IBCLC Detailed Content Outline: Pathology Focused CERPs - Section III
Access CERPs on Pathology for the IBCLC Detailed Content Outline recertification requirements. Enjoy convenient on-demand viewing of the latest Pathology focused IBCLC CERPs at your own pace.

Maternal & Infant Assessment for Breastfeeding: Essential Concepts for Midwives

Barbara Wilson-Clay became a La Leche League Leader in 1982. She certified as an IBCLC and entered private practice in Austin, Texas in 1987. Barbara was named a Fellow of the International Lactation Consultant Association in 2008. She recently retired from her practice, which specialized in difficult breastfeeding situations. With a client load of 400-450 visits yearly, Barbara garnered a wealth of clinical and counseling experience and a trove of clinical teaching photos. In partnership with Kay Hoover, she created The Breastfeeding Atlas, which was translated into Chinese in 2019 by Fudan University Press. A Korean translation will be published in September 2020.
Barbara has been a citizen advocate for breastfeeding in the Texas legislature and helped pass a landmark law protecting breastfeeding rights. She is one of the co-founders of the non-profit Mothers Milk Bank at Austin, and retired as Vice President of the Board of Directors in 2010. She continues to serve on the Advisory Board. Barbara's research and commentaries have appeared in the Journal of Human Lactation, Archives of Disease in Childhood, the International Breastfeeding Journal, and others. She has served on various editorial review boards and contributed chapters to several lactation textbooks.
Topic: Looking Both Ways: Taking Wisdom from the Past Into the Future - [View Abstract]
Topic: Looking Closely at The Baby - [View Abstract]
Topic: Maternal & Infant Assessment for Breastfeeding: Essential Concepts for Midwives - [View Abstract]
Infants born at term following an uneventful birth generally require no breastfeeding interventions aside from a supportive environment. However, even in populations of women who are well-motivated to breastfeed, fully one third of infants demonstrate sub-optimal breastfeeding behavior in the first week postpartum. Risk factors have been identified that predict which mother-infant pairs may require extra assistance to protect the option to fully breastfeed once conditions stabilize. Careful assessment of the dyad helps identify who will need the most help. Such assessment is necessary to protect the infant from excessive weight loss and, because the calibration of milk supply is a time-sensitive event, serves to protect the potential for a full milk supply. Midwives must be familiar with new research that recommends that, in the presence of risk factors, milk expression should begin in the first hour after birth, with expressed colostrum being delivered to the infant by spoon or cup.

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Neonatal Cardiac Defects: Immediate and Long-Term Management

Angela Gooden, a Pediatric Nurse Practitioner with dual certification and expertise in pediatric cardiology, is the Director of Advanced Practice Providers at Texas Children's Hospital. Ms. Gooden has a special interest in reducing morbidity and mortality for infants born with complex congenital heart defects who require staged palliative surgical interventions. Additionally, in her leadership role, Ms. Gooden is focused on promoting the advanced practice role through advocacy, organizational engagement, professional development, and mentorship. She currently serves as a legislative ambassador for the Texas Nurse Practitioners organization.
In neonates, a comprehensive approach to the management of known or suspected cardiac defects is critical to ensuring diagnostic accuracy and the best possible outcome. Essential elements of this process include early recognition, initial resuscitation and stabilization, systematic evaluation, and immediate and long-term management strategies.

Neuromusculoskeletal Disorders in the Breastfed Baby: Causes, Assessment, & Treatment

Dr. Valérie Lavigne graduated from the Canadian Memorial Chiropractic College in 1998. In July 2005, she became an IBCLC, the first chiropractor in Quebec with the title. She has her fellowship in pediatrics from the International Chiropractic Pediatric Association and has graduated in November 2014 with a Master of Science in Pediatric Musculoskeletal Health from the Anglo-European Chiropractic College. She is working in private practice in her chiropractic clinic in Kirkland, Quebec.
How comfortable are you at identifying neuromusculoskeletal issues in babies. This lecture will explore the triad aspect of breastfeeding – neurological, muscular and skeletal. A review of the causes, main conditions combined with tips to help you recognize neuromusculoskeletal issues will provide you with a more astute eye during your evaluation. Treatment options will be reviewed in addition to a review of the chiropractic and lactation literature. This lecture should create awareness amongst health professionals about the importance of treating neuromusculoskeletal issues in baby to optimize breastfeeding!

