Mom Katie Schaftlein bonds with baby Sadie for the first time.

Quintuplets arrive at UK, granting mom a special birthday wish

The smallest of the quintuplets, Sadie, defied her size with her energy, churning her legs inside and out of the womb. Her sister Scarlett, on the other hand, established herself as the calm and docile member of the bunch. And family members have already pinned Lucas, the sole boy in the group, as the sweetheart perhaps a future golfer, his dad speculated.

“They have the same personalities as they did in my belly,” mom Katie Schaftlein said while getting situated for Kangaroo Care bonding with baby Sadie.

Surrounded by her 6-day-old babies in the Kentucky Children’s Hospital Neonatal Intensive Care Unit (NICU), Katie Schaftlein beheld a lifelong dream fulfilled overnight. She always wanted five children, although her husband Lucas thought they might end up with three or four. The couple’s quintuplets arrived as on Katie’s 26th birthday. She delivered five early but healthy babies Sadie, Sofia, Scarlett, Savannah and Lucas at the UK HealthCare Birthing Center before the stroke of midnight on Friday, Nov. 11.

Preparing for quintuplets

The Lexington couple and UK graduates found out early in Katie’s pregnancy that five babies were on the way. They consulted with high-risk obstetrics specialists at UK HealthCare and neonatologists at Kentucky Children’s Hospital in preparation for delivery, with the goal of sustaining the pregnancy through 28-weeks gestation.

An interdisciplinary team of doctors, nurses and therapists from UK Women’s Health, Obstetrics and Gynecology and Kentucky Children’s Hospital coordinated a integrative care plan for the Schaflein quintuplets, whose expected early arrival would require specialty care in the region’s only Level IV Neonatal Intensive Care Unit.

Quintuplets are extremely rare, with the Centers for Disease Control reporting 47 national cases of quintuplets or higher order multiple births in 2014.

On a Friday morning in September, Lucas boarded a flight for a business trip to Japan. As soon as he landed on the other side of the world, he learned Katie, who was 22-weeks pregnant at the time, was admitted to the hospital while he was in flight. He booked a flight back to the U.S. as soon as possible, flying home a couple days later.

“I left her that day and kissed her goodbye, and three four hours later she was in the hospital,” Lucas said.

Five babies in four minutes

Katie remained in the hospital on bed rest for two months before delivering the babies at 29 weeks and five days gestation. Teams of nurses were assigned to each of the five babies upon arrival, and the medical teams made special accommodations to ensure three additional neonatologists were on-call at all times. Five NICU beds were reserved for the Schaftlein quintuplets.

Neonatologists met with the family during inpatient treatment to assess infant development and predict the status of each baby upon arrival. Katie’s ultrasound a day prior to delivery provided the comprehensive medical team with current information on the development status of each baby.

When Sadie’s water broke at 7:30 p.m. on Nov. 11, Dr. Wendy Hansen’s obstetrics team alerted KCH neonatologists to prepare to receive the babies and took Katie into surgery for an emergency caesarian section. The operation started at 11:30 p.m., but all the babies were delivered in time to share a birthday with their mother.

Hansen, who delivered five babies within four minutes, presented each baby to Lucas and Katie before sending the infants to the NICU for precautionary care and respiratory support. Hansen delivered the last baby at 11:56 p.m., a declaration that sent a cheer through the halls of the UK Birthing Center.

“We were worried because we didn’t want them to have two different birthdays,” Katie said. “Everyone cheered, and at that point I was like, ‘Okay, they are out.’”

It takes a team

Dr. Peter Giannone, the chief of the Department of Neonatology at KCH, credits the dedication of the Schaftlein family, as well as collaborative efforts and streamlined communication among obstetricians, nurses, neonatologists and therapists, for a positive outcome for the quintuplets.

The two departments recently formed the Obstetrics, Maternal-Fetal-Medicine, Neonatology, and Infant (OMNI) follow-up care service line, eliminating communication and collaboration barriers common in academic medical systems by coordinating cross-disciplinary efforts and uniting medical teams to enhance family-centered care.

