we have combined sessions for many mothers then we allow only female family members to be part of the session.
5. What do you do to create awareness and sensitivity to this issue from other family members?
We involve other family members in the sessions. We also talk to the family on emotional support that the mother requires. We explain the process to relevant family members, so as to muster their support to the process.
6. How does follow-up happen?
We generally request mothers to call us up and give us an update. We also write to the primary doctor who referred them to us to follow-up the mother and child. In situations where we feel one session is not enough, we call them for multiple sessions.
7. Is the general public aware of MILCCC?
We reach-out to the public mainly through referrals. We do conduct awareness programmes every year during the world breast feeding week.
8. Is there anything unique about the centre?
MILCCC is probably only one of its kind in India. We have two IBCLC certified consultants and we have three more junior trainees who run the sessions. We have the relevant support structure and equipment’s provided in a safe environment under the strict overview of astute clinicians.
9. What are the future goals/interventions planned?
Our future goals include setting up of a training program for lactation consultants, establishing similar units outside Chennai and reaching out to the middle and lower socio-economic strata of the population in order to have a more profound impact.