Breastfeeding Complications Online Course(s) & Continuing Education

Most children, happily, encounter no significant illness during childhood. Of those who do, some will be breastfed. Exclusive breastfeeding for 6 months, as well as continued breastfeeding alongside appropriate introduction of solid foods until the age of two years and beyond is recommended by the World Health Organisation. Breastfeeding is known to confer multiple well-documented protective properties, and the risks of not being breastfed are profound, even in well-developed countries.
Although breastfeeding reduces the overall risk of many serious childhood illnesses and malignancies, it is not a panacea. Many children who are breastfed optimally will still develop a serious health condition. This small group of children, and their families are an important population, with specific needs that are under-represented in policy, literature and professional training.
This presentation will identify specific childhood cancers, their prevalence and common treatments. It will also introduce some of the challenges experienced by parents breastfeeding their child through cancer, and some practical ways to support families facing this ordeal.

Breastfeeding can sometimes be challenging for some families even when baby and mother are healthy. The immunological and nutritional benefits provided by breast milk must be considered when feeding any baby; it is by far the best start for babies that have any other disease where they can tend to suffer from multiple respiratory infections and other medical complications putting babies’ health, wellbeing and lives at risk. When there is a baby with a congenital cardiac disease we can face a lack of evidence and homogenous practices regarding breastfeeding. Many mothers feel helpless and many surgeons and cardiologists are not convinced that breastfeeding is better and easier for the infant with congenital heart disease. They are uncomfortable with not knowing the volume baby consumes and are not used to observing oxygen saturation and heart rate when the baby is feeding at the breast. Current challenges in treating patients with chronic conditions include the prioritization of breastfeeding, identification of the most effective nutritional interventions, and the prevention or recovery of acquired growth failure.

Children with congenital heart disease who breastfeed have better growth, shorter hospital stays, and higher oxygen saturations than children with congenital heart disease who receive formula. It is necessary to support these families with evidenced based information to promote and support breastfeeding to all mothers and babies. Create programs to meet the needs of these vulnerable babies and train surgical and pediatric staff of the neonatal surgery unit so they can support and facilitate multidisciplinary work.

Breastfeeding is the normative way to feed babies all over the world. We have access to a large amount of scientific evidence that supports it. Advocates of breastfeeding such as health care professionals that protect, promote and support the breast/chest feeding dyad can struggle sometimes with women or babies who cannot breastfeed as the World Health Organization suggests. Mothers with low milk supply are often supported by family, friends and health care with well meaning advice and remedies to help them do their best. Women who have insufficient glandular tissue (IGT) struggle with their milk supply, despite good breastfeeding management. It is common to see families with this issue during their second or third lactation failure without really understanding what might be going wrong. These babies can have dehydration in the neonatal period, hypernatremia or even death without anybody that could help with a correct diagnosis or help with achievable goals that can benefit both mother and baby. It is of great importance to help with accurate diagnosis that can also benefit psychologically and can help parents choose to continue breastfeeding with breast/ chest supplementation.

IBCLCs, often with limited education in newborn medicine and obstetrics, care for the infant-parent dyad within the context of a complex healthcare system staffed by providers with variant training in breastfeeding medicine. This is an interaction filled with knowledge gaps and fraught with the possibility for misunderstanding and dangerously missed diagnoses. I plan to combine my training in general pediatrics and my clinical experience as a pediatric ER physician with my IBCLC training. I will teach conference participants about medical emergencies when caring for the breastfeeding newborn and the post-partum parent so that they can recognize clinical scenarios presenting to their care that require immediate medical assessment. The presentation will focus on high-yield topics in newborn medicine and postpartum obstetrics to deepen the IBCLCs recognition and ensure appropriate ongoing care for common and life-threatening complaints. It will include a discussion of neonatal jaundice, neonatal fever, severe weight loss, pyloric stenosis, congenital birth defects and genetic disorders; the lecture will also address postpartum depression, post-operative infections, and postpartum preeclampsia. Armed with this understanding of clinical red flags, IBCLCs will be empowered to better care for their breastfeeding patients, while also understanding when immediate medical assessment is imperative.