“My biggest memory is the teamwork that everyone showed to pull this off so seamlessly,” Giannone said.

The Schaftlein quintuplets will remain in the hospital for several weeks before they are ready to go home. In the meantime, UK neonatologists will monitor the respiratory strength and development of the babies. Lucas and Katie Schaftlein, as well as family members in Louisville and Lexington, are visiting and bonding with the babies in the NICU.

The couple said they are grateful for the support, dedication and poise of members of their integrative medical team. Katie was put at ease by the calm demonstrated by Hansen as her water broke and delivery was imminent. Several nurses who assisted the family throughout Katie’s hospitalization were present at the delivery to “catch” (or retrieve) each baby to the NICU.

“It came full circle,” Katie said. “Everyone who helped in the beginning was there for the delivery.”


Next steps:

Media inquiries: Elizabeth Adams, University of Kentucky Public Relations and Marketing, elizabethadams@uky.edu

Tomosynthesis at UK HealthCare

Advanced technology for breast cancer screening

Is it time for your annual breast cancer screening? Do you need diagnostic imaging? Here’s something to consider.

The Comprehensive Breast Care Center (CBCC) at the UK Markey Cancer Center offers state-of-the-art digital tomosynthesis for breast cancer screening and diagnostic services. UK HealthCare is one of only a few medical centers in the state to offer this new technology.

Tomosynthesis is 3-D technology that allows radiologists to see individual breast structures without overlapping tissue. In addition to providing the traditional top and side images of the breasts taken during a regular 2-D mammogram, tomosynthesis allows the technologist to take X-ray pictures of each breast from many angles. A computer then combines all this information into one 3-D image, making it possible to find much smaller and earlier-stage cancers. A tomosynthesis exam will feel no different from a usual mammogram, except that it takes just four seconds longer.

Dr. Margaret Szabunio, associate medical director of the CBCC and division chief of women’s radiology at UK HealthCare, along with her team of dedicated breast radiologists, specialize in using tomosynthesis for the early detection of breast cancer.

“Tomosynthesis produces images in tiny 1 millimeter slices that can be reconstructed into a 3-D image of the tissue, similar to the way a CT scan works,” Szabunio said. “It allows us to look at breast tissue in a way we’ve never been able to before.”

Dr. Mark Evers, director of the UK Markey Cancer Center, says the technology, along with Szabunio and her team’s expertise, have a significant impact on patients.

“Dr. Szabunio’s experience with tomosynthesis digital breast imaging is of great benefit to our patients when it comes to detecting breast cancer in its early stages,” Evers said. “The earlier a cancer is detected, the higher a patient’s chances are for a full recovery. This technology has the potential to save many, many lives.”

The CBCC uses tomosynthesis as a regular screening tool for all women, women who are at a high risk for breast cancer or for women that need diagnostic follow-up for a mammogram that shows an abnormality.

Make an appointment with the CBCC by calling 859-323-2222 or visiting our online appointment request form.


Next steps:

  • Confused about when to get a mammogram? Check out our Q&A with Dr. Szabunio, who tells us why mammograms are so important and what she recommends when it comes to screening.
  • Our latest Making the Rounds blog featured breast cancer specialist Dr. Aju Mathew. He tells us about his newest hobby and which historical figure he most admires. Check it out.
A new study led by UK Markey Cancer researchers and published in the Journal of Cell Science establishes a novel link between cell polarity and cancer-associated inflammation.

Proposed clinical trial could change the game for triple-negative breast cancer

This is the first post in a two-part series about UK Markey Cancer Center researchers’ efforts to improve treatment for triple-negative breast cancer, a deadly form of the disease. Check out Part Two here.

