IBCLC Detailed Content Outline: Pathology Focused CERPs - Section III
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Building Bridges: Early IBCLC Recognition and Triage of Common and Life-Threatening Newborn and Maternal Pathology
Topic: How Low Is Too Low? Managing Newborn Hypoglycemia - [View Abstract]
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.
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Caring for Three Generations at a Time: Clinical Perinatal Care of Individuals With Obesity
Cecilia Jevitt is the Midwifery Director and a tenured associate professor at the University of British Columbia, Faculty of Medicine. From 2013 to 2018, she directed the Yale School of Nursing’s Midwifery and Women’s Health Nurse Practitioner master’s degree programs. She has done capacity-building teaching and curriculum consultations in Switzerland, Laos, China and Ghana.
Jevitt studied midwifery at Emory University. Her 1993 doctorate in applied medical anthropology is from the University of South Florida. She established an academic division of midwifery with the University of South Florida College of Medicine while jointly appointed to the Colleges of Nursing and Public Health.
She is an elected Fellow of the American College of Nurse-Midwives and is the At Large Member of the FACNM Board. Jevitt was a Florida Nurses Association Great 100 Nurse in 2009, the 2010 Reviewer of the Year for the Journal of Midwifery & Women’s Health, the University of South Florida Department of Anthropology’s Distinguished Alumni in 2012, and a 2014 Connecticut Nightingale Excellence in Nursing Award winner.
Jevitt’s scholarship focuses on perinatal weight gain optimization and integrating obesity prevention and management into women’s health especially the perinatal and lactation periods.
Obesity affects more than 35% of women ages 20-39 in the United States. This presentation will summarize recent research that reconceptualizes obesity as adipose disease associated with smoking; socio-economic disparities in employment, education, health care access, food quality and availability; and environmental toxins, ultimately altering microbiomes and epigenetics. Obesity is an adaptation to an unhealthy environment more than poor individual eating choices. The female fetus forms her lifetime complement of ova during pregnancy; therefore, the effects of obesity may affect three generations in one pregnancy.
Individual prenatal care of women with obesity includes early testing for diabetes, counseling on epigenetic diets, advice supporting weight gain within national guidelines, and vigilance for signs of hypertensive disorders of pregnancy. Intrapartum care includes mechanical cervical ripening measures, patience with prolonged labor and uterotonic medication readiness in the event of postpartum hemorrhage. Postpartum care includes thrombus risk amelioration through early ambulation, use of compression stockings and anticoagulation. Delays in lactogenesis II can be offset by measures to support early breastfeeding. Sociopolitical actions for midwives at national, state and community levels to reduce population disparities in racism, education, employment; reduce pollution from obesogenic chemicals and improvement of food quality and distribution policies will be reviewed.
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Chasing the Butterfly: Understanding How the Thyroid Gland Impacts Breastfeeding
Alex has been a lactation consultant in the Washington, DC area since 2010. In addition to running her private practice, Bethesda-Chevy Chase Lactation Consultants, Alex cares for breastfeeding moms and babies at Hirsch Pediatrics in Rockville, MD. After earning her master's in English Literature and teaching for several years, Alex met two extraordinary people that inspired her to enter the field of lactation: her daughters. Alex has worked at Inova Fairfax Hospital and Sibley Memorial Hospital as an in-patient lactation consultant. In 2015, she graduated summa cum laude from the University of Maryland Baltimore School of Nursing with a Bachelors of Science in Nursing. Alex is committed to increasing awareness for impaired mammary organ development (IMOD) and impaired mammary organ function (IMOF).
