Lactation Conference 2013
This is a series of lectures originally presented in 2013 at our GOLD Lactation Conference. It is a resource suitable for all skill levels and is a perfect fit for IBCLCs, Lactation Consultants, Nurses, Lactation Educators, Breastfeeding Counselors, Mother to Mother (Peer to Peer) Support Workers, Midwives, Physicians, Dietitians, Doulas, Childbirth Educators and anyone else working or studying within the maternal-child health industry.
Annet Mulder first became interested in breastfeeding in the year 2000, when she became a mother for the first time. During and because of her own breastfeeding experiences, in 2002 she became a volunteer with the Dutch breastfeeding Organization and in 2008 sat for and passed the exam administered by the International Board of Lactation Consultant Examiners. As an International Board Certified Lactation Consultant, she now works with breastfeeding families at a BFHI Hospital in the Netherlands.
Objective 1: The viewer will be able to describe what ABE (Antenatal Breast Expression) Objective 2: The viewer will be able to inform her clients about antenatal breast expression Objective 3: The view will be able to inform her clients about the positive and negative effects of ABE
Expressing colostrum during pregnancy is a subject that is new for many lactation consultants and health care providers. Expectant women begin to produce colostrum in the latter stages of pregnancy; learning to express colostrum during pregnancy for use in the early post partum period is useful skill for all mothers, and can help them build and maintain their milk supply in the early days after childbirth. Use of prenatally collected colostrum in the early post partum period can assist infants with weight gain, help maintain blood sugar levels, and can be an important tool in avoiding temporary formula supplementation. During this session, Annet Mulder will discuss research on this topic, benefits of using this skill and when and how to teach the skill to mothers.
Karen Campbell, RN, has been a Public Health Nurse with the Durham Region Health Department since 2001, where her focus has been on Reproductive and Child Health. Her primary focus has been on breastfeeding. Karen was involved in an innovative infant feeding surveillance system to monitor the rates of breastfeeding within the region. This work lead to the initiation of a research study on the factors affecting adolescent mothers decisions towards breastfeeding. Karen has presented at multiple conferences and workshops about supporting younger mothers in breastfeeding as well as the socioeconomic factors that affect breastfeeding. Karen is currently working on a baby-friendly initiative within the community with a local breastfeeding coalition.
Objective 1:To share national & local adolescent breastfeeding rates Objective 2:To discern the facilitating factors and barriers to adolescent breastfeeding Objective 3:To share how research was moved into action within the community
There is increased recognition of the importance of breastfeeding at a national level as evidenced by the increased number of Canadian mothers initiating breastfeeding. However, adolescent mothers (19 years), compared to all other mothers, have lower rates of breastfeeding initiation and duration. This presentation will identify the facilitating influences and barriers to initiating, and cotinuing breastfeeding, as perceived by adolescent mothers in Canada. The presenter will share national and local statistics and share strategies for effectively translating the research into practice.
Alia Macrina Heise is a former sufferer of Dysphoric Milk Ejection Reflex and, despite initial resistance from sceptical care providers, she spearheaded the initial investigation of the phenomenon of D-MER. In this regard, she has been called “the girl who talks until somebody listens.” She lives in the Fingers Lakes region of New York State with her three children. Alia is a homeschooling mother and is an independent curriculum contributor for Peace Hill Press. As well as educating others about Dysphoric Milk Ejection Reflex, she is in private practice as an IBCLC.
Objective 1: Understand how D-MER presents differently from postpartum mood disorders Objective 2: Describe the basic mechanisms of D-MER Objective 3: Understand the use of various D-MER treatments and management techniques Realize that the investigation of D-MER is incomplete as well as see the need for further overall education and recognition of the condition
D-MER - Dysphoric Milk Ejection Reflex - is not a new phenomenon. In the past, it was almost like Voldemort, the Problem That Must Not Be Named. But now it has been named and brought into daylight, and an understanding of the details of the mechanism and a sustainable solution are newly being sought. Mothers with D-MER feel, as a reflexive response with every single milk release, a wave of negative emotions ranging (depending on severity) from homesickness to hopelessness and despair, perhaps even anger and suicidal ideation. These emotions dissipate shortly after milk release and re occur with the start of every MER, whether with breastfeeding, expressing or with spontaneous releases. Most sufferers kept the problem to themselves preferring the weaning of their baby to being incorrectly labeled as depressed or victims of abuse. Most were convinced the problem was hormonal - and it is. In this PowerPoint presentation I discuss the various manifestations of the D-MER spectrum and how we can help mothers.
