On-Demand Sessions
Deficiencies of Humanitarian Aid Practices Toward Infant Feeding During Natural Disaster On Demand
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During disaster and displacement, the affected families often receive humanitarian aid from a variety of governmental/non-governmental organizations and donor agencies. Very limited information is available on the effects of humanitarian aid on the breastfeeding practices of mothers affected by disaster and displacement. The aim of this study is to explore the effects of humanitarian aid on breastfeeding practices of displaced mothers affected by natural disaster.
Shela Hirani, PhD, MScN, BScN, RN, IBCLC
Overview
During disaster and displacement, the affected families often receive humanitarian aid from a variety of governmental/non-governmental organizations and donor agencies. Very limited information is available on the effects of humanitarian aid on the breastfeeding practices of mothers affected by disaster and displacement. The aim of this study is to explore the effects of humanitarian aid on breastfeeding practices of displaced mothers affected by natural disaster.
Speakers
Shela Hirani, PhD, MScN, BScN, RN, IBCLC
Breastfeeding the Brave: Providing Lactation Support for Families of Critically Sick Children Beyond the Neonatal Period On Demand
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Many infants and children require medical care for acute or chronic illness. Breastfeeding confers multiple benefits to children both in the short and long term. Breastfeeding may shorten the duration and severity of illness and provide important immunological protection to potentially buffer children against hospital acquired infection. Breastfeeding also provides pain relief, comfort, and normality during times of fear, pain, stress, and difficulty for families. However, maintaining breastfeeding during hospital admission can be challenging, due to institutional barriers, difficulty accessing specialist support, and lack of information and training for health care staff. While there is robust evidence about the needs of infants born prematurely, and a convincing and well-established acceptance of the importance of breastmilk and for critically sick neonates, far less is known about the needs of older infants and children who develop illness or have ongoing health needs beyond the neonatal period. This presentation will explore the profound ways in which breastfeeding can support sick infants and children alongside medical treatment, introduce a model of collaborative working between medical, nursing and lactation professionals and make recommendations for practical ways in which breastfeeding can be protected, preserved and promoted in the hospital setting.
Lyndsey Hookway, BSc, RNC, SCPHN, IBCLC
Overview
Many infants and children require medical care for acute or chronic illness. Breastfeeding confers multiple benefits to children both in the short and long term. Breastfeeding may shorten the duration and severity of illness and provide important immunological protection to potentially buffer children against hospital acquired infection. Breastfeeding also provides pain relief, comfort, and normality during times of fear, pain, stress, and difficulty for families. However, maintaining breastfeeding during hospital admission can be challenging, due to institutional barriers, difficulty accessing specialist support, and lack of information and training for health care staff. While there is robust evidence about the needs of infants born prematurely, and a convincing and well-established acceptance of the importance of breastmilk and for critically sick neonates, far less is known about the needs of older infants and children who develop illness or have ongoing health needs beyond the neonatal period. This presentation will explore the profound ways in which breastfeeding can support sick infants and children alongside medical treatment, introduce a model of collaborative working between medical, nursing and lactation professionals and make recommendations for practical ways in which breastfeeding can be protected, preserved and promoted in the hospital setting.
Speakers
Lyndsey Hookway, BSc, RNC, SCPHN, IBCLC
Protection Against Compassion Fatigue for the Lactation Advocate On Demand
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According to research compassion fatigue, commonly known as burnout, impacts anyone working in healthcare. Because lactation professionals must have empathy, and even forge an emotional connection with the families they work with, their risks for compassion fatigue are great. In addition, these workers must frequently act as advocates for families in general, and often find themselves engaged in emotionally fraught discussions centering around appropriate lactation support. This can lead to personal and professional exhaustion, stress, and burnout; with some of our best providers leaving the field. This session discusses how to recognize the symptoms of compassion fatigue before they become critical. More importantly, participants will learn what they can do to prevent and self-monitor these symptoms, as well as how and where to find help during professional crisis.
Denise Altman, RN, IBCLC
Overview
According to research compassion fatigue, commonly known as burnout, impacts anyone working in healthcare. Because lactation professionals must have empathy, and even forge an emotional connection with the families they work with, their risks for compassion fatigue are great. In addition, these workers must frequently act as advocates for families in general, and often find themselves engaged in emotionally fraught discussions centering around appropriate lactation support. This can lead to personal and professional exhaustion, stress, and burnout; with some of our best providers leaving the field. This session discusses how to recognize the symptoms of compassion fatigue before they become critical. More importantly, participants will learn what they can do to prevent and self-monitor these symptoms, as well as how and where to find help during professional crisis.
Speakers
Denise Altman, RN, IBCLC
Developmental Implications for Lactation in Premature and Medically Fragile Babies On Demand
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Despite continuing efforts to reduce prematurely worldwide, a significant number of infants are born less than 37 weeks of gestation, less than 2,500 grams, or in a fragile medical condition. Premature infants usually spend weeks or months in a neonatal intensive care unit where their parents receive services and support; however, after they transition from the neonatal intensive care unit to the home, families usually face challenges to connect with services which affect the physical and mental health with long-lasting impacts. Lactation consultants and supporters would benefit from expanding their understanding of the impact of the neonatal intensive care unit (NICU) stay based on families? experiences in order to implement effective and sensitive follow-up programs. Family voices and experiences provide guidance and connection to the lived experience of families and their needs in the neonatal intensive care unit and as they prepare to go home, in the first days after transition, and in the first years of life. Using Parents Child Relationships Framework participants will discuss nervous system development and strategies for parental regulation, parent-child mutual regulation, regulatory environments and their implications in mental health, baby communication, social emotional development, states modulation, wake-sleep cycles specific to premature or medically complex babies.
Paulina Erices, MS, IBCLC, IMH-E Family Specialist
Overview
Despite continuing efforts to reduce prematurely worldwide, a significant number of infants are born less than 37 weeks of gestation, less than 2,500 grams, or in a fragile medical condition. Premature infants usually spend weeks or months in a neonatal intensive care unit where their parents receive services and support; however, after they transition from the neonatal intensive care unit to the home, families usually face challenges to connect with services which affect the physical and mental health with long-lasting impacts. Lactation consultants and supporters would benefit from expanding their understanding of the impact of the neonatal intensive care unit (NICU) stay based on families? experiences in order to implement effective and sensitive follow-up programs. Family voices and experiences provide guidance and connection to the lived experience of families and their needs in the neonatal intensive care unit and as they prepare to go home, in the first days after transition, and in the first years of life. Using Parents Child Relationships Framework participants will discuss nervous system development and strategies for parental regulation, parent-child mutual regulation, regulatory environments and their implications in mental health, baby communication, social emotional development, states modulation, wake-sleep cycles specific to premature or medically complex babies.
Speakers
Paulina Erices, MS, IBCLC, IMH-E Family Specialist
The Many Faces of Baby Cafés: Increasing Lactation Access to Reduce Health Disparities Using the Baby Cafe model in Your Community On Demand
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Baby Cafés are community-funded, free-of-charge breastfeeding support sites, specifically targeting under-served populations with low breastfeeding rates and access to lactation care. There are currently 148 licensed Baby Cafés, in 32 U.S. states, in a variety of communities providing weekly drop-in access to IBCLC care for any person breastfeeding/chestfeeding. The Baby Café community-based model provides crucial community support to families, offering a safe and welcoming place to develop social connections while providing lactation guidance and education. The model’s flexible design enables communities to address specific needs while stimulating collaboration between other resources. Baby Cafés satisfy step 10 requirements of the Baby-Friendly Hospital Initiative, as well as supporting Healthy People 2020 goals by reducing health disparities. Baby Café USA 501(c)(3) is the non-profit licensing organization, founded in 2011, that sets the standards for Baby Cafés and reports on gathered data for program evaluation. The organization’s sole mission is to support the development of a nation-wide standardized network of community-based breastfeeding resource sites delivering free and effective lactation care. Facilitators operating Baby Cafés in four diverse areas of the U.S. will present a synopsis of their programs, focusing on how their Cafés are tailored to meet specific community challenges in efforts to reduce disparities and increase breastfeeding rates. The presentation will include statistical and outcome data collected by the Cafés, and quoted commentary by parents. Facilitators will also highlight the inexpensive Café mentoring curriculum designed to empower others who are passionate about lactation and interested in pursuing a career in the lactation field.
