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

Collaboration is the foundation of the work of lactation professionals. As allied health providers, the team approach is at the centre of our professional relationships. Differences in professional practice and standards of care are aggravated by health care systems that are fragmented and operate in silos, while the high emotion and urgency of infant feeding concerns interfere with reasoned collaborative decision-making. Where adequate training, workplace policies and management oversight fail, conflicts within the team may escalate to incivility, lateral violence and bullying. IBCLC must be able to name and act when conflict crosses these boundaries.
At a policy level, the problems facing breastfeeding are among the most "wicked" of public health's "wicked problems".

In perpetually resource- limited settings, the challenges of policy-making, good governance and innovative programs require effective collaboration and co-operation within and across organizations.
Limited time and energy is available for the enormous work required to provide excellent care to families and create societies that fully support them to breastfeed their children for as long as they wish to. Moreover, because of the intensity of the "wicked" problems we face and the urgency of resolving them both in individual cases and at the policy level, conflict and erosion of trust often occur. Because we cannot only work with those we would like to work with to accomplish our goals, we must learn "stretch collaboration", explored using Adam Kahane's model of working in absence of friendliness, agreement or trust.

The majority of women begin breastfeeding at birth. Within the first 6 weeks, however, breastfeeding rates fall dramatically. To help women hang in with breastfeeding beyond the first weeks, we must first understand why they struggle. Learn what the research is saying and what you can do in your practice to help women meet their breastfeeding goals. IBCLC’s who specialize in the early weeks of breastfeeding will share case examples based on over 20 years of working with breastfeeding families.

Despite 90% of women experiencing breast and nipple pain during breastfeeding, mothers rarely receive adequate knowledge and skills for breastfeeding pain self-management and cease breastfeeding. Our randomized control trial (RCT) pilot study tested the feasibility, acceptability, and efficacy of a breastfeeding self-management intervention (BSM) on breast and nipple pain and breastfeeding outcomes. Sixty women were recruited after delivery and completed survey measures of pain and breastfeeding outcomes, pain sensitivity testing and a biological sample to assess genetic risk for pain at baseline. Both groups completed pain and breastfeeding outcomes surveys via texting links using REDCap 7.4. Women in the intervention group received biweekly nurse-lead texting and cloud-based educational modules addressing breast and nipple pain and breastfeeding challenges. The BSM intervention was acceptable and sustainable for 94% of the women who continued to breastfed to 6 weeks. Acute breast and nipple pain at 1 and 2 weeks were significantly reduced and was associated with pain sensitivity polymorphisms, suggesting a genetic risk profile of pain-associated breastfeeding cessation.

Participants will be invited to holistically consider the postpartum needs of birth parents. Through an invitation to walk through the various aspects of their human journey - from the spiritual and cultural, to the emotional, the cognitive and the physical- participants will be invited to think critically and holistically about the human needs of those on their journey towards giving birth and after giving birth. Emily will use these directions to invite participants to support professionals in asking their patients and clients: what they want out of their pregnancy/postpartum journey? Who and what is within their constellation of support, and how? How do we support our parents in accessing their own agency to ask for support in the event that they experience the symptoms of postpartum mood and anxiety disorders?

Lactation professionals can provide invaluable assistance to Muslim families seeking to successfully breastfeed. However, cultural differences and a lack of understanding of Islamic culture could create barriers between professionals and the families they are trying to support. It is crucial that professionals and health care providers are aware of and acknowledge the unique role that culture and religion can play in this dynamic, both to prevent obstacles to breastfeeding and to encourage breastfeeding through culturally specific methods and arguments.

This presentation will show how to adapt your approach, language and content to ensure effective and sensitive care that will be more readily accepted by the mother and her family. It explores what the Qur’an says about breastfeeding and delves into traditional and cultural Islamic attitudes and practices surrounding breastfeeding. Moreover, it will explore the father’s role in Muslim culture and offer religious justification to encourage him to support breastfeeding, as well as issues of wet-nursing, milk sharing and adoption (as it relates to breastfeeding) within the Islamic context. As a participant, you will be encouraged to challenge your own assumptions about Islamic traditional and cultural practices and to use new knowledge gained to empower others to reflect on the benefits of being a culturally sensitive and responsive lactation professional and health care provider.

