Lactation & Breastfeeding Online Course(s) & Continuing Education

With the increase in the prevalence of obesity internationally, the world is turning its attention to effective forms of treatment. As a result, surgical techniques are increasingly being used in an attempt to ensure weight loss, reduction of comorbidities and hormonal balance in young patients of childbearing age. However, as a restrictive and disabsortive surgery, its impacts on pregnancy, childbirth and postpartum outcomes have been increasingly studied closely. Scientific studies provide substantial data on lactation after bariatric surgery, with common outcomes such as greater use of supplementation, less exclusive breastfeeding, shorter duration of breastfeeding and a higher rate of nutritional and vitamin deficiencies. Less studied, however, are its emotional effects on the lactating person, as well as the impacts on body recognition and the difficulties in dealing with the new morphological breast/chest configuration. Therefore, it is essential that the health professional who is dedicated to working in support of breastfeeding is specially trained to support families for the proper management of breastfeeding in the presence of substantially increased risks, as demonstrated after bariatric surgery.

This case describes a 32-year-old primiparous woman who experienced an anaphylactic reaction associated with breastfeeding and milk expression on postpartum day four. With each episode her symptoms worsened and she developed hives, edema and difficulty breathing and swallowing. She had to be treated for her anaphylactic reaction in a hospital ER and ICU and she was released on postpartum day five on antihistamines.

Lactation anaphylaxis is a very rare condition that was first reported in the scientific literature in 1991. Since then there have been 11 other reported cases. Lactation anaphylaxis can be life-threatening and symptoms can include a rash, hives, edema resulting in difficulty breathing or swallowing, a dangerous decrease in blood pressure and a loss of consciousness. We will review this case and do a brief review of the previous case reports. We will discuss the possible causes for lactation anaphylaxis, the related risk factors, common treatments and possible breastfeeding outcomes. In most cases with proper treatment and management breastfeeding and milk expression can continue. Enhanced awareness of and knowledge about this rare condition will allow lactation consultants and other members of the health care team to better support breastfeeding parents who experience lactation anaphylaxis.

Most families plan to breastfeed during their pregnancy and are successful for the first month but fail to continue breastfeeding once they have returned to work. Although there is substantial evidence on factors that influence exclusive breastfeeding in the early postpartum period, there is a general lack of information to help mothers and lactating people continue to breastfeed after returning to work. When there is financial pressure combined with a lack of long-term, paid leave, many lactating parents must return to work shortly after the birth of their infant. When the workplace does not provide support, maternal employment becomes one of the major barriers to continued breastfeeding. There are many factors that play a role in the discontinuation of breastfeeding after returning to work, ranging from lack of support from the employer to the physical ability to express enough milk needed to satisfy baby. During this presentation we will address the lack of information and provide solutions to increase breastfeeding rates and duration after returning to work.

One of the most challenging experiences on a parent’s lactation journey is managing return to work. When lactating workers have access to both time and space for expressing breast milk, they are more likely to meet their breast/chestfeeding goals, yet many struggle to access these simple accommodations. Participants will gain an understanding of how workplace conditions influence lactation, become familiar with key legal principles protecting lactating parents in the workplace, and, learn strategies to ethically support their clients in reducing workplace barriers to continued lactation.

Professionals working with new mothers and infants are drawn to the field by compassion. However, when a loss occurs, whether prenatally or following birth, many of us are unprepared to deal with the loss ourselves, or in assisting the family. One of the many decisions that needs to be made in this time of grief is how the mother will deal with lactogenesis II, the surge of breast milk at two to four days. This session will provide an overview of anatomy and physiology of milk production, and discuss various choices the mother can make regarding how she will deal with the milk supply that occurs. To close the session, the speaker will briefly discuss self-care for professionals to aid recovery from such a loss.

The profession of lactation consultant has grown around the world and has evolved enormously since its inception in 1985. At first, the development of the profession provided skilled breastfeeding counsellors with a role that aligned with the medical model, provided a career pathway, and provided evidence of lactation skills and experience.

