In a perfect world, every baby would latch beautifully right after delivery and breastfeed happily ever after. In reality what we often see is that most moms and babies need a little help to get breastfeeding off to a good start. Many dyads need a lot of help. And a few mother/baby pairs need a miracle to breastfeed successfully. How can we best help those tough cases? There are many reasons babies struggle to latch and feed well. Some issues may include structural issues, physical discomfort, respiratory concerns, medical issues, digestive issues, poor feeding tool choices, prematurity, etc. Many providers are frustrated when they are unable to help a dyad latch and feed successfully. This presentation will cover some reasons why babies struggle to latch and breastfeed well. We will go over cases that portray challenging situations and the assessment techniques and care plan strategies that helped. This session is designed to help providers implement critical thinking skills in order to think outside the box when it comes to difficult cases.

Survivors of trauma are at an increased risk not only of experiencing post-traumatic stress symptoms during their pregnancy, but also birth trauma and postpartum PTSD. Yet too often survivors’ needs are ignored and traditional childbirth preparation is neither trauma-informed nor supportive of survivors’ emotional experiences. This presentation envisions what childbirth preparation looks like from a trauma-informed perspective. It will explore how to create safety in our relationships with birth givers, how to help survivors feel their power, and how to hold space for their emotional journey to parenthood. I discuss the impact of previous trauma on birth givers in pregnancy and birth, and explore what can be done prenatally to prevent birth trauma. Participants will gain practical skills for supporting survivors’ emotional wellbeing and for helping them to plan for a safe birth experience. This involves rethinking the birth plan. Instead of merely articulating a birth givers’ preferences for or against interventions, a birth plan should be rethought as a Birth Support Plan: that is, it should communicate what a birth giver needs to feel safe, understood, and in control of the decisions they make around their care whether their birth goes to plan or not.

Dysphoric milk ejection reflex (D-MER), is not a new phenomenon. In the past, it was almost like Voldemort, the Problem That Must Not Be Named. But for over 10 years now, it has had a name and been brought into daylight. Though still not widely known or understood by many, the hypothesis of the mechanism and possible sustainable solutions are becoming better documented all the time. D-MER has been the subject of two case studies, one case series, and a qualitative research study. Two other studies as also in process at this time.

Mothers with D-MER feel, as a reflexive response with every single milk release, a wave of negative emotions ranging (depending on severity) from homesickness to hopelessness and despair, perhaps even anger and suicidal ideation. These emotions dissipate shortly after milk release and reoccur with the start of every MER, whether with breastfeeding, expressing or with spontaneous releases. Many sufferers keep the problem to themselves preferring the weaning of their baby to being incorrectly labeled as depressed or victims of abuse. Upon experiencing D-MER mothers are initially convinced the problem is physiological and not psychological, and they are correct.

As both a lactation consultant and a sufferer of D-MER, I first named and identified D-MER over 10 years ago. Now, through the case studies that have been done, collaboration with other medical and breastfeeding care providers, and the collection of information from the anecdotal reports from over 1,000 mothers, there is now a foundation of understanding of D-MER. Though the evidence base for D-MER is still mainly unestablished at this time, there are many professionals always working to bring evidenced-based information to the study of human lactation. This is exactly what the slow work and understanding of D-MER is about; the process of bringing new information into the light for further research and understanding.

In the PowerPoint presentation that I have to present, I discuss how D-MER presents, its tell-tale manifestation, and its spectrum and intensities. The presentation also explains the currently proposed mechanism of the MER anomaly, how health care providers can identify a mother it D-MER and how to help and support mothers with the condition.

Primitive reflexes play an instrumental role in the birth process and lactation, motor, regulatory, and social emotional skill development. Reflexes not only serve to help us develop a sense of self, but they also assist to promote meaningful interactions with other people and the world around us. In this presentation, we explore how the integration of sensory processing and primitive reflexes support parents and infants in lactation. We will also look at how the function of these reflexes can impact learning, mental health and regulation skills in infants, children, and adults. Experiential activities will be used to enhance participants understanding of each reflex and experiment with supportive strategies to use with families.