Dr. Hazelbaker has 30 years of experience specializing in cross-disciplinary treatments using specialized training in several modalities to best assist her clients. She is a certified Craniosacral Therapist, a Lymph Drainage Therapy practitioner, and an International Board Certified Lactation Consultant. Earning her Master’s Degree in Human Development specializing in Human Lactation from Pacific Oaks College, Dr. Hazelbaker received her doctorate in Psychology from The Union Institute and University. Her original research on tongue-tie, in 1993, has changed clinical practice both in the USA and abroad. She authored the Assessment Tool for Lingual Frenulum Function (ATLFF) which remains the only research-based tongue-tie screening process in infants under 6 months. Recently, Dr. Hazelbaker revised her Master’s thesis on tongue-tie into a comprehensive book on the condition titled: Tongue-tie: Morphogenesis, Impact, Assessment and Treatment published by Aidan and Eva Press. More information can be found at www.aidanandevapress.com.
Topic: The Faux Tie: When is a "Tongue-tie" NOT a Tongue-tie? - [View Abstract]
Topic: The Hazelbaker Assessment Tool for Lingual Frenulum Function - [View Abstract]
Topic: The Impact of Bodywork on Infant Breastfeeding - [View Abstract]
Topic: The Impact of Infant Trauma on Breastfeeding - [View Abstract]
Topic: What Does Torticollis Have to do with Breastfeeding? - [View Abstract]
Objective 1: The viewer will be able to describe what ABE (Antenatal Breast Expression) Objective 2: The viewer will be able to inform her clients about antenatal breast expression Objective 3:The view will be able to inform her clients about the positive and negative effects of ABE
Fleur Bickford is a mother of two, an RN, IBCLC and retired LLLL. She worked in obstetrics as an RN for several years before taking time off to raise her family. During that time she gained experience in labour and delivery, post partum care and pediatrics. As a Leader for La Leche League Canada, she served as a member of both the Professional Liaison Department and the Social Media Advisory Committee. Currently, Fleur works as an IBCLC in private practice in Ottawa, Ontario as owner and operator of Nurtured Child. She is active in her local lactation community as President of Ottawa Valley Lactation Consultants. Fleur maintains a blog (nurturedchild.ca), and is very active on both Twitter (@NurturedChild) and Facebook (NurturedChild).
Topic: What do Bottles and Formula have to do with Breastfeeding? - [View Abstract]
Objective 1: List the 4 main types of infant formula and indications for their use and
Describe the correct preparation of powdered infant formula and the risks associated with incorrect preparation and describe the process and benefits of baby-led bottle feeding
Objective 2: Understand how talking to parents about bottle and formula feeding fits in with the WHO code and IBLCE's Code of Professional Conduct
Objective 3: Understand the need for caution and the importance of timing when talking to parents about the risks of formula feeding
Breastfeeding mothers may turn to formula and/or bottles for many reasons. Some are already supplementing with formula by bottle when they reach out for help, and for some moms, supplementing by alternative methods may be very overwhelming. Some moms need or choose a combination of breast milk and formula and others may decide to give occasional or regular bottles of expressed milk. Whatever the reason, as health care professionals helping a mother to breastfeed, it is our job to be able to help her to reach her own personal goals even when she needs, or chooses to use, bottles or formula. Learn about baby-led bottle feeding and why it's so important, different types of formula, their uses and how to prepare them, and how this all fits in with the WHO code and our code of professional conduct.
Dr. Frank J. Nice has practiced as a consultant, lecturer, and author on medications and breastfeeding for over 35 years. He holds a Bachelor’s Degree in Pharmacy, a Masters Degree in Pharmacy Administration, Masters and Doctorate Degrees in Public Administration, and Certification in Public Health Pharmacy. He practiced at the NIH for 30 years and currently serves as a project manager at the FDA.Dr. Nice has organized and participated in over a three dozen medical missions to the country of Haiti. He retired from the US Public Health Service after 30 years of distinguished service. Dr. Nice has published over three dozen peer-reviewed articles on the use of prescription medications, Over-the-Counter (OTC) products, and herbals during breastfeeding, in addition to articles and book chapters on the use of power, epilepsy, and work characteristics of health care professionals. He continues to provide consultations, lectures, and presentations to the breastfeeding community and to serve the poor of Haiti.