Often overlooked and as elusive as the butterfly it resembles, the thyroid gland may lurk behind a number of breastfeeding difficulties, including low-supply, over-supply, and overt lactation failure. Recent research has revealed that thyroid disorders during pregnancy and postpartum are more common than previously thought. A substantial amount of our current professional discourse centers around tongue-tie, which occurs in anywhere from 4.2%-10.7% of babies, while thyroid disorders in lactating women may in fact be more prevalent than tongue tie, affecting anywhere from 6.7%-13.3% of women in the postpartum period. Even more alarming is that as many 50-80% of these cases may be missed by a woman’s healthcare provider. During this presentation, you will gain a basic understanding of how the thyroid gland functions and the various ways in which a dysfunctional thyroid can adversely affect lactation. You will also learn which signs and symptoms warrant a referral to a primary health care provider. We will review the latest evidence-based thyroid hormone reference values appropriate for a woman during pregnancy and postpartum so that, if your patient does undergo testing, you will feel confident discussing those results with her. Finally, we will discuss some herbal and dietary recommendations for improving thyroid function.
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Melissa Cole, MS, IBCLC, RLC is a board certified lactation consultant, neonatal oral-motor assessment professional, and clinical herbalist in private practice. Melissa has been passionate about providing comprehensive, holistic lactation support and improving the level of clinical lactation skills for health professionals. She enjoys teaching, researching and writing about wellness and lactation-related topics. Melissa holds a bachelor of science degree in maternal child health and lactation consulting and her master’s work is in therapeutic, clinical herbalism. Melissa actively conducts research and collaborates with several lactation and health care professional associations. Before pursuing her current path, Melissa’s background was in education and cultural arts, which has served her well in her work as a lactation consultant and healthcare educator. She loves living, working and playing in the beautiful Pacific Northwest with her 3 children.
Topic: Beyond Fenugreek: An Individualized Approach to Dietary and Herbal Galactagogues - [View Abstract]
Topic: Beyond the Basics of Latch: Support Strategies for Helping Babies when the Basics Aren’t Enough - [View Abstract]
Topic: Common Infant Digestive Health Concerns and Useful Support Strategies - [View Abstract]
Topic: Connection and Care: Virtual Support for Tongue-Tied Infants - [View Abstract]
Topic: Feeding is Movement: Activities for Supporting Optimal Infant Oral Function - [View Abstract]
Topic: Infant Gut Health: Common Concerns and Useful Support Strategies - [View Abstract]
Topic: Infant Oral Assessment: Exploring Anatomy and Function Beyond the Frenulum - [View Abstract]
Topic: Low Milk Production Detective Work: Assessment and Care Plan Considerations - [View Abstract]
Topic: Nature’s Nurturers: Plant Medicine for Perinatal Mental Health - [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: Thinking Critically About the Use of Clinical Lactation Tools - [View Abstract]
Topic: Will It Hurt? Frenotomy Aftercare Strategies to Optimize Healing Outcomes for the Newborn - [View Abstract]
This session will focus on common concerns regarding infant digestive health and useful support strategies that care providers can incorporate into their work with families. We will discuss what's normal and what's not in regard to stooling, spit up/reflux, colic/fussiness, food sensitivities, and more. Many parents are coping with babies that are uncomfortable and unhappy due to digestive health concerns. Dealing with a fussy, uncomfortable baby is emotionally and physically draining. Having a basic understanding of infant gut health and care strategies can be useful tools for any type of practitioner working with infants.
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Debbie Fraser is an Associate Professor, Faculty of Health Disciplines, Athabasca University and a neonatal nurse practitioner in the NICU at St Boniface Hospital in Winnipeg Manitoba. She is the editor-in-chief of Neonatal Network and is the Executive Director of the Academy of Neonatal Nursing. Debbie has published three textbooks and over 70 book chapters and peer reviewed articles on topics related to high-risk newborns.
Topic: Late Preterm Infants: Not as Grown up as they look! - [View Abstract]
Topic: Not always a safe place: Intrauterine Infections - [View Abstract]
We think of the fetus as living in an impenetrable environment, protected from the outside elements. While most bacteria are too large to cross the placental barrier or infiltrate the amniotic membranes, some bacteria, viruses and parasites are capable of reaching the fetus and causing intrauterine infections. Over the years, the list of organisms responsible for these infections has grown with the addition of pathogens such HIV and West Nile Virus. Most recently, a resurgence of congenital syphilis has been identified in newborns born to women with an active infection in pregnancy. This session will review pathogens responsible for intrauterine infection with particular attention to congenital syphilis. A review of the effects of these infections will be accompanied by a discussion of the diagnosis, management and prognosis of intrauterine infections.
