IBCLC Detailed Content Outline: Clinical Skills / Public Health and Advocacy Focused CERPs - Section VII E

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.

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.

Muchos de nosotros comenzamos a trabajar en lactancia visualizando un mundo donde las madres y los bebés pueden amamantar sin barreras; sin embargo, aprendemos rápidamente que los desafíos de la lactancia materna van más allá del prendimiento y el posicionamiento.

Para apoyar efectivamente a una familia que amamanta, debemos apoyar a los padres, a la familia extendida, al doctor, a la cultura del lugar de trabajo, a la guardería y a la comunidad; en resumen, apoyar a una familia se transforma en la oportunidad para afectar todo el sistema social. De hecho, promover la lactancia se trata de construir sistemas y liderar cambios culturales para reforzar más profundamente la alimentación con leche humana como la norma.

Kouzes y Posner (2012) afirman: "si desea tener un impacto significativo en las personas, en las organizaciones y en las comunidades, lo más recomendable sería invertir en aprender comportamientos que le permitan convertirse en el mejor líder que pueda ser". Con esto en mente, los consultores y asesores de lactancia se beneficiarían aprendiendo conductas de liderazgo y habilidades que apoyarán sus esfuerzos hacia el cambio cultural, inspirarán visiones compartidas, desafiarán procesos, se convertirán en asesores estratégicos y liderarán desde adentro hacia afuera.

Los líderes en el mundo de la lactancia se beneficiarían de poder alinear valores y motivaciones con acciones y estrategias para promover la lactancia como parte del desarrollo de toda la comunidad y como una estrategia de salud pública. De esta forma, la lactancia tiene presencia en las iniciativas para la primera infancia, la salud materna e infantil, los programas de salud mental y cualquier intervención sanitaria, social y educativa.

¿Quiere normalizar la lactancia? Participe de esta presentación y aprenda a liderar iniciativas de lactancia extraordinarias en su comunidad.

During a time when lactation professionals are facing unprecedented negativity on top of the usual challenges, it’s easy to get drawn into the conflict or to start wondering if what we do makes a difference. How do we lift one another up to maintain a positive focus on using our knowledge and skills to guide families who are feeling scared and confused? How do we set aside our biases to make sure we’re listening to all sides? How do we connect and collaborate with other professions to expand the network of support for new families? This panel discussion focuses on answering those questions and providing steps that can be taken to promote collaboration both within the field of lactation and with other members of the health care team to improve breastfeeding knowledge translation and mobilization. This is your chance to hear from Dr. Amy Brown, Christy Jo Hendricks and Joy MacTavish as they share their thoughts on this hot topic during our panel discussion titled “Lifting up the Lactation Profession”.

It’s been a decade since the Surgeon General’s call to action to support breastfeeding. While great strides have been made to improve breastfeeding rates in the US, diverging societal conditions, disparate birth outcomes and changing family dynamics have necessitated adjustment and adaptation of more inclusive and multifaceted approaches to lactation support. With up to 34% of birthing people having experienced a traumatic birth, one study has shown how the effect on breastfeeding can go in either direction. If we factor in housing instability, mental health and race/immigration status we see greater disparities and/or differing needs according to the target population. However, the paradox is that these issues are not mutually exclusive, therefore a one size fits all approach is not sufficient. The COVID-19 Pandemic shed light on pre-existing gaps and disparities in this field and forced us to reimagine what breastfeeding promotion, protection and support should and can be. Implementing a multi-disciplinary plan to approach breastfeeding and lactation should be the trend moving forward. In this presentation you will learn how to:

Identify disciplines that can collaborate with lactation specialists to support breastfeeding promotion. Discuss challenges in supporting populations with multiple needs and high risk. Strategize a plan for reaching marginalized communities and populations at high risk and high need for lactation support.

In the absence of adequate banked donor human milk for distribution to all infants in need, many families choose to engage in the practice of Private Arrangement Milk Sharing (PAMS), partially facilitated through social media, to procure human milk for their infants. Evidence regarding the participant and infant characteristics, and risk abatement practices is limited. This presentation explores the state-of-the-science of PAMS, characteristics of recipient participants and infants, donor screening practices, and risk abatement strategies. Results are contextualized with a socioecological framework of factors affecting infant feeding practices. Influence of health care providers, lactation support, birth attendant, and sources sought during decision making and the impact of these influences on supporting families are discussed.