Topic: Domperidone and Breastfeeding - [View Abstract]
Topic: Herbal and Pharmaceutical Galactogogues Use During Breastfeeding - [View Abstract]
Objective 1: Describe a physiologically based breastfeeding pattern and physiologically based breastfeeding behaviours. State that they have a basic understanding of several psychological developmental models and concepts
Objective 2: Describe salient behaviours and themes in breastfeeding familes -discuss the interactions between family embers in nursing families
Objective 3: Describe the development of sensitive parenting and family interaction, and discuss the implications of family themes, behaviours associated with physiological breastfeeding
The use of a nonprescription medication does not require a doctor’s prescription. Therefore, the decision to take a nonprescription medication is almost always made by the breastfeeding mother.Of course, family and friends may influence her decision as to choice. Pharmacists, doctors, and lactation consultants must be able to provide proper advice on the use or safety of nonprescription products during breastfeeding. The presentation on Breastfeeding and Nonprescription Drugs will provide the necessary information to do so.
Dr.Jack Newman graduated from the University of Toronto medical school in 1970. He has worked as a physician in Central America, New Zealand and as a paediatrician in South Africa (in the Transkei). He founded the first hospital based breastfeeding clinic in Canada in 1984. He has been a consultant for UNICEF for the Baby Friendly Hospital Initiative, evaluating the first candidate hospitals in Gabon, the Ivory Coast and Canada.
Dr. Newman has several publications on breastfeeding: With Teresa Pitman, published in 2000 is Dr. Jack Newman's Guide to Breastfeeding, as it's known in Canada (revised editions, April 2012); also with Teresa Pitman, published in 2006, is The Latch and Other Keys to Breastfeeding Success which has now come out in French. He has also, along with Edith Kernerman, developed a DVD as a teaching tool for health professionals and mothers which is available in English and French with subtitles in Spanish, Portuguese and Italian.
Objective 1: Outline reasons why a baby who previously gained well might start to gain poorly or even if does continue to in, is fussy at the breast
Objective 2: Have an approach to preventing such a situation
Objective 3: Have an approach treating this situation without undermining the breastfeeding
Based on our clinic and email experience, late onset decreased milk supply is a common problem. Though this may manifest as slow or no weight gain after 2 or 3 months of age in a previously well gaining baby, as this problem occurs most commonly in mothers who once had an abundant milk supply, adequate weight gain may continue despite the mother’s decreased milk supply. The baby’s behaviour, often diagnosed as “reflux”, late onset colic and “overactive letdown reflex”, may include biting, late onset sore nipples, pulling and crying while on the breast, the baby’s “weaning himself” and much more. The presentation will discuss ways of preventing and dealing with this problem.
Melissa Cole, IBCLC, RLC is a board certified lactation consultant and neonatal oral-motor assessment professional in private practice. Melissa has been passionate about providing comprehensive, holistic lactation care and education to parents and healthcare professionals for over a decade. She is an adjunct professor at Birthingway College of Midwifery in Portland, OR where she teaches advanced clinical lactation skills. She is active with several lactation and health care professional associations. Melissa lives and works in the beautiful Pacific Northwest.
Topic: Infant Gut Health: Common Concerns and Useful Support Strategies - [View Abstract]
Topic: Lactation After Loss - [View Abstract]
Topic: New Thoughts on Infant Pre and Post-Frenotomy Care - [View Abstract]
Topic: Placenta Medicine as a Galactogogue: Tradition or Trend? - [View Abstract]
Topic: Will it hurt? Frenotomy aftercare strategies to optimize healing outcomes for the newborn - [View Abstract]
Objective 1: Describe the context of the grief process of perinatal, neonatal, or infant loss
Objective 2: Describe the physical process a mother experiences after loss
Objective 3: Describe care strategies for lactation concerns after perinatal, neonatal or infant loss
After losing an infant, grieving mothers may still have to cope with postpartum issues, including lactation. This presentation reviews and addresses care options for lactation concerns after pregnancy, neonatal, or infant loss. Currently, lactation care and advice after loss varies greatly. Lactation consultants are instrumental in providing mothers with anticipatory guidance and evidence-based care. Implementing system-wide training and education regarding this topic will help families receive the information they need to deal with the physiological aftermath of infant loss.
