IBCLC Detailed Content Outline: Clinical Skills Focused CERPs - Section VII

One of the most challenging experiences on a parent’s lactation journey is managing return to work. When lactating workers have access to both time and space for expressing breast milk, they are more likely to meet their breast/chestfeeding goals, yet many struggle to access these simple accommodations. Participants will gain an understanding of how workplace conditions influence lactation, become familiar with key legal principles protecting lactating parents in the workplace, and, learn strategies to ethically support their clients in reducing workplace barriers to continued lactation.

The profession of lactation consultant has grown around the world and has evolved enormously since its inception in 1985. At first, the development of the profession provided skilled breastfeeding counsellors with a role that aligned with the medical model, provided a career pathway, and provided evidence of lactation skills and experience.

Over the years, the certification has grown and now there are over 33,000 International Board Certified Lactation Consultants© (IBCLC©) in 125 countries with the exam now offered in 17 languages. Lactation consultants are now recognised at national and global levels as providers of expert lactation care, and they work within a “landscape” of varied roles and qualifications, each of which brings their own important skill set. IBCLCs play many roles, ranging from advocate to clinical expert, from policy consultant to researcher. The profession has evolved in response to sociocultural change and global issues. One major change has been the increasing importance of technology and the internet, driven partly by the fact that the consumers of breastfeeding care are the most internet involved generation in history, with a particularly rapid transition in response to the COVID-19 pandemic. Major shifts have included the recognition of structural racism, health disparities, inequities in health care and in breastfeeding support, the importance of building a more diverse workforce, recognition of the gendered nature of lactation care and the need for inclusion for people of all genders, breastfeeding as a reproductive right and as a human right of the breastfeeding dyad, and the impact of how babies are fed on many other spheres, including climate change and public health.

Breastfeeding facilitates good health in infants and mothers, and for all humans throughout life. Medical professionals should be advocates for breastfeeding, and physicians could be one of the most influential advocates. However, many medical students, residents and physicians have very limited opportunities to learn about breastfeeding and human lactation during their medical education. From another point of view, breastfeeding is a private experience as well as a scientific matter. If a physician or a partner successfully breastfeeds, she/he may become a more effective advocate for breastfeeding. So, it is imperative to provide medical students, residents, and young physicians with education about breastfeeding and to enable them to experience successful breastfeeding personally, in order for them to promote and support breastfeeding among their patients.

The Academy of Breastfeeding Medicine is an international organization of physicians who protect, promote, and support breastfeeding, and one of its goals is to develop and disseminate the standard for physician education around breastfeeding and human lactation. ABM has developed protocols and statements for health care providers to utilize for breastfeeding management.

The WHO/UNICEF revised Ten Steps to Successful Breastfeeding in 2018, includes in Step2 “Ensure that staff have sufficient knowledge, competence and skills to support breastfeeding”. This included physician education. There are many ways to educate physicians, and ABM materials could be one option.

Are you a lactation professional or health care provider looking for ways to engage your audience? Whether your audience is breastfeeding families, parents-to-be, peer counselors, volunteers, health care professionals or lactation specialists, then this presentation is for you! In it, I will show how creative solutions can overcome a lack of resources or technology to provide mothers and families with engaging and effective breastfeeding support. This session will cover innovative and interactive educational strategies and activities that can be used to capture your audience’s attention and to encourage them to retain vital information and strategies to help them breastfeed.

These concepts are practical and applicable to all types of settings, including but not limited to: breastfeeding support groups, lectures and presentations, training sessions, webinars, seminars and one-on-one lactation consultations. Moreover, they are easily modifiable to fit the needs of different populations and cultures. As many lactation professionals work in low-income communities or resource-poor settings that frequently lack many of the latest gadgets and expensive lactation aids, this presentation will offer demonstrations and tutorials of Do-It-Yourself (DIY) options that can ensure that breastfeeding mothers and families get the best support possible, even when resources are scarce.

