Martha Eliot Health Center

Weiner award winner fights for nursing needs

Harriet Sanclemente, RNC, MS, PNP, CANFrom the second-story windows of Boston Children's Hospital's Martha Eliot Health Center (MEHC), Harriet Sanclemente, RNC, MS, PNP, CAN, nurse manager, has a clear view of the center's place in the neighborhood. She points out its previous location, an abandoned brick building with boarded-up windows that still stands next door to the current facility, as well as the local market with which it shares a parking lot. "This place has always been a part of the community," she says. "The original clinic grew out of public housing. It literally started out in a closet."

Cramped beginnings haven't stopped MEHC from becoming a leader in providing top quality, culturally sensitive health care, ranging from pediatric primary care to optometry and nutrition services. But when Sanclemente transferred to MEHC after spending 15 years at Children's main campus as a nurse practitioner and nurse manager, she was shocked to find the health center lacking a service its families desperately needed: a lactation support program. "This center provides well-visits for low-income mothers and their babies--women with traditionally low success rates when it comes to breastfeeding to six months," says Sanclemente. "Our mothers wanted to breastfeed, but we really didn’t have the resources to support them.” Without delay, she began developing a plan to create the first comprehensive lactation program at the health center. Now, as the winner of this year's David S. Weiner Award for Leadership and Innovations in Child Health, her dream is about to become reality. The $30,000 grant will be used to start the MEHC Breastfeeding Project, which will offer support services and equipment to nursing moms, as well as lactation education for both families and staff.

Even when mothers intend to breastfeed, it can be an insurmountable challenge without appropriate equipment, like breast pumps, and lessons on effective nursing techniques. Donna Karl, RNC, MS, PNP, newborn coordinator for Children's Healthy Connections Program and a pediatric nurse practitioner at Brigham and Women's Hospital, refers newborns to MEHC and tracks breastfeeding data. According to her, 84 percent of the mothers she sends to MEHC start out nursing, but by their infant's 1-month well-visit, less than 25 percent are still breastfeeding. The high numbers of mothers who abandon breastfeeding early is worrying, as early cessation of breastfeeding is known to increase the risk of chronic diseases like obesity, Types-1 and 2 diabetes and leukemia in children, and maternal breast cancer, ovarian cancer and Type-2 diabetes in mothers. Many moms who stop breastfeeding report feeling like they just don't have enough milk; a misperception that can be easily addressed with proper lactation education and support.

Currently, MEHC supports the nursing needs of their families through the efforts of two women: Laura Sprauer, RD, IBCLC, a nutritionist and certified lactation consultant, and Jaegar Ashton, RN, PNP, a pediatric nurse who's working toward her lactation consultant certification. "We've all felt such a huge desire to do more," says Sanclemente. She's quick to credit Sprauer, Ashton, Karl and Kim Barbas, BSN, RN, IBCLC, a specialist from the Lactation Support Program at Children's main campus, for helping envision this ambitious project. Barbas (who's known among the group as "the mother of all breastfeeding at Children's"), stresses the importance of the new equipment the grant will fund. "The reality is that most of our moms can't simply stay home and nurse," she says. Access to pumps and milk storage equipment will make it easier for moms to continue breastfeeding while transitioning back into the workplace.

The program will also provide new mothers with social support. When mothers come in to MEHC for their child's well-visit when the baby is 2 or 3 days old, they'll now automatically receive a lactation consult. In addition, a telephone "warm line" and monthly support groups will be offered in both English and Spanish. Eighty percent of MEHC's nursing staff will be trained in early breastfeeding support and triage, and the center's perinatal case managers, all of them women from the neighborhoods MEHC serves, will act as peer-level counselors. "Our mothers want someone who can say, 'I've been there and you're going to be fine,'" says Sprauer.

There's much work to be done, but Sanclemente has a simple vision for the future of the program--to see it grow and evolve to meet the needs of MEHC's mothers. She's thrilled to have the funding to get the program up and running, and feels optimistic about how the center’s patients are going to respond. "The families we see have an even bigger stake in successful breastfeeding than we do," she says. "After all, happy babies lead to happy mommies."