IBCLC Detailed Content Outline: Clinical Skills / Public Health and Advocacy Focused CERPs - Section VII E

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.

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 roles of peer counselors (PC) in breastfeeding support is important to reach mothers and families in community as they would bridge the gaps within the warm chain of breastfeeding support. However, challenges has overcome in many forms, especially their reliability in providing breastfeeding support skills and knowledge. Malaysian Breastfeeding Peer Counselors (MBfPC) program has started in 2010 to enhance breastfeeding support for Malaysian community. Its training syllabus were adapted and modulated to be culturally acceptable. More than 500 PCs were trained.

The original syllabus was continuously being revised prior to each training since Malaysia is multicultural with great diversity, with few adaptations of new tools to enhance the understanding among the trainees whom majority are not health personnel. MBfPC Association (MBfPCA) is responsible to reliability queries by other parties, thus overseen the needs for MBfPC training reform. Three training levels were introduced in 2016; entrance, advanced, and train-of-trainers; to increase reliability of certified PC, even though the sustainability of the network is yet to be observed. The mechanisms used to select, train and certify the PCs had strengthened the roles and functional relevancy of MBfPCA existence in Malaysian scenario. This presentation will share the challenges and framework of capacity building among PCs to function as breastfeeding peer supporters in Malaysian context.

Background: According to the World Health Organization, suboptimal breastfeeding contributes to 1.45 million deaths in developing countries. Haiti, the first black Republic has had various initiatives to promote breastfeeding. While 97% of Haitian-born neonates are ever breastfed (Ministry of Public Health, 2013), initiation within the first hour of birth is only slightly more than half (46.7% in 2008-2012, MIH). Exclusive breastfeeding for 6 months was 39.7% (2008-2012 data in MIH).Various initiatives have been implemented to promote breastfeeding in Haiti.

Objectives: The purpose of this presentation is to analyze and evaluate the implementation of baby tents and baby friendly hospitals in Haiti through a literature review.

Findings: The literature has a limited scope of methodical research for these initiatives. Baby tents increased exclusive breastfeeding through psychosocial support, breastfeeding counseling, and nutrition training of health professionals. Baby Friendly hospitals have increased breastfeeding initiation but have limited recertification status. The literature indicates a sustainability and supportive infrastructure which is feasible through global partnerships, culturally appropriate trainings for health professionals, and fostering peer-to-peer support.

The Relational Breastfeeding Framework is a process driven model for clinical breastfeeding supports that is consistent with the origins of the IBCLC profession. Little has been published that theorizes pragmatically about lactation support, bridging both the instrumental and relational aspects of this work. The introduction of this framework is an important contribution to theory development within the profession in that it unravels the complexity of reflective and dyad centered care, making clear the process for those who seek to practice in this way. This presentation makes the case that relational breastfeeding support is consistent with the underlying philosophy and history of the profession and should be the goal of all lactation consultants. However, equally relevant, another purpose to this presentation is to spark a generative debate about what we do and how we do it.


Despite the recommendations and various initiatives to promote breastfeeding, most women don’t reach the exclusive breastfeeding target in both developed and developing countries. Similar has been the case in the United Arab Emirates.

Therefore based on the decree by the ruler of the Emirate of Sharjah, UAE, a multi-sectorial, multi-directional breastfeeding campaign-the Sharjah Baby-Friendly Campaign- was launched in March 2012. It consisted of 4 initiatives namely Baby-Friendly Health Facility, Mother-Friendly Workplace, Breastfeeding-Friendly Nursery and Mother-Baby Friendly Public Place. Once an organization met the criteria for any of these initiatives it was awarded the designation or accreditation of that initiative.

The campaign initiatives worked through capacity building of healthcare workers, developed breastfeeding education content and resources, and conducted community outreach through social media.

The positive impact of the campaign on breastfeeding promotion, protection and support is evident by the tripled exclusive breastfeeding rate at 6 months over a 5 years period.

The International Code of Marketing of Breastmilk Substitutes (WHO Code) exists to protect health during a vulnerable period of life. In the course of practicing health care in the service of families with babies and young children, health care workers of all disciplines will encounter situations which should be guided by the WHO Code. It is in the interest of families and health for all health workers to be aware of the WHO Code and what it requires, as well as to be able to evaluate a situation where a commercial entity is interacting with the public regarding infant and young child feeding. Using a rubric of WHO Code guidance, the participant will practice evaluating real-world case studies and determining whether or not they are in compliance with the WHO Code.