Equity and Safer Infant Feeding in Times of Disaster and Civil Unrest
Lourdes Santaballa is a community activist and organizer, with a background in domestic violence, affordable housing, and economic equity advocacy. A La Leche League leader from 2009-2017 and IBCLC since 2011, she was the founder of the lactation program at sePARE, providing coordinated services to low income families, leading it to receive the ILCA Care Award and received the Wilson-Clay Hoover Award for Research. Lourdes received the notorious Drs. Ruth Lawrence and Audrey Naylor Legacy Scholarship in 2016 by the United States Breastfeeding Committee, the Miriam H. Labbok Award for Excellence at the Breastfeeding and Feminism conference in 2018 and is currently completing her master’s degree in clinical nutrition. In October 2017, following Hurricanes Irma and Maria, Lourdes founded Alimentación Segura Infantil or ASI, an Infant and Young Child feeding program focused on increasing breastfeeding, leadership and training in marginalized communities in Puerto Rico.
In times of civil instability and changing global climate, we risk natural disasters, infrastructure failure, terrorist situation, police brutality, mass migration, chemical accident, war or other type of emergencies. Infants and young children under the age of 2 are the most vulnerable due to their dependence on adults for survival and their delicate physiology. We know that lactation in emergencies saves lives, yet the unrest that occurs in the days immediately after the disaster may contribute to premature weaning. At the same time, many babies are not breast or chestfed at all or only partially. This session will explore the methods to preserve breastfeeding, decrease the use of formula and other human milk substitutes, promote relactation, and teach appropriate complementary feeding in a disaster appropriate, low tech and resource limited environment. We will also discuss the colonial and patriarchal of humanitarian relief and how to make equity our focal point.
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Establishing & Maintaining Milk Production When Exclusively Pumping
Kimarie Bugg is currently a Doctor of Nursing Practice student and is President and CEO of Reaching Our Sisters Everywhere (ROSE), a National nonprofit corporation developed in 2011 to address breastfeeding inequities in the African American community. Kimarie previously worked for Emory University, School of Medicine, as a nurse practitioner. She is a member of the faculty for CHAMPs, a Baby Friendly Hospital Initiative, and chair of the nominating committee of United States Breastfeeding Committee. She also provides training for healthcare providers and community transformers nationwide. She completed a Community Health Leadership Program, within the Satcher Health Leadership Institute at Morehouse School of Medicine that stressed best practices to provide global health equity and eliminating health disparities through action-oriented projects. In 2016, Kimarie received a Legacy Award from the United States Breastfeeding Committee for her work in the breastfeeding arena for 38 years. She believes that Truth, Racial Healing and Transformation can take place in marginalized communities, starting with Breastfeeding. Kimarie lives in the Atlanta area with her husband, Dr. George W. Bugg Jr, a neonatologist and they are the parents of 5 adult children.
Topic: Reaching Our Sisters Everywhere (ROSE) - [View Abstract]
In this presentation, you will learn about working with mothers' who are struggling to maintain their milk supply when infant is unable to latch or they have an infant in the NICU or wanting to plan ahead and maintaining a supply perhaps while they are either returning to work or school.
Kelsie Barta is an International Board Certified Lactation Consultant (IBCLC) who lives in Richmond, Texas with her spouse and two young children. She is currently pursuing a Doctorate of Philosophy in Nursing Science with Texas Woman’s University, with a primary research interest in lactation. She occupies her time with various part-time endeavors, including working as a Family Nurse Practitioner, a Clinical Nursing Instructor for nursing students in their maternal child health and pediatric clinical experiences, lactation consulting, and volunteer work with an emerging nonprofit maternal health organization in Houston, Texas. Her experiences with lactation are dynamic. Professionally, she has worked with breastfeeding/chestfeeding dyads in a postpartum hospital unit, through outpatient clinic visits, and via antenatal education. Her personal experiences include breastfeeding her children, serving as a resource to friends and family, and generally being “plugged in” to how lactation and lactation consulting may be perceived among people her age. She is passionate about empowering parents to reach their infant feeding goals, equitable access to lactation care, and health policy.