Lucia Jenkins; Portia Williams; Jackee Hack; Lisa Miller; Abigail Malman-Case
Overview
Baby Cafés are community-funded, free-of-charge breastfeeding support sites, specifically targeting under-served populations with low breastfeeding rates and access to lactation care. There are currently 148 licensed Baby Cafés, in 32 U.S. states, in a variety of communities providing weekly drop-in access to IBCLC care for any person breastfeeding/chestfeeding. The Baby Café community-based model provides crucial community support to families, offering a safe and welcoming place to develop social connections while providing lactation guidance and education. The model’s flexible design enables communities to address specific needs while stimulating collaboration between other resources. Baby Cafés satisfy step 10 requirements of the Baby-Friendly Hospital Initiative, as well as supporting Healthy People 2020 goals by reducing health disparities. Baby Café USA 501(c)(3) is the non-profit licensing organization, founded in 2011, that sets the standards for Baby Cafés and reports on gathered data for program evaluation. The organization’s sole mission is to support the development of a nation-wide standardized network of community-based breastfeeding resource sites delivering free and effective lactation care. Facilitators operating Baby Cafés in four diverse areas of the U.S. will present a synopsis of their programs, focusing on how their Cafés are tailored to meet specific community challenges in efforts to reduce disparities and increase breastfeeding rates. The presentation will include statistical and outcome data collected by the Cafés, and quoted commentary by parents. Facilitators will also highlight the inexpensive Café mentoring curriculum designed to empower others who are passionate about lactation and interested in pursuing a career in the lactation field.
Speakers
Lucia Jenkins; Portia Williams; Jackee Hack; Lisa Miller; Abigail Malman-Case
Pediatric Disaster Planning: Training and Partnerships for a Formal Operation Plan for Safe Infant and Young Child Feeding On Demand
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It is important for local agencies to partner with community members to prioritize maternal child health and lactation during a disaster. Research indicates that infants and young children are most at-risk during an emergency due to their immune system’s immaturity and dependence on adults’ care. Continuation of breast/chestfeeding is the safest infant feeding method in an emergency; and formula-fed infants are at highest risk in a shelter due to potential access limitations to clean water, supplies, and knowledge of proper human milk substitutes preparation. Jefferson County Public Health in Colorado recognized the gap in pediatric preparedness, and through internal collaboration, as well as partnerships with community members and organizations, we established a formal plan focused on safe infant and young child feeding. The protocols were co-created with community members for cultural and linguistic competency and are inclusive of lactation, child development, mental health, and parent-child relationships practices. This presentation will share how partnerships were involved to formalize the safe infant feeding plan, what partnerships and training had to be developed, how data and information is being shared between Emergency Preparedness and Maternal Child Health partners, what our materials and shelter kits cover, and how other local city and county agencies can replicate a similar process to elevate maternal child health in emergency preparedness response. We will also share worksheets for participants to complete in assessing the process and partnerships in their unique regions.
Paulina Erices, MS, IBCLC, IMH-E Family Specialist ; Allison Wilson
Overview
It is important for local agencies to partner with community members to prioritize maternal child health and lactation during a disaster. Research indicates that infants and young children are most at-risk during an emergency due to their immune system’s immaturity and dependence on adults’ care. Continuation of breast/chestfeeding is the safest infant feeding method in an emergency; and formula-fed infants are at highest risk in a shelter due to potential access limitations to clean water, supplies, and knowledge of proper human milk substitutes preparation. Jefferson County Public Health in Colorado recognized the gap in pediatric preparedness, and through internal collaboration, as well as partnerships with community members and organizations, we established a formal plan focused on safe infant and young child feeding. The protocols were co-created with community members for cultural and linguistic competency and are inclusive of lactation, child development, mental health, and parent-child relationships practices. This presentation will share how partnerships were involved to formalize the safe infant feeding plan, what partnerships and training had to be developed, how data and information is being shared between Emergency Preparedness and Maternal Child Health partners, what our materials and shelter kits cover, and how other local city and county agencies can replicate a similar process to elevate maternal child health in emergency preparedness response. We will also share worksheets for participants to complete in assessing the process and partnerships in their unique regions.
Speakers
Paulina Erices, MS, IBCLC, IMH-E Family Specialist ; Allison Wilson
Nonprofits and Breastfeeding: Where Do I Start? On Demand
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Do you have a great idea for a breastfeeding program, but you do not know where to start? Do you see a need in your community that you wish were fulfilled, but it feels like too big of a project for you to take on? As a founder of a non-profit organization, this speaker will give details on how to get started, what the legal structure will look like, and how to recruit and grow your organization. Because of the unique structure of this speaker’s organization, she learned how to quickly overcome barriers in fundraising, etc. when crossing state borders. This 60-minute presentation will delve deep into the ins and outs of non-profit work and give the attendee a sense of readiness to start an organization of their own. The tools given within this presentation include a business plan, marketing plan, legal structure, fundraising, and more.
Stephanie Carroll, MBA, BS, IBCLC, RLC
Overview
Do you have a great idea for a breastfeeding program, but you do not know where to start? Do you see a need in your community that you wish were fulfilled, but it feels like too big of a project for you to take on? As a founder of a non-profit organization, this speaker will give details on how to get started, what the legal structure will look like, and how to recruit and grow your organization. Because of the unique structure of this speaker’s organization, she learned how to quickly overcome barriers in fundraising, etc. when crossing state borders. This 60-minute presentation will delve deep into the ins and outs of non-profit work and give the attendee a sense of readiness to start an organization of their own. The tools given within this presentation include a business plan, marketing plan, legal structure, fundraising, and more.
Speakers
Stephanie Carroll, MBA, BS, IBCLC, RLC
Living with HIV in High Resource Settings and the Deeper Meaning of Breastfeeding Avoidance: Considering Counseling Standards On Demand
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Lactation professionals in high resource settings are ethically obligated to provide the highest standard of evidence-based counseling. Clinical recommendations to avoid breastfeeding/chestfeeding and/or the provision of human milk for women living with HIV (WLHIV) in high resource settings has resulted in a gap in the clinical literature which guide counseling. This presentation reports results of original research in 2 parts. The first part reports the findings from a published literature review that aimed to describe the social and emotional experiences of infant feeding decisions for women living with HIV in high resource settings. The findings demonstrate a substantial emotional burden associated with breastfeeding/chestfeeding avoidance. The second part reports findings from a current qualitative study of participants living with HIV in an urban setting in the U.S. and their experiences in receiving counseling. A ‘person-centered care’ conceptual framework is applied to the current study and will be discussed in the context of lactation counseling for this population. The following concepts are highlighted: a.) holistic; encompassing biological but also psychological context b.) individualized; in which interventions are customized c.) respectful; recognizing that individuals are competent to make decisions about their own care and d.) empowering; supporting self-determination and participation in decision-making. The overarching aim of this research is to open a dialogue with the lactation community on supportive and effective counseling for families living with HIV in high resource settings.
Michele Griswold, PhD, MPH, RN, IBCLC ; Jesica Pagano-Therrien
Overview
Lactation professionals in high resource settings are ethically obligated to provide the highest standard of evidence-based counseling. Clinical recommendations to avoid breastfeeding/chestfeeding and/or the provision of human milk for women living with HIV (WLHIV) in high resource settings has resulted in a gap in the clinical literature which guide counseling. This presentation reports results of original research in 2 parts. The first part reports the findings from a published literature review that aimed to describe the social and emotional experiences of infant feeding decisions for women living with HIV in high resource settings. The findings demonstrate a substantial emotional burden associated with breastfeeding/chestfeeding avoidance. The second part reports findings from a current qualitative study of participants living with HIV in an urban setting in the U.S. and their experiences in receiving counseling. A ‘person-centered care’ conceptual framework is applied to the current study and will be discussed in the context of lactation counseling for this population. The following concepts are highlighted: a.) holistic; encompassing biological but also psychological context b.) individualized; in which interventions are customized c.) respectful; recognizing that individuals are competent to make decisions about their own care and d.) empowering; supporting self-determination and participation in decision-making. The overarching aim of this research is to open a dialogue with the lactation community on supportive and effective counseling for families living with HIV in high resource settings.