This session will look at how for profit corporations are seeking to aggregate, control and exploit human milk. In the absence of federal health policy and consumer regulation/protection, companies are emerging seeking to build commercial markets for human milk often under the guise of improving the economic status of women and infant health.
We will examine companies currently paying for milk both domestically and internationally and the implications for women and emerging policy both at the federal and state level.
Entities setting a price for human milk in the absence of supportive public policy may in fact undermine women’s biological integrity, infant health and contribute to the vulnerability of women and babies.
I will ask participants to consider the issues and to support models of community engagement and decision making that are women centered and women led that keep this biologically critical substance within the community from where it comes; supporting breastfeeding and benefiting women and babies.

A baby’s birth can have a significant impact on breastfeeding outcomes. Medical intervention in normal birthing situations is rife, and globally cesarean rates have soared since 2000. Along with this, breastfeeding rates are less than ideal. A mother who feels a sense of grief about the birth of her baby is consequently more likely to face breastfeeding challenges. IBCLC’s, midwives and medical officers will often begin a breastfeeding consultation by listening to a mother’s unhappy perception of her baby’s birth. This aspect needs to be sensitively supported.

It is high time we take stock and pay more attention to what world health authorities are recommending to improve birthing and thus breastfeeding outcomes. These outcomes can affect a mother’s feelings of empowerment, her physical and mental health. Baby’s health and general development are statistically better when breastfed. There are significant financial savings made by reducing costs in various countries health systems when mothers breastfeed successfully.

There are definite changes we can make, following recommended guidelines and recent research. We can do this individually in our work and also in our affiliations with professional bodies by supporting and encouraging government policymakers and advocacy groups. These are our future challenges.

Having a strong understanding of pelvic and vulvovaginal anatomy and physiology is crucial to help prepare the birthing body for childbirth. Whether preparing for homebirth, birthing center, or hospital setting, prevention of injury of the birthing person supports a healing and positive birthing and post-partum experience. Deepen your knowledge of the fascia, pelvic joints, muscles and nerves in the pelvis and learn what the latest research tells us about positioning for labour and birth, spontaneous pushing and perineal preparation and common myths.

Birth trauma is a preventable complication of pregnancy and providers play a critical role in this prevention. Preventing birth trauma not only supports a positive birth experience for the birthing person, but sets the foundation for optimal post-pregnancy health. This is because birth trauma is a catalyst for various long-term health issues for the birthing person including attachment difficulties, chronic pain, chronic illness, autoimmune diseases, postpartum mood and anxiety disorders, as well as an increased risk of pregnancy complications in future pregnancies. Through the study of somatic and somatosensory modalities, as well as years of client work in the high-risk pregnancy population, I have seen clients at risk for pregnancy complications and preterm birth defy medical odds and protect themselves from a traumatic birth in their pregnancies after loss or preterm birth. This presentation will cover the three most important roles of a provider in the facilitation of birth trauma prevention.

Birth and breastfeeding/chestfeeding are intimately woven together although many separate the two. One's labor and birth process however, have a direct impact on how their nursing journey begins. Naturally, most infants can independently progress through the fetal to neonatal transition and produce a baby-led latch within the first hours of life. However, the process of birth is often unpredictable and many birthing families are regularly faced with common or unexpected labor interventions that can adversely affect milk supply and the initiation and receptivity of breastfeeding/chestfeeding for the infant. Some of the most common interventions include: IV fluids, induction of labor, epidurals, and continuous electronic fetal monitoring. These maternity care practices come with unintended consequences that directly impact lactation. Furthermore, studies indicate that many of these interventions are done more for convenience as opposed to medical reasoning. In order to promote, protect and support breastfeeding/chestfeeding for birthing families, providers and other members of the healthcare team should be encouraged to work in tandem; using effective communication and facilitating open dialogue. By including families in every aspect of their birth and postpartum period, self-efficacy and confidence is increased and trust is developed, setting the foundation for increased initiation and duration of human milk feeding.

Is a red spot always a key indicator of mastitis? What about the deep purple trademark of vasospasm? How does eczema present on non-white skin? Performing a standard breast assessment may cause clinicians to overlook or misidentify key indicators of maladies in patients that are not fair skinned. Learn how you can improve your assessments and familiarize yourself with other ways to identify common conditions in patients populations that may not have been featured in your textbooks.