IBCLC Detailed Content Outline: Development and Nutrition Focused CERPs - Section I

Childbirth educators are often challenged to find ways to meet the needs of LGBTQ families in the classroom. This presentation offers an in-depth understanding of what is required to truly hold space for LGBTQ families. Concepts of sexual orientation and gender identity are explained in relation to the transformative experience of becoming a parent. A detailed outline is provided for protecting LGBTQ families against marginalization in the classroom, from advertising and communication with class participants to course materials and the physical classroom space. An exploration of gender inclusive language is included, so that childbirth educators can uniformly discuss pregnancy, birth and infant feeding in ways that are inclusive of new parents of all genders, orientations and family structures. For those who wish to teach specialized classes for LGBTQ families, additional aspects that arise in an exclusive space will be presented.

Lactation support in US prisons and jails continues to be limited in access and scope. Up to the COVID pandemic, the rate of women incarcerated in the US rose by 800% since the 1980s. Approximately 60-80% of these women are the parent of a minor, many the primary caregiver of their child/children. Every year, approximately 10% of women entering custody are pregnant. Native American, Black/African American and women of lower educational attainment and socioeconomic standing are also overrepresented in American prisons, perpetuating cycles of intergenerational trauma and health disparities.

Enabling mothers/lactating parents to breast-feed or express milk for their infants while in custody has the potential to reduce the harm associated with infant-parent separation. Mothers have expressed positive mental health impacts from the act of milk expression and knowing their milk was reaching their infants. The availability of lactation support can help mothers manage breast health throughout the postpartum period. Infants maintain connection with their parent, while receiving all the benefits human milk brings.

Milk Banks can play a unique role in their ability to support infants, parents-in-custody and caregivers through their expertise in human milk handling, transportation and storage. Our presentation will highlight the Expressions of Care program of the Northwest Mothers Milk Bank: to provide a potential model of how organizations might further expand infant access to human milk within this important and often-overlooked population.

This presentation outlines a new understanding of why early infant feeding matters, generated by recent research into the microbiome and epigenetics as well as clinical and personal experience over decades. It focuses on allergy as an bilateral legacy which compounds through generations. Emphasis is on presenting symptoms and management in the breastfeeding family, although some infant formula issues are considered.. Maternal diet in pregnancy and lactation, and the effects of allergy on families, are all discussed.

Infant feeding behavior is a complex neurodevelopment behavior. Infant feeding is compressed of infants’ latch and SuPPRT (sucking pressure pattern regulated over time) in both bottle and breastfeeding sessions. In preterm bottle feeding infants, the regulation of these two components is a measure of neurodevelopment. However, infants’ latch and SuPPRT in breastfeeding has not been explored. Dr. Lucas will review infants’ latch and SuPPRT during bottle and breastfeeding and explore how these differences make breastfeeding a more sensitive newborn neurodevelopmental measure. Finally, Dr. Lucas will propose why we should consider differences in infant latch and SuPPRT to be a neurodevelopmental infant measure.

Is it a tongue tie? What else could be going on? Having a deeper understanding of the orofacial complex and functional oral motor patterns can help take your assessment techniques to the next level. Curious about jaws, tongues, palates, oral tone, suck patterns, and more? This presentation will focus on understanding the finer details and the bigger picture when it comes to infant oral assessment.

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.

Hospitalization of a baby in a Neonatal Intensive Care Unit (NICU) has been described as a traumatic experience for both parents and baby leading to higher rates of postpartum depression and posttraumatic stress disorder in parents and to adverse developmental, cognitive and behavioral outcomes in their infants. The focus of care in the NICU has been broadening and evolving to emphasize the importance of supporting the family-infant relationship, since ultimately, the well-being of the family affects the well-being of the baby. Research documents that NICU parents both desire and benefit from psychosocial support from NICU staff, yet many staff, including neonatologists and neonatal nurses, do not feel they have adequate skills to support these needs. NICU staff need knowledge and tools beyond what typical healthcare education provides. Interdisciplinary recommendations for work toward best practice around psychosocial support of infants/parents and staff are presented.

Interoception is a term used to describe our nervous system's awareness of the sensations from the gastrointestinal and visceral system, as well as the primary sensory part/input to baby's Autonomic Nervous System. ANS function and regulation underlay all automatic processes of the body, from heart beat to breastfeeding and digestion function, as well as maintaining a calm state in order to engage in social interaction or to transition easily in and out of sleep. More simply put, interoception is "feelings from the body". In addition to visceral information, interoceptive pathways carry information related to affective touch, itch, temperature and pain and are delivered to a separate area of the brain, the insular cortex, which also contains a map of the body, similar to the well known homunculus. Interception plays a large role in dynamic equilibrium and autonomic regulation of tissues of the body. Interoceptive information and the processing is the basis of all important activity to optimize energy utilization. This system is often compromised in babies who present with complex oral dysfunction, tethered oral tissues, postural asymmetries, fussiness, gas, reflux or other dysregulation in function. How babies feel is mirrored in how they function, compromised function equals compromised interoceptive processing. This talk covers the basics of this system and practical clinical applications for precrawling babies to optimize neurodevelopment and breastfeeding abilities.

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.

This presentation will discuss the difficulties that surround defining and assessing for tongue-tie. It will explore what we know about the role of the tongue in infant feeding by reviewing evidence from ultrasound studies and other research on latch and examining what this tells us about the normal functioning of the tongue. Various available assessment tools will be described along with how these may assist in differentiating between a normal and abnormal lingual frenulum. Also discussed will be other causes of tongue restriction and how to differentiate these from an abnormal lingual frenulum.