IBCLC Detailed Content Outline: Physiology and Endocrinology Focused CERPs - Section II

Mast Cell diseases are rare but still underdiagnosed. Even among specialists, there is a lack of consensus on terminology, diagnostic techniques and even diagnostic criteria. Clinically, mast cell diseases manifest in divergent ways. Triggers, symptoms, management and treatments differ widely from patient to patient. To date, there is no cure, just palliative management of this chronic, sometimes life-threatening condition. Because of this, there is a poor understanding of Mast Cell-related issues in the broader medical community, particularly in the realms of pregnancy, birth and lactation.
This webinar will provide participants with a general overview and understanding of the various types of Mast Cell Diseases including Mast Cell Activation Syndrome (MCAS), Mast Cell Activation Disease (MCAD) and Mastocytosis. Participants will learn how to put this knowledge into practice to provide their Mast Cell clients with specialized, empathetic, and supportive care. It will discuss how to provide patient-centered care, the importance of coordinated care and the crucial role lactation specialists play within their client’s multidisciplinary health care team. It will examine Mast Cell treatments that are compatible with lactation.
Additionally, light will shed on approaches lactation specialists can utilize to empower their clients with the tools needed to establish and maintain the breastfeeding relationship desired, including helping clients manage their parenting and breastfeeding expectations given the limitations imposed by their disease.

A certificate in midwifery acupuncture has been available in New Zealand since 2007. This short course was specifically developed for midwives and run through an acupuncture school. Midwives successfully completing this qualification receive elective education points and may incorporate acupuncture into their midwifery practice. In June 2008, a maternity acupuncture service began operating within the Hutt Valley Hospital outpatient department, offering women access to free acupuncture care for pregnancy and postpartum period. This was the first and, to date, the only clinic of this type within a New Zealand hospital. This clinic is also run through The New Zealand School of Acupuncture and Traditional Chinese Medicine, with fourth year students providing treatment under supervision. This presentation reports on how acupuncture is used by the New Zealand midwives and in this outpatient’s clinic. It will also cover the current evidence base for acupuncture in pregnancy and the postpartum period.

Advanced Breastfeeding Case Reports will cover 4 unusual situations in a format that will allow you to use your skills to discover the ultimate outcome. One part of the excitement of our field is being detectives. These 4 cases will challenge your detective skills.

For health care officials aromatherapy is becoming a tool many clients and patients are relying on, learn what can be used to support clients and patients safely. Often with any sudden popularity with a modality unsafe practices can be found and safe information needs to be available to health practitioners. Learn what essential oils and aromatherapy is and how you can explore the health benefits of this modality with your clients.

Breast cancer is the most frequent malignant tumor during reproductive age. Around 1/10000 nursing mothers are diagnosed with breast cancer every year. In this rare and difficult situation, patients and healthcare providers should be knowledgeable about the prognostic and practical implications of such an event. Chemotherapy may pass into the milk and breastfeeding is usually contraindicated during chemotherapy. Weaning should be gradual, to avoid breast inflammation and mastitis. A thorough psychological support should be given to the nursing mother to help her into the oncological trajectory.
On the other hand, the number of young breast cancer survivors is increasing and more and more patients enquire about the possibility of subsequent pregnancies and breastfeeding. The breast treated with conservative surgery and subsequent radiation is less responsive to hormonal stimulation, with reduced glandular hyperplasia and hypertrophy. Milk production is usually decreased in the previously affected breast and surgery may affect duct integrity. Nonetheless, each breast has the capability to self regulate milk production according to the baby’s suckling habits, and many evidences support the notion that one breast is enough. Specific education programs should focus on adequate baby positioning, correct latching and reinforcement of the advantages of on demand breastfeeding. Data from our group demonstrate the feasibility of breastfeeding after breast cancer, but qualified lactation counseling to support patients and caregivers is needed.

Feeding is the most complex task of infancy, even in term babies with no complications. There are many diagnoses, conditions, syndromes, and co-morbidities that can impact feeding in neonates and infants. This talk will briefly highlight many of those, but we will focus on three specific populations of interest –Cleft lip and palate, Infants of Diabetic Mothers, and Down Syndrome. We will discuss the specific implications these conditions can have on feeding, why these infants may have difficulty, and the classic symptoms one could expect to see. The differences between delayed and disordered feeding will also be addressed. Strategies and adaptions for both breast and bottle feeding will be discussed. Positioning, nipple flow rate, and external strategies will be explained. Case studies will be shared at the end of the presentation.

This session will help you understand the challenges of a multiple pregnancy and birth. Discover preparations that can help ease stress and increase success in lactation. Learn how to support families experiencing premature birth. You will understand the best way to help parents establish breastfeeding their multiples, even with late preterm/early term birth. This session will help attendees gain and understanding of how to navigate the challenges of breastfeeding multiples and how to support families effectively during the different stages of their breastfeeding journeys.

Breastfeeding is the normative way to feed babies all over the world. We have access to a large amount of scientific evidence that supports it. Advocates of breastfeeding such as health care professionals that protect, promote and support the breast/chest feeding dyad can struggle sometimes with women or babies who cannot breastfeed as the World Health Organization suggests. Mothers with low milk supply are often supported by family, friends and health care with well meaning advice and remedies to help them do their best. Women who have insufficient glandular tissue (IGT) struggle with their milk supply, despite good breastfeeding management. It is common to see families with this issue during their second or third lactation failure without really understanding what might be going wrong. These babies can have dehydration in the neonatal period, hypernatremia or even death without anybody that could help with a correct diagnosis or help with achievable goals that can benefit both mother and baby. It is of great importance to help with accurate diagnosis that can also benefit psychologically and can help parents choose to continue breastfeeding with breast/ chest supplementation.

IBCLCs, often with limited education in newborn medicine and obstetrics, care for the infant-parent dyad within the context of a complex healthcare system staffed by providers with variant training in breastfeeding medicine. This is an interaction filled with knowledge gaps and fraught with the possibility for misunderstanding and dangerously missed diagnoses. I plan to combine my training in general pediatrics and my clinical experience as a pediatric ER physician with my IBCLC training. I will teach conference participants about medical emergencies when caring for the breastfeeding newborn and the post-partum parent so that they can recognize clinical scenarios presenting to their care that require immediate medical assessment. The presentation will focus on high-yield topics in newborn medicine and postpartum obstetrics to deepen the IBCLCs recognition and ensure appropriate ongoing care for common and life-threatening complaints. It will include a discussion of neonatal jaundice, neonatal fever, severe weight loss, pyloric stenosis, congenital birth defects and genetic disorders; the lecture will also address postpartum depression, post-operative infections, and postpartum preeclampsia. Armed with this understanding of clinical red flags, IBCLCs will be empowered to better care for their breastfeeding patients, while also understanding when immediate medical assessment is imperative.

Breastfeeding parents who are navigating autoimmune disorders of inflammation such as lupus, and rheumatoid arthritis face unique challenges. This presentation will look at the lived experiences, limited research, and express challenges of these parents including the most common and debilitating symptoms for the prenatal and post partum periods, and ways these conditions can affect mammary gland development or interfere with lactogenesis stages. Also covered will be how managing the symptoms of these disorders affects the stress of recovery and breastfeeding or pumping goals, what methods of support can be offered and areas for future clinical improvement and advocacy.