Over the years, the certification has grown and now there are over 33,000 International Board Certified Lactation Consultants© (IBCLC©) in 125 countries with the exam now offered in 17 languages. Lactation consultants are now recognised at national and global levels as providers of expert lactation care, and they work within a “landscape” of varied roles and qualifications, each of which brings their own important skill set. IBCLCs play many roles, ranging from advocate to clinical expert, from policy consultant to researcher. The profession has evolved in response to sociocultural change and global issues. One major change has been the increasing importance of technology and the internet, driven partly by the fact that the consumers of breastfeeding care are the most internet involved generation in history, with a particularly rapid transition in response to the COVID-19 pandemic. Major shifts have included the recognition of structural racism, health disparities, inequities in health care and in breastfeeding support, the importance of building a more diverse workforce, recognition of the gendered nature of lactation care and the need for inclusion for people of all genders, breastfeeding as a reproductive right and as a human right of the breastfeeding dyad, and the impact of how babies are fed on many other spheres, including climate change and public health.

Breastfeeding facilitates good health in infants and mothers, and for all humans throughout life. Medical professionals should be advocates for breastfeeding, and physicians could be one of the most influential advocates. However, many medical students, residents and physicians have very limited opportunities to learn about breastfeeding and human lactation during their medical education. From another point of view, breastfeeding is a private experience as well as a scientific matter. If a physician or a partner successfully breastfeeds, she/he may become a more effective advocate for breastfeeding. So, it is imperative to provide medical students, residents, and young physicians with education about breastfeeding and to enable them to experience successful breastfeeding personally, in order for them to promote and support breastfeeding among their patients.

The Academy of Breastfeeding Medicine is an international organization of physicians who protect, promote, and support breastfeeding, and one of its goals is to develop and disseminate the standard for physician education around breastfeeding and human lactation. ABM has developed protocols and statements for health care providers to utilize for breastfeeding management.

The WHO/UNICEF revised Ten Steps to Successful Breastfeeding in 2018, includes in Step2 “Ensure that staff have sufficient knowledge, competence and skills to support breastfeeding”. This included physician education. There are many ways to educate physicians, and ABM materials could be one option.

Are you a lactation professional or health care provider looking for ways to engage your audience? Whether your audience is breastfeeding families, parents-to-be, peer counselors, volunteers, health care professionals or lactation specialists, then this presentation is for you! In it, I will show how creative solutions can overcome a lack of resources or technology to provide mothers and families with engaging and effective breastfeeding support. This session will cover innovative and interactive educational strategies and activities that can be used to capture your audience’s attention and to encourage them to retain vital information and strategies to help them breastfeed.

These concepts are practical and applicable to all types of settings, including but not limited to: breastfeeding support groups, lectures and presentations, training sessions, webinars, seminars and one-on-one lactation consultations. Moreover, they are easily modifiable to fit the needs of different populations and cultures. As many lactation professionals work in low-income communities or resource-poor settings that frequently lack many of the latest gadgets and expensive lactation aids, this presentation will offer demonstrations and tutorials of Do-It-Yourself (DIY) options that can ensure that breastfeeding mothers and families get the best support possible, even when resources are scarce.

Good doctor–patient communication is essential for positive health care outcomes. Ideal doctor–patient communication generally is reflected in a partnership communication style. However, in Southeast Asian settings, we often see a more one-way style with little input from the patient. Helpline services is breaking the ice, and is considered a new option modality for patients in Indonesia. The ease in contacting medical professionals through phone and text messages seems more comfortable, personal and inexpensive.
Breastfeeding support via a helpline helps mother to feel reassured, confident and more determined to continue breastfeeding, and in majority of occasions resolves their particular concerns.
Lactation Clinic in Puri Cinere Hospital, Depok, West Java, Indonesia was established in August 2011 and operated a helpline since the beginning of its establishment. Helpline service is open 24 hours daily, through phone, text messages, whatsapp, or blackberry messenger directly to doctors who are also breastfeeding counselors. There are six doctors who take turns every month to receive calls and reply to messages. Helpline numbers are distributed to patients during post natal rounds or at patients doctors appointments in lactation clinic.
A longitudinal study conducted in March to December 2014 shows 202 helpline cases in 9 months. There were 29 cases (14%) questioning EBM handling, 24 cases (12%) asking about complementary feeding, 19 cases (9%) of infant stool, 19 cases (9%) medication and mother's milk, 15 cases (7%) frenotomy after care and other various problems. 63% cases were successful managed via helpline, and 37% cases were referred to the Lactation Clinic to get further help.
There were many cases resolved through helpline calls and messages. High success rate of helpline management shows that helpline program is effective to help mothers and resolved their particular concerns; especially in Indonesia.

Infants with biologically based sucking problems can often breastfeed with specific lactation management and supportive techniques. This presentation provides an overview of some common medical problems that cause feeding difficulty and strategies that can help an infant with suboptimal sucking skills to feed more normally.