Carole Hervé is a private IBCLC (since 2011). She helps breastfeeding mothers at home or location of their choice, mostly in Paris and in the nearest neighborhood.
Prior to opening her private practice, she has been a La Leche Leader since 2008. Carole is passionate about information-gathering, education, articles writing, communications and training to provide lactation consulting and sensitive support to the families she works with.
She has been trained to support families with Sensory Food Aversion issues by Catherine Senez, a speech therapist in 2013 and is also BNCLC (Biological Nurturing Certified Lactation Consultant®).
She has been a speaker at the GOLD Lactation Online Conference in 2012, and in 2013 she translated 20 presentations from the GOLD Lactation Online Conference into French.
Carole has been strongly involved in the coordination of the International Breastfeeding Day (Journée Internationale de l’Allaitement), an event organized by La Leche League France. Carole is the mother of three children born in 2001, 2003 and 2006.
Children with Sensory Food Aversions consistently refuse to eat certain foods related to the taste, texture, temperature, smell and/or appearance. Feedings or mealtimes are therefore a displeasure for everyone.
Oral disorders are eating disorders caused by hypersensitivity.
Food aversions are common and believed to occur along a spectrum of severity, with some children reluctant to try new foods, and refusing whole food groups (vegetables, fruits, meats). Indeed, after an aversive experience, some children tend to generalize and refuse foods that look and/or smell like the aversive food (e.g., aversion to broccoli may be generalized to all green foods).
Reactions to the aversive foods can range from grimacing to gagging, throwing up, or spitting out the food. Some babies cannot even accept to be touched near their face, or mouth, they may not accept to be held in a wrap. Some children can't stand to have dirty hands, to walk in the sand, to be touched.
While this can be a challenge when a mother is trying to start solid food, this hypersensitivity may also even start with breastfeeding.
Babies need proper nutrition to grow and thrive, and difficulties with feeding in infancy can be a worrisome and become a dangerous condition. There are many different reasons why a baby may struggle with feeding. All merit evaluation and treatment. This conference aims at exploring solutions to support families who deal with oral aversion.
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Creating Flow: Using Lymphatic Drainage Therapy for Breastfeeding Issues
Dr. Hazelbaker has been a therapist in private practice for over 30 years. She specializes in cross-disciplinary treatment and to that end has taken training in several modalities to best assist her clients. She is a certified Craniosacral Therapist, a Lymph Drainage Therapy practitioner, a Tummy Time™ Trainer, a Haller Method practitioner, A Pre and Perinatal Psychology Educator, a Lactation Therapist Diplomate, an International Board Certified Lactation Consultant and a fellow of the International Lactation Consultant Association.
She earned her Master’s Degree from Pacific Oaks College (Human Development specializing in Human Lactation) and her doctorate from The Union Institute and University (Psychology, specializing in Energetic and Transformational healing.)
People recognize her as an expert on infant sucking issues caused by various structural problems like torticollis, plagiocephaly, brachycephaly and tissue shock-trauma. She invented the Hazelbaker™ FingerFeeder and the Infant Breastfeeding CranioSacral Protocol™ to assist in the resolution of this type of infant sucking dysfunction.
Topic: Cranial Nerves: A Critical Component of the Process of Breastfeeding - [View Abstract]
Topic: Creating Flow: Using Lymphatic Drainage Therapy for Breastfeeding Issues - [View Abstract]
Topic: Finger Feeding: What Do We Know? What Should We Know? - [View Abstract]
Topic: Gamechangers: New studies that will change the way we think about tongue-tie - [View Abstract]
Topic: Infant Trauma: Impact on Breastfeeding - [View Abstract]
Topic: The Faux Tie: When is a "Tongue-tie" NOT a Tongue-tie? - [View Abstract]
Topic: The Impact of Bodywork on Infant Breastfeeding - [View Abstract]
Topic: What Does Torticollis Have to do with Breastfeeding? - [View Abstract]
Surprisingly, lymphatic congestion forms the foundation of some lactation problems like chronic plugged ducts and un-resolving nipple and breast pain. In this cutting-edge presentation, Dr. Hazelbaker covers the anatomy and physiology of the lymphatic system (especially as it pertains to the breast) and discusses the most common presentations and causes of lymphatic breast congestion. She demonstrates the Lymphatic Drainage Therapy technique in videos of three cases. Dr. Hazelbaker leaves the audience with a brief breast self-care regimen that can enhance the breast health of every participant when used consistently.
