CLCH breastfeeding clinic research published in the Journal of Health Visiting

Published: 27th January 2022


A peer-reviewed article showcasing the innovation of Central London Community Healthcare (CLCH) in being the first International Board-Certified Lactation Consultant led specialist clinic in the NHS was recently published in the Journal of Health Visiting. The research paper, entitled ‘Providing effective lactation care: The Merton NHS Specialist Breastfeeding Clinic’ was produced by the Indira Lopez-Bassols as lead author, assisted by other clinic staff, and was published in December.

The Merton Specialist Breastfeeding Clinic has been running for three and a half years and is a unique service. It is staffed by International Board-Certified Lactation Consultants (IBCLCs) and runs on a referral system. Therefore, the mothers that attend have already been seen by midwives, nurses, GPs, sometimes several healthcare professionals, and they are still struggling to breastfeed. Healthcare professionals can refer mothers to the clinic, knowing that they will get help from experts in breastfeeding and human lactation.

The IBCLCs at the clinic already know that their work is having a positive impact from the feedback they receive from the mothers they help, as well as the fact that the clinic has grown as a service. However, the purpose of the paper was to test the impact in the community, to evidence this, and to highlight the need for IBCLCs across the UK. The findings have shown that mothers who were helped by the clinic are now either still breastfeeding fully, or their babies are receiving some form of their mothers’ own milk at six months, which really evidences that the clinic does make a difference to the mothers that it supports.

Something that makes the clinic so unique is that the lactation consultants are competent in carrying out intra-oral examinations. The consultants can do a thorough assessment for the mothers and explain their findings on whether their baby has a tongue tie.

Another thing that the clinic offers is something called ‘at breast supplementation’, which is when an NG tube is placed at the mother's nipple so the baby can have additional mother's milk or formula from a container while feeding. This means they do not need to use a bottle for the baby, which in the early days can cause flow preference and nipple confusion.

If all other methods have failed the team also sometimes will do a pre- and post- weigh-in which enables them to check how much millilitres a baby has transferred at the breast when they are not sure why a baby is not thriving and growing. This can further help understand the full picture.

Over time the team have developed a lot of clinical experience with babies that are complex, and they are pioneering new techniques. For example, Indira Lopez-Bassols published another peer-reviewed article as she helped a baby feed at the breast with assistance last year who had a full unilateral cleft lip from birth

One of the reasons this research is so important is because the UK as a country ranks lowest in the world in terms of duration (how long a baby breastfeeds), so IBCLCs play a crucial role in improving these suboptimal duration rates in the UK. The paper highlights the need for breastfeeding specialists and recommends that breastfeeding specialists in healthcare should be the expected norm. The Merton Specialist Breastfeeding clinic is showcasing this need to hire and integrate these IBCLCs in the NHS as part of these breastfeeding clinics.

This research was led by Indira Lopez-Bassols and assisted by Iman Hikal, Iona de Wet and Gayle Subramaniam. You can read the full paper here.

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