Miranda Buck, (RN(Paeds), BA(Hons), MPhil, IBCLC), has been a paediatric nurse since 1995 and has a background in neonatal and paediatric intensive care nursing. She is currently a PhD candidate at the Judith Lumley Centre and a lactation consultant at the Royal Women's Hospital in Melbourne, Australia. She also enjoys teaching into the undergraduate and postgraduate nursing programs as a visiting lecturer. Miranda is noted for her enthusiasm for evidence based care and an approach which draws on anthropological and developmental theories. Her particular research interests are breastfeeding difficulties, online peer support and breastfeeding in the neonatal intensive care unit. She lives in Melbourne with her daughters, Esme, seven and Sylvie, four.
Topic: Right from the start: Supporting effective breastfeeding in the first 24 hours of life - [View Abstract]
Objective 1: Outline the causes of nipple pain
Objective 2: Describe treatments commonly used
Objective 3: Understand the results of the CASTLE Study and implications for clinical practice regarding nipple pain.
CASTLE is a National Health and Medical Research Council funded longitudinal descriptive study of breastfeeding mothers and their babies. The CASTLE study has gathered data on nipple pain, trauma and treatment from 360 women. Nipple pain scores were collected at weeks 1, 2, 3, 4 and 8 post partum. In this presentation, Ms. Buck will disseminate the results of the study and discuss implications for lactation professionals.
Roberto Mario Silveira Issler, 54, is a Brazilian Pediatrician, graduated at Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil. He attended Residency on Pediatrics (3y) at Hospital de Clínicas de Porto Alegre. He has a Master Degree and a Ph Degree on Infant and Adolescent Health. Since 1992 he is a Professor of Pediatrics in “Faculdade de Medicina”, UFRGS, Porto Alegre, Brazil. He has been in the Breastfeeding Committee of State Pediatric Society (Rio Grande do Sul, Brazil) for many years. In 1998 he got his certification as IBCLC (re-certified to 2013). He is member of a Multidiscipline Research Group on Infant Health, focused mainly in issues related to Primary Care (breastfeeding, infant growth and development, health promotion at ambulatory level). He also works as Pediatrician in his private office.
Objective 1: Describe Brazilian BF Program, with comments about it development and the impact on BF figures
Objective 2: Describe an on going evaluation of a Ambulatory Based strategy to increase BF figures at Primary Health Care Network
The name of this project in Portuguese (Rede Amamenta Brazil), translated as “Brazil’s Breastfeeding Network”, is a word game (see project symbol and details in Portuguese at: http://portal.saude.gov.br/portal/saude/cidadao/visualizar_texto.cfm?idtxt=30133)because “Rede” in Portuguese means both “network” and “hammock”. The main goal of the strategy is to create a nationwide network, supported by the Ministry of Health, to promote, protect and support breastfeeding practices at the Primary Health level. This initiative, established in 2008, is based on education and supervision of the multidiscipline team who attend mothers & babies at Outpatients Clinics throughout the country; supported by continuing education and giving consideration to regional differences. I will talk about the development of the strategy and preliminary results of a multicenter survey designed to evaluate the impact of the project in terms of breastfeeding statistics.
Dr Virginia Thorley is a pioneer of the breastfeeding movement in Australia. She was the first breastfeeding counsellor in Queensland and in 1985 was in the first cohort in the world to certify IBCLC. In 2008 she was one of the first Fellows of the International Lactation Consultant Association (FILCA). She has two Research Higher Degrees in History (MA and PhD) and her current research interests include influences on mothers' infant-feeding decisions, wet-nursing, milk-sharing and milk banking. Dr Thorley is an Honorary Research Fellow in the School of HPRC at the University of Queensland. She is the author of several books and book chapters and most recently was co-editor, with Melissa Vickers, of The 10th Step & Beyond: Mother Support for Breastfeeding. She has presented at conferences on five continents.
Topic: Latch problems arising from mothers' fear response to anticipated pain - [View Abstract]
Topic: Mother Support for Breastfeeding: Why, What, How? - [View Abstract]
Objective 1: Understand why mothers need breastfeeding support
Objective 2: Increase understanding of a variety of forms of breastfeeding support, including in special circumstances
Objective 3: Develop an awareness of how culture and circumstances can impact the provision of the most appropriate spport for the mother to breastfeed (or to provide her milk to her infant in special circumstances)4: Identify best practice for mother support
Breastfeeding has been described as a confidence trick. Thus new mothers are vulnerable to negative comments or poor advice, especially in the many cultures where artificial feeding is commonplace and breastfeeding invisible.