Good doctor–patient communication is essential for positive health care outcomes. Ideal doctor–patient communication generally is reflected in a partnership communication style. However, in Southeast Asian settings, we often see a more one-way style with little input from the patient. Helpline services is breaking the ice, and is considered a new option modality for patients in Indonesia. The ease in contacting medical professionals through phone and text messages seems more comfortable, personal and inexpensive.
Breastfeeding support via a helpline helps mother to feel reassured, confident and more determined to continue breastfeeding, and in majority of occasions resolves their particular concerns.
Lactation Clinic in Puri Cinere Hospital, Depok, West Java, Indonesia was established in August 2011 and operated a helpline since the beginning of its establishment. Helpline service is open 24 hours daily, through phone, text messages, whatsapp, or blackberry messenger directly to doctors who are also breastfeeding counselors. There are six doctors who take turns every month to receive calls and reply to messages. Helpline numbers are distributed to patients during post natal rounds or at patients doctors appointments in lactation clinic.
A longitudinal study conducted in March to December 2014 shows 202 helpline cases in 9 months. There were 29 cases (14%) questioning EBM handling, 24 cases (12%) asking about complementary feeding, 19 cases (9%) of infant stool, 19 cases (9%) medication and mother's milk, 15 cases (7%) frenotomy after care and other various problems. 63% cases were successful managed via helpline, and 37% cases were referred to the Lactation Clinic to get further help.
There were many cases resolved through helpline calls and messages. High success rate of helpline management shows that helpline program is effective to help mothers and resolved their particular concerns; especially in Indonesia.

Infants with biologically based sucking problems can often breastfeed with specific lactation management and supportive techniques. This presentation provides an overview of some common medical problems that cause feeding difficulty and strategies that can help an infant with suboptimal sucking skills to feed more normally.

Many of us come to work in breastfeeding envisioning a world where mothers and babies can breastfeed without barriers; however, we quickly learn that breastfeeding challenges go beyond latching and positioning.

To effectively support a breastfeeding/chestfeeding family, we have to support the parents, the extended family, the primary care provider, the workplace culture, the childcare, and the community; in summary, supporting one dyad can be an intervention to the whole social system. Indeed, breastfeeding advocacy is about building systems and consistently leading cultural changes to more deeply reinforce human feeding as the norm.

Kouzes and Posner (2012) state: “if you want to have a significant impact on people, on organizations, and oncommunities, you’d be wise to invest in learning the behaviors that enable you to become the very best leader you can.” With that in mind, lactation consultants and lactation advocates would benefit by learning leadership behaviors and skills that will support their efforts towards cultural change, inspire shared visions, challenge processes, becoming strategic advisors, and leading from the inside out.

Lactation leaders would benefit by being able to align values and beliefs with actions and strategies to promote breastfeeding as part of whole community development and as a public health strategy. In that way, lactation has a presence in early childhood initiatives, maternal and infant health, mental health programs, and any health, social, educational intervention. Want to normalize lactation? Join this interactive session and become the leader who can make extraordinary lactation things happen in your community.

Learning styles can be defined as the cognitive, effective and psychosocial behaviours that can serve as relatively stable indicators of how learners perceive, interact with and respond to a learning environment. Learning styles are just one part of Adult education theory, how do the theories around Androgogy, Transformation learning, Experiential learning and programme development affect those offering education in the world of breastfeeding. In this session, we will explore what we have to understand about how adults learn in order to be able to communicate effectively. We will also explore ways to empower people to understand breastfeeding and their role in advocating for women and babies.

Food/nutrition is a basic need of individuals. Unethical, uncontrolled marketing practices have added to age-old confusions and misconceptions. Products are subtly portrayed as essential and convenient to “modern parents”.
Since the time that WHO/UNICEF has declared an International Code, many WHA resolutions have been resolved. Convention on the Rights of the Child accepts the right to enjoy a highest attainable standard. Innocenti Declaration was adopted on Protection, Promotion and Support of Breastfeeding.
It is important to support woman, by enacting legislation and adopting its enforcement and by providing adequate paid maternity benefits/leave.
The Indian government has enacted the Infant Milk Substitutes, Feeding Bottles & Infant Foods Act.
People should be vigilant enough to realize that legislations are not merely pieces of paper. Health workers have a moral and ethical responsibility to provide health education and report violations by becoming a “Watch-guard”.
Even after many legislations, some manufacturers are behaving as if these recommendations don’t affect them and have ignored or just given lip services. Health workers, and the general population has a great influence on decision making. There is need to follow laws in spirit rather than words.

Fed is Best is a foundation with a major social media presence who seek to warn parents and practitioners about the dangers of insufficient exclusive breastfeeding. Through their social media campaigns that have galvanized a backlash against exclusive breastfeeding, lactation care providers, and the Baby-Friendly Hospital Initiative. Although lactation specialists disagree with much of their content, they have raised awareness about mothers who do fall through the cracks of our care system and may suffer as a result. The steep drop-off in rates of exclusive breastfeeding is an indication of this. This presentation will examine three provider-level barriers that negatively impact breastfeeding and what we can do to improve care so that mothers will reach their breastfeeding goals.