Health professionals that interact with birthing parents and their infants in the first few days of life are uniquely positioned to impact lactation. In the context of the maternal guilt, shame, and stigmatization that can accompany infant feeding decisions, lactation professionals have an obligation to provide ethical care. This presentation will review the ethical guidelines of autonomy, nonmaleficence, and justice in the context of lactation support in the early postpartum period. Participants will be presented with strategies to mitigate harm, promote autonomous decision-making, and increase equity in lactation care. Based on these ethical principles, the extent of lactation promotion and language considerations will be discussed, as well as an in-depth look at the health professional’s ethical responsibilities when encountering cessation of exclusive human milk feedings.
Robyn Lee is an Assistant Professor in Sociology at the University of Alberta. Previously, she was visiting scholar at the Brocher Foundation (Geneva, Switzerland) and a Banting Postdoctoral Fellow at Brock University. She holds a PhD in Social and Political Thought from York University. Her research interests include contemporary social theory, gender, sexuality, care work, and embodiment. She is the author of The Ethics and Politics of Breastfeeding: Power, Pleasure, Poetics, published by University of Toronto Press (2018) and has published articles in journals including Feminist Theory, Hypatia, Gender, Work, and Organization, and Family Theory and Review.
This presentation will explore some contemporary ethical issues in breastfeeding, situating them in social contexts. Issues to be explored will include social responsibilities vs individual responsibilities, social disparities and inequalities, and gender identity/expression.
Pauline Sakamoto's nursing career in milk banking started as a volunteer donor to the Mothers’ Milk Bank in San Jose 35 years ago. Previously, she worked at the County Health Department of San Bernardino as a Public Health Nurse in the largest county in the US covering the Hi Desert. She was also employed by the CA State Department of Health, Fiscal Intermediary Management Division for Medi-Cal. Her experience with the nonprofit San Jose Milk Bank for 35 years included processing and operations, the screening of donors and dispensing of donor human milk for inpatient and outpatient services, administration of the San Jose Mothers’ Milk Bank for over 20 years and concurrently leadership roles in the Human Milk Banking Association of North America. Currently, she serves on multiple committees within HMBANA regarding policies and standards, auditing member banks, and reviews legislative and state statutes on milk banking and lactation. She has been representing HMBANA at the US Breastfeeding Committee for over 9 years and served on the Board of USBC for 6 years. Internationally, in 2012-14, she served on PATH’s Milk Banking Policy Group and continues to work internationally on issues on processing and safety. She has stepped down from the Executive Director position at the Milk Bank in 2019 but continue to pursue her passion on milk banking (half time in the office) and Lactation.
This session will explore the ethical issues of milk collection, priority use and distribution. Currently, there are limited regulations and cultural norms regarding human milk. Is it a human tissue or food? Is human milk a commodity? How does this relate to the treatment of women and their infants? What is the current status of access to human milk and equity of services? What does “safe milk” mean? This session is to explore the current condition of ethical issues surrounding human milk, “liquid gold”…the panacea for life for the most vulnerable in our society.
Professor Lisa Amir is a general practitioner and has been an International Board Certified Lactation Consultant since 1989. She is the author of over 120 peer-reviewed articles on breastfeeding. She works in breastfeeding medicine at The Royal Women’s Hospital in Melbourne, Australia. She is a Principal Research Fellow at Judith Lumley Centre, La Trobe University and is the Editor-in-Chief of the open access journal, International Breastfeeding Journal.
Topic: Ethical Issues in the Use of Medications During Lactation - [View Abstract]
Topic: Taking a Lactation History: From Pregnancy to Postpartum and Beyond - [View Abstract]
Topic: Urban Design Solutions to Support Breastfeeding in Public - [View Abstract]
Public health ethics relates to moral implications of activities aimed at maintaining and improving population health. Public health researchers embrace participation of affected populations in all stages of research from design to translation. In the past, pharmaceutical companies have avoided the issue of women’s reproductive life and excluded pregnant and breastfeeding women from the drug development process and then advised prescribers to avoid their medications in pregnancy and lactation. Therefore, when clinicians need to prescribe medications during lactation, they do this off-label, often without evidence or guidance regarding optimal dosing or treatment recommendations. Application of the concept of equity should ensure that all groups, including breastfeeding parents, are not neglected and receive directly targeted interventions to improve their health outcomes. The ethical frame which routinely excluded participants who may be pregnant or lactating from clinical trials, is now being turned around to recognise that these groups have the right to be included.
