Nancy Edmonds Hanson

It’s Nature’s way, bringing mothers and newborns together in essential moments that bind nutrition and bonding. But lactation consultant Jaci McCaskell Kulish understands that “natural” doesn’t always equal “easy.”
Jaci’s Northern Prairie Lactation Services helps mothers prepare for successful breastfeeding and ensure that the experience is successful after their babies are born. Breast milk, she points out, is Nature’s perfect food for infants. Yet research suggests many mothers who’d prefer to provide their babies’ nutrition run into issues that prevent them from continuing for the recommended six months.
“Some studies suggest that 40 to 60% of new mothers face issues with breastfeeding their babies,” Jaci says. “Most of the time, moms seem to blame themselves. In most cases, though, it’s actually something with Baby – something we can correct.”
A long-time leader of the local La Leche League, Jaci has been working to untangle those issues since setting up Northern Prairie Lactation Services a year ago. Word of mouth has spread awareness of her mission in the months since she completed the rigorous training and testing required for certification as an IBCLC (International Board Certified Lactation Consultant.
“If Mom is having pain when she’s breastfeeding, if she’s having sore nipples, if Baby is constantly nursing and they’re worried their flow is low, I can tell her that’s not usually the problem. It’s usually something else.”
According to the lactation consultant, one common problem is tongue-tie. A tongue-tie can make breastfeeding difficult for both the baby and the mother. The condition restricts the tongue’s movement, impacting the baby’s ability to latch, suck and swallow effectively, and potentially leading to nipple pain, low milk supply, and other breastfeeding challenges.
She explains that the issue lies in the oral frenulum, the fold of tissue that connects the baby’s tongue to the floor of the mouth. Its length and the spot where it’s attached affects tongue movement, critical to the baby’s ability to suck and swallow its mother’s milk. That tightness can be eased with exercise. If that fails, a medical professional can gently snip it, freeing up movement in the mouth.
“It’s basically the frenulum under the tongue that causes the tongue to be restricted. That’s what the baby uses to push the nipple into the right position. If the tongue can’t get up high enough, or if their palate is too narrow, then they have to use their jaw. That’s going to cause pain.”
While less common, mothers’ issues, too, can affect breastfeeding success. Hormonal issues and insufficient glandular tissue can affect milk production. “With the epidemic of obesity, we’re seeing more insulin resistance. That can also cause low milk supply, as can thyroid issues,” Jaci explains.
Lactation consultations begin with gathering a full health history on the mother and possibly her family, looking for problems with the thyroid or immune response among other issues. That research may be done while she is pregnant. After the birth, Mom and Baby come together to their first visit at Northern Prairie Lactation. “Every single time, we do a feed,” Jaci reports. “We watch what Baby eats, whether it’s at the breast or the bottle, however they’re currently being fed. I watch how it goes with both of them.
“That’s important because I’m the only member of their health-care team who works with both. When you’re pregnant, you see an obstetrician. As soon as baby’s born, they’ll be treated by the pediatrician. Out of all the health-care providers, the lactation consultant is the only one who looks at both of them for feeding troubles.”
Jaci came to her calling on a roundabout path. She graduated from Minnesota State University Moorhead in 2005 with a degree, not in biology, but in photography. She realized that was the wrong direction. Instead, after marrying and giving birth to the first of her three sons, she became involved with La Leche League, the international organization that offers breastfeeding support in more than 80 countries. She continued as a leader of local groups from 2010 to 2024.
In the meantime, she turned her attention to accreditation as a lactation consultant. It involved returning to campus for biology- and nutrition-related classes, as well as a 90-hour online study of the subject. When she was ready for the accreditation test, however, COVID had closed down testing, thus putting her plans on “pause.” Testing eventually resumed; after refreshing her knowledge with more study, she went on to achieve IBCLC status several years later.
Patients can make appointments with Northern Prairie Lactation Consultants without referrals. “My services are usually covered by insurance, since the Affordable Care Act defines them as preventive care,” she points out. For more information on her services, visit www.FargoLactation.com.