UK Markey Cancer Center Oncologist Dr. Edward Romond spent his career at UK treating and studying breast cancer, even leading major Phase 3 clinical trials on the breast cancer drug trastuzumab in the early 2000s. Commonly known as Herceptin, this drug became a standard of care for patients with HER2-positive breast cancer.

Though he retired from practice last year, Romond continues to work part-time with the research team at Markey, this time pushing toward a cure for a different, more deadly, type of breast cancer.

“Breast cancer, we now recognize, is at least five different diseases that are completely different from each other,” Romond said. “And the hardest nut to crack is this one called triple-negative breast cancer.”

Treating triple-negative breast cancer

Triple-negative breast cancer is a moniker given to a particularly aggressive group of breast cancers that often affect younger women. Unlike the receptor-positive types of breast cancer, which have biomarkers that tell oncologists which treatment the patient should respond to, triple negative breast cancers have no definitive biomarkers. If the patient does not respond well to the current standard of care, it’s up to the oncologist to make an educated guess about which chemotherapy will do the job.

The good news is that triple-negative breast cancers do generally respond well to chemotherapy. However, because triple-negative breast cancers are not the same, and every single patient responds differently to various chemotherapies, it’s difficult to predict which chemotherapy will best treat each patient’s cancer.

But the researchers at Markey are working to change that paradox. Markey’s Breast Translational Group is currently developing a proposed clinical trial that could create a major shift in the way triple-negative breast cancers are treated.

Currently, after a patient is diagnosed with triple-negative breast cancer, she usually receives chemotherapy first to try and shrink the tumor (known as neoadjuvant therapy), followed by surgery to remove as much of the mass as possible. The patients are then monitored for signs of recurrence. If a patient has residual cancer despite getting neoadjuvant chemotherapy, they are at a high risk for recurrence.

Proposed clinical trial

There are currently at least six different types of chemotherapy that can be used as a possible therapy for patients, and each one may affect each individual patient in a different way. To tailor the treatment to each distinct patient, the investigators aim to test the tumors in a set of animal model “avatars” with these different therapies to gauge the response.

Here’s how the proposed trial would work: after the patient’s biopsy, her cancerous tissue would be transferred into a mouse that is bred to grow human tumors, then subsequently into three dozen mice: her “avatars.” While the patient undergoes neoadjuvant chemotherapy and then surgery – a process that can take up to six months – the avatars will be divided into groups, with each group receiving one of the six available chemotherapies.

When the researchers see which avatar group has the best result, they’ll know which chemotherapy should work best for that patient. Knowing this would provide additional options for women who have residual cancer after neoadjuvant chemotherapy, and may reduce their risk for disease recurrence.

“It would prevent us from having to experiment with each individual patient, and end up finding that they didn’t respond to that therapy,” said Kathleen O’Connor, director of Markey’s Breast Translational Group. “If we can do this, then the oncologists will no longer have to guess.”

Disrupting the standard of care

Dr. Aju Mathew, a medical oncologist who treats triple-negative breast cancer patients at Markey, compares his team’s game-changing proposition to the way Uber has altered the use of public and personal transportation.

“We often hear about disruptive technology — Uber being one, for example,” he said. “It disrupted the current paradigm of everyone driving a car on their own or hiring a cab. This trial is our way of disrupting the current standard of care, the current technology, and the current practice of medicine, to try to change the paradigm of ‘one size fits all’ approach for triple-negative breast cancer patients.”

Though the avatar model of research isn’t new, O’Connor notes that not many researchers are using them specifically for the treatment of an individual patient. Using a trial protocol to get the tissues directly from the patient’s biopsy is a key factor in making the research work.

“The important thing is that we need to get the tumor tissue before they’ve been exposed to chemotherapy,” O’Connor said. “This is one of the things that makes our trial unique.”

With the trial design in place, the team just needs to provide ample data showing that growing a patient’s tumor in the avatar from biopsy will work. But to gather that data, they need more funding. Initial pilot funds stemming from Markey’s National Cancer Institute (NCI) designation grant have enabled the team to establish their first set of avatars with tissues taken from patients’ surgeries. But a boost in funding would help them establish the preliminary data for the trial and allow the team to then apply for major federal funding.

