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A New Mother’s Dilemma: Hospital Staff Play Crucial Role In Breastfeeding

Editor's note: This is the first in a three-part series. Here's part two and here's part three.

Reported by Katie Schoolov

A New Mother's Dilemma: Hospital Staff Play Crucial Role In Breastfeeding


Stephanie Laurean, group leader, La Leche League and breastfeeding coordinator, Imperial County WIC


Part 1: The benefits of breast-feeding have been reported to be long-lasting for both babies and their mothers. But for many new moms, breast-feeding is a struggle.

Carolina Alban-Stoughton was determined to breastfeed her first-born child. But when Kai was born last June, things didn’t work out like she had planned.

“At first with Kai, I’m not gonna lie, it was very challenging," Alban-Stoughton said. "I had a difficult delivery, with a bunch of issues, and Kai ended up being in the NICU.”

Kai was in the neonatal intensive care unit for a few days. As soon he got out, Alban-Stoughton tried to breast-feed him.

Her nipples were sore. Kai couldn’t latch on. Alban-Stoughton started to panic.

“It’s amazing, how emotional breast-feeding can be," she said. "Our hormones are going crazy, we’re overwhelmed, we want to feed our babies, and we are losing perspective.”

Photo credit: Katie Schoolov

Carolina Alban-Stoughton and her son, Kai, Aug. 9, 2016.

The importance of well-trained staff

Fortunately, Kai was born at Scripps Memorial Hospital in Encinitas, where they have six board-certified lactation consultants on staff.

Lactation consultants at this hospital check in with every new mom and make sure that they aren’t having any problems with breastfeeding.

Vicki Wolfrum was the lead lactation consultant at Scripps Encinitas. She died in October.

All of the staff at Scripps Encinitas have been trained on best practices to promote breast-feeding. Wolfrum said these include helping moms to initiate breast-feeding within an hour of birth.

“So if the baby is placed skin to skin, a lot of times the baby will try to scooch over to the breast, and will actually just latch on all by themselves," she said. "It doesn’t always happen, and in those cases, the nurse, of course will help. But if she’s not having success, then she’ll come and get the lactation consultant.”

Photo credit: Katie Schoolov

Former Scripps Encinitas Hospital lead lactation consultant Vicki Wolfrum visits with a new mom, Aug. 9, 2016.


Scripps Encinitas has adopted the ten steps required to become a “Baby-Friendly” hospital.

The World Health Organization introduced the Baby-Friendly Hospital Initiative in 1991. It’s based on research that shows that breastfed infants have lower rates of asthma, childhood obesity and a number of other adverse health conditions.

Scripps Encinitas became the first Baby-Friendly hospital in San Diego County in 2004.

Nurse Judy Mills has worked at the hospital for 18 years. She said some women have a lot of problems with breastfeeding.

“But we can certainly work with those moms," Mills said. "And we have, and we do help them to succeed. We have all kinds of things we pull out of our hat to make them be able to breastfeed and be successful at it.”

The numbers

The California Department of Public Health issues an annual report on in-hospital breastfeeding rates.

The latest report reveals nearly 91 percent of women at Scripps Encinitas exclusively breastfeed their babies.

But just 15 miles away, at Tri-City Medical Center in Oceanside, the in-hospital breastfeeding rates are much lower.

Tri-City is not a certified Baby-Friendly Hospital.

Photo caption:

Photo credit: Jorge Contreras

Exclusive in-hospital breast-feeding rates in 2015.

Marissa Allen, registered nurse supervisor at Tri-City's lactation services, said her staff encourages breast-feeding. But she admits only 57 percent of moms exclusively breast-feed at Tri-City, the lowest rate of any hospital in San Diego County.

“We have moms that come in that want to exclusively breast-feed and we try to support them the best that we can," Allen said. "And some moms that come in, and if they ask for formula, we give them the risks of formula. But ultimately, it’s really their choice.”

Photo credit: Katie Schoolov

Marissa Allen, registered nurse supervisor at Tri-City Medical Center's lactation services, Aug. 29, 2016.

According to the World Health Organization and the Centers for Disease Control and Prevention, hospital staff that are trained in baby-friendly techniques greatly increase the percentage of moms who exclusively breastfeed.

Bella Kaufman, senior director of clinical services at Scripps Encinitas, points out not all women come in wanting to breastfeed.

“There are a lot of moms who really don’t know the difference, still," Kaufman said. "And the formula companies do an excellent job of marketing. Nobody markets breastfeeding because no one gets paid for marketing breast-feeding.”

Nonetheless, California law requires all hospitals that have a birthing center to be Baby-Friendly by 2025.

Only four hospitals in San Diego County currently have that designation.


After many failed attempts, Carolina Alban-Stoughton was finally able to breast-feed Kai. A lactation consultant at Scripps Encinitas helped her position him just right.

“And he latched on," she said, smiling. "And it didn’t hurt.”


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