Diane Wiessinger, MS, IBCLC, is a co-author, with Diana West, Linda Smith, and Teresa Pitman, of La Leche League International’s Sweet Sleep Nighttime and Naptime Strategies for the Breastfeeding Family. She is also a co-author, with Diana West and Teresa Pitman, of the 8th edition of LLLl's Womanly Art of Breastfeeding. Other publications include chapters in Genna's Supporting Sucking Skills in Breastfeeding Infants and Smith's The ABC's of Private Practice, and journal articles and essays on latching, lip ties, D-MER, motherhood in other mammals, and breastfeeding language. Diane self-publishes more than 75 breastfeeding handouts for mothers. She has spoken in over 40 states and provinces and in Europe, Asia, and Oceania.
Topic: The Safe Sleep Seven: Middle Ground for Safe Infant Sleep - [View Abstract]
Babies haven’t changed, but our understanding of how they attach to the breast certainly has. A journey through more than 50 years of “skilled help” with breastfeeding, what we thought we knew, what we think we know, and how we’re circling back to our beginnings and some surprisingly simple conclusions.
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Examining the Roots of the Formula Crisis and Insights on Ending Exploitative Marketing from the 2023 Lancet Breastfeeding Series
Cecília Tomori is Associate Professor and Director of Global Public Health and Community Health at the Johns Hopkins School of Nursing with a joint appointment at the Johns Hopkins Bloomberg School of Public Health. She is a Hungarian American anthropologist and public health scholar whose work investigates the structural and sociocultural drivers that shape health, illness and health inequities. Dr. Tomori is an internationally recognized expert on breastfeeding, infant sleep and maternal child health.
During the COVID-19 pandemic, she has supported numerous organizations focused on maternal child health and health equity and advocated for equitable pandemic policies. She has authored three books on breastfeeding and reproduction, and published numerous articles on a range of public health and anthropological topics.
Topic: Resolving Cultural Conflicts in Nighttime Breastfeeding and Infant Sleep - [View Abstract]
This presentation will address the North American formula crisis that was triggered by investigations into the deaths and illness of several infants from contaminated commercial milk formula (CMF), leading to an extended shut down of a major plant and acute shortages of CMF. Infant feeding decisions are shaped by powerful, inequitable systems and this presentation will identify the corporate practices entailed in perpetuating harmful practices in this crisis and provide policy solutions for how to establish a more equitable and just system of infant feeding in a time of multiple, accelerating infant feeding emergencies due to climate change.
The second part of this 2 hour workshop will address key lessons from the 2023 Lancet Breastfeeding Series. Specifically, the presentation will review Series insights into the extensive influence of the commercial milk formula industry and outline the elements of the corporate playbook employed to increase sales and undermine breastfeeding. Additionally, the presentation will highlight sources from the extensive evidence brought together in the Series to demonstrate industry tactics ranging from scientific claims that lack evidential basis to the misconstruing of infant behavior, influencing health professionals and national as well as global regulations and policies. We will also discuss recommendations of the Lancet Breastfeeding Series workgroup to end exploitative marketing and improve support at all levels for breastfeeding and engage in discussion around opportunities to implement recommendations. This will be an interactive session with ample opportunities for questions and discussion.
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Expanding Our Audience to Gain Greater Appreciation and Acceptance of Breastfeeding
Christy Jo has over 25 years of teaching experience. She is passionate about teaching in ways that simplify learning. She has been awarded the United States Presidential Volunteer Award for her community service, the Phyllis Klaus Founder's Award for her contribution to the Mother/Baby bond and the Above and Beyond Award for innovative projects that exemplify the mission of Public Health. She has also been named Lactation Educator Faculty of the Year from Childbirth and Postpartum Professionals Association and earned their Visionary Award in 2015. Christy Jo is the author of Mommy Feeds Baby and co-author of Making Milk. She created the Grow Our Own Lactation Consultant/IBCLC Prep Course which has been used to train hundreds of students to become Lactation Consultants. She currently resides in California with her husband and three children. She continues to serve her community as a birth doula, Private Practice IBCLC, Health Educator for Public Health, and faculty for the CAPPA CLE© and Childbirth Educator Programs.
