August 07, 2018

From the Ground Up: Building Mountainside Medical Center’s Lactation Program

Laurie Barbalinardo and Tish Buggeln are two very recognizable faces around the town of Montclair, New Jersey, whether they’re at the grocery store or walking to work. Laurie and Tish started Mountainside Medical Center’s breastfeeding lactation program over twenty years ago, in October of 1998.

Laurie had been a nurse for eight years working in labor and delivery newborn nursery postpartum high-risk antepartum and had helped countless mothers get their babies to latch. “I used to work the night shift, so it was really just mom and I and the baby and we would work together”, she says. But when her first child came along, she experienced trouble with breastfeeding. “Here you have a mom who is very comfortable handling babies and very knowledgeable about that process and I could not get this child to feed! I ended up calling a lactation consultant/midwife friend of mine who came to my house and ultimately, we got him to feed, but he was five days old!” She credits this experience with causing her to look more into lactation. “I did a lot of research about it and I took an extension program through UCLA that was a 45 credit graduate course in human lactation and the whole thing fascinated me.” That was about 23 years ago, and she’s been a lactation consultant ever since. “We’ve really become a big part of the team here and it’s really amazing, I’ve been teaching childbirth classes for a total of 36 years, so I’m starting to feel like the grandmother because some of the people that I taught are now the grandmothers of the women who come in here to deliver.” 

Tish was previously a nurse as well, but became interested in lactation after successfully breastfeeding her own children. “I had a very good experience breastfeeding my three children. When I started, I received no direction whatsoever from the hospital, I was just lucky that my first born was a natural and he kind of taught me. But I realized there was a place for somebody to help mothers.” Tish became a certified childbirth educator when she started to work towards her lactation certification. “I realized that there was a gap in education for new moms about breastfeeding. Breastfeeding became more the norm, therefore there was more of a need for lactation consultants, so we kind of, between my good experience and seeing that there was a need and that it was important for mothers to breastfeed, that’s really the reason why I continued my education towards breastfeeding and became a board-certified consultant.”

At Mountainside Medical Center, the labor and delivery nurses will typically help new moms with their first latch, in the hours right after delivery. Tish and Laurie are on-hand if any new moms need help or if a new mother isn’t sure if she wants to breastfeed or not. “If there’s a patient whose on the fence about whether or not they want to breastfeed, we’re not here to make anybody feel guilty or feel bad about it,” says Laurie. “The nurses will ask us to visit with mothers to help educate and so we’ll talk about it and I’ll let them know if they think they want to try to latch the baby at the following feeding, to please reach out to me, so we just try to not give them any pressure, but we will see them as many times as we can during the their stay.” Laurie and Tish also routinely call the new mothers once they are at home settling in with their babies, in case they have any questions or need any extra support. 

Breastfeeding has many benefits for moms and babies, with just a few being that babies are less likely to be overweight and develop diabetes, and have fewer respiratory problems like infections, asthma, and allergies. “When a baby is starting to put foreign objects, like your knuckle or the watch band that’s on your wrist in their mouth at maybe four or five months, there is a boost to their immune system through the breast milk because they’re going to be exploring their environment and ingesting things that are bacteria,” Laurie adds, also noting “one thing that I think is really fascinating about breast milk is that it is age specific, so it changes and evolves not only through the course of the day but the course of the time that a mother is breastfeeding”. Many moms ask how often they should be breastfeeding their babies, and if they should wake them in the middle of the night or not. “If you read the American Academy of Pediatrics statement, it’s about eight to twelve times per day, so roughly every two or three hours. You might find that there is a given day where they may eat thirteen times because they’re going through a growth spurt but the average is about eight to twelve times per day”. When mothers inquire about waking the baby up to feed them, Laurie and Tish work with mothers to familiarize them with hunger cues and help the baby to understand the feeding timeline throughout the day. “Usually when I’m working with somebody, we talk about hunger cues and the fact that the baby has never been hungry, it was fed continuously for nine months and now it’s trying to identify the pain in its belly as hunger”, Laurie notes. They try to start the baby on a routine so they will get used to feeding every few hours and establishing the milk supply and feeding routine. “If the baby is jaundiced or premature that would be a situation where we might even have a mom setting an alarm if the baby really needs to be awakened to feed, but otherwise we recommend that the mother wake the baby until the milk supply and feeding routine is established”.  

Tish shared her advice for new moms who are just starting their breastfeeding journey. “Relax, this is something learned, and just to be patient but persistent, and seek help if you’re having difficulty.”

Mountainside Medical Center and Montclair Film are cohosting a Free MILK Film Screening and Discussion Panel on Wednesday, August 29th from 10:30 a.m. – 12:30 p.m. To learn more, please visit our Facebook event page by clicking on this link –

Mountainside Medical Center also offers a free support group for breastfeeding mothers every Wednesday from 1-2pm. (// The group is open to the community, whether or not mothers delivered at Mountainside, they are welcome to come and get support and have questions answered. 

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