Speakers
Michele Griswold, PhD, MPH, RN, IBCLC ; Jesica Pagano-Therrien
Improving the Care and Feeding of Small and Sick Newborns through the Baby Friendly Hospital Initiative: Findings and Proposed Solutions from Malawi On Demand
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Background: Globally, most neonatal deaths occur in small and sick newborns (SSNs). These babies require specialized lactation and social support, which is often neglected in low- and middle-income settings due to health systems challenges. The Maternal and Child Survival Program (MCSP) support the Malawi government to integrate care and feeding of SSNs into the country’s existing Baby Friendly Hospital Initiative (BFHI). A bottleneck analysis (BNA) was conducted to identify bottlenecks to supporting breast milk feeding for SSNs in hospital settings. Methods: MCSP, in collaboration with hospital and government personnel, used an adapted version of the globally-endorsed Every Newborn Action Plan BNA tool to identify bottlenecks and solutions through: facility-level observations and interviews with clinical and supervisory staff at the eight hospitals; interviews with government representatives; and a desk review of national nutrition and child health policies and guidelines. Data were analyzed for the presence/absence of significant bottlenecks. Findings: Findings were categorized according to WHO health systems building blocks, with consideration for how they could be implemented through the BFHI platform. Significant bottlenecks were similar across hospitals, including lack of job aids and supportive supervision tools around care and feeding of SSNs; inadequate human resources; limited space in maternity wards and NICUs for family-centered care; and inadequate facility-to-community linkages. Proposed solutions included task-shifting, improving the monitoring of SSN care, and building capacity of health providers. Conclusions: This assessment revealed the need to strengthen support for SSNs. Malawi’s existing BFHI program could provide an ideal platform for addressing the identified bottlenecks. Funding: USAID
Corinne Mazzeo, MHS, MPH, RD ; Patti Welch
Overview
Background: Globally, most neonatal deaths occur in small and sick newborns (SSNs). These babies require specialized lactation and social support, which is often neglected in low- and middle-income settings due to health systems challenges. The Maternal and Child Survival Program (MCSP) support the Malawi government to integrate care and feeding of SSNs into the country’s existing Baby Friendly Hospital Initiative (BFHI). A bottleneck analysis (BNA) was conducted to identify bottlenecks to supporting breast milk feeding for SSNs in hospital settings. Methods: MCSP, in collaboration with hospital and government personnel, used an adapted version of the globally-endorsed Every Newborn Action Plan BNA tool to identify bottlenecks and solutions through: facility-level observations and interviews with clinical and supervisory staff at the eight hospitals; interviews with government representatives; and a desk review of national nutrition and child health policies and guidelines. Data were analyzed for the presence/absence of significant bottlenecks. Findings: Findings were categorized according to WHO health systems building blocks, with consideration for how they could be implemented through the BFHI platform. Significant bottlenecks were similar across hospitals, including lack of job aids and supportive supervision tools around care and feeding of SSNs; inadequate human resources; limited space in maternity wards and NICUs for family-centered care; and inadequate facility-to-community linkages. Proposed solutions included task-shifting, improving the monitoring of SSN care, and building capacity of health providers. Conclusions: This assessment revealed the need to strengthen support for SSNs. Malawi’s existing BFHI program could provide an ideal platform for addressing the identified bottlenecks. Funding: USAID
Speakers
Corinne Mazzeo, MHS, MPH, RD ; Patti Welch
Getting to the Goal: A Pediatrician's Perspective of Slow Weight Gain in First-time Breastfeeding/Chestfeeding Families On Demand
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Many times, accompanying breastfeeding families as a prolactation pediatrician is challenging due to cultural barriers regarding lactation practices as the gold standard of nutrition for all babies. This is even more challenging, when for one reason or another, these families are not able to reach the expected goal in the weight gain for their babies. There are multiple factors that can influence this clinical expression of a lactation history, but even today, within the medical community and culturally within some Latin American populations, there are persisting beliefs that nutritional recovery with human milk and through breastfeeding as a dynamic process is not feasible. Therefore, whenever the desired weight gain goal is not easily achieved, lactation becomes dispensable in the strategy designed for the family. For this fundamental reason, the infant is evaluated within a biased anthropometric and clinical context, which ultimately drives families away from achieving their growth and developmental goals through the practice and reinforcement of human lactation.
Patricia Diaz, MD, IBCLC, Doula
Overview
Many times, accompanying breastfeeding families as a prolactation pediatrician is challenging due to cultural barriers regarding lactation practices as the gold standard of nutrition for all babies. This is even more challenging, when for one reason or another, these families are not able to reach the expected goal in the weight gain for their babies. There are multiple factors that can influence this clinical expression of a lactation history, but even today, within the medical community and culturally within some Latin American populations, there are persisting beliefs that nutritional recovery with human milk and through breastfeeding as a dynamic process is not feasible. Therefore, whenever the desired weight gain goal is not easily achieved, lactation becomes dispensable in the strategy designed for the family. For this fundamental reason, the infant is evaluated within a biased anthropometric and clinical context, which ultimately drives families away from achieving their growth and developmental goals through the practice and reinforcement of human lactation.
Speakers
Patricia Diaz, MD, IBCLC, Doula
Clinical Case Study: Breast/Chest Feeding Infants with Tongue Tie and Oral Motor Disorganization On Demand
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Tongue tie is a pathology that affects approximately 12% of lactation problems. The most frequent issues that are seen in babies are poor weight gain, prolong feedings, fussy and gassy and even reflux. Mothers can present pain and cracks, mastitis, plugged ducts etc. Release of a tongue tie is curative and many times it is the solution to the breastfeeding issues. But, when there is a baby with a tongue tie but also other motor oral pathology such as suckling disorganization, hypotonia, poor weight gain breast/chest feeding is a real challenge. Learning different tools and abilities to come along with the dyad, sustaining baby’s health and maintaining a breastfeeding relation can be burdensome.
Mariana Colmenares, MD, IBCLC
Overview
Tongue tie is a pathology that affects approximately 12% of lactation problems. The most frequent issues that are seen in babies are poor weight gain, prolong feedings, fussy and gassy and even reflux. Mothers can present pain and cracks, mastitis, plugged ducts etc. Release of a tongue tie is curative and many times it is the solution to the breastfeeding issues. But, when there is a baby with a tongue tie but also other motor oral pathology such as suckling disorganization, hypotonia, poor weight gain breast/chest feeding is a real challenge. Learning different tools and abilities to come along with the dyad, sustaining baby’s health and maintaining a breastfeeding relation can be burdensome.
Speakers
Mariana Colmenares, MD, IBCLC
Exclusive Pumping: Pros, Cons, and Considerations On Demand
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Approximately 85% of mothers have expressed milk sometime since their infant was born. About 5.6% of these mothers exclusively pump their milk. There are many reasons for this and a number of unanswered questions regarding the practice. Do the same health advantages accrue to the exclusively pumping mother compared with a parent that directly breastfeeds (reduction in reproductive cancers, type II diabetes, myocardial infarction, metabolic syndrome)? Are there different health outcomes for the infant? Is pumped milk equivalent to milk directly fed from the breast? Expressed milk can be exposed to nutrient degradation through handling, storing, and even altered depending on which bottle-feeding system is used. Bacterial richness is lower in pumped milk which can alter the infant gut microbiome. Milk lipolysis can occur during storage causing an off odor and rancid flavor. Breastmilk components communicate the time of day to infants through a process called chrono nutrition and may not be circadian matched. Milk pumped during the day is different than milk pumped at night. This presentation will explore the many nuances of expressed breastmilk, breast pumps, pumping more effectively, typical problems and possible interventions. Recommendations will be provided for a healthy, successful experience.
Marsha Walker, RN, IBCLC
Overview
Approximately 85% of mothers have expressed milk sometime since their infant was born. About 5.6% of these mothers exclusively pump their milk. There are many reasons for this and a number of unanswered questions regarding the practice. Do the same health advantages accrue to the exclusively pumping mother compared with a parent that directly breastfeeds (reduction in reproductive cancers, type II diabetes, myocardial infarction, metabolic syndrome)? Are there different health outcomes for the infant? Is pumped milk equivalent to milk directly fed from the breast? Expressed milk can be exposed to nutrient degradation through handling, storing, and even altered depending on which bottle-feeding system is used. Bacterial richness is lower in pumped milk which can alter the infant gut microbiome. Milk lipolysis can occur during storage causing an off odor and rancid flavor. Breastmilk components communicate the time of day to infants through a process called chrono nutrition and may not be circadian matched. Milk pumped during the day is different than milk pumped at night. This presentation will explore the many nuances of expressed breastmilk, breast pumps, pumping more effectively, typical problems and possible interventions. Recommendations will be provided for a healthy, successful experience.
Speakers
Marsha Walker, RN, IBCLC
Using Technology to Provide Relevant and Personalized Lactation Support On Demand
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Breastfeeding initiation rates in the US are not consistent across the states and duration rates decrease dramatically at 3 and 6 months. Two of the reasons cited for early weaning are low maternal self-efficacy and pain. Both can be resolved with access to lactation support. Unfortunately, many women incorrectly assume that the pain is part of the process or they perceive infant crying as a sign that they are not producing enough milk. These incorrect beliefs manifest as a reason for abandonment even before seeking help. Since this issue is highly amenable to an intervention, early recognition of a mother experiencing pain or doubting her milk supply would allow caregivers to provide the right support and suggest corrective action. There is an opportunity for technology to provide relevant and personalized support and encouragement to drive positive outcomes. This presentation will conduct a literature review of how technology has been used in the field of lactation care. I will also present the experience I have working with a digital health start up providing breastfeeding support. My team developed a solution that would provide continuous assessments and real time feedback to the mother while also providing 24/7 support from IBCLCs. These offerings would increase maternal self-efficacy and identify breastfeeding issues early on while delivering professional management and resolution of these issues.
