Breast and chest feeding an infant provides a whole host of health benefits, including reducing a baby’s risk of asthma, obesity, diabetes, and ear infections. It also lowers the parent’s risk of high blood pressure, breast cancer, and ovarian cancer.
But with affordable lactation and chest-feeding support often limited after discharge from the hospital, 60 percent of mothers who initiate breastfeeding stop earlier than they desired—usually within the first two weeks.
“Formula is really easy to get at one in the morning when the child has been screaming for six hours and won't latch,” said Karina Vattana, MD, FAAP, medical director at Trillium Health’s Pathway Pediatrics in Rochester. “We're preaching ‘breast is best,’ but we're not providing families with the resources to achieve that.”
Dr. Vattana, who tackled the issue during her fellowship with United Hospital Fund’s Pediatrics for an Equitable Developmental Start (PEDS) Learning Network, notes that lactation support in the critical days after birth requires both awareness and financial resources. Contributing to financial challenges, a newborn’s insurance status might take a few weeks to be incorporated in a parent’s insurance status which can delay referral processing for services. Plus, the need for services was further exacerbated during the pandemic, when it became the norm to discharge families earlier—both from the hospital and the in-house lactation support offered there.
“I saw the inequity firsthand,” said Dr. Vattana, noting that around half of Pathway Pediatrics’ patients are on Medicaid or New York State insurance. “I was really upset and really frustrated that I didn't have anyone to send my families to who don't have $150 an hour to pay out of pocket for support services.”
Thanks to Dr. Vattana, these patients will soon have a new option.
Through her fellowship project, Dr. Vattana partnered with ROC Baby Café, a local chapter of the nonprofit Baby Café USA, which offers free, drop-in, informal breastfeeding support groups and professional lactation care. At the time of Dr. Vattana’s project, the nonprofit housed three locations in Rochester and was looking into renewing its funding.
Through a collaboration with medical organizations that sustain the existing Baby Café locations in Rochester, Dr. Vattana helped secure a $987,510 grant over five years to open a new Baby Café at Pathway Pediatrics, plus fund the three other sites. The Pathway Pediatrics café will be open every Thursday, making it so the lactation specialists and support group benefits of the Baby Café are available four days a week in Rochester. The three other Rochester sites are open Mondays, Wednesdays, and Tuesdays.
Plus, the Pathway Pediatrics site will help Baby Café reach a more diverse group of parents, Dr. Vattana said. Pathway Pediatrics is one of two sites in Rochester that specialize in LGBTQ+ care and gender-affirming care in pediatrics.
“You can see a mom who's breastfed three of her kids and is now here with the fourth, or someone who's breastfeeding up until two years of age, or a dad who's chest feeding,” Dr. Vattana said. “They all can give support and encouragement to new parents.”
Given the grant, Dr. Vattana was able to use a stipend from her PEDS fellowship to add yet another layer of support. Both she and her staff are training to be certified lactation support specialists. Dr. Vattana said she has already started using the knowledge to help patients she sees each day struggling with breast and chest feeding.
Dr. Vattana credits the success of her PEDS fellowship project, which saw several logistical challenges along the way, to the knowledge and support of mentors and fellow participants in the program.
But perhaps even more significant is the project’s impact on her personally. The opportunity to create change has been a powerful antidote to the disconnection and disillusionment that can often come with the many challenges of being a physician, she said.
Not to mention, the projects of other fellows have inspired new ideas at Pathway Pediatrics, including applying for a state grant to hire a child development professional known as a HealthySteps Specialist at the practice and investigating a dental referral initiative.
“I think the most important part of this program was helping me to feel less isolated and to feel like I wasn’t alone, fighting the good fight,” Dr. Vattana said. “This fellowship was instrumental in helping me feel like I could make a change...That's not [just] within my project, but within the work that I do every day.”
UHF's pediatric fellowship was launched in 2020 to help changemakers reimagine pediatric care in a way that reduces childhood health inequities. It is part of UHF’s Pediatrics for an Equitable Developmental Start (PEDS) Learning Network, which is funded by a grant from the Mother Cabrini Health Foundation.