“We have a large group of people who have freely given their time up to this point,” O’Connor said. “But we need to have money to protect the time of the researchers doing this work, and we need enough money to get the mice in order to do this.”

Check out the video below to see Markey researchers talk about their triple-negative breast cancer research.


Next steps:

Triple-negative breast cancer can be difficult to treat, but a new clinical trial currently in development at the University of Kentucky Markey Cancer Center could potentially change the standard of care for this deadly disease.

Mom continues daughter’s fight to raise breast cancer awareness

This is the second post in a two-part series about UK Markey Cancer Center researchers’ efforts to improve treatment for triple-negative breast cancer, a deadly form of the disease. Check out Part One here.

Funding for triple-negative breast cancer has been a major focus for Lexington resident Cindy Praska, whose daughter Whitney was diagnosed with the disease in 2007 at age 24. After undergoing a double mastectomy, chemotherapy and radiation at another hospital, Whitney was deemed cancer-free.

In the years following her diagnosis, Whitney became an advocate for breast cancer awareness and fundraising, becoming actively involved in the Frankfort Country Club’s Rally for the Cure, which has raised money for the Susan G. Komen Foundation and the UK Markey Cancer Center for nearly 20 years.

Though her initial treatment for triple-negative breast cancer was successful, Whitney then developed bone cancer, or osteosarcoma, in 2012. This time, she elected to have her surgery out of state and came to Markey for her chemotherapy. Genetic testing revealed she carried a P53 genetic mutation, which was the cause of her original cancer, and combined with the radiation she had received prior, also caused her osteosarcoma. Despite Whitney’s and her doctors’ best efforts, her cancer metastasized and she succumbed to the disease in November of that year.

Carrying the torch for her daughter, Cindy continues to push for education, awareness and research toward triple-negative breast cancer and is still heavily involved in fundraising.

This Saturday, Oct. 15, Cindy and the team behind the Frankfort Country Club Rally for the Cure have planned a “party with a purpose” called Bourbon & Jazz for the Cure to celebrate the organization’s 20th anniversary. Held at the Frankfort Country Club on Saturday at 6:30 p.m., this special fundraising gala includes a silent and live auction featuring limited-edition Buffalo Trace bourbon bottles, and the funds raised from the gala will directly benefit the research team behind Markey’s proposed triple-negative breast cancer clinical trial.

“Whitney helped bring awareness to this disease, and it is so rewarding to me that work is progressing so that more young women her age will live to marry, have a family, and be able to see their young children grow up,” Cindy said. “It has given me a purpose to be an advocate for these causes and it’s an honor to be supporting Markey, who we called family and home the last year of her life.”


Next steps:

Clearing up confusion about breast cancer screening.

Confused about when to get a mammogram?

Dr. Margaret Szabunio

Dr. Margaret Szabunio

When should you have your first mammogram? How often should you be screened?

There are a lot of different answers out there, and the result is confusion and frustration for many women. In honor of Breast Cancer Awareness Month, we sat down with Dr. Margaret Szabunio, associate medical director of the UK Comprehensive Breast Care Center, to discuss why mammograms are so important and what she recommends.

How common is breast cancer?

Szabunio: One in eight women will develop breast cancer in her lifetime. Of these women, three in four will have no family history of breast cancer.

Why should women have mammograms?

Szabunio: Despite varying recommendations about timing and frequency, mammography remains the best method we have for finding breast cancer early at a curable stage. Since mammography screening became widespread in the 1990s, the U.S. breast cancer death rate has decreased by 30 percent.

When should women have their first mammogram?

Szabunio: You should have your first mammogram at age 40 and an annual screening every year after that. Why? Because it results in the greatest mortality reduction, the most lives saved and the most life years gained.