Kristina Chamberlain, CNM, ARNP, IBCLC
Overview
Breastfeeding initiation rates in the US are not consistent across the states and duration rates decrease dramatically at 3 and 6 months. Two of the reasons cited for early weaning are low maternal self-efficacy and pain. Both can be resolved with access to lactation support. Unfortunately, many women incorrectly assume that the pain is part of the process or they perceive infant crying as a sign that they are not producing enough milk. These incorrect beliefs manifest as a reason for abandonment even before seeking help. Since this issue is highly amenable to an intervention, early recognition of a mother experiencing pain or doubting her milk supply would allow caregivers to provide the right support and suggest corrective action. There is an opportunity for technology to provide relevant and personalized support and encouragement to drive positive outcomes. This presentation will conduct a literature review of how technology has been used in the field of lactation care. I will also present the experience I have working with a digital health start up providing breastfeeding support. My team developed a solution that would provide continuous assessments and real time feedback to the mother while also providing 24/7 support from IBCLCs. These offerings would increase maternal self-efficacy and identify breastfeeding issues early on while delivering professional management and resolution of these issues.
Speakers
Kristina Chamberlain, CNM, ARNP, IBCLC
Impact of Lactating Parent's Health History and Conditions on Breastfeeding/Chestfeeding On Demand
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When consulting with the breastfeeding dyad, sometimes the priority of obtaining the breastfeeding history and observing the breastfeeding baby leads to too little emphasis and time placed on mother’s health and getting a maternal history. This presentation will review questions to ask mother, identify information you are looking for in a maternal history, and explain how the information you obtain impacts breastfeeding success and your recommendations. Maternal conditions and how they impact breastfeeding will be briefly discussed. These conditions are broken down into the following categories: hormonal diseases (Infertility, PCOS, diabetes, thyroid and pituitary disorders, anemia, and vitamin D deficiency), autoimmune diseases (lupus, multiple sclerosis, rheumatoid arthritis, celiac disease, inflammatory bowel disease and ulcerative colitis), chronic conditions (cystic fibrosis, organ transplantation, seizures and hypertension), and viral/bacterial conditions (HIV/AIDS, herpes, cytomegalovirus, hepatitis, West Nile virus, Zika virus, and Lyme disease.)
Ellen Lechtenberg, MPH, RD, IBCLC
Overview
When consulting with the breastfeeding dyad, sometimes the priority of obtaining the breastfeeding history and observing the breastfeeding baby leads to too little emphasis and time placed on mother’s health and getting a maternal history. This presentation will review questions to ask mother, identify information you are looking for in a maternal history, and explain how the information you obtain impacts breastfeeding success and your recommendations. Maternal conditions and how they impact breastfeeding will be briefly discussed. These conditions are broken down into the following categories: hormonal diseases (Infertility, PCOS, diabetes, thyroid and pituitary disorders, anemia, and vitamin D deficiency), autoimmune diseases (lupus, multiple sclerosis, rheumatoid arthritis, celiac disease, inflammatory bowel disease and ulcerative colitis), chronic conditions (cystic fibrosis, organ transplantation, seizures and hypertension), and viral/bacterial conditions (HIV/AIDS, herpes, cytomegalovirus, hepatitis, West Nile virus, Zika virus, and Lyme disease.)
Speakers
Ellen Lechtenberg, MPH, RD, IBCLC
Making a Difference: Using Your Facility to Teach Lactation Care to Healthcare Students and Professionals On Demand
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Lactation education amongst healthcare providers has historically been insufficient to prepare the provider for lactation issues he/she will encounter in practice. Most medical schools, medical residency programs, and nursing schools offer little formal training in lactation or supporting a lactating dyad. Methods: Through partnerships with Universities, Texas WIC is changing this. Texas WIC funds five outpatient lactation clinics who offer lactation education experiences for medical students, medical residents, and nursing students. Students spend half to a several days at a Lactation Support Center learning through a variety of methods: didactic, video, clinical/case reviews, and practical/hands-on with clients. There will be discussion on ways to initiate and implement a student program. Participants will use an online app such as kahoot.com to respond to this question, “Who can you contact in your community to begin the conversation about initiating a student lactation learning experience?”
Susan Glaeser ; Linda Zeccola ; Christine Wiseman ; Burlene Carrizales
Overview
Lactation education amongst healthcare providers has historically been insufficient to prepare the provider for lactation issues he/she will encounter in practice. Most medical schools, medical residency programs, and nursing schools offer little formal training in lactation or supporting a lactating dyad. Methods: Through partnerships with Universities, Texas WIC is changing this. Texas WIC funds five outpatient lactation clinics who offer lactation education experiences for medical students, medical residents, and nursing students. Students spend half to a several days at a Lactation Support Center learning through a variety of methods: didactic, video, clinical/case reviews, and practical/hands-on with clients. There will be discussion on ways to initiate and implement a student program. Participants will use an online app such as kahoot.com to respond to this question, “Who can you contact in your community to begin the conversation about initiating a student lactation learning experience?”
Speakers
Susan Glaeser ; Linda Zeccola ; Christine Wiseman ; Burlene Carrizales
Preparing a Research Manuscript for Publication On Demand
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In this session, Joan Dodgson, PhD, MPH, RN, FAAN; Kathie Marinelli, MD, IBCLC, FABM; and Sara Gill, PhD, RN, IBCLC present on the importance to share research, evaluation, and clinical projects with others who might benefit from your findings. Although it can seem like a huge challenge, the best way to share your work with others is by publishing in professional journals.This presentation will deconstruct the preparation of manuscript for submission and delineate the process for submission of your manuscript. The established conventions of writing for publication will be discussed and examples presented. The components of a scholarly article will be presented in the form of worksheets that participants can use to develop their manuscripts. Additionally, choosing the right journal where your work will reach the right audience is an important decision. The three primary criteria for choosing a journal will be explained. Each professional journal has specific requirements that include both content and style. How to determine the specific requirements for a particular journal and how to set up your manuscript to comply with these will be covered. Once your manuscript has been prepared, submitting it and what happens after your submission will be detailed. This presentation will provide the information and tools the novice or experienced writer needs to be successful at publishing their work.
Joan Dodgson, PhD, MPH, RN, FAAN ; Kathie Marinelli, MD, IBCLC, FABM ; Sara Gill, PhD, RN, IBCLC
Overview
In this session, Joan Dodgson, PhD, MPH, RN, FAAN; Kathie Marinelli, MD, IBCLC, FABM; and Sara Gill, PhD, RN, IBCLC present on the importance to share research, evaluation, and clinical projects with others who might benefit from your findings. Although it can seem like a huge challenge, the best way to share your work with others is by publishing in professional journals.This presentation will deconstruct the preparation of manuscript for submission and delineate the process for submission of your manuscript. The established conventions of writing for publication will be discussed and examples presented. The components of a scholarly article will be presented in the form of worksheets that participants can use to develop their manuscripts. Additionally, choosing the right journal where your work will reach the right audience is an important decision. The three primary criteria for choosing a journal will be explained. Each professional journal has specific requirements that include both content and style. How to determine the specific requirements for a particular journal and how to set up your manuscript to comply with these will be covered. Once your manuscript has been prepared, submitting it and what happens after your submission will be detailed. This presentation will provide the information and tools the novice or experienced writer needs to be successful at publishing their work.
Speakers
Joan Dodgson, PhD, MPH, RN, FAAN ; Kathie Marinelli, MD, IBCLC, FABM ; Sara Gill, PhD, RN, IBCLC
Techniques for Safe Implementation of Communities and Hospitals Advancing Maternity Practices (CHAMPS) Training On Demand
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As the Baby Friendly Hospital Initiative has gained momentum across the world, considerations for safety have increased to assure that practice changes are done in a way that maintains safety. The Communities and Hospitals Advancing Maternity Practices (CHAMPS) initiative has demonstrated improvements in maternity care practices and shrinkage in gaps between care in the Black/African American population compared to the non-Black AA population in the Southern United States. However, safety concerns regarding rooming-in and skin-to-skin continue to exist in the literature and are being discussed by hospital staff. CHAMPS created and implemented a 2-hour curriculum through the lens of safety as one solution to support exclusive breastfeeding/chestfeeding within the framework of the Ten Steps to Successful Breastfeeding. This hands-on ‘train the trainer’ workshop provides an overview of the new curriculum, with a focus on safety approaches for skin-to-skin care, rooming in, and prevention of falls. The platform employs principles of visual design and case-based participation to enhance learning. It was piloted and used successfully in Mississippi, a region of the US with known breastfeeding disparities and high infant mortality rates. During the workshop, qualified lactation educators who train hospital staff will learn strategies for conducting effective education, background to the unique visual-based learning approach, key content topics, and options for conducting engaging activities as part of the curriculum. Participants will receive access to the curriculum to use with training their staff and are encouraged to bring a laptop computer so they can download and use the platform throughout the workshop.
