Lactation & Breastfeeding Online Course(s) & Continuing Education

Some mothers find it challenging to breastfeed outside the home, and this may contribute to cessation of breastfeeding earlier than planned. To date, breastfeeding women have not been included in most public space designs, such as parks, shopping centres or public buildings. I worked with experts in planning and urban design to explore design features that invite or deter breastfeeding in public. We conducted interviews and focus groups with breastfeeding mothers in three local government areas in Victoria, Australia. We received input from over 80 mothers speaking five languages, as well as health professionals and council planning staff. Many participants reported avoiding breastfeeding in public spaces due to social expectations or physical comfort. Mothers reported that best spaces for breastfeeding were dignified, safe, comfortable, accessible, compatible with their other needs and responsibilities with a high level of amenity. Using these data, we developed design guidelines that outline how a range of everyday shared spaces could become breastfeeding-friendly as well as the optimal design characteristics for dedicated breastfeeding spaces.

This presentation reviews available commercial and clinician-assembled supplementer devices and their use during breastfeeding in a problem solving context. It includes special considerations for infants with oral clefts and cardiorespiratory conditions.

It’s time to rethink how we teach breastfeeding. This session describes the science on early positioning and its implications to our current epidemic of breastfeeding problems. It includes an overview of research on hands-on versus hands-off help, the hardwiring mothers and babies bring to breastfeeding, and a simplified breastfeeding initiation strategy with checklist designed to reduce the incidence of the three most common early breastfeeding problems: nipple pain, latching struggles, and concerns about low milk production.

Despite the best efforts of the health care community, many rural women during pregnancy do not have access to obstetrical health care providers or a hospital that delivers near their home. This decreased access to services may lead to poor pregnancy and neonatal outcomes and when a woman has a high-risk pregnancy, access to care becomes a critical issue. Due to this disparity in access to care and maternal/infant outcomes, it is essential that health care providers and communities examine different ways to improve access. Connected health and telehealth technology is an innovative way to reduce access to care issues and assist women in having a healthier pregnancy, ideally improving maternal and neonatal outcomes.

The body’s ability to process sensory information provides the basis of all function. Interestingly, our most foundational sense of movement is often overlooked as a component of lactation support. In this presentation, we will tie together research in neurology, primitive reflexes, mental health, and sensory integration to demonstrate the significant impact vestibular function has on the quality of lactation and infant/caregiver relationships. Participants will enhance their observational skills and explore ways to provide support for body/breastfeeding dyads using a vestibular processing perspective. Experiential activities will offer participants the opportunity to play with movement and reflect on personal experiences to enhance self-awareness and compassionate care.

Unless access to clean water and appropriate infant formula is reliable, the World Health Organization does not recommend HIV-infected mothers stop breastfeeding. Remarkably, only about 15% of babies exclusively breastfed by their HIV-infected mothers become infected with HIV. This suggests that although breast milk is a vehicle for HIV transmission, the milk itself exhibits a strong protective effect against infection. Breastfed babies ingest 100,000 - 100,000,000 maternal cells every day via breast milk; what remains largely unclear is the contribution of these cells to the milk’s anti-viral qualities. A large study has been undertaken to isolate cells from human milk in order to measure the ability of these cells to engulf and destroy HIV by a mechanism known as phagocytosis. Over 50 samples of breast milk obtained from healthy women have been analyzed. Phagocytosis of HIV was detected in all samples. Activity did not appear to correlate with stage of lactation. Various cell types known for phagocytic capacity were identified and measured, including granulocytes, monocytes, macrophages, and dendritic cells. All samples exhibited strong granulocyte activity.These data further demonstrate that phagocytosis of HIV by immune cells from breast milk can be measured. This information will be critical for design of therapeutic vaccines capable of reducing the likelihood of mother-to-child transmission of HIV in areas where breastfeeding is essential.

Within the lactation world, it is widely accepted that optimizing infant feeding practices and normalize breastfeeding, we must frame breastfeeding as the physiological norm and not breastfeeding as the risk behaviour. For example, breastfeeding does not reduce the risk of type II diabetes, but rather not breastfeeding increases the risk of type II diabetes. Most of us have had this framing drilled into us during our training and can deftly turn around any headline to reflect the correct wording.

It is, indeed, scientifically correct that breastfeeding is the physiological norm for human: artificial feeding is no more “normal” for the human baby than using a wheelchair to be mobile. However, health communication is about more than delivering scientifically accurate facts to the target population. In motivating parents to initiate breastfeeding and then maintain exclusive breastfeeding for 6 months and alongside complementary foods for at least 2 years and beyond, the science of health behaviour is often overlooked.

In this session, we will discuss some of the major models of health behaviour change and how risk is perceived and acted up on within these models, drawing from both maternal-child health and other public health. We will review the rationale for using risk-based language as well as the evidence for different perspectives, including the use of social marketing strategies.

Skilled support for weaning from the breast is often overlooked. Most policies and programs focus on initiation of breastfeeding, the continuation of lactation and support for overcoming challenges. In practice it can be harder for families to find information, support, and guidance to wean, whatever stage of their breastfeeding journey. Often it is perceived that support for breastfeeding is all about continuing. Like breastfeeding, weaning has socio-cultural, biological, immunological, physiological and anthropological considerations, and affects the physical and mental health of both mother and child. This talk will explore the many considerations, and complex interplay between multiple factors, that the infant feeding support workforce need to understand to meet the support needs of families. We will explore: the child’s developmental readiness, emotional, immunological, and nutritional needs, and what the milk and relationship mean to them. We will also look at the impact on the mother: what we know about how the pace of weaning may impact the lactating parent’s breast health and wellbeing and how to meet the evolving needs of their baby. And finally, we look at the dyad collectively. Supporting a positive ending to breastfeeding is an essential part of the skills and knowledge of lactation professionals.

While lactation support spans the time from the prenatal period through weaning, there is less available information about the process of weaning. We know that there are a variety of reasons why families need or desire to stop lactation. We also know that there are emotions and logistics involved in ending a breastfeeding/chestfeeding relationship. Depending on the goals, timeline, and individual context of each dyad there are a variety of factors that need to be considered by the family. Unfortunately, these families often feel that the clinical information and emotional support available for weaning is lacking.

Evidence-based support presented in a compassionate manner can make a world of difference to the individual's decision-making process and overall weaning experience. For lactation supporters and professionals, being able to support families who are stopping lactation and/or ending their breastfeeding/chestfeeding relationship is a vital skill. This presentation will offer research-based information about the reasons for weaning, steps lactation supporters and professionals can take when working with families, and scripts for compassionate phrasing while offering this important information and support.

New mothers experience the milk ejection reflex, or “letdown,” in various ways. While some feel no physical symptoms, others experience a tingling sensation and some even have significant pain or sadness. Babies also have different experiences, from the overactive “drink from the firehose” to frustratingly long waiting at feeding time. This presentation explores the multitude of influences on letdown, from internal hormones and chemical signaling pathways to the research related to such external influences as diet, alcohol, stress, and the use of synthetic oxytocin.

Many moms believe that they either do not produce sufficient milk or need a quicker, more effective letdown. Suggestions to deal with these issues range from drinking beer to adding different nutritional supplements to the diet, from hypnosis to oxytocin nasal spray. We will explore the research and unravel the best practices and recommendations we can give to clients related to their concerns about the milk ejection reflex.