IBCLC Detailed Content Outline: Clinical Skills / Education and Communication Focused CERPs - Section VII B

What good is a successful patient consult if the follow-up instructions are not thorough or are too complicated to follow? In this talk, we’ll review best practices in Care Plans, and explore innovative approaches to developing plans. The goal is to increase patient compliance and the right Care Plan can be a powerful tool towards full compliance. We will discuss pitfalls of traditional plans, dos and don'ts in writing plans, and crafting plans that are culturally sensitive and realistic. We’ll also explore using to technology to create adaptable and adjustable plans.

The age-old practice of mindfulness meditation has increased in popularity across the globe over the past four decades and gained traction within the psychological and medical fields. Mindfulness centers on non-judgmental awareness of one’s bodily sensations, thoughts, and emotions in the present moment. It has been scientifically shown to reduce stress, chronic pain, medical and psychological symptoms, and enhance immune function. Mindfulness practices often focus on psychobiological processes, which makes them well suited as in intervention during the perinatal period, and even more specifically breastfeeding. This presentation outlines the ways in which mindfulness can positively impact lactation, during its normal course and especially when there are challenges. As lactation professionals who clinically and holistically support clients, it is beneficial to be able to share mindfulness strategies that can serve as a bridge between the mental, emotional, and physiological realms. Through a greater understanding of the practical aspects of mindfulness, gentle interventions can be incorporated into each feeding session. By supporting calm and connection within the parent and between the parent and infant, the experience of breastfeeding can be enhanced.

Aims: The aims of this study were to explore the role of education and support in the development of self-efficacy in first-time mothers during the transition to motherhood.

Methodology: Using a qualitative approach, first time mothers, whose babies were less than 15 months old, were recruited from among women who had attended various models of antenatal classes They took part in a semi-structured interview on their experiences and personal constructs relating to the perceived quality of support they received were then elicited.

Findings: Becoming a mother was a process that held great meaning for all the mothers. For the women interviewed, breastfeeding was both a practice and a process which held meaning for these women. The impact of the various forms of antenatal classes in developing self-efficacy for all parental tasks is explored. The elicitation of personal constructs provides a novel format for women to evaluate the quality of the support they received – a topic which has been seldom researched.

Despite irrefutable research evidence for the benefits of breastfeeding, less than 37% of infants worldwide meet WHO targets for optimal breastfeeding. Persistently low breastfeeding rates are due in part due to poor uptake of breastfeeding best-practice guidelines, such as the Baby-Friendly Hospital Initiative. The growing field of knowledge translation in healthcare reveals that it takes from 8-30 years for research findings to be adopted into clinical practice, and that up to 45% of patients don’t receive evidence-based healthcare. This presentation aims to help those providing lactation support to better understand the complexity of factors influencing the use of evidence in practice, as well as what can be done to facilitate the uptake of best practice guidelines to protect, promote and support breastfeeding. Whether or not care providers follow evidence-based practices is influenced by the nature of the evidence (e.g., perceived relevance of the evidence), characteristics of the care providers (e.g., motivations to change practice) as well as characteristics of the care environment (e.g., leadership support for change). Successful strategies for supporting practice change are tailored to local barriers and facilitators to evidence use, and can be informed by the growing number of theoretical models and frameworks for KT in healthcare.

The feeding of breast milk during the NICU admission reduces the risk of short-and long-term morbidities especially in premature infants. Breastmilk provides immunological, anti-infective, anti-inflammatory, epigenetic, and mucosal membrane protecting properties. The mechanisms by which human milk provides its protection are varied. These mechanisms include immunological and specific unique human milk components that are not present in formula. Thus, the feeding of mother’s own breastmilk should be a NICU priority and every NICU should have a breastmilk storage and handling policy. In this presentation we will discuss how we can counsel parents about the infection control measures and guidelines related to storage, handling and administration of breastmilk to babies in the NICU. Learn more about hospital grade pumps, pumping at home vs pumping in hospital setting, prevention and management of potential mistakes such as giving a child another mother’s milk and how to handle and store fortified breastmilk.