Your chances of getting breast cancer increase substantially around age 40. In fact, women ages 40-44 are twice as likely to develop the disease as women ages 35-39. One in six breast cancers occur in women age 40-49.

By not getting annual mammograms starting at age 40, you increase your chances of dying from breast cancer and the likelihood that you will experience more extensive and expensive treatment for any cancers found.

If you have a family history of breast cancer or you are otherwise at increased risk, let your doctor know and discuss the best screening plan for you.

Besides talking with their doctor about mammograms, what else can women do to prevent breast cancer?

Szabunio: A healthy lifestyle decreases risk for cancer and many other diseases. Eat a healthy diet low in fat with plenty of fresh fruits and vegetables, and exercise regularly. Avoid alcohol and cigarettes, both of which increase the risk for breast and other cancers.

But remember, even women with a healthy lifestyle may develop breast cancer, and there is no substitute for screening mammography to find cancers early and reduce deaths from breast cancer.


Next steps:

E-cigarettes are not safe during pregnancy

Written by Kristin Ashford, PhD, WHNP-BC, FAAN, associate professor and assistant dean of research in the UK College of Nursing.

Kristin Ashford, PhD, WHNP-BC, FAAN, is an associate professor and assistant dean of research in the UK College of Nursing.

Kristen Ashford, PhD, WHNP-BC, FAAN

E-cigarettes are increasingly popular, and adult women of childbearing age are the most common users. This is especially true in Kentucky, which has the country’s second highest rate of smoking during pregnancy. Many women try to quit or reduce their smoking while pregnant, and may turn to e-cigs under the belief that they are safer or harmless during pregnancy.

But are e-cigs and other electronic smoking products safe for an unborn child? The short answer is no.

E-cigarettes may be new, but we know they’re harmful

E-cigs and similar products are fairly new, so we are still learning about their full health effects on the body and brain of developing babies, but we do know that e-cigarettes are not safe during pregnancy. Here are the reasons why:

  • Nicotine harms a fetus. E-cigarettes and other electronic smoking products, like vapes, contain nicotine, which we know can cause birth defects and long-term health consequences for the developing brain and body of an unborn child.
  • E-cigs don’t help you quit smoking. Recent research shows that most pregnant women who have used e-cigs end up using both e-cigs and traditional cigarettes (dual use), or relapse back to traditional cigarettes entirely. It is possible that e-cig use could actually increase harm to a fetus as a result of dual use or full relapse.
  • E-cigs contain other harmful chemicals. There is formaldehyde and cancer-causing agents in the cartridges and aerosol (commonly referred to as vapor) of e-cigarettes. A fetus is exposed to these agents if the mother uses e-cigs. E-cigs and similar products were not previously regulated, so it is not always clear what other harmful chemicals they might contain.
  • Secondhand exposure e-cigs is also dangerous during pregnancy. Pregnant women should not be around e-cig aerosol (vapor), just like they should not be around secondhand smoke from traditional cigarettes.

If you are pregnant or might become pregnant and would like to quit smoking or using e-cigs, talk to your nurse midwife, doctor or pregnancy care provider. You can also call the Health Department’s Quit Line, specifically for women who are pregnant or recently had a baby, at 800-784-8669.

At UK, we are conducting a health research study to learn more about the effects of e-cig use during pregnancy. If you are in your first trimester of pregnancy and have used cigarettes or e-cigs in the last three months, we invite you to participate. All information is kept confidential. To learn more, call our research team at 859-333-1572 or visit our website.


Next Steps

Philip A. Kern, MD, talks with Angelique Bell, who participated in a diabetes-related study he led.

Research participation leads to a life-saving personal discovery

On the first of May, 2015, Angelique Bell waited in a hair salon, reading the weekend section of the newspaper. She noticed an ad for a health research study that needed participants who had risk factors for diabetes. Since she met the criteria and had some time to pass, she decided to call about the study right then, from the salon chair. It was her 45th birthday.