Ellen Kamman was born in the Netherlands. After completing her degree in Biomedical Health Sciences in 1995, she decided to move to South Africa in 1997. She runs her own research support company, focussing on social statistics, poverty, HIV and development research. She became a La Leche League leader in 2008 to help other mothers breastfeed, and is actively involved in the field of breastfeeding in South Africa. In 2011, Ellen became an IBCLC. She currently lives in Johannesburg with her husband and three children.
Objective 1: Understand the South African context around breastfeeding
Objective 2: Understand the breastfeeding context in South Africa, especially in light of the HIV pandemic Understand policies of HIV mothers in South Africa
Mother support for breastfeeding takes many forms. The traditional support of the extended family is lacking in mobile societies or where older generations lack breastfeeding experience. When other self-help and mutual support groups emerged to provide the individual with a peer group with a common life stage or need, breastfeeding groups also began. Face-to-face groups and telephone hotlines have embraced new technologies. Special needs have led to groups for mothers of prematures or multiples. Support by volunteers may be supplemented or replaced by remunerated breastfeeding peer counsellors matched to disadvantaged groups. Some groups or programs are consumer driven, others guided by health workers.
Hannah Katsman grew up in Cincinnati, Ohio, USA, and earned a BA from Barnard College and an MA in education from Hunter College. She moved to Israel in 1990 with her husband and 6-month-old son. After a poor experience breastfeeding her oldest, and a much better one after the birth of her second son only 18 months later, she began answering breastfeeding questions from mothers in the neighborhood. In 1999 she became a La Leche League Leader, and has worked as an IBCLC in private practice since 2011. At her popular website, A Mother in Israel, she writes social commentary on breastfeeding, parenting, Judaism, and women’s issues. Her second website, Cooking Manager, is about healthy and efficient home cooking and also grew out of her work supporting young families. She lives in Petach Tikva with her husband and six children, aged 9-23, and serves as Area Coordinator of Leaders for LLL Israel.
Objective 1: Learn basics about Israel as background to discussion of breastfeeding; Know current breastfeeding rates in Israel and trends
Objective 2: Be familiar with birth and hospital policies vs. reality
Objective 3: Understand issues in public debate over formula distribution in hospitals
Best practice for mother support is where health workers and lay counselors fill complementary roles.
With an undergraduate degree from the University of Rijeka School of Medicine, Croatia, and a diploma in obstectics and gynaecology from Mercy Hospital for Women, Melbourne, Irena undertook her internship and residency at the Alfred Hospital in Melbourne, Australia. There she worked as a general practitioner, antenatal shared-care practitioner and lactation consultant, during which time she served as the GP representative on the Victorian Board of the Australian Lactation Consultants Association. Currently she teaches at the University of Split School of Medicine, where she also gained her doctoral degree, while conducting antenatal breastfeeding classes and private practice lactation consultations. Dr. Zakarija-Grković is a founding member of the Croatian National Breastfeeding Committee, a BFHI educator, co-founder and president of the Croatian Association of Lactation Consultants and a breastfeeding course provider. Serving as a past IBLCE coordinator for Croatia, she is now an active member of ILCA and ABM. She is a proud mother of 3.
Objective 1: Introduce the audience to Croatia and inform the audience of the history of bf promotion in Croatia
Objective 2: Familiarise the audience with traditions and practices in Croatia related to bf
Objective 3: Inform the audience of the types of lactation health care provided in Croatia and plans for the future
Croatia, as an up and coming member of the European Union, is striving to meet modern standards, including implementation of the Baby-Friendly Initiative and International Code for the Marketing of Breast Milk Substitutes. Find out what the challenges were and how they were overcome. Learn a bit about Croatian culture, including old breastfeeding traditions and myths. Find out how Croatia stands in regard to breastfeeding statistics and forms of lactation support. Discover what we have in common with other countries and what makes us unique. Learn about the role of ILCA, IBLCE, ABM, RODA and other NGOs in Croatia and how they spearheaded breastfeeding promotion and education. See how collaboration and team work has enabled 84% of maternity facilities in Croatia in receiving the BFHI designation. An experience not to be missed!