The possibility of serving as a mentor can feel perfectly comfortable to some people, while overwhelming and frightening to others. This presentation will discuss the steps to becoming a mentor and fostering a productive mentoring relationship to grow the lactation care profession. Join one of the founders of NYC's Lactation Learning Collective for an in-depth look at the why’s and how’s of mentoring the next generation. Learn about IBLCE’s requirements and how to smooth the process and make it fulfilling for both mentees and mentors.

It is well known that breastfeeding is beneficial to both mother and baby. What happens if breastfeeding is not well established? Researchers are looking closer to postpartum mood disorders and what influence breastfeeding may have in a new mother's psychological well being.

Postpartum depression has been linked to low breastfeeding rates, as well as lower duration rates. Postpartum depression falls under the diagnosis of "major depressive disorder with peripartum onset during pregnancy or in the weeks following delivery" (Bascom & Napolitano, 2015). It has been estimated that postpartum mood disorders, strike an estimated 10-20% of new mothers (Bascom & Napolitano, 2015). However, it has been argued that this number reflects only those women who have sought help for their symptoms. The probability that more women are affected by postpartum mood disorders is high.

Postpartum mood disorders adversely affect not only the health of the mother, but also the relationship with her partner, interaction with her newborn and infant growth (Yusuff, Tang, Binns, Lee, 2015). There are several predictors that can help determine if a woman is at risk for postpartum mood disorders, including mental health history, social status, and labor and delivery. Researchers have found that when more medical interventions were used during labor, the higher the depressive symptoms for the mother. This presentation will aid personnel working with new families to be aware of the signs and syptoms of postpartum mood disorders and how to preserve the breastfeeding relationship.

The need to provide virtual support for breast/chestfeeding families may have been ignited by the pandemic, but telehealth is here to stay. The convenience and flexibility of meeting with families virtually removes barriers, such as location, childcare, and transportation. It also comes with its own set of challenges, such as difficulties reading body language, making connections with our clients, and assessing oral anatomy/milk transfer. Yet, with some intentional preparation, crafty detective skills, open-ended questions, and protocols for complicated situations, you may find that virtual consultations can truly meet the needs of your clients/patients.

This presentation will help attendees think through those important preparations to optimize virtual support.

Hospital visits from a Peer Counselor just after delivery can have a tremendous impact on breastfeeding for mom and baby. Evidence-based research shows that Peer Counselors can share an important role in the success of breastfeeding for families. Peer Counselors making an early connection and reminding families that there is someone here to help them with their breastfeeding journey, now and after mom and baby discharge from the hospital, can be very comforting for those nervous new parents. Often, a short visit from a Peer Counselor to reassure a new mother that she is right on track with breastfeeding is just what mom needs to encourage her for the learning period she is going through. Learn about the success stories of a Peer Counselor Program from the implementation of hospital visitation through years of success in hospital visits and the difference it has made in their Peer Counselor Program participation and breastfeeding numbers.

There are challenges to getting Peer Counselor hospital visits started. It may not be as easy to get your foot in the door as you would think. We will discuss some of the red tape situations you may encounter as you start trying to set up hospital visits. Adding hospital visits to your Peer Counselor activities can have a positive impact on your Peer Counselor Program and increase breastfeeding rates for your area.

We are aware that an increasing number of babies are exposed to opiates, to methadone, to cannabis and cocaine through maternal breastmilk. In this presentation, I will discuss the pharmacokinetics of the medications and how this impacts the clinical care of the babies both immediately after delivery and later on. We need mothers to be open and honest about any drugs which they have taken in order that we may care for the baby appropriately if it is exhibiting clinical symptoms. This impacts on safeguarding issues but our aim should be to help the mother consider the impact on her baby using evidence-based information and to maintain breastfeeding appropriately. What are the long- and short-term implications of exposure for mother and baby? Is there sufficient research? As always, more questions than answers.