“I don’t have diabetes, but I have a strong family history of diabetes and some of the risk factors, and I thought that the information from this study could be something that could benefit me in the future,” Bell said.

She didn’t expect, however, that her impromptu birthday decision to call about the study would potentially save her life.

An unexpected finding

As part of the screening for the study, Bell had to do blood work and an EKG — standard tests to get baseline health data. Her results, however, were anything but standard: they showed extremely low levels of potassium and an arrhythmia in her heart that could be fatal if not treated.

“When she came in, she was having a lot premature ventricular contractions, which is potentially dangerous because your heart could suddenly go into ventricular tachycardia or fibrillation, which can kill you,” said Dr. Philip A. Kern, director of the University of Kentucky Center for Clinical and Translational Science and principal investigator of the diabetes study in which Bell participated.

At the time Bell was taking two medications to help control her blood pressure. One medication was a diuretic, which, unknown to Bell, was causing her to lose too much potassium through her urine. The resulting potassium deficiency was causing the arrhythmia in her heart.

Kern and the research team sent Bell to the UK Gill Heart Institute for further evaluation and treatment. She was taken off the diuretic, had to wear a heart monitor for 48 hours, and received potassium supplements.

“I was 45 years old at the time and I had to wear this heart monitor. Three-fourths of my grandparents had heart attacks. My mother had congestive heart failure. So it was a scary,” Bell said. “I was relieved to find out that the condition had not gotten to a point of causing damage. A really serious problem was averted.”

The importance of participation

Once the arrhythmia was resolved, Bell, undeterred by her own health scare, went back to Kern and participated in the diabetes-related study that she had originally phoned about.

The study was not Bell’s first experience as a research participant, nor was it her last. She had previously participated in two asthma-related studies at other institutions, motivated by her own diagnosis as a child, and she subsequently volunteered again at UK as a healthy participant in a study examining how our bodies process fat intake. Through each experience she learned more about her own health.

“That is one of the good things about being in the study — a lot of times when people get in studies, they find out about other issues with their health,” she said. “There’s a pretty in-depth amount of testing done, and it could uncover something that wouldn’t be found in a routine exam.”

Bell was also familiar with health research through family members’ experiences. Her father participated in a longitudinal study on gout, and her uncle was a researcher with the Centers for Disease Control and Prevention (“he was very excited about science”). Exposure to both researcher and participant experiences has convinced Bell of the importance of empirical, evidence-based information, as well as the need for research participants.

“Having people around who do research, you see how important it is for them to get people in their studies so they have enough evidence,” she said.

She additionally emphasizes the importance of racial and gender diversity among research participants, in order to understand how health conditions and treatments affect people differently, but she simultaneously acknowledges the legacy of the infamous Tuskegee experiment conducted between 1932 and 1972. In the course of that study, hundreds of poor African-American men were knowingly left untreated for syphilis.

When the Tuskegee story was uncovered, it created an understandable distrust of health research, particularly among African-Americans. At the same time, however, the story initiated a host of stringent federal regulations enacted to protect research participants. In 1974, Congress passed the National Research Act and created the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, which developed guidelines for human subject protection, including the landmark Belmont Report.

Health research involving people is now “very highly regulated, with multiple layers of protection,” Kern said. Studies require a process of informed consent and communication of diagnosis, as well as reporting of the study results. Institutions like UK that conduct health research must have institutional review boards (which include community members) to review the plans for all studies. UK also has an Office of Research Integrity that can answer questions and support research participants.

“Because of Tuskegee I think a lot of African-Americans are leery of participating in research studies,” Bell said. “But if you don’t participate in the research then the data that relates to you is not there. Some things do have a genetic factor, and some things might affect people of African descent differently than people of European and Asian descent.”

Improving health for others

If there is residual distrust about health research, there is also a great deal altruism that motivates many people to participate. According to Roxane Poskin, participant recruitment manager at the UK CCTS, a large percentage of volunteers join studies as way to give back to society and contribute to discoveries that improve health for others and future generations.

