When Allison Gonzales found out she was pregnant with twins, she said it was a “full-circle moment.” Gonzales had wanted to be a mom since she was a child, but she and her husband, Chris, struggled with infertility and she was unsure if and how they would be able to start a family.
As she prepared for the twins’ birth, Gonzales knew that she wanted to tandem nurse her children — meaning she wanted to breastfeed them at the same time.
But when they were born five weeks premature, tandem breastfeeding was something she thought could only happen “in a perfect world.” Her babies, Thea and Enzo, were placed in the Neonatal Intensive Care Unit (NICU) at Akron Children’s Hospital, where they received around-the-clock care from a team of doctors and nurses.
“Unfortunately, when we had our NICU stay, we had some feeding issues and struggles,” Gonzales said. “I ended up not breastfeeding the babies until they were 2 months old.”
After the twins were discharged from the NICU, Gonzales told her pediatrician at their first appointment about her hope of breastfeeding the babies. They recommended a new program at Akron Children’s that specializes in helping parents navigate the challenges of nursing their kids.
A program birthed from a pediatrician’s personal journey
The Breastfeeding Medicine Program, led by Dr. Carly Dulabon, launched in February. Gonzales and her twins were Dulabon’s first patients.
A pediatrician by training, Dulabon became interested in breastfeeding medicine when she gave birth to her twin boys at 30 weeks in 2019. Like Gonzales, Dulabon’s babies spent some time in the NICU, and she knew that she wanted to breastfeed, but did not know what that would look like.
“I was lucky that we had a pretty uncomplicated NICU course,” Dulabon said. “And realistically, we had a pretty uncomplicated breastfeeding course, but we left the NICU and I was like, ‘I have no idea what I’m doing.’”
Dulabon said that she had very little training on anything breastfeeding-related during medical school and her residency — she went to medical school at the University of Toledo and completed a residency in pediatrics at Children’s Hospital of Pittsburgh of UPMC.
“I was like, ‘I’m a pediatrician. If I can’t do this, I have to imagine a lot of people have a problem,’” Dulabon said.
Breastfeeding medicine is a specialized area of healthcare that focuses on navigating the challenges of breastfeeding. Some of the difficulties tackled include low milk supply, trouble with the baby latching and breast infections.
She decided to learn more about breastfeeding medicine for her own knowledge and to potentially introduce it to future residents. In 2021, she received her certification as an International Board Certified Lactation Consultant, and in the fall of 2023 she joined a pilot program to become board-certified at the physician level for breastfeeding medicine.
Now, Dulabon is one of 100 physicians in the United States who are board-certified in breastfeeding and lactation medicine. Dulabon provides one-on-one care for parents who want to breastfeed their babies.
“I think anybody that is interested in providing breast milk should come to see me. I think it’s a wonderful thing,” Dulabon said.
The Breastfeeding Medicine Program at Akron Children’s focuses on four priorities:
- Breastfeeding concerns during pregnancy
- Creating a plan for premature babies, multiple births or babies with complex medical conditions
- Breastfeeding after breast surgery
- Breastfeeding/chestfeeding in LGBTQ+ patients
Program provides medical care for parents and children
One of the differences between a breastfeeding medicine appointment with Dulabon and a pediatric checkup is the length of the appointment — visits with Dulabon are at least 90 minutes long. About half of each appointment is dedicated to the parent, and the other half is reserved for the baby.
“I really want to get to the root of feeding problems, and you just can’t do that in a quick visit,” Dulabon said.
Generally, she watches the parent feed or pump milk, so she can pinpoint where the problems may be. From there, she can also do diagnostic testing, like ultrasounds, or prescribe medication if needed, which is a benefit of her physician status.
Gonzales and her babies had three-hour appointments with Dulabon. At their first appointment, Dulabon and Gonzales talked about her breastfeeding goals. What Gonzales found remarkable, she said, was how validating it was to have a doctor who was also a first-time mom of multiple children. She found that Dulabon’s tips and tricks, even outside of the breastfeeding realm, were useful.
“I found her very easy to talk to, and very warm and welcoming,” Gonzales said.
Because the appointments were so long, there would be times when one of the twins would cry or need a diaper change and Gonzales and her husband, who attended the appointments as well, would have their hands full, so Dulabon would kick in to help.
“She would just grab a diaper, grab a baby,” Gonzales said.
Having her husband at the appointments also proved helpful for Gonzales. Since they “graduated” from the program in April, the Gonzales family is putting their new skills to the test.
“At home when it became stressful or hard he would say, ‘Remember what Dr. Dulabon said.’ Like ‘It’s OK’ or ‘It’s time to call it’ or ‘Why don’t you try this position,’” Gonzales said. Her husband would ask “How can I support you?” and help find ways to foster the relationship between her and the babies, Gonzales said.
One of Gonzales’ main takeaways from Dulabon was learning how to say “when” and take a break from trying to breastfeed. If one of the twins was getting too fussy, she knew it was OK to take a break, feed them a bottle and try again later.
“I am in the business of feeding babies,” Dulabon said. When caring for her patients she is looking for the route that is mutually beneficial for the parent and the baby, whether that’s breastfeeding, bottle feeding or both.
“It’s hard enough being a parent,” Dulabon said, “and it is very hard being a parent of a baby, so let’s try to make this easier.”
Breastfeeding myths
Dulabon is working to dispel common breastfeeding myths. Some of the common myths include:
- Certain foods the breastfeeding parent eats will make the baby gassy.
- Dulabon said that other than a rare instance where dairy products can be harmful, parents don’t have to worry about foods causing extra gas.
- Formula feeding makes babies sleep longer.
- Dulabon said studies so far have not shown this. If anything, the parent may sleep less because nighttime feedings would require them to prepare bottles.
- Parents have to pump and dump after taking medication or drinking alcohol.
- Most medications are safe to take while continuing to breastfeed, Dulabon said. She also said that it is generally safe to have a casual drink, which she defines as one glass of wine or one beer a day.
Breastfeeding support group
Twice a month, Akron Children’s offers a virtual breastfeeding support group. Both daytime and evening time slots are available.
Dulabon said the support group is open to anyone who has an interest in learning more about breastfeeding. The goal of the group is to expand the community’s knowledge base and connect parents with similar experiences.
Eventually, Dulabon plans to host more niche support groups, such as groups for NICU parents or parents of color.
“Finding someone who is more similar to the experiences they’ve gone through I think can be really helpful,” Dulabon said.