Cathy Carothers, BLA, IBCLC, FILCA
Overview
As the Baby Friendly Hospital Initiative has gained momentum across the world, considerations for safety have increased to assure that practice changes are done in a way that maintains safety. The Communities and Hospitals Advancing Maternity Practices (CHAMPS) initiative has demonstrated improvements in maternity care practices and shrinkage in gaps between care in the Black/African American population compared to the non-Black AA population in the Southern United States. However, safety concerns regarding rooming-in and skin-to-skin continue to exist in the literature and are being discussed by hospital staff. CHAMPS created and implemented a 2-hour curriculum through the lens of safety as one solution to support exclusive breastfeeding/chestfeeding within the framework of the Ten Steps to Successful Breastfeeding. This hands-on ‘train the trainer’ workshop provides an overview of the new curriculum, with a focus on safety approaches for skin-to-skin care, rooming in, and prevention of falls. The platform employs principles of visual design and case-based participation to enhance learning. It was piloted and used successfully in Mississippi, a region of the US with known breastfeeding disparities and high infant mortality rates. During the workshop, qualified lactation educators who train hospital staff will learn strategies for conducting effective education, background to the unique visual-based learning approach, key content topics, and options for conducting engaging activities as part of the curriculum. Participants will receive access to the curriculum to use with training their staff and are encouraged to bring a laptop computer so they can download and use the platform throughout the workshop.
Speakers
Cathy Carothers, BLA, IBCLC, FILCA
The Effect of Simulation-based Education on Counseling Skills of Lactation Consultants: An effective Pedagogical Approach. On Demand
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Breastfeeding not only improves mother-infant bond, but also provides immunity to prevent the infant from early health problems. Yet, breastfeeding rates remain among the lowest in Pakistan. The breastfeeding report card 2007 shows that Pakistan ranks 3rd (Grade B) in exclusive breastfeeding with 50% rates, suggesting that Pakistan needs to put in extra efforts to improve its breastfeeding continuation rates. A lactation consultant is a strong indicator of initiating and maintaining breastfeeding by mothers. Since there are currently no Lactation Consultants (LC’s) serving in the country; only a handful LC’s are found in Pakistan. There is limited data on the effectiveness of Lactation Consultants in our context. Therefore, Aga Khan University School of nursing and midwifery would like to establish this role at the hospital, thereby increasing breastfeeding rates and outcomes.
Zohra Kurji ; Shelina Bhaman ; Zahra Shaheen ; Amina Aijaz
Overview
Breastfeeding not only improves mother-infant bond, but also provides immunity to prevent the infant from early health problems. Yet, breastfeeding rates remain among the lowest in Pakistan. The breastfeeding report card 2007 shows that Pakistan ranks 3rd (Grade B) in exclusive breastfeeding with 50% rates, suggesting that Pakistan needs to put in extra efforts to improve its breastfeeding continuation rates. A lactation consultant is a strong indicator of initiating and maintaining breastfeeding by mothers. Since there are currently no Lactation Consultants (LC’s) serving in the country; only a handful LC’s are found in Pakistan. There is limited data on the effectiveness of Lactation Consultants in our context. Therefore, Aga Khan University School of nursing and midwifery would like to establish this role at the hospital, thereby increasing breastfeeding rates and outcomes.
Speakers
Zohra Kurji ; Shelina Bhaman ; Zahra Shaheen ; Amina Aijaz
New Data on Utilizing Lactation Acuity to Improve Hospital Lactation Services On Demand
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This presentation will describe use of a lactation acuity classification system to improve the efficiency of a hospital lactation service. Analysis of productivity data from a hospital-wide lactation service in 2013 will be compared to previously reported 2006 data to determine if high acuity lactation patients were actually distributed to the care of International Board Certified Lactation Consultants (IBCLCs) vs low acuity patients. New data will be presented giving more detail on time spent on various types of NICU consults versus common reasons for high acuity consults on a mother/baby unit (MBU). This research adds to the body of knowledge on efficacy of lactation acuity as a classification system. It replicates results from a 2010 publication by demonstrating: increased efficiency or productivity of the lactation team; increase in consult rate per location; increase in number of consults per patient and provides more detail on time spent per consult stratified by acuity, location and reason for lactation consults. This data will be used to inform updated recommendations for lactation consultant staffing based on volume of patients and distribution of high acuity patients. Opportunities for further research on this topic include testing lactation acuity for reliability and validity and controlling for other patient/staff related factors that could impact acuity and breastfeeding outcomes, e.g. nurse to patient ratio variations, IBCLC staffing shortages (weekends, holidays), increased census and prenatal education.
Rebecca Mannel, MPH, IBCLC, FILCA
Overview
This presentation will describe use of a lactation acuity classification system to improve the efficiency of a hospital lactation service. Analysis of productivity data from a hospital-wide lactation service in 2013 will be compared to previously reported 2006 data to determine if high acuity lactation patients were actually distributed to the care of International Board Certified Lactation Consultants (IBCLCs) vs low acuity patients. New data will be presented giving more detail on time spent on various types of NICU consults versus common reasons for high acuity consults on a mother/baby unit (MBU). This research adds to the body of knowledge on efficacy of lactation acuity as a classification system. It replicates results from a 2010 publication by demonstrating: increased efficiency or productivity of the lactation team; increase in consult rate per location; increase in number of consults per patient and provides more detail on time spent per consult stratified by acuity, location and reason for lactation consults. This data will be used to inform updated recommendations for lactation consultant staffing based on volume of patients and distribution of high acuity patients. Opportunities for further research on this topic include testing lactation acuity for reliability and validity and controlling for other patient/staff related factors that could impact acuity and breastfeeding outcomes, e.g. nurse to patient ratio variations, IBCLC staffing shortages (weekends, holidays), increased census and prenatal education.
Speakers
Rebecca Mannel, MPH, IBCLC, FILCA
Is Fem Tech Our Friend? The Fabulous and Frightening Significance in Lactation On Demand
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With the rise of the digital era, it was only a matter of time before technology would place a strategic eye on women/people with breasts and uteri. FemTech means anything and everything that involves the technology, diagnostics, software, and services involving menstruation, fertility, adoption, pregnancy, fertility, or women’s health. The industry is approaching a $100 Billion market per year. This exploding area of digitized health support has many celebrating, however, just as many people worry about issues such as privacy and surveillance. There are also more profound questions involving intersectionality, equitable access, and exploitation of segments of the population that FemTech can take advantage of or leave out altogether. Join Laurel Wilson, lactivist and avid research reviewer, on this journey through some of the current lactation and perinatal FemTech available, and implications in the world of lactation.
Laurel Wilson, BCLC, RLC, CLE, CLD, CCCE, BSc
Overview
With the rise of the digital era, it was only a matter of time before technology would place a strategic eye on women/people with breasts and uteri. FemTech means anything and everything that involves the technology, diagnostics, software, and services involving menstruation, fertility, adoption, pregnancy, fertility, or women’s health. The industry is approaching a $100 Billion market per year. This exploding area of digitized health support has many celebrating, however, just as many people worry about issues such as privacy and surveillance. There are also more profound questions involving intersectionality, equitable access, and exploitation of segments of the population that FemTech can take advantage of or leave out altogether. Join Laurel Wilson, lactivist and avid research reviewer, on this journey through some of the current lactation and perinatal FemTech available, and implications in the world of lactation.
Agenda and Speakers
Laurel Wilson, BCLC, RLC, CLE, CLD, CCCE, BSc
Impact of Online Peer-to-Peer Lactation Support on Breastfeeding Literacy Among Mothers in the Middle East On Demand
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The internet was reported as the most frequently used source for health-related information around the world. We are bombarded by health information almost 24-hours a day but mothers are still confused and have low breastfeeding literacy. Low breastfeeding literacy can get expensive - not breastfeeding is associated with economic losses of about 302 billion dollars annually or 0.49 percent of world gross national income. Peer-to-peer support for breastfeeding mothers is effective in increasing the duration of exclusive breastfeeding, particularly for infants aged 3 to 6 months in low- and middle-income countries. In this presentation, I explore the online peer-to-peer support impact on breastfeeding literacy, as well as breastfeeding mother perceptions regarding the use of technology to obtain breastfeeding-related information. A total of 95 volunteers were recruited via an online breastfeeding support group in Jordan, Syria, and Palestine. Breastfeeding mothers completed a pretested survey in the local language in order to learn more about their perspective and understanding of breastfeeding. Results indicate that access to online peer-to-peer support group have been linked to better breastfeeding experience as well as increased relationship satisfaction. However, despite the popularity of the internet as a source of information, 40 percent of mothers did not feel that they had the skills needed to evaluate web-based health resources. Given the important consequences of health-related decisions, breastfeeding mothers are an important population to target for health literacy interventions.