Hospital visits from a Peer Counselor just after delivery can have a tremendous impact on breastfeeding for mom and baby. Evidence-based research shows that Peer Counselors can share an important role in the success of breastfeeding for families. Peer Counselors making an early connection and reminding families that there is someone here to help them with their breastfeeding journey, now and after mom and baby discharge from the hospital, can be very comforting for those nervous new parents. Often, a short visit from a Peer Counselor to reassure a new mother that she is right on track with breastfeeding is just what mom needs to encourage her for the learning period she is going through. Learn about the success stories of a Peer Counselor Program from the implementation of hospital visitation through years of success in hospital visits and the difference it has made in their Peer Counselor Program participation and breastfeeding numbers.

There are challenges to getting Peer Counselor hospital visits started. It may not be as easy to get your foot in the door as you would think. We will discuss some of the red tape situations you may encounter as you start trying to set up hospital visits. Adding hospital visits to your Peer Counselor activities can have a positive impact on your Peer Counselor Program and increase breastfeeding rates for your area.

Collaboration is the foundation of the work of lactation professionals. As allied health providers, the team approach is at the centre of our professional relationships. Differences in professional practice and standards of care are aggravated by health care systems that are fragmented and operate in silos, while the high emotion and urgency of infant feeding concerns interfere with reasoned collaborative decision-making. Where adequate training, workplace policies and management oversight fail, conflicts within the team may escalate to incivility, lateral violence and bullying. IBCLC must be able to name and act when conflict crosses these boundaries.
At a policy level, the problems facing breastfeeding are among the most "wicked" of public health's "wicked problems".

In perpetually resource- limited settings, the challenges of policy-making, good governance and innovative programs require effective collaboration and co-operation within and across organizations.
Limited time and energy is available for the enormous work required to provide excellent care to families and create societies that fully support them to breastfeed their children for as long as they wish to. Moreover, because of the intensity of the "wicked" problems we face and the urgency of resolving them both in individual cases and at the policy level, conflict and erosion of trust often occur. Because we cannot only work with those we would like to work with to accomplish our goals, we must learn "stretch collaboration", explored using Adam Kahane's model of working in absence of friendliness, agreement or trust.

From the moment of conception, maternal and fetal physiology is intrinsically linked in a synergistic partnership, with optimal infant development dependent on this relationship continuing well into the infants first 1001 days. A key pivotal facet of this reciprocal relationship is responsive breastfeeding. Responsive breastfeeding is far more than a way of infant feeding, but a sensitive synchronous parenting style that secures optimal growth, nutrition, immune development, infant /maternal attachment, whilst fostering successful lactation and the development of positive feeding habits well into infancy. This presentation will explain what is meant by responsive breastfeeding, exploring the science behind how this type of feeding promotes optimal infant health.

The presentation will conclude with an exploration of the wider benefits of responsive breastfeeding, examining the possibility of this type of feeding style contributing to improving several public health issues, in particular childhood aversity and obesity. Lastly, recommendations for promotion and support of responsive breastfeeding will be outlined.

The roles of peer counselors (PC) in breastfeeding support is important to reach mothers and families in community as they would bridge the gaps within the warm chain of breastfeeding support. However, challenges has overcome in many forms, especially their reliability in providing breastfeeding support skills and knowledge. Malaysian Breastfeeding Peer Counselors (MBfPC) program has started in 2010 to enhance breastfeeding support for Malaysian community. Its training syllabus were adapted and modulated to be culturally acceptable. More than 500 PCs were trained.

The original syllabus was continuously being revised prior to each training since Malaysia is multicultural with great diversity, with few adaptations of new tools to enhance the understanding among the trainees whom majority are not health personnel. MBfPC Association (MBfPCA) is responsible to reliability queries by other parties, thus overseen the needs for MBfPC training reform. Three training levels were introduced in 2016; entrance, advanced, and train-of-trainers; to increase reliability of certified PC, even though the sustainability of the network is yet to be observed. The mechanisms used to select, train and certify the PCs had strengthened the roles and functional relevancy of MBfPCA existence in Malaysian scenario. This presentation will share the challenges and framework of capacity building among PCs to function as breastfeeding peer supporters in Malaysian context.