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Book Review: Counseling the Nursing Mother: A Lactation Consultant’s Guide (Fourth Edition)

This gem of a book should be required reading for all lactation consultants and other health care providers serving mothers and babies. It fits easily into a lab coat pocket and would be a welcome addition on the desk of any pediatrician, obstetrician, or advice nurse. It includes all the information contained in the full 2003 edition of The Breastfeeding Answer Book, without lengthy research reviews and explanations. The range of information, however, is complete; and where there is controversy or disagreement among experts, Mohrbacher presents all sides of the issue. It opens with a concise, easily understandable explanation of breast development and structure, hormonal influence on lactogenesis, and autocrine control of breastfeeding. Newer information based on research about breast storage capacity is also included. Normal breastfeeding patterns are thoroughly explained and the 22 chapters cover the gamut of breastfeeding issues and problems. Topics are well organized and easily accessible in the index. Although research references are not included, the well-informed lactation consultant will recognize that information in this text is evidence based. The chapter on health problems in the mother has the most complete and easily accessible list of infectious diseases and their implications for breastfeeding that I have seen. Mohrbacher also discusses drugs, vaccines, and diagnostic tests and their compatibility with nursing, affording the health care provider readily available information to share with mothers. The guide also contains 5 appendices with invaluable additional information, including the use of alternative feeding methods, manual expression (with a full description of the Marmet technique), the use of breast compression to enhance flow and to keep the baby interested in sucking, and indications for and correct use of nipple shields. Appendix 5 has a thorough description by K. Jean Cotterman of reverse pressure softening, which can be used in the first 14 days to help resolve breast edema and engorgement. I wish there were a bit more information about the early, transient problems the hospital-based lactation consultant encounters. Also the book needs to be sturdier to stand up to the frequent use it deserves. With that said, I unreservedly recommend it to all who have an interest in breastfeeding.