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Melissa Cole is a board-certified lactation consultant, neonatal oral-motor assessment professional and clinical herbalist in private practice. Melissa is passionate about providing comprehensive, holistic lactation support and improving the level of clinical lactation skills for health professional. She enjoys teaching, researching and writing about wellness and lactation-related topics. Her bachelor’s degree is in maternal/child health and lactation and her master’s degree is in therapeutic herbalism. Before pursuing her current path, Melissa’s background was in education and cultural arts, which has served her well in her work as a lactation consultant and healthcare educator. She loves living, working and playing in the beautiful Pacific Northwest with her 3 children.
Topic: Beyond Fenugreek: An Individualized Approach to Dietary and Herbal Galactagogues - [View Abstract]
Topic: Beyond the Basics of Latch: Support Strategies for Helping Babies when the Basics Aren’t Enough - [View Abstract]
Topic: Common Infant Digestive Health Concerns and Useful Support Strategies - [View Abstract]
Topic: Connection and Care: Virtual Support for Tongue-Tied Infants - [View Abstract]
Topic: Infant Oral Assessment: Exploring Anatomy and Function Beyond the Frenulum - [View Abstract]
Topic: Low Milk Production Detective Work: Assessment and Care Plan Considerations - [View Abstract]
Topic: New Thoughts on Infant Pre and Post-Frenotomy Care - [View Abstract]
Topic: Thinking Critically About the Use of Clinical Lactation Tools - [View Abstract]
Topic: Will it hurt? Frenotomy aftercare strategies to optimize healing outcomes for the newborn - [View Abstract]
A hotly debated topic among tongue tie professionals is pre and post-frenotomy care. Infants may have varying degrees of suck dysfunction and lip/ tongue mobility issues before and even after release. In addition, wound care of the incision sites, structural support, emotional support for the dyad and optimal feeding care plan formation is vital. Melissa Cole, IBCLC, RLC will present some pre and post-frenotomy case studies and care basics from her own clinical practice that have proven to improve frenotomy healing outcomes. Parents are often exhausted from the physical and emotional roller coaster that feeding a tongue/lip tied infant presents and sensitive care for the whole family is needed. Melissa also recognizes that pre and post-frenotomy care ‘best practice’ is still in its infancy and she proposes a call to research this subject matter further

Organization of tongue movements before and after frenotomy for posterior tongue-tie: an Ultrasound analysis

Catherine Watson Genna BS, IBCLC is an International Board Certified Lactation Consultant in private practice in New York City. Certified in 1992, Catherine is particularly interested in helping moms and babies breastfeed when they have medical challenges and is an active clinical mentor. She speaks to healthcare professionals around the world on assisting breastfeeding babies with anatomical, genetic or neurological problems. Her presentations and her writing are enriched by her clinical photographs and videos. Catherine collaborates with Columbia University and Tel Aviv University Departments of Biomedical Engineering on research projects investigating the biomechanics of the lactating nipple and various aspects of sucking and swallowing in breastfeeding infants. She is the author of Selecting and Using Breastfeeding Tools: Improving Care and Outcomes (Praeclarus Press 2009) and Supporting Sucking Skills in Breastfeeding Infants (Jones and Bartlett Learning 2008, 2013, 2017) as well as professional journal articles and chapters in the Core Curriculum for Lactation Consultant Practice and Breastfeeding and Human Lactation. Catherine served as Associate Editor of the United States Lactation Consultant Association’s official journal Clinical Lactation for its first seven years.
Topic: Critical Assessment of Apparent Tongue-Tie - [View Abstract]
Topic: Introduction to Cervical Auscultation - [View Abstract]
Topic: Lactation Support for Infant Biomedical Challenges - [View Abstract]
Topic: Organization of tongue movements before and after frenotomy for posterior tongue-tie: an Ultrasound analysis - [View Abstract]
Topic: Positioning and Latch for Breastfeeding - [View Abstract]
Topic: Positioning and Latch for Breastfeeding - [View Abstract]
Topic: Ultrasound Analysis of Sucking: Tongue-Tie and Confounders - [View Abstract]
Topic: Using Breastfeeding Supplementers - [View Abstract]
Recent biomechanical analysis of tongue movements during breastfeeding has illuminated how healthy infants use their tongues to produce subatmospheric (negative) pressures and move milk in the mouth for swallowing. This talk reviews normal tongue kinematics during breastfeeding and extends this objective analysis to tongue-tied infants before and after frenotomy and briefly discusses the clinical implications of the changes seen in infants with ankyloglossia.
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Physiologic Biomarkers to Detect Subclinical Acute Kidney Injury in Premature Infants