Due to the global shortage of mental health professionals, many primary care providers have become the first-line responders to a wide variety of psychiatric concerns. While lactation consultants and breastfeeding support counselors are not called upon to diagnose and treat mental health disorders, they nonetheless often become enmeshed in the topic due to the holistic nature of breastfeeding management. An understanding of the major psychiatric topics that can arise during lactation consultation is therefore a valuable asset.

In this presentation, we will describe mental health benefits and drawbacks of breastfeeding, and explore the controversy surrounding the “breast is best” campaign as it regards maternal mental health. We will also briefly explore the pharmacological and non-pharmacological options in treatment of major psychiatric disorders (e.g. generalized anxiety, major depressive disorder, bipolar mood disorder, schizophrenia) as they relate to lactation. Finally, we will review the scientific literature related to potential long-term mental health effects of breastfeeding on babies.

Perinatal professionals in hospitals have great influence over how much human milk a baby receives, as well as how encouraged parents feel related to pumping and initiating and maintaining their milk production and eventually meeting their infant feeding goals. When hospital staff help with pumping in the early hours, days, and weeks of a new and fragile baby’s life—especially when at breast, chest or body feeding isn’t possible—getting that professional support is likely to make a difference in the long-term health of that child as well as the health of their parent. Healthcare providers can facilitate milk collection and provision of it to babies and support parents with specific and updated guidance on pump choices, pump usage, flange fit and milk storage. Those who work in hospitals with families can make an important positive impact on long-term breastfeeding and human-milk feeding rates. This session will cover 12 simple ways (including the what, why, how, when and where of pumping) that healthcare providers can support parents who pump for their hospitalized baby.

Raynauds is an illusive condition that tends to be confused with other conditions, misdiagnosed, and consequently rarely treated--causing the breastfeeding dyad to suffer. This program provides a review of the symptoms, medical and lactation resources, and clinical applications that facilitate most the effective treatment/comfort for the patient.

Breastfeeding rates are exceptionally low in Lebanon. Only 40% of mothers exclusively breastfed through the first month and 2.4% continued to exclusively breastfeed between 4 and 5 months. In 2012, I developed, implemented and evaluated a pilot Breastfeeding Peer Counselor (BPC) Training Program in Beirut, Lebanon. I chose this format since BPCs are adaptable to local contexts and studies have shown that that improve rates of breastfeeding initiation, duration, and exclusivity in a variety of settings and across diverse populations.

The program successfully trained 8 BPCs and led directly to the establishment of the largest mother-to-mother peer breastfeeding online support network in the Middle East (over 11,000 members to date). This presentation will provide participants with the knowledge to develop, adapt, and implement their own BPC Training programs suited to their local context. In addition, this presentation will reflect upon ethical considerations of such programs and will offer guidance on the process of program evaluation. This will allow participants to identify their own program’s strengths and weaknesses, which can improve the effectiveness of subsequent organizations.

Nighttime breastfeeding and proximate mother-infant sleep play a crucial role in sustaining lactation but present challenges for parents in settings where solitary infant sleep is the norm, and bedsharing is viewed as controversial and inherently dangerous. While separate parent-child sleep arrangements are a relatively recent cultural invention, they have become the dominant cultural norm, which also shapes medical infant sleep guidance in the U.S. and other similar settings. Recent breastfeeding promotion efforts, however, conflict with these cultural and medical imperatives for separate sleep. As more parents breastfeed, they find themselves falling asleep next to their babies. Some may fall asleep on unsafe surfaces in their attempt to avoid bedsharing, while others regularly bedshare in secret to avoid social stigma and other repercussions. To ensure both safety and wellbeing for infants and families, an integrated approach to nighttime breastfeeding and infant sleep will be recommended that incorporates evolutionary and cross-cultural perspectives.