Yafa Ajweh, IBCLC, RN
Overview
The internet was reported as the most frequently used source for health-related information around the world. We are bombarded by health information almost 24-hours a day but mothers are still confused and have low breastfeeding literacy. Low breastfeeding literacy can get expensive - not breastfeeding is associated with economic losses of about 302 billion dollars annually or 0.49 percent of world gross national income. Peer-to-peer support for breastfeeding mothers is effective in increasing the duration of exclusive breastfeeding, particularly for infants aged 3 to 6 months in low- and middle-income countries. In this presentation, I explore the online peer-to-peer support impact on breastfeeding literacy, as well as breastfeeding mother perceptions regarding the use of technology to obtain breastfeeding-related information. A total of 95 volunteers were recruited via an online breastfeeding support group in Jordan, Syria, and Palestine. Breastfeeding mothers completed a pretested survey in the local language in order to learn more about their perspective and understanding of breastfeeding. Results indicate that access to online peer-to-peer support group have been linked to better breastfeeding experience as well as increased relationship satisfaction. However, despite the popularity of the internet as a source of information, 40 percent of mothers did not feel that they had the skills needed to evaluate web-based health resources. Given the important consequences of health-related decisions, breastfeeding mothers are an important population to target for health literacy interventions.
Speakers
Yafa Ajweh, IBCLC, RN
Oral Research Presentation: Breastfeeding Practices and Attitudes Toward Breastfeeding in Human Milk Donors On Demand
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Mother’s milk is recommended as the best primary source of infant nutrition for the first year of life, with human donor milk as the next best option. This study aims to determine breastfeeding outcomes and attitudes toward breastfeeding among human milk donors. Barriers to milk donation process were also assessed. Methods: A prospective descriptive study using an online internet survey was conducted in milk donor women who were on the U.S. National Milk Bank listserv. Data were analyzed using descriptive statistics, Chi-square, and Independent samples t-test. Results: A total of 236 milk donor women with the mean age of 33 years old and infant mean gestational age of 38 weeks completed the online survey. These women resided in suburban, urban, and rural areas. Infants’ first feedings were reported as using mothers’ own breast milk, donated milk, and formula. Women who did not breastfeed during the first hour of delivery tended to have more low birth weight and small for gestational age infants compared to those women who initiated breastfeeding within the first hour of delivery. Breastfeeding practices reported by these women were exclusive, partial, and formula feedings. Conclusion: Milk donor women in this study had positive attitudes toward breastfeeding with high breastfeeding initiation and exclusivity rates. Mothers’ milk donor screening process and standard procedures can be streamlined to accommodate women who are willing to donate their breast milk. Implications to practice and policy include increasing milk donation awareness among breastfeeding women, healthcare professionals, and lactation consultants.
Azza Ahmed, DNSc, CPNP, IBCLC, FAAN ; Wilaiporn Rojjanasrirat, PhD, RN, IBCLC
Overview
Mother’s milk is recommended as the best primary source of infant nutrition for the first year of life, with human donor milk as the next best option. This study aims to determine breastfeeding outcomes and attitudes toward breastfeeding among human milk donors. Barriers to milk donation process were also assessed. Methods: A prospective descriptive study using an online internet survey was conducted in milk donor women who were on the U.S. National Milk Bank listserv. Data were analyzed using descriptive statistics, Chi-square, and Independent samples t-test. Results: A total of 236 milk donor women with the mean age of 33 years old and infant mean gestational age of 38 weeks completed the online survey. These women resided in suburban, urban, and rural areas. Infants’ first feedings were reported as using mothers’ own breast milk, donated milk, and formula. Women who did not breastfeed during the first hour of delivery tended to have more low birth weight and small for gestational age infants compared to those women who initiated breastfeeding within the first hour of delivery. Breastfeeding practices reported by these women were exclusive, partial, and formula feedings. Conclusion: Milk donor women in this study had positive attitudes toward breastfeeding with high breastfeeding initiation and exclusivity rates. Mothers’ milk donor screening process and standard procedures can be streamlined to accommodate women who are willing to donate their breast milk. Implications to practice and policy include increasing milk donation awareness among breastfeeding women, healthcare professionals, and lactation consultants.
Speakers
Azza Ahmed, DNSc, CPNP, IBCLC, FAAN ; Wilaiporn Rojjanasrirat, PhD, RN, IBCLC
Oral Research Presentation: Impacts of Inpatient Pasteurized Donor Human Milk Utilization on Well-baby Feeding Practices at Discharge and at One Week and One Month Post-discharge On Demand
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Background: The use of pasteurized Donor Human Milk (DM) in the USA has increased. In February 2018, Lucile Packard Children's Hospital Stanford implemented DM supplementation for well-babies with medical indications, which contributed to increased exclusive breast milk feeding rate from 57% to 72% in three months. However, there is a lack of study on the impact of DM on post-discharge feeding practices (3). Objective: To explore the effect of using DM for well-babies on feeding outcomes at discharge, one week and one-month post-discharge. Methods: A retrospective study by chart review and follow-up phone surveys of DM recipients from December 2018-April 2019. Results: With 112/132 completed data, the exclusively breast milk feeding rates were 70.5%, 47.3%, and 47.3% at discharge, one week and one-month post-discharge, respectively. Exclusive breast milk feeding rate by discharge was correlated to the rate in one week and one-month post-discharge (p<0.01, p<0.001). While inpatient, 92.4% of mothers hand expressed and/or pumped, and 33.3% of infants had formula exposure. Top three reasons for using formula post-discharge were inadequate milk supply, latch issues, and feeding multiples.
Jie Chang, BSN, MMed, MBBS, IBCLC
Overview
Background: The use of pasteurized Donor Human Milk (DM) in the USA has increased. In February 2018, Lucile Packard Children's Hospital Stanford implemented DM supplementation for well-babies with medical indications, which contributed to increased exclusive breast milk feeding rate from 57% to 72% in three months. However, there is a lack of study on the impact of DM on post-discharge feeding practices (3). Objective: To explore the effect of using DM for well-babies on feeding outcomes at discharge, one week and one-month post-discharge. Methods: A retrospective study by chart review and follow-up phone surveys of DM recipients from December 2018-April 2019. Results: With 112/132 completed data, the exclusively breast milk feeding rates were 70.5%, 47.3%, and 47.3% at discharge, one week and one-month post-discharge, respectively. Exclusive breast milk feeding rate by discharge was correlated to the rate in one week and one-month post-discharge (p<0.01, p<0.001). While inpatient, 92.4% of mothers hand expressed and/or pumped, and 33.3% of infants had formula exposure. Top three reasons for using formula post-discharge were inadequate milk supply, latch issues, and feeding multiples.
Speakers
Jie Chang, BSN, MMed, MBBS, IBCLC
Oral Research Presentation: Macronutrient Analysis of Modified-Fat Human Milk Produced by 3 Methods of Fat Removal On Demand
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Background: Infants with chylothorax after congenital heart disease surgery are commonly treated using modified-fat human milk. The effect of fat removal on human milk macronutrients remains unclear. Research Aim: To compare macronutrient content of human milk with human milk skimmed using three methods, including a novel device, a cream separator. Methods: Thawed frozen human milk samples from 30 women were defatted using refrigerated centrifuge, cream separator, and manual separation after refrigeration. Energy, protein, and fat were measured using standard assays. Results: All fat removal methods yielded skimmed human milk with substantially lower fat and energy content. Mean energy content in human milk skimmed by centrifuge (36.7 [SD 3.6] kcal/100 mL) was similar to that from cream separator (38.8 [3.5] kcal/100 mL). Both centrifuge and cream separator methods removed almost all fat and substantially more fat than the manual fat removal method. For unprocessed milk, energy and fat content estimated by creamatocrit was similar to reference method measurements; in skimmed milk, the creamatocrit significantly overestimated fat content. Mean protein content of skimmed human milk was similar to unprocessed human milk (mean 1.25 [0.31] g/100 mL).
Kimberly Barbas, BSN, RN, IBCLC
Overview
Background: Infants with chylothorax after congenital heart disease surgery are commonly treated using modified-fat human milk. The effect of fat removal on human milk macronutrients remains unclear. Research Aim: To compare macronutrient content of human milk with human milk skimmed using three methods, including a novel device, a cream separator. Methods: Thawed frozen human milk samples from 30 women were defatted using refrigerated centrifuge, cream separator, and manual separation after refrigeration. Energy, protein, and fat were measured using standard assays. Results: All fat removal methods yielded skimmed human milk with substantially lower fat and energy content. Mean energy content in human milk skimmed by centrifuge (36.7 [SD 3.6] kcal/100 mL) was similar to that from cream separator (38.8 [3.5] kcal/100 mL). Both centrifuge and cream separator methods removed almost all fat and substantially more fat than the manual fat removal method. For unprocessed milk, energy and fat content estimated by creamatocrit was similar to reference method measurements; in skimmed milk, the creamatocrit significantly overestimated fat content. Mean protein content of skimmed human milk was similar to unprocessed human milk (mean 1.25 [0.31] g/100 mL).