Breastfeeding parents who are navigating autoimmune disorders of inflammation such as lupus, and rheumatoid arthritis face unique challenges. This presentation will look at the lived experiences, limited research, and express challenges of these parents including the most common and debilitating symptoms for the prenatal and post partum periods, and ways these conditions can affect mammary gland development or interfere with lactogenesis stages. Also covered will be how managing the symptoms of these disorders affects the stress of recovery and breastfeeding or pumping goals, what methods of support can be offered and areas for future clinical improvement and advocacy.

When an infant does not gain weight or loses weight there are many factors to consider. Lactation professionals, working in tandem with anxious families and health care providers can help to problem-solve to determine what the issues are and how best to address these so that infant health is promoted and the family’s plan to breastfeed is supported. This presentation will offer three clinical scenarios that Lactation professionals may encounter—the newborn who does not gain well initially, the four-week-old infant who begins losing weight after normal gain in the first weeks, and the infant who does not gain well despite interventions. For each infant, there will be discussion regarding the possible reasons for poor gain, suggested clinical interventions, and communication strategies with the family and providers.

Background: Higher intensity and longer duration of breastfeeding is associated with protection against type 2 diabetes development. While exclusive breastfeeding is optimal, women with gestational diabetes mellitus (GDM) have lower exclusive breastfeeding rates than non-diabetic women. While women with GDM have expressed that they feel that their milk “comes in” late, there is limited biochemical validation of their perception and a lack of information regarding the difference in metabolite composition of colostrum which may influence the transition to lactogenesis II. Methods: Researchers conducted a prospective case-control pilot study involving the comparison of metabolite concentrations and maternal perception of milk “coming in” between postpartum women with GDM and without GDM. Results: There were lower concentrations of lactose and citrate, metabolites that indicate transition to lactogenesis II, in colostrum samples of women with GDM compared to non-diabetic women. Furthermore, a higher proportion of women with GDM reported a perceived delay in their milk “coming in.” Conclusions: Lower levels of lactose and citrate in the colostrum samples of women with GDM compared to those without GDM indicate delayed lactogenesis II with GDM which may suggest a biological mechanism associated with lower breastfeeding rates among women with GDM. Additionally, maternal perception of delayed lactogenesis II among women with GDM appears to be validated by biomarkers. The implications for practice relate to lactation support in the early postpartum period among women with GDM.

Suck swallow breathe coordination is one of the earliest and most meaningful motor milestones of a developing infant. That level of coordination varies between breastfeeding and bottle feeding. Too frequently, if there are any challenges while feeding at the breast, bottle feeding is recommended, often without a complete assessment around the challenge itself. Infant feeding may be disorganized for one of a variety of contributing factors. It is important to be able to identify one or more of those factors, and to facilitate a solution, which may include seeking the insight and intervention of another allied health professional. Honing observation skills, incorporating diagnostic tools, and coordinating feeding assessments and protocols with specialists assist in preserving the initial breastfeeding relationship, with equity.

Feeding is the most complex task of infancy, even in term babies with no complications. There are many diagnoses, conditions, syndromes, and co-morbidities that can impact feeding in neonates and infants. This talk will briefly highlight many of those, but we will focus on three specific populations of interest –Neonatal Abstinence Syndrome, Infants of Diabetic Mothers, and Downs Syndrome. We will discuss the specific implications these conditions can have on feeding, why these infants may have difficulty, and the classic symptoms one could expect to see. The differences between delayed and disordered feeding will also be addressed. Strategies and adaptions for breast feeding will be discussed. Positioning and external strategies will be explained. Case studies will be shared at the end of the presentation.

Breastfeeding is orchestrated by the newborn’s brain, eliciting the parent’s responses via their nervous system and hormones. The newborn uses 6 cranial nerves, 22 bones, 34 articulations, and 60+ muscles - all tied together by fascia, and multiple physiological processes to accomplish a smooth suck, swallow and breathe cycle. Any abnormal function of the nervous, muscular or skeletal system can disrupt the biomechanics of breastfeeding, which the baby would circumvent with compensations. If this is detected, corrected and supported the innate breastfeeding bond can be reestablished. Detection includes looking for clues in the history (pregnancy, birth, breastfeeding), in the physical examination of the baby, oral exam, and the breastfeeding process. This presentation helps the learner to identify the structures involved, what could have caused dysfunction, the kind of dysfunction that ensues, and the breastfeeding compensations being used by the baby. These can then be effectively addressed by the IBCLC along with a collaborative care team to ensure a competent breastfeeding journey.