e-Blender #46: October 2017

e-Blender                          October 2017
La Leche League of New York

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October is
Breast Cancer Awareness Month  

Katie Lewis,
Area Professional Liaison (APL)

As Leaders, we get many questions from parents about changes they experience in their breasts. Of course, we always encourage parents to discuss any concerns they have with their healthcare providers. We can remind parents of how biologically appropriate and good for their bodies breastfeeding is.  
The health benefits we give our children are reason enough to breastfeed, but the health benefits for us are significant as well. Research has shown us that breastfeeding reduces risk factors for three of the most serious diseases for women – female cancers, heart disease, and osteoporosis-without any significant health risks. Breastfeeding has been shown to be protective against breast and ovarian cancer for baby girls that are breastfed. 
Despite the benefits of breastfeeding in reducing cancer risks, we should be aware of signs that something isn’t quite right when a parent describes certain breast changes and how to help parents talk to their doctor’s to get appropriate diagnostic tests. Jayne Charlamb’s information on mammography and her Breast Cancer checklist provide accurate, up-to-date information we can share with others.

Breast Cancer Checklist

Jayne R. Charlamb,

Associate Area Professional Liaison, (AAPL) LLL NY
Associate Professor of OBGYN, Pediatrics and Internal Medicine
Director, Division of Breast Health and Breastfeeding Medicine
SUNY Upstate Medical University

As LLL Leaders we sometimes get questions from mothers about changes in their breasts that concern them.  Most of the time these changes will turn out to be benign, easily treatable conditions.  However, sometimes they can be signs of breast cancer.  Whatever we think the cause might be, we should encourage mothers to see their health care providers to rule out serious conditions.  It is, however, helpful to know what some red flags of breast cancer are:
1. LUMP OR THICKENING – A persistent lump or thickening that can be located in the breast, underarm, or near the clavicle.
2. NIPPLE CHANGES – This can be a new nipple inversion or change. It can also be an unexplained persistent rash or crusting, especially if it is unilateral.
3. SKIN CHANGES – This can show up as new skin dimpling or puckering.  It can also be unexplained bruising, darkening, swelling, or redness.  Sometimes it looks like “peau d’orange” or dimpled skin that looks like the skin of an orange.
4. UNUSUAL MASTITIS – A mother who describes recurrent bouts of what she thinks is mastitis in the same place on her breast or symptoms of mastitis that don’t resolve as expected after treatment. Sometimes painless mastitis can be a red flag as well. 

Mammography and Sonography in Breastfeeding Women
Jayne R. Charlamb, MD, FACP, IBCLC
Associate Area Professional Liaison, (AAPL) LLL NY
Associate Professor of OBGYN, Pediatrics and Internal Medicine
Director, Division of Breast Health and Breastfeeding Medicine
SUNY Upstate Medical University
Both mammography and sonography (ultrasound) of the breast can be performed safely while a woman is lactating. There is absolutely no reason for a breastfeeding mother to wean in order to undergo these studies whether they are performed for screening purposes or as part of a diagnostic evaluation of a suspected problem.
Neither a mammogram (which uses xray technology) nor an ultrasound (which uses sound wave technology) will affect the quality or the quantity (volume) of a mother’s milk. It is perfectly safe for a lactating woman to undergo mammography and/or sonography and then nurse her baby immediately afterward.
However, lactation can make it more difficult to interpret the images obtained with both mammography and sonography of the breast. Therefore, before deciding how to proceed, a breastfeeding mother and her physician should discuss the following:
1) Can and should the imaging be delayed until the mother is no longer breastfeeding?
Imaging performed as part of a diagnostic workup (for a palpable mass, for example) should never be delayed because a woman is breastfeeding! Likewise, a mother should never be advised to wean in order to undergo diagnostic imaging of a breast problem. Quite notably, it can often take weeks to months for lactating tissue to revert back to the “normal” appearance of non-lactating breast tissue on imaging. It would be potentially dangerous and inappropriate to delay a diagnostic evaluation for that time period.
Often, though, mammograms and sonograms are used in healthy women to screen for breast cancer when there are presently no breast symptoms or problems. These are called “screening studies” (in contrast to “diagnostic studies” which are performed to evaluate a specific symptom or problem).
In cases in which a screening study is recommended, a woman should talk to her doctor about the pros and cons of undergoing breast screening imaging while she is lactating. Depending on her own personal underlying risk of breast cancer, and depending on her own thoughts about the benefits of screening compared to the risks of screening (such as false alarms and “overdiagnosis” of disease), a breastfeeding mother may choose to delay breast cancer screening imaging for some period of time. It should be noted that the breast tissue of a woman early on in lactation may be denser than later in lactation when a child typically nurses less frequently. Therefore, image quality may be better later on in lactation than during the early months of breastfeeding. This should also be considered when planning the timing of screening imaging. The decision of when to start breast screening imaging should be made after careful consideration and discussion with a physician who is well-versed in breast cancer risk assessment and screening.
2)  Who will be interpreting the breast images?
It may be helpful for a breastfeeding woman to have a mammogram or breast sonogram performed at a breast imaging center that uses dedicated breast radiologists (rather than radiologists who do not focus on breast imaging and who therefore have less experience interpreting breast images). A dedicated breast radiologist will be more likely to have a comfort level and expertise in interpreting images of a lactating breast.
3) How can the quality of the mammogram and breast sonogram be maximized?
A lactating mother should attempt to have her breasts as “empty” as possible during breast imaging. She might bring her breast pump or her nursing child (and another responsible adult who can care for the child during the imaging study) with her to her imaging appointment. She can then remove as much milk as possible (through nursing, pumping, or hand expression) immediately before the breast imaging studies are performed. It is usually helpful for a breastfeeding mother to contact the imaging center in advance of the scheduled study in order to arrange a time and place for pumping or nursing before the imaging is performed. If such arrangements are not possible, she may be able to come up with a “creative” solution such as pumping or nursing in her car before going into the imaging center.
Additionally, a lactating mother who will be having a mammogram should discuss the possibility of using breast tomosynthesis (3D mammography) rather than traditional mammogram technology for her imaging.  Tomosynthesis is better able to “see through” the dense breast tissue that is often present in lactating women. It can improve the ability to detect disease in the breast and may also decrease the likelihood of the “false alarms” which can lead to unnecessary procedures and unnecessary concern.