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Current Trends in Identifying and Managing Neonatal Diabetes Mellitus
Tiffany Gwartney, DNP, APRN, NNP-BC, is an Assistant Professor at the University of South Florida (USF), College of Nursing. In addition to her neonatal clinical practice at Nemours Children’s Hospital in Orlando, Dr. Gwartney has been an Assistant Professor at USF since May 2015, where she has written and deployed experiential learning modules for the evidence-based practice course for undergraduates, integrated delegation simulations for undergraduate leadership students, and taught sim labs for the women, children & families course. Her most recent work was the implementation of a simulation regarding nursing interaction with a maternity couplet who was under airborne precautions, while in full personal protective equipment. This simulation was integrated into her COVID Care Education Module in which undergraduate students in their final practicum participated in a pilot program at designated clinical partner sites, providing bedside care for patients with COVID-19 disease. Her research interests include education, neonatal diabetes, role transition for novice Neonatal Nurse Practitioners (NNP), simulation, management of high-risk newborns in the delivery room, and couplet care for mothers with COVID-19. Dr. Gwartney has had several opportunities to speak internationally regarding the benefits of deliberate routine practice of high acuity, low-volume technical skills, and nationally regarding neonatal diabetes and conflict management. She is a member of Sigma Theta Tau (Iota Chapter) and is actively involved in several neonatal professional organizations: Florida Association of Neonatal Nurse Practitioners, Council of International Neonatal Nurses [education committee member], National Association of Neonatal Nurses [member], and The American Academy of Pediatrics [member, conference planning committee]. Dr. Gwartney enjoys traveling for pleasure but has also found herself working triage in a children’s clinic located in the remote village of Zapote, Guatemala, as well as educating NICU nurses in Paisley, Scotland and Shanghai, China.
Neonatal Diabetes Mellitus (NDM) is defined as persistent hyperglycemia (>200 mg/dL) that requires insulin treatment and occurs before six months of age (Habeb et al., 2020). While the incidence of neonatal diabetes is merely 1 in 90,000 to 160,000 live births, the rarity of this disease can make diagnosis challenging and potentially result in delayed treatment (Letourneau et al., 2017). Uniquely set apart from type I diabetes by its strictly genetic etiology, NDM can be associated with developmental delay and epilepsy (DEND). Insulin is a growth factor that is critical for optimal growth. Insulin dependence can be permanent or transient. Management of NDM includes insulin followed by stabilization using oral sulfonylureas (Hattersley et al., 2018). Positive outcomes are contingent upon early diagnosis, euglycemia, early interventions including multidisciplinary involvement, rehab services and parental support with regard to hypo/hyperglycemia management and insulin administration. The purpose of this presentation shall be to describe the etiology, pathophysiology and clinical presentation of NDM, discuss clinical management strategies, and recognize the importance of a multi-faceted, inter-disciplinary approach to caring for an infant with NDM.
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Christine Bishop is a neonatologist, bioethicist, medical educator, and Assistant Professor of Pediatrics at Wake Forest University School of Medicine and Brenner Children’s Hospital in Winston-Salem, NC. She founded and directs the Brenner Children’s Hospital Care Always ™ Neonatal/Perinatal Palliative Care Program that provides holistic care for infants with life-limiting and complex medical conditions. Dr. Bishop received her MD from The Ohio State University School of Medicine and Public Health and completed her pediatric residency and neonatology fellowship at the University of Texas Health Sciences Center San Antonio. She completed a Master of Arts in bioethics at the Wake Forest University Center for Bioethics, served as the lead clinical ethics consultant for Wake Forest Baptist Medical Center, chairs the Clinical Ethics Consultation Committee, and co-directs the undergraduate medical humanities course at Wake Forest University School of Medicine.