Speakers
Kimberly Barbas, BSN, RN, IBCLC
Oral Research Presentation: Assessment of Differences in Breastfeeding Knowledge and Comfort with Breastfeeding in Public among College Students from Varying Countries of Origin On Demand
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Having knowledge about breastfeeding and being comfortable with viewing people breastfeed in public is essential to support efforts to improve breastfeeding rates in the United States (US) and in other developing countries. People originating from countries with higher breastfeeding rates than that of the US may have higher levels of breastfeeding knowledge and comfort than those born in the US. The purpose of this study was to analyze differences in breastfeeding knowledge and comfort with viewing breastfeeding in public, between domestic and international college students, at one public university in the southern US. Seven-hundred and sixty-one students, 18 years of age and older, took a 78-item, web-based survey. There were no significant differences in breastfeeding knowledge (p=0.054) nor comfort (p=0.052) between students with either US or International student status. The US students had a slightly higher mean knowledge score (184.96 ±26.74 vs. 178.18 ±25.39). Significant differences in both knowledge and comfort by race, age, gender, marital status, breastfeeding experience and having been breastfed as child (p<0.001) were observed. To date, this is the first study to assess and analyze differences in breastfeeding knowledge and comfort between domestic and international college students studying in the US. International students coming to the US are not bringing a higher level of knowledge and comfort with them to share with the US. Parenting or breastfeeding education programs aimed at college students should establish knowledge and comfort baseline levels at which to begin efforts and should produce materials in needed languages, in addition to English.
Erin McKinley PhD, RD, LDN, CLC, CHES
Overview
Having knowledge about breastfeeding and being comfortable with viewing people breastfeed in public is essential to support efforts to improve breastfeeding rates in the United States (US) and in other developing countries. People originating from countries with higher breastfeeding rates than that of the US may have higher levels of breastfeeding knowledge and comfort than those born in the US. The purpose of this study was to analyze differences in breastfeeding knowledge and comfort with viewing breastfeeding in public, between domestic and international college students, at one public university in the southern US. Seven-hundred and sixty-one students, 18 years of age and older, took a 78-item, web-based survey. There were no significant differences in breastfeeding knowledge (p=0.054) nor comfort (p=0.052) between students with either US or International student status. The US students had a slightly higher mean knowledge score (184.96 ±26.74 vs. 178.18 ±25.39). Significant differences in both knowledge and comfort by race, age, gender, marital status, breastfeeding experience and having been breastfed as child (p<0.001) were observed. To date, this is the first study to assess and analyze differences in breastfeeding knowledge and comfort between domestic and international college students studying in the US. International students coming to the US are not bringing a higher level of knowledge and comfort with them to share with the US. Parenting or breastfeeding education programs aimed at college students should establish knowledge and comfort baseline levels at which to begin efforts and should produce materials in needed languages, in addition to English.
Speakers
Erin McKinley PhD, RD, LDN, CLC, CHES
Oral Research Presentation: Evaluation of Breast Milk Knowledge Among Students in Health Care Fields On Demand
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Background: It is important to identify gaps in breast milk knowledge of students in health care fields. Research Aim: To determine allied health and medical students? knowledge regarding breast milk. Methods: This descriptive study used an anonymous internet-based Qualtrics survey. Content validity was established using input from members of IBCLC and RD. Survey was distributed via email to 1396 students from medical, nursing, nutrition and dietetics, and physician assistant departments. Data were analyzed using SAS to calculate frequency of responses and cross-tabulations descriptive statistics. ANOVA, T-test and chi-square analysis were also conducted. Results: Seventy-eight students responded completely to 40 survey questions (5.59% respond rate). Majority of respondents were from the School of Nursing and Nutrition and Dietetics Department. Majority of respondents were female (83.3%) and graduate students (59.5%). Only 42.31% of participants had some exposure to breastfeeding > 6 months. Vast majority (84.6%) of respondents were non-parent. Mean knowledge score was 49.5% ± 6.75% across all groups. No significant differences in mean knowledge scores among students across all departments (P = .948). A much higher number of respondents had taken courses that included nutritional knowledge with only a third having taken courses that included information on immunological properties (67% vs 34%). Over 70% had never attended seminar/webinar related to breastfeeding and only 1% were familiar with WHO-UNICEF training course. Over half students preferred to learn from online courses (67%) or seminars/webinars (60%).
Ummu Erliana, MS ; Millie Mattfeld-Beman, PhD, RD, LD ; Laurie P. Shornick, PhD, IBCLC
Overview
Background: It is important to identify gaps in breast milk knowledge of students in health care fields. Research Aim: To determine allied health and medical students? knowledge regarding breast milk. Methods: This descriptive study used an anonymous internet-based Qualtrics survey. Content validity was established using input from members of IBCLC and RD. Survey was distributed via email to 1396 students from medical, nursing, nutrition and dietetics, and physician assistant departments. Data were analyzed using SAS to calculate frequency of responses and cross-tabulations descriptive statistics. ANOVA, T-test and chi-square analysis were also conducted. Results: Seventy-eight students responded completely to 40 survey questions (5.59% respond rate). Majority of respondents were from the School of Nursing and Nutrition and Dietetics Department. Majority of respondents were female (83.3%) and graduate students (59.5%). Only 42.31% of participants had some exposure to breastfeeding > 6 months. Vast majority (84.6%) of respondents were non-parent. Mean knowledge score was 49.5% ± 6.75% across all groups. No significant differences in mean knowledge scores among students across all departments (P = .948). A much higher number of respondents had taken courses that included nutritional knowledge with only a third having taken courses that included information on immunological properties (67% vs 34%). Over 70% had never attended seminar/webinar related to breastfeeding and only 1% were familiar with WHO-UNICEF training course. Over half students preferred to learn from online courses (67%) or seminars/webinars (60%).
Speakers
Ummu Erliana, MS ; Millie Mattfeld-Beman, PhD, RD, LD ; Laurie P. Shornick, PhD, IBCLC
Agenda: 19 August 2020 - all times listed as Eastern Time U.S.
Presidents Welcome and Everyone Wants to Hold the Baby, Who Will Hold the Mother? 11:00AM - 12:15 PM
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In this session, Jabina Coleman, LSW, MSW, CLC, IBCLC discusses how breastfeeding and maternal mental health are public health imperatives in the United States. Although breastfeeding is the most optimal way to nourish infants and has lifelong health benefits for the parent-baby dyad, family and community there continues to be racial disparities that disproportionately affect marginalized communities impeding on social determinants of health and health equity. Similarly, there continues to be disparities in maternal mental health affecting childbearing women. Perinatal Mood and Anxiety Disorders (PMADs) are the number one complication during a woman's childbearing years affecting 1 in 7 women. Women of Color are three times more likely to experience perinatal mood disorder compared to white women. PMADs, unlike many other comorbidities, are detectable and treatable. However, there are many systemic barriers that prohibit adequate assessment, diagnosis and treatment of PMADs. Therefore, those on the frontline-birthworkers, doulas, lactation professionals, medical providers-supporting women and families during the perinatal period need to be informed and equipped to help combat complications that present with breastfeeding and maternal mental health as they are often times treated separately, however, not mutually exclusive. Consequently, if supported and addressed appropriately, providers can support bridging the maternal health gaps and racial disparities that exist. Credit: 1 L CERP and 1 Contact Hour
Jabina Coleman, LSW, MSW, CLC, IBCLC
Overview
In this session, Jabina Coleman, LSW, MSW, CLC, IBCLC discusses how breastfeeding and maternal mental health are public health imperatives in the United States. Although breastfeeding is the most optimal way to nourish infants and has lifelong health benefits for the parent-baby dyad, family and community there continues to be racial disparities that disproportionately affect marginalized communities impeding on social determinants of health and health equity. Similarly, there continues to be disparities in maternal mental health affecting childbearing women. Perinatal Mood and Anxiety Disorders (PMADs) are the number one complication during a woman's childbearing years affecting 1 in 7 women. Women of Color are three times more likely to experience perinatal mood disorder compared to white women. PMADs, unlike many other comorbidities, are detectable and treatable. However, there are many systemic barriers that prohibit adequate assessment, diagnosis and treatment of PMADs. Therefore, those on the frontline-birthworkers, doulas, lactation professionals, medical providers-supporting women and families during the perinatal period need to be informed and equipped to help combat complications that present with breastfeeding and maternal mental health as they are often times treated separately, however, not mutually exclusive. Consequently, if supported and addressed appropriately, providers can support bridging the maternal health gaps and racial disparities that exist. Credit: 1 L CERP and 1 Contact Hour
Speakers
Jabina Coleman, LSW, MSW, CLC, IBCLC
Break with Exhibitors 12:15 - 12:45 PM
Advanced Approaches to Optimizing Birthing Care Practices in 2020 and Beyond 12:45 - 1:45 PM
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This session will focus on approaches to optimizing birthing care practices, using quality improvement and centering equity. Lessons learned from national level collaboratives will be shared. Global participants will learn about models of care for scale up using the revised Ten Step to Successful Breastfeeding. Pivots to public health programming due to COVID-19 will also be discussed.