Cynthia Massey, Interim Coordinator Of Leader Accreditation
The Leader Accreditation Department (LAD) has recently published a new document for Leaders to facilitate dialogue with potential Leader Applicants who experienced separation from their babies or children in the first three years. This new document, “Pre-Application Dialogue about Separation Experiences,” will help Leaders gather information and fill out the Leader Recommendation form in a way that will aid the LAD when considering a new application for activation. This document replaces “Discussions About Mother-Baby Togetherness.”
The document is available at http://www.lllny.org/leader-accreditation.htm. Access to the password-protected Leader pages is breastfeeding.

Pre-Application Dialogue about Separation Experiences password:breastfeeding

What’s happening in the Finance Department

Aimée Readhead, Area Finance Coordinator

Aimee and Theresa are looking forward to attending the Area Council meeting in October. This will be a wonderful way for all Leaders to connect and share ideas about the coming year. It would be great to see you there!
Payments from all Leaders and Groups for this year’s dues are almost completed. A huge thank you to everyone who has already paid Leader and Group dues. There are a small handful of Leaders still to pay or make contact with the Area Team. Please check in with your co-Leaders to see if they have paid or need help.
Please note that Aimee’s address is: Aimee Readhead, AFC, 6923 W Laredo Street, Chandler, Arizona 85226 USA.
Do you know anyone you would like to recommend for the Finance Department? Yourself, perhaps? LLL Alliance has several openings. These sorts of jobs are small and a great way to support and learn more about LLL.
Are you or one of your co-Leaders planning to retire from leadership?
Please let Haley Scribner, hmscribner@gmail.com or 518-755-8713, know as soon as possible so that we can update our databases.  
Fundraising Fantasies: A few more ideas.
Thanks to some questions and feedback about the article, “Fundraising Fantasies,” in the e-Blender, August 2017, here are some additional ideas to share with you.
Home visits are always free and can be done by any Leader who feels comfortable providing this service. If a family asks you how it can show its gratitude, this could be the time a Leader might mention that it costs money to run a La Leche League Group, and that monetary donations are always very welcome following a visit.
Remember that memberships, monetary donations to the Group, and sales are great ways to make and retain money. In La Leche League of New York, Area Groups are asked to share ten percent of profits from any direct fundraising with the Area.   

If you have any ideas, comments, or questions about fundraising activities, please feel free to contact Aimee, AFC, at aimee.lll.ny@gmail.com or 347 735 3009 (text, call, and voicemail).

Leader Department NEWS
Haley Scribner,
Area Coordinator of Leaders (ACL)

Questions We’re Asking 
Q: I need proof of the Group Liability Insurance.How do I go about getting it? 
A: To process insurance requests, please send the ACL, Haley Scribner, the following information: 

  • Name of Group
  • Type of event (Series Meeting, conference, WBWC, etc.)
  • Date – either standard meeting date (e.g., the third Thursday of the month) or specific event date
  • Name and complete address of event location
  • Leader contact and email address

All Insurance requests get sent to LLL USA.  Please be advised that it can take up to two weeks for requests to get back to you.

Say a warm farewell to retiring Leaders
Laura Nacheman
Morgana Elasky 

Hello Leaders! 
Due to security reasons, the Area Team would prefer not to have Leader Lists with all of your personal information on the LLL NY website, even under password protection. While we are always available to give information when needed, we recognize that you may wish to have a hard copy of a Leader Directory.  If you are interested in receiving a hard copy Leader Directory, please email Haley, ACL, at hmscribner@gmail or Scarlett Miles, APC, at LLLNYpublications@gmail.com with your request and mailing address. 

The Area Team has purchased a Blue Jeans license instead of renewing with WebEx for online video meetings. We believe that this change is valuable for many reasons. The main reason is that we can have many more users online together and we can now offer this tool to Leaders. If you would like to use it, please email Haley Scribner, ACL, at hmscribner@gmail.com.

A few ideas for using Blue Jeans:
·Leader meetings
·Group Meeting preparation
·MEF (Monthly Evaluation Form)
·Getting in touch with your DA
·Working with Leader Applicants
·Online meetings

Leading, Loving, Learning
Heather Gansky, Area Coordinator of Events (ACE)
Recently updated articles coming from The Academy of Breastfeeding Medicine: 

Share your breastfeeding photos- individual or group photos are wecome! Have an idea for an article? Or is there something you would like to see in the newsletter? We are in need of articles for future issues. Please send your ideas or article to Scarlett Miles, APC
1872 State Rt 21, Palmyra, NY 14522  or email to LLLNYPublications@gmail.com   Articles selected for publication may be edited for length, clarity, and adherence to LLL publishing guidelines.

Copyright © 2017 LLL NY, All rights reserved.

La Leche League is an international, nonprofit, nonsectarian organization dedicated to providing education, information, and encouragement to women who want to breastfeed. BLENDER and e-BLENDER are publications of La Leche League of New York, 125 Curtis Hill Rd E, Nassau, NY 12062 and are devoted to the enrichment and inspiration of Leaders and Leader Applicants.

Copyright © 2017 La Leche League of New York, All rights reserved.

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