Palliative care is a dynamic, multidisciplinary field of medicine that focuses on holistic care for patients with complex, serious, and life-limiting conditions. Neonatal/perinatal palliative care involves care for women pregnant with fetuses who have potentially life-limiting conditions, a holistic approach to family care and decision making, and care for infants with life-limiting or complex medical conditions. This session will discuss key aspects of neonatal/perinatal palliative care. We learn so much from our patients and families, and their stories will provide the framework as we work through important concepts in neonatal/ perinatal palliative care. Topics to be discussed include communication, shared decision making, managing uncertainty, pharmacologic and non-pharmacologic approaches to care, the role of hospice, and ethical issues involved in care of neonates at the end of life.
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Ruth Patterson is Cloud Nine's P I O N E E R & Most Sought Lactation Specialist with 33 years of rich experience - currently practicing at Jayanagar C9, Bangalore-India and a visiting Lactation Consultant with 9 other Cloud Nine branches locally. She also heads the 24 Pan India Cloud Nine Hospitals as the Manager Lactation.
Ruth's 30+ years of rich experience includes maternity, allied health and nursing care, both in rural and urban sector in India & Abroad. Her exclusive 18 years of experience in Lactation services, she has acquired immense practical knowledge in the last decade to identify most critical disorders of mother and babies during breastfeeding stage. She is acclaimed to have expertise in a lesser-known art of re-lactation and induced lactation.
Ruth is known for her ability to identify the most critical issues in Breastfeeding and restore/re-initiate feeds. She is acclaimed for the use of Dynamic Taping (only available at Jayanagar C9) that arrests/prevents breast surgery/abscess. This Dynamic Taping practice, alongside, a Gynecologist, Pediatrician and Physiotherapist at Cloud Nine, is patented.
Ruth is a well sought out person for patient hearing and provides her expert comments in News columns/Media and also delivers guest lectures.
Dr. Shazia Shadab (PT) is the HOD of the Cloud nine physiotherapist department (PAN-India). She has 10 years experience and has been exceptional in her career with constant learning of new skills and improvising in her services.
She has multiple articles published in acclaimed newspapers
and many international certifications affiliated with her name like
pelvic girdle dysfunction, labor mechanism, and has done basic advanced certification in dynamic tapping to name a few. She also has pursued her post-graduation in research methodology after her bachelor's in physiotherapy.
She has always been keen to learn how to progress in a variety of different treatment approaches to find better results. This has helped her and her team to develop an intervention to prevent breast abscess with no surgical approach and has been granted a patent on "a device to promote feeding and scar-free treatment of breast abscess treatment during lactation".
She has worked along with professionals like Dr. Kishore Kumar, Dr. Prakash Kini, and Ruth Patterson, and has treated more than 100 patients suffering from breast abscesses without any surgical intervention. This would be an exceptional resource to help and provide better care.
She has extensive expertise in not only treating but also preventing multiple
musculoskeletal conditions during pregnancy and postpartum. She has been awarded the ABCD (Above and Beyond the Call on Duty) Award for her unwavering and selfless dedication to her patients.
"Lactational breast abscess is a common problem during breastfeeding. Surgical treatment of breast abscess involves maternal child separation and discontinuation of breast feeding. Surgical intervention with its inherent anxiety and probable unwanted side effects can deprive the lactating parent and baby of innumerable benefits. Non-surgical therapeutic modalities can potentially circumvent these problems. Dynamic taping with the help of a physiotherapist is a potential non-surgical intervention. This presentation presents the results of an observational, cohort study which was conducted in 20 consenting mothers with breast abscess attending an out-patient services tertiary maternal and neonatal unit. The mothers were administered two layers of dynamic tape as a single long segment on the breast avoiding the areola in an outward radiating direction to optimize lymphatic flow. Treatment was considered successful if there was resolution of the breast abscess with or without natural oozing."
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