Infant Anatomy & Physiology Online Course(s) & Continuing Education

Cranial Nerve Dsyfunction, CND, is a term used to describe a disruption, dysregulation or dysfunction in one or more cranial nerves in the precrawling period. Cranial Nerves are twelve, paired nerves, ten of which originate in the brainstem. They mediate all incoming sensory input and also help regulate, move and maintain the health of the muscles of the face, head, neck, jaw, tongue and throat. From sensing mother’s smell, touch, taste to rooting, latching and coordinating suck/swallow/breathe patterns, optimal cranial nerve function is paramount. Lactation consultants need to be able to identify CND, identify a couple of treatment interventions and know when to refer to appropriate health care professional such as OT, PT, Speech, or Manual Therapist/Bodyworker. CND explains how many tongue/lip tied babies who have had a frenotomy continue to struggle significantly with the activities and movements of optimal breastfeeding. Michelle will cover the basics of CND, a simple classification system, and her 4 Principle Functional Movement Protocol, which she states can optimize cranial nerve function in the precrawling baby and improve breastfeeding outcomes.

Evaluating feeding and observing babies at the breast is a big part of what lactation professionals do. The privilege to observe babies at the breast in private practice at a much slower pace has provided a unique observation opportunity. Each baby and parent dyad is unique and so are the challenges that come with it. The focus of this interactive workshop is to help participants become astute observers of the infant’s movements and posture before and during feeding. It will further enhance their clinical skills by looking at the big picture of how the infant's innate behaviors ensure harmonious breastfeeding ecology. This presentation will take a deeper dive into how the infant’s use of their senses, and nine steps of the breast crawl not only lead to self-attachment but it also lays down the foundation for self-efficacy and self-regulation in babies.

IBCLCs assess chest/breast and bottle feeding skills and infant’s oral and body anatomy, and the motions that contribute to, or inhibit, the process of feeding as well as post-feeding comfort (digestion and elimination for infant, breast comfort for parent). When infants present with feeding dysfunction, the root of the issue could be from a variety of sources - effects of in utero positioning, prematurity, effects of birth interventions, tight frenulum (ties), asymmetric/tense muscles/fascia, neurological/ reflexive issues, low/high muscular tone, or suckling discoordination, suck-swallow-breathe discoordination, laryngomalacia, compensations for low supply, cleft lip/palate, and more. IBCLCs help families navigate the differential assessment of feeding dysfunction, and at the same time support the family’s feeding and milk supply choices.

This presentation will examine the role of the IBCLC when suckling dysfunction is occurring - for example aiding with latch and bottle feeding, oral/body exercises, referrals for oral evaluations and/or bodywork, or help with frenotomy pre/post work if needed. IBCLCs adjust the care plan as the infant’s feeding skills and parents’ goals grow and change. Developing the skills to aid oral function, and coordinate with specialized practitioners to aid this process, is crucial in order to determine the best course of clinical care, meet the families needs, and allow for the best possible outcome.

Knowledge of neuroanatomy, reflexes, and biomechanics as related to breastfeeding is essential to IBCLC competency. This presentation will define breastfeeding in terms of posture, movement, and reflexive function. Examples of neuromuscular dysfunction that impair breastfeeding will be provided through a series of case studies with emphasis on dissipating stress while empowering families with strategies to optimize movement essential to breastfeeding success. The presentation will build on the definition of breastfeeding as a first movement milestone strengthened through interactive tummy time at a most basic level, and through ongoing movement related assessment and treatment as necessary for complex feeding challenges. Also addressed will be some new research on pressure to breastfeed. Awareness of how IBCLC care might be perceived is important for establishing trust among families seeking it and the healthcare community referring to it.

Reflexes play an important role in role in an infant’s ability to feed effectively. This foundational presentation discusses the process of reflex emergence and integration, the importance of reflexes in breastfeeding/chestfeeding and the impact of disorganized or absent reflexes. Also covered will be the impacts of trauma on infant reflex integration and the role of the lactation consultant in assessment and referral.

Biology often explains it all. Beyond the cranial and Musculo-skeletal system, the cerebral spinal/dural system and the cranial nerves play a huge roll not only in feeding function, but in the overall physical and cognitive health of the child. These systems are reciprocal- the structural system can cause neurological impairment; and likewise, neurological impairment can lead to structural imbalance and weak muscles. Many different therapeutic disciplines acknowledge this relationship in different ways. This presentation focuses on: (1) the cranial nerves specific to breastfeeding function; (2) The dura and CSF (cerebral spinal fluid) systems; (3) clinical presentations: Failure to thrive, colic, KISS/KIDD (4) Studies and articles from various approaches of care; and (5) the consequences of Cesarean Section on CSF and neuropathology.

Inappropriate use of growth charts can cause familiar anxiety, unnecessary supplementation, early weaning, unnecessary testing and force-feeding. With half of the population below the mean, at least a 3% of the average weight of people are (and have to be) under the third percentile. Percentile lines are mathematical constructions, and do not represent the actual growth patterns of individual babies.

Identifying musculoskeletal issues that can impact breastfeeding is an important component of proper management. When surveyed, IBCLCs reported that half were not comfortable identifying musculoskeletal issues .Referrals for musculoskeletal problems were thus hypothesized to be delayed as a result of this discomfort. It was recommended that lactation professionals could benefit from more specialized training in identifying musculoskeletal issues, as early intervention for breastfeeding difficulties is a critical determinant in success.
Attendees will be able to take away the skills and tools to better identify musculoskeletal problems, the indications for co-management/referral and the safety and effectiveness of manual therapy for suboptimal breastfeeding . Issues such as TMJ dysfunction, postural asymmetry, cranial asymmetry, myofascial and joint restrictions commonly cause suboptimal breastfeeding. Current literature supports the fact that favorable outcomes are probable when these issues are treated with manual therapy. Thus the timely identification, referral, and resolution of musculoskeletal issues is one factor that can contribute to the resolution of breastfeeding difficulties.

In order to identify sucking dysfunction, it's important to first know what normal looks like. Being able to do a thorough oral assessment of an infant is a crucial skill for IBCLCs. The focus of this presentation is to discuss what to look for when performing an oral exam, as well as how to assess oral motor function as it relates to infant sucking skills. Knowing how the anatomy affects an infant's oral-motor skills is crucial to determining the cause of breast/chestfeeding problems and suggesting proper treatment.

Breast is best! We all know that; however, often parent and child struggle so much at the beginning that breastfeeding either isn’t possible or the parent becomes discouraged and gives up. When feeding challenges occur, sometimes the problem is not with the mother’s technique, but rather with the baby himself- barriers within the alignment and tone of his body causing abnormal function and preventing normal breastfeeding. There can also be tethered oral tissues present (tongue or lip ties) causing even more dysfunction. This presentation focuses on: (1) why breastfeeding is best- nutritionally and neurologically; (2) The cause of imbalance- The birth process; (3) the importance of the integrative collaboration of therapists- i.e. the LC, DDS, chiropractor and/or cranial therapist.