Topic: Enhanced Counseling Skills for the Lactation Educator - [View Abstract]
Topic: Expanding Our Audience to Gain Greater Appreciation and Acceptance of Breastfeeding - [View Abstract]
Topic: Sharing Your Wisdom: From Abstract Idea to Awesome Prenatal Breastfeeding Class - [View Abstract]
Topic: The Art of Communication: Simplifying Birth and Breastfeeding - [View Abstract]
As educators and health organizations, we mostly target prenatal women with the breastfeeding message and then are surprised at the push-back we receive from those who do not embrace breastfeeding. In order to tip the scale in breastfeeding acceptance, we must broaden our audience.
This presentation will focus on reaching a larger audience. We must project our message to the masses. It is crucial to share breastfeeding education to society, early and frequently. Breastfeeding education should begin in the school system and be geared for each age appropriately.
We must offer education in a way that each person and organization understands how it applies to them and their situation. For instance, employers will be more likely to embrace the employee that breastfeeds if they understand the far-reaching effects of breastfeeding. The lawmakers will be more likely to approve lactation laws if they comprehend the need for legislation. Partners will offer appropriate support if they receive the same education that is often reserved for the pregnant woman. This presentation will give suggestions of how to reach family, communities, professionals, and lawmakers with the breastfeeding message. When societies embrace breastfeeding, they will embrace breastfeeding women and see it as the norm.
Expected Weight Changes After Birth for Full-Term, Breastfed Newborns
Dr. Diane DiTomasso achieved a Diploma in Nursing from Newport Hospital School of Nursing; a Bachelor of Science in Nursing, a Master of Science in Nursing Education, and a PhD from the University of Rhode Island. She is an Associate Professor at the University of Rhode Island College of Nursing.
Her research focus is human lactation and infant weight. She has multiple publications in journals such as Journal of Gynecologic & Neonatal Nursing (JOGNN), Journal of Human Lactation, Journal of Perinatal and Neonatal Nursing, and Nursing for Women’s Health and has presented her work nationally and internationally.
Dr. DiTomasso has received various honors and awards with the most recent being the 2020 Suzanne Feetham Nurse Scientist Family Research Award by the Eastern Nursing Research Society (ENRS) and the 2020 Best of JOGNN Award as first author of the article, “Systematic Review of Expected Weight Changes After Birth for Full-Term, Breastfed Newborn. She has served as Principal Investigator for a variety of neonatal research studies. Dr. DiTomasso is a member of AWHONN, the International Lactation Consultant Association, the Eastern Nursing Research Society, and Sigma Theta Tau International. She currently serves as a Member on the AWHONN Research Advisory Panel.
This presentation will summarize the findings of recent studies on neonatal weight changes that occur in the early weeks of life among full-term, breastfed newborns.
Data Sources: Using the keywords breastfeeding, newborn, infant, weight, weight loss, and growth, we searched PubMed, Cumulative Index of Nursing and Allied Health Literature, Cochrane Library, and MEDLINE for primary studies and secondary analyses. We also reviewed the reference lists of retrieved articles. Study Selection: Quantitative studies published in the English language from 2015 through 2019 that focused on newborn weight changes. From a total of 827 records initially screened, we included 11 studies in this analysis.
Data Extraction: Two authors independently reviewed the selected articles with the use of the Johns Hopkins Nursing Evidence-Based Practice Synthesis and Recommendations Tool. To determine evidence levels and quality ratings, we evaluated the consistency and generalizability of study results, sample sizes, study designs, adequacy of controls, and definitive nature of the conclusions. This presentation will discuss the finding of this study related to expected weight changes after birth for full-term, breastfed newborns.
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