Nancy Mohrbacher, IBCLC, FILCA, is author of the professional books, Breastfeeding Answers Made Simple and its Pocket Guide Edition. She co-authored (with Kathleen Kendall-Tackett) the popular book for parents, Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers. She is also author of the tiny 2013 troubleshooting guide, Breastfeeding Solutions: Quick Tips for the Most Common Nursing Challenges and the Breastfeeding Solutions smartphone app. Nancy began working with breastfeeding families in 1982 and became board-certified as a lactation consultant in 1991. From 1993 to 2003 she founded and maintained a large private lactation practice in the Chicago area. In 2008 the International Lactation Consultant Association officially recognized her contributions to the field of breastfeeding by awarding her the designation FILCA, Fellow of the International Lactation Consultant Association. Nancy was one of the first group of 16 to be recognized for their lifetime achievements in breastfeeding.
Topic: Pumping for the NICU Baby: An Evidence-Based Update - [View Abstract]
Topic: Using Gravity-Assisted Positions to Prevent Early Breastfeeding Problems - [View Abstract]
Topic: What Mothers Need to Exclusively Breastfeed - [View Abstract]
Objective 1: Summarize the research on milk ejection during pumping and how to incorporate it into our recommendations.
Objective 2: Identify when a larger or smaller diameter nipple tunnel could improve pumping results.
Objective 3: Recommend individualized pumping plans for women based on differences in breast storage capacities.
This talk provides a summary of the latest research on how mothers who are pumping for babies in the NICU can establish healthy milk production and maintain it long term. It includes strategies for estimating a mother’s breast storage capacity and using this information to individualize her pumping plan.
Jodine Chase owns a public relations firm specializing in news analysis. She is a longtime breastfeeding advocate with five children and three grandchildren. She curates Human Milk News. She provides communications and social media strategy support to the Alberta Breastfeeding Committee as a volunteer member of the board. She is a founder of the Breastfeeding Action Committee for Edmonton (BACE), Human Milk for Human Babies, and is a supporter of the Calgary Mothers’ Milk Bank. She works to raise the profile of breastfeeding discrimination issues in Canada and around the world.
Topic: Breastfeeding Harrassment: When Moms Face Humilitation, Discrimination and Even Arrest - [View Abstract]
Objective 1: Understand what constitutes breastfeedng harassment
Objective 2: Identify when clients/patients are being or have been subject to breastfeeding harassment
Objective 3: Assist clients and patients in working through harassment issues
Mothers are told that breastfeeding is ‘best’ and that their milk is magic and the gold standard in nutrition; they are encouraged to feed their baby on demand, be attached and attentive to their babies, and breastfeed “anytime, anywhere,” yet they are hit with dirty looks, rude comments, or demands to cover, move, or stop what they are doing. These mothers have been told they are doing something disgusting, they’ve been harassed for ‘being inappropriate’, yelled at for ‘exposing’ themselves and been accosted by staff and onlookers. Some have even faced arrest, simply for meeting the needs of their breastfeeding child. Why does this happen? Where does it happen? Who does it happen to? And what happens after the harassment? Further, what can health care professionals do to help mothers who have faced or are facing discrimination due to breastfeeding?
Katherine Carroll (PhD) is a post-doctoral research fellow and medical sociologist at the Centre for Health Communication at the University of Technology Sydney, Australia. Her current research investigates the rise in popularity of donor human milk for feeding preterm infants in the neonatal intensive care unit. Her research grant is titled, “Liquid Gold: Establishing the Place of Donor Human Milk in the Tissue Economy”, and is funded by the Australian Research Council. Her research field sites for this project include hospitals and milk banks in the United States of America, Norway, and Australia. Dr. Carroll second research project titled, “Milk Donation After Neonatal Death’ explores how bereaved mothers may obtain benefit from donating breast milk after a neonatal loss. This research will be used to develop national policy on milk donation after bereavement. Dr. Carroll’s employs qualitative research methodologies in order to explain the cultural and organizational complexities of delivering health care in high-acuity and ethically charged settings.