Catherine Sullivan, MPH, RD, LDN, IBCLC, FAND
Overview
This session will focus on approaches to optimizing birthing care practices, using quality improvement and centering equity. Lessons learned from national level collaboratives will be shared. Global participants will learn about models of care for scale up using the revised Ten Step to Successful Breastfeeding. Pivots to public health programming due to COVID-19 will also be discussed.
Speakers
Catherine Sullivan, MPH, RD, LDN, IBCLC, FAND
Break to view posters 1:45 - 2:00 PM
The Right Way to Say "You're Wrong": Effective Ethical Scripting for Tough Talk in Lactation 2:00 - 3:00 PM
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In day-to-day practice, IBCLCs and other lactation care providers frequently meet ‘push-back’ in their care of lactating parents. Examples: Primary healthcare providers who are not familiar with lactation research and practice (and undercut the care plan); family members who negate supportive teaching; colleagues who practice with ‘loose ethics’ or conflicts-of-interest; co-workers who overstep their scope of practice or clinical competencies; social media kerfuffle about everything from formula supplementation to safe sleep to predatory marketing tactics. What can (or should?) an IBCLC say, without compounding the problem? Effective communication matters so much so that IBLCE will soon require five hours of teaching on communication skills for new IBCLC aspirants. This session will cover the legal and ethical requirements for effective education and communication. It will describe principles of adult learning that improve communication and provide sample scripts (freely adaptable or used as-is) to cover a wide range of issues that vex the lactation support provider.
Elizabeth Brooks, JD, IBCLC, FILCA
Overview
In day-to-day practice, IBCLCs and other lactation care providers frequently meet ‘push-back’ in their care of lactating parents. Examples: Primary healthcare providers who are not familiar with lactation research and practice (and undercut the care plan); family members who negate supportive teaching; colleagues who practice with ‘loose ethics’ or conflicts-of-interest; co-workers who overstep their scope of practice or clinical competencies; social media kerfuffle about everything from formula supplementation to safe sleep to predatory marketing tactics. What can (or should?) an IBCLC say, without compounding the problem? Effective communication matters so much so that IBLCE will soon require five hours of teaching on communication skills for new IBCLC aspirants. This session will cover the legal and ethical requirements for effective education and communication. It will describe principles of adult learning that improve communication and provide sample scripts (freely adaptable or used as-is) to cover a wide range of issues that vex the lactation support provider.
Speakers
Elizabeth Brooks, JD, IBCLC, FILCA
Break to view Posters 3:00 - 3:15 PM
Conflict of interest in breastfeeding: how the International Code and World Health Assembly Resolutions Protect Health Workers, Mothers and Babies 3:15 - 4:15 PM
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In the field of breastfeeding, the health professionals’ and policy makers’ primary interest is to improve health and nutrition outcomes, and to do that they need to work to Increase breastfeeding rates. On the other side, the baby food industry’s primary interest is to increase profits for its shareholders, and to do that they need to sell more breastmilk substitutes, which requires persuading mothers to give up breastfeeding and purchase their expensive and inferior milk formulas. So, one can understand the sort of conflict that arises when a health worker accepts support or sponsorship from the baby food industry. This session will explain how the World Health Assembly has worked to protect health workers, mothers and babies from the harmful effects of conflict of interest, first through the adoption of the International Code of Marketing of Breastmilk Substitutes, and more recently, by welcoming the WHO Guidance on ending inappropriate promotion of foods for infants and young children. The session will also explore the specific recommendation that companies that market foods for infants and young children should not create conflicts of interest in health facilities or throughout health systems and provide details of the types of conduct that are considered to constitute such a conflict and should thus be avoided.
David Clark, LLB (Hons), UNICEF
Overview
In the field of breastfeeding, the health professionals’ and policy makers’ primary interest is to improve health and nutrition outcomes, and to do that they need to work to Increase breastfeeding rates. On the other side, the baby food industry’s primary interest is to increase profits for its shareholders, and to do that they need to sell more breastmilk substitutes, which requires persuading mothers to give up breastfeeding and purchase their expensive and inferior milk formulas. So, one can understand the sort of conflict that arises when a health worker accepts support or sponsorship from the baby food industry. This session will explain how the World Health Assembly has worked to protect health workers, mothers and babies from the harmful effects of conflict of interest, first through the adoption of the International Code of Marketing of Breastmilk Substitutes, and more recently, by welcoming the WHO Guidance on ending inappropriate promotion of foods for infants and young children. The session will also explore the specific recommendation that companies that market foods for infants and young children should not create conflicts of interest in health facilities or throughout health systems and provide details of the types of conduct that are considered to constitute such a conflict and should thus be avoided.
Speakers
David Clark, LLB (Hons), UNICEF
Break to view Posters 4:15 - 4:30 PM
Let's Get Ethical - The Code of Professional Conduct for IBCLCs: Procedures, Determinations, and Updates 4:30 - 5:30 PM
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Are you interested in learning about ethics decisions pertaining to IBCLCs over the past thirty-five years? Do you want to deepen your understanding of recent updates to the accompanying procedures? This presentation will provide an official statistical overview of ethics case determinations by the International Board of Lactation Consultant Examiners ® (IBLCE®) and describe recent changes in the accompanying ethics procedures and submission process. This presentation will separate fact from fiction and deepen your practical understanding of the ethics process for IBCLCs.
Norma Escobar , IBCLC, RLC J.D., CAE
Overview
Are you interested in learning about ethics decisions pertaining to IBCLCs over the past thirty-five years? Do you want to deepen your understanding of recent updates to the accompanying procedures? This presentation will provide an official statistical overview of ethics case determinations by the International Board of Lactation Consultant Examiners ® (IBLCE®) and describe recent changes in the accompanying ethics procedures and submission process. This presentation will separate fact from fiction and deepen your practical understanding of the ethics process for IBCLCs.
Speakers
Norma Escobar , IBCLC, RLC J.D., CAE
Break to view Posters 5:30 - 5:45 PM
We can Learn Some Things from Them, but They can Learn Some Things from us too: an Intergenerational Account of Shared Infant Feeding Information 5:45 - 6:45 PM
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The cultural views of infant feeding (IF) and the presence or absence of optimal breast/chestfeeding support influences feeding behaviors. Intergenerational communication is a significant linkage between the past, present and future. Among African Americans (AAs), their own mother and maternal grandmother greatly influence their feeding behaviors. Thus, this study explroed how and what IF information (i.e., stories, messages and experiences) were shared across at least two generations of AAs. The lived experiences of these Southeastern United States AA women were examined utilizing ethnographic methodology.
Alexis Barr, PhD, MS, BA
Overview
The cultural views of infant feeding (IF) and the presence or absence of optimal breast/chestfeeding support influences feeding behaviors. Intergenerational communication is a significant linkage between the past, present and future. Among African Americans (AAs), their own mother and maternal grandmother greatly influence their feeding behaviors. Thus, this study explroed how and what IF information (i.e., stories, messages and experiences) were shared across at least two generations of AAs. The lived experiences of these Southeastern United States AA women were examined utilizing ethnographic methodology.
Speakers
Alexis Barr, PhD, MS, BA
Break to view Posters 6:45 - 7:00 PM
Collaboration Not Competition: Improving Lactation Outcomes Together 7:00 - 8:15 PM
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While most lactation consultants understand that they are part of a healthcare team, building collaboration between lactation consultants both locally and virtually can be difficult. Private practice lactation consultants may have difficulty understanding the challenges faced by hospital-based lactation consultants. Dominant culture lactation consultants may not see the additional barriers faced by their peers who lack privilege. Internet-based forums may lead to division even among the most well-intentioned professionals. From a business perspective, it may seem that competition is the straightest path to success, but this competition is harmful for families, for our profession, and for us. When we are willing to give up our own points of view, our own privilege, and even our own resources in the spirit of collaboration, we create more opportunities for ourselves as a community of healthcare providers that will also improve lactation outcomes overall. When we focus on collaboration not competition, not only do we make things better for families but we advocate for the value of the IBCLC as a key member of the perinatal and postpartum team.
Annie Frisbie, IBCLC
Overview
While most lactation consultants understand that they are part of a healthcare team, building collaboration between lactation consultants both locally and virtually can be difficult. Private practice lactation consultants may have difficulty understanding the challenges faced by hospital-based lactation consultants. Dominant culture lactation consultants may not see the additional barriers faced by their peers who lack privilege. Internet-based forums may lead to division even among the most well-intentioned professionals. From a business perspective, it may seem that competition is the straightest path to success, but this competition is harmful for families, for our profession, and for us. When we are willing to give up our own points of view, our own privilege, and even our own resources in the spirit of collaboration, we create more opportunities for ourselves as a community of healthcare providers that will also improve lactation outcomes overall. When we focus on collaboration not competition, not only do we make things better for families but we advocate for the value of the IBCLC as a key member of the perinatal and postpartum team.
Speakers
Annie Frisbie, IBCLC
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