Dr. Marin is currently an Assistant Professor at Augusta University, and is an active researcher in the Level IV NICU at Children’s Hospital of Georgia. She received her BSN from the University of Tennessee, her MSN from Stony Brook and her PhD from Emory University. Dr. Marin’s program of research is focused on defining non-invasive methods to predict early-onset acute kidney injury in preterm infants, including analysis of metabolomics, proteomics, the gut-kidney microbiome axis, and renal hypoxia measured by near-infrared spectroscopy as they relate to subclinical and actual acute kidney disease.
Acute kidney Injury (AKI) prior to the completion of nephrogenesis at 34 weeks’ gestation has significant life-long effects. The immature kidney only receives 3-4% of total cardiac output, compared to 20% in term infants, children and adults. Therefore, minimal decreases in oxygen delivery may substantially compromise proper oxygen utilization increasing the risk for morphologic changes and reduced nephron endowment. Current diagnostic criteria (serum creatinine (sCr) elevations with oliguria) cannot detect early-onset AKI, as up to 50% of nephron damage has already occurred by the time these abnormalities become apparent. This presentation will look at new research related to the current diagnostic criteria for AKI in the preterm infant, the physiologic mechanisms involved in AKI and short and long-term implications.


Diana West is an IBCLC in private practice. She is the co-author of “Sweet Sleep: Naptime and Nighttime Strategies for the Breastfeeding Family,” the 8th edition of La Leche League International’s “The Womanly Art of Breastfeeding,” “The Breastfeeding Mother’s Guide to Making More Milk,” the clinical monograph “Breastfeeding After Breast and Nipple Procedures,” and ILCA’s popular “Clinician’s Breastfeeding Triage Tool.” She is the author of the “Defining Your Own Success: Breastfeeding After Breast Reduction Surgery.” She is on the Editorial Review Board for the “Journal of Clinical Lactation,” a La Leche League Leader and the Director of Media Relations for La Leche League International. She has a bachelor’s degree in psychology and is the administrator of the popular BFAR.org, LowMilkSupply.org, and LactSpeak.com websites. She lives with her three sons and one husband in the picturesque mountains of western New Jersey in the United States.
Topic: Mothers Speak Out: Top Five Traits of a Great Lactation Consultant - [View Abstract]
Topic: Postpartum Nipple Pain: Causes, Treatments, and Empathy - [View Abstract]
Topic: Sweet Sleep: Bedsharing for Breastfeeding Mothers and Babies - [View Abstract]
In a vivid (and sometimes graphic!) presentation of photos contributed by lactation colleagues around the world, a wide variety of nipple pain causes, treatments, and counseling strategies are explored and discussed.

