Lactation is an ancient adaptation perhaps 300 million years old. Each species of mammal has its own variety of milk and even each mother has her own variety. Exclusive breastfeeding for the first six months of an infant’s life, with continued breastfeeding for up to two years or longer, is recognized as the “gold” standard for infant feeding because human milk is uniquely suited to the human infant, and its nutritional content and bioactivity promote healthy development.

While research shows the positive benefits of breastfeeding, it doesn’t always come easily. At UConn Health, Marisa Merlo, lactation consultant, offers support to families and babies learning how to breastfeed.

Breast milk has endless benefits and research shows it is the best source of nutrition for all babies, but especially those born prematurely. Breast milk can benefit a baby’s overall survival, healthy growth and development, and immunity.

Merlo works with parents and their individual breastfeeding goals. “It’s not always all or nothing,” says Merlo. “Every family has their specific situation to make breastfeeding work for them and I’m there to assist in helping reach their goals.”

Courtney Chandler and her husband welcomed their first child, Theo, two weeks early at exactly 8 pounds at UConn John Dempsey Hospital.

Theo latched on immediately and there were no breastfeeding issues at the hospital. Merlo helped them and they thought they were doing everything right.

Theo was 7lbs 1oz when he left the hospital, which is typical for a baby to lose a little weight after birth with the goal to be back to birth weight in two weeks. At his first pediatrician appointment, Theo was not on track to hit his two-week birth weight goal.

At that point, Chandler reached out to Merlo who sees patients in an outpatient setting to help moms build confidence, provide tips and assist with effective baby feeding.

Merlo started meeting with Chandler and Theo weekly. At their first meeting, they did what is called a weighted feed where the baby is weighed before and after feeding to see if there is a transfer of milk.

Merlo quickly diagnosed the problem that Theo was a “sleepy” feeder. While he was latching on, he wasn’t actively transferring milk. She provided helpful tips and different methods, such as switching breasts, hand expressions, and tickling him to keep him awake.

“I almost wanted to quit,” said Chandler. “It was discouraging and incredibly stressful knowing that my newborn was losing weight and not getting enough breast milk. Thankfully, Marisa quickly identified the problem and encouraged me to keep trying.”

After a week of using these tips, Theo was still not gaining enough weight and Merlo indicated they needed to get him on an aggressive plan to get him back to birth weight, including pumping, feeding at the breast, and giving bottles.

Merlo helps patients learn how to use a breast pump in the hospital and can assist with obtaining a pump through insurance or the breast pump donation program at UConn Health.

With the new plan in place, they turned a corner and Theo started gaining more than an ounce a day.

At the next pediatrician’s visit, he had hit his birth weight and was steadily gaining.

“Marisa knew how much I wanted to breastfeed my baby,” said Chandler. “She gave me the perfect plan that helped Theo exceed his weight goals and helped me improve my own skills. It was hard work, but when Theo finally hit 8 pounds we were all celebrating. The work was worth it.”

“Theo continues to gain weight, thrive, and reap the benefits of my breast milk—which is important to me during COVID and the upcoming cold and flu season,” Chandler continues.

Merlo has been a registered nurse for 18 years and her entire nursing career has been working with mothers and babies. She spent several years as a bedside nurse in the neonatal intensive care unit (NICU) and became a lactation consultant and member of the International Board of Lactation Consultants.

“I saw a need, having struggled with personal experience with my own three babies and knowing the science behind breast milk and that the NICU babies I was caring for needed and deserved breast milk,” says Merlo. “I realized there was more I could do to help struggling moms.”

A lactation consultant can determine if any adjustments are needed and help address any concerns you have about how breastfeeding is going. It’s important to have support when questions or breastfeeding issues come up, and a lactation consultant is an ideal person to call in these cases.

“Every postpartum patient who wishes to breastfeed should have access to lactation support,’’ said Chandler. “Breastfeeding is incredibly challenging and doesn’t come as naturally or easy as people say.”

Merlo also teaches monthly prenatal breastfeeding classes, which are currently held online, covering topics such as breastfeeding for both mother and baby; how breast milk is made; how a supply is established and maintained; positioning for breastfeeding; feeding cues; teaching an effective latch; how to determine if baby’s nutritional needs are being met and if feedings are going well; going back to work; pumping and bottle feeding; and more. This course can help moms feel more confident with breastfeeding before the baby’s birth.

Learn more about the breastfeeding and lactation services at UConn Health.