This is particularly true for healthy participants, who don’t have a health condition they hope to address through a study but who are essential to research that broadens our understanding of what Kern calls “the basic mechanisms of disease and how the body works.” While participants receive information about their health and sometimes receive compensation for participating, they don’t always receive a direct health benefit for themselves.

“They want to be involved and help others even, if it doesn’t help them directly,” Poskin said. “If we didn’t have volunteers, we wouldn’t be able to accomplish research studies. Even the smallest things have been researched, like thermometers and crutches.”

Bell, who has spent her career in non-profit organizations (she currently works with Kentucky Refugee Ministries and ITNBluegrass), says she doesn’t personally know many people who participate in studies, but that she would encourage anyone to participate, either for their own benefit or to advance medical knowledge that could help others.

“We have to have evidence-based research,” she said. “And you get a lot more information about your health than you would in a normal physical.”


Next steps:

5 benefits of breastfeeding

5 benefits of breastfeeding

Breastfeeding is a natural way for mothers to bond with their new baby and provide the vital nutrition the baby needs.

Celebrate World Breastfeeding Week this week by learning more about breastfeeding’s benefits.

  1. Breastfeeding has preventive power. Research has shown that breastfeeding can help prevent allergies, asthma, diabetes, ear infections, childhood obesity, leukemia and even sudden infant death syndrome. Your first milk, colostrum, provides your baby with all your immunity to diseases.
  2. It creates a special bond. Breastfeeding allows you to have a special bond with your baby. Studies have shown that breastfeeding can improve your child’s neurodevelopment. And the hormones released during breastfeeding have been found to decrease maternal stress and increase bonding.
  3. Breast milk is easy on your baby’s tummy. Breast milk is easier to digest than formula, meaning your baby will have fewer stomach aches and develop fewer food allergies. Breast milk also changes to meet your growing baby’s needs
  4. Breastfeeding is good for you, too. Breastfeeding can decrease your risk of heart disease, diabetes, osteoporosis, postpartum depression and some forms of breast and ovarian cancer. The longer you breast feed, the greater your protection. Plus, you burn an extra 500 calories per day breastfeeding!
  5. Breastfeeding saves you money. Formula, bottles and supplies can cost about $3,000 annually, but breast milk is free. There’s no prep time for breast milk, and it’s always the right temperature.

The Birthing Center at UK HealthCare wants your breastfeeding experience to get off to the right start. Our nursing staff and physicians have received special training to help you begin breastfeeding. We also have lactation consultants who will see you during your hospitalization and the Mommy and Me Clinic, located at the Kentucky Clinic, for assistance after you are discharged.

For more information, visit our breastfeeding support services website or contact your physician or the Childbirth Education Coordinator at 859-323-2750.


Next steps:

  • UK HealthCare is a Baby-Friendly Hospital, which means we offer the highest-quality care for newborns and their mothers, emphasizing mother-baby bonding and successful breastfeeding. Learn more out what it means to be Baby-Friendly.
  • Are you expecting or thinking about having a child? Check out our UK Delivers blog, where our experts discuss topics related to pregnancy and childbirth.
Former UK nurse Kristin Ashford has dedicated her life to researching ways to prevent pre-term birth and promote healthy pregnancies.

UK nurse, researcher helps prevent pre-term birth

Working as a labor and delivery nurse for a decade, Kristin Ashford was surrounded by happy beginnings. She helped women and families welcome healthy babies into the world. But Ashford also helped mothers and their families deal with the stressful and heart-wrenching experience of pre-term birth.

As a first-hand witness of the negative outcomes associated with pre-term birth, Ashford was motivated to make a difference. She transitioned from nursing into a researcher, studying risk factors of pre-term birth and creating strategies to prevent them through pregnancy interventions.

“It really got me interested in how to help these women more,” Ashford said of her nursing experience in labor and delivery. “Not only to reduce their risk, but also to help them emotionally cope with pre-term birth.”