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Lisa Marasco has been working with breastfeeding mothers for 35 years and has been Internationally Board Certified since 1993. She holds a Master’s degree in Human Development with specialization in Lactation Consulting and was designated a Fellow of ILCA in 2009.
Lisa is co-author of Making More Milk: The Breastfeeding Guide to Increasing Your Milk Production, a contributing author to the Core Curriculum for Interdisciplinary Lactation Care, and a Cochrane Collaborative author. She is employed by WIC of Santa Barbara County while she continues to research, write and speak. In addition, Lisa is affiliated with La Leche League of So. Calif/Nevada, and serves on the Breastfeeding Coalition of Santa Barbara County.
Topic: The Mysterious Milk Ejection Reflex - [View Abstract]
Breastfeeding is normally a robust process, but sometimes mothers and babies end up in a gray area where your gut isn’t sure that everything is going to be okay. When low milk production concerns present, where do you start? Is it real or perceived? Delayed, secondary or primary? Which came first, the chicken or the egg? This session walks through the assessment process to determine whether a problem exists and what the cause of a low milk supply might be.

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Dr Philip Hand practices in Melbourne, Australia . His certifications include: BDS (Otago N.Z.), FICCDE LA&HA Master in Laser Dentistry (Slovenia), MSc Laser Dentistry (UCSC – Rome). He is the Secretary of the International Academy of Innovative Dentistry (IAID) and Assistant Professor UCSC-Rome. Dr. Hand is interested and practices in all fields of general dentistry. These include Implant Dentistry, Endodontics, Periodontics and Orthodontics (POS Graduate). He is a devoted proponent of the use of the dental microscope and dental lasers. He is passionate about tackling the issues and treatment for infant feeding both breast and bottle, airway health and growth and sleep from a dental perspective. He works collaboratively with lactation consultants, maternal health nurses, paediatricians, paediatric osteopaths and chiropractors in the treatment of infants in this pursuit and is actively involved in teaching the importance of this treatment for our patients from infants to adults.
This presentation will look at new research into lingual frenulum restriction and its surgical release to achieve improvement in problems with reflux, breastfeeding and pain for the breastfeeding mother. I will also expand this into restrictive tethered oral tissues (lip-tie, buccal-tie) as a whole, as this was part of my published study into the laser surgical release of restrictive tethered oral tissues on breastfeeding and Gastroesophageal Reflux Disease (GERD). Learn more about the impact of surgical release (frenotomy) of tongue- tie, lip-tie, buccal-tie on both reflux and breastfeeding outcomes for the classically recognised anterior tongue-tie and the less obvious (without functional assessment) posterior tongue-tie. Posterior tongue-tie was noted in 71% of the study cohort.


Dr. Narvey began his training in Pediatrics at the University of Manitoba in Winnipeg where he completed a year of further training in Neonatology. This was followed by two years of Neonatal fellowship at the University of Alberta in Edmonton. Afterwards he began his career as a Neonatologist in the same city and over the 6 years he spent there, his career included both clinical and administrative duties including 4 years as the Fellowship Program Director and two years as the Medical Director for a level II unit. In late 2010 he accepted a position in Winnipeg to become the Section Head of Neonatology and continues to hold this post. In 2016 he took on the additional role of Medical Director of the Child Health Transport Team. In 2015 he became a member of the Canadian Pediatric Society’s Fetus and Newborn Committee and in 2019 took over as Chair of the same. His interests predominantly lie in the use of non-invasive technology to minimize painful procedures during an infants stay in the NICU. He is active on social media and has a passion for fundraising and is an active board member of the Children’s Hospital Foundation of Manitoba.
Topic: Human Milk Diet and Fortification: Controversies and Evidence - [View Abstract]
Topic: Many Different Shades of Yellow - [View Abstract]
Topic: Respiratory Problems in the Newborn: Where Are We in 2022? - [View Abstract]
Topic: Sweet and Sour: Hypoglycemia in the Newborn - [View Abstract]
Newborns may develop respiratory distress for a number of reasons. Using a case study approach, several conditions will be explored with emphasis on what the standard of care is and what is the latest in our 2022 toolbox for treating them.