Objective 1: Understand the cost-effectiveness of using donor milk in the NICU
Objective 2: Know the cost of using donor milk to achieve exclusive human milk feedings for very preterm infants in the NICU
Objective 3: Understand how the cost of donor milk feedings are moderated by mother’s own milk production
An exclusively human milk diet is the gold standard for very premature infants admitted to the NICU. In order to achieve this, it is not uncommon for infants to require donor milk (DM) to supplement or wholly replace mothers own milk (MOM) in situations where MOM is unavailable. This presentation draws on data obtained from an American NICU and human milk bank. It details the cost of DM to achieve an exclusive human milk diet through adopting DM when MOM is unavailable. It is unique in that it accounts for the variation in DM required for infants as a result of variations in MOM supply. This presentation is suitable for all clinicians, managers, administrators and policy makers who are interested in costing donor milk programs for the preterm infant in NICU.
Jill Demirci is a Post-Doctoral Fellow at the University of Pittsburgh School of Medicine, Department of General Academic Pediatrics. She worked clinically as a staff nurse on a mother-baby unit for seven years, and obtained IBCLC certification in 2010. Dr. Demirci received her PhD in 2012 at the University of Pittsburgh School of Nursing. Her dissertation was a qualitative grounded theory study examining breastfeeding establishment and maternal role acquisition in mothers of late preterm infants. Her clinical and research interests involve breastfeeding issues in premature and vulnerable populations, low breast milk supply management and “diagnosis,” and perceptual and communicative barriers to breastfeeding continuation and exclusivity. She is currently conducting a pilot study comparing the effect of meditation versus an herbal supplement on the perception of insufficient milk supply.
Objective 1: Explain 3 contributing factors to poor breastfeeding outcomes in the
late preterm population.
Objective 2: Describe 2 expert recommendations for supporting breastfeeding in LPI dyads.
Objective 3: List two practical measures one can employ to help prevent or treat insufficient breast milk supply in LPI dyads.
Late preterm infants (LPIs), born between 34-36 6/7 weeks gestation, are at high risk for breastfeeding-associated morbidity and early breastfeeding cessation. This risk stems from multiple, interrelated factors, including: maternal comorbidities, corollaries of preterm labor, infant physiological immaturities, poor anticipatory breastfeeding guidance and follow-up, and maternal anxiety. This presentation will describe practical considerations, maternal input from serial interviews, and current evidence-based recommendations for supporting breastfeeding establishment in LPI dyads. Particular focus will be given to prevention of insufficient or low milk supply and provision of psychological support to mothers of LPIs.
Pamela has been speaking and writing on behalf of breastfeeding in the context of HIV since 1995. Having certified in 1990 as the first IBCLC in Zimbabwe, a country with extremely high HIV-prevalence, she worked in private practice and served as a member of the Zimbabwe National Multi-sectoral Breastfeeding Committee, as a BFHI trainer and assessor, and assisted with development of national Code legislation and HIV and breastfeeding policy. She emigrated to Australia in 2003 and subsequently to England in 2005. She served as Co-Coordinator of the WABA Task Forces on Human Rights from 2001 to 2002 and on Breastfeeding and HIV from 2005 to 2009. She recently completed writing the WABA 2012 publication, International Policy on HIV and Breastfeeding: a Comprehensive Resource
Objective 1: Discuss the History of WHO’s Recommendations about Breastfeeding
Objective 2: Define current WHO Stance towards Breastfeeding
Objective 3: Provide guidelines Lactation Consultants can follow regarding how to provide consultations with HIV mothers.
- Before the discovery that HIV could be transmitted through mothers’ milk, breastfeeding’s role in protecting against death and disease had enjoyed an era of unprecedented global promotion. But from 1985 onwards, the possibility of transmission of a lethal virus through mothers’ milk led to profound changes in infant feeding advice. Banned outright in Europe and America, replaced by formula-feeding only to be later re-endorsed in resource-poor settings, and now enjoying a relaxation of previous prohibitions in industrialized countries, breastfeeding in the context of HIV has come full circle. Is it any wonder that health-workers are confused? This session tracks which research influenced HIV and infant feeding policy, and when. It describes a journey spanning promotion of maternal infant feeding choice in the face of an uncertain outcome to a clear recommendation based on up-to-date evidence about child-survival. Twenty-five years later breastfeeding enjoys a renewed endorsement regardless of a mother’s HIV-status.
Please note this is NOT a live presentation and is a bonus recording from GOLD Lactation Online Conference 2013. You may have already viewed this presentation, but an additional educational hour can be claimed.
This program has been approved for 12 CERPs . If you have already participated in this program, you are not eligible to receive credits for this program a second time. Please sent us an email to firstname.lastname@example.org if you have any questions.
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