Risk factors for pre-term birth

Pre-term birth is defined as delivery prior to 37 weeks gestation. Several risk factors, including smoking, substance abuse, poor socioeconomic conditions and obesity, increase a woman’s chance of experiencing pre-term birth. The consequences for the baby include respiratory illness, gastrointestinal disorders, immune deficiency, hearing and vision problems, and a prolonged hospital sta. There can also be longer-term motor, cognitive, visual, hearing, behavioral, social-emotional, health, and growth problems.

Now, as the assistant dean of research in the UK College of Nursing, Ashford oversees multiple research projects and interventions driven by the common goal of prolonging pregnancy.

“I think that any time that you can prolong a pregnancy, it is a rewarding experience,” she said. “If you can prevent the child from being sick, prevent that family’s stress and prevent life-long complications associated with that risk, that’s extremely rewarding.”

Research and interventions

Ashford’s research covers the issues relevant to pre-natal care, as there are many things that can be changed in order to prevent pre-term birth, like tobacco use. Her interventions aim to prevent tobacco and illicit drug use, manage chronic conditions such as diabetes and obesity, and reduce emotional distress in expectant mothers.

Ashford’s interventions are founded on the CenteringPregnancy model, which prepares women for pregnancy, labor and delivery, and motherhood through a peer support groups led by nursing and other health professionals. Ashford has designed CenteringPregnancy interventions to help pregnant women in high-risk categories like diabetes, tobacco use, substance abuse, or other socioeconomic or ethnic risk factors.

“Our UK program actually wants to put women together that have more in common with one another,” Ashford said. “So, in addition to being put in the group about the same time that they’re pregnant, they also are put in (a group) based on their most high-risk factor for pre-term birth.”

One intervention effort led by Ashford effort seeks to inform pregnant women about the dangers of using tobacco products while pregnant and give them resources to quit. Despite the known risks of using tobacco products during pregnancy, many pregnant women in Kentucky still smoke. Ashford is troubled by the rising popularity of e-cigarettes among women of childbearing age. Her research studies indicate that women are using both e-cigarettes and traditional tobacco products during pregnancy.

“Tobacco causes birth defects in pregnancy — that’s known,” Ashford said. “And so, it’s very clear that electronic cigarettes contain tobacco. Certainly, there’s risks associated with electronic cigarette use in pregnancy.”

Ashford is expanding CenteringPregnancy programs to areas in Eastern and Western Kentucky. She is working with local health departments to provide a Centering support network for pregnant women in high-risk groups.

She said her position in the UK College of Nursing allows her to research and circulate interventions, teach future nurses and nursing researchers, and serve communities by improving the quality of health care.

A UK physician created the PATHways clinic to help pregnant women with opioid addiction get clean and learn how to care for their baby.

UK clinic helps pregnant women with opioid addiction

After coming to UK two years ago, Dr. Agatha Critchfield, an OB-GYN at UK HealthCare Women’s Health, was overwhelmed by the cases of pregnant women with opioid addiction she saw in her practice. So she decided to do something about it.

Dr. Critchfield created PATHways, an opioid treatment clinic for pregnant women recovering from addiction. It combines treatment with prenatal care, counseling and a support group. The program is based on the Centering Pregnancy model, which reduces negative outcomes and prepares women to have a child through group counseling and peer support.

PATHways is special because it works to help patients in three important ways. First, the program treats the medical condition of opioid addiction. Then it delivers specialized prenatal care. Finally, PATHways gives women the skills and knowledge to fulfill their maternal roles once their babies arrive.

The program was born out of necessity to serve a large population of prenatal patients coming to UK with substance abuse disorders. Critchfield said few evidence-based opioid treatment programs were designed for pregnant women. So she started one herself, and it has been successfully treating patients who might have otherwise not been helped.

To learn more about the PATHways program and how it has helped many mothers-to-be, click here.