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.

Breast cancer is the most frequent malignant tumor during reproductive age. Around 1/10000 nursing mothers are diagnosed with breast cancer every year. In this rare and difficult situation, patients and healthcare providers should be knowledgeable about the prognostic and practical implications of such an event. Chemotherapy may pass into the milk and breastfeeding is usually contraindicated during chemotherapy. Weaning should be gradual, to avoid breast inflammation and mastitis. A thorough psychological support should be given to the nursing mother to help her into the oncological trajectory.
On the other hand, the number of young breast cancer survivors is increasing and more and more patients enquire about the possibility of subsequent pregnancies and breastfeeding. The breast treated with conservative surgery and subsequent radiation is less responsive to hormonal stimulation, with reduced glandular hyperplasia and hypertrophy. Milk production is usually decreased in the previously affected breast and surgery may affect duct integrity. Nonetheless, each breast has the capability to self regulate milk production according to the baby’s suckling habits, and many evidences support the notion that one breast is enough. Specific education programs should focus on adequate baby positioning, correct latching and reinforcement of the advantages of on demand breastfeeding. Data from our group demonstrate the feasibility of breastfeeding after breast cancer, but qualified lactation counseling to support patients and caregivers is needed.

Recently, much scientific inquiry has turned to the new frontier of the “microbiome", the many microscopic beings living commensally or symbiotically in and upon the human body. Breast milk’s contribution to the development and sustenance of healthy gut bacteria is immense, in that it not only provides bacteria for the initial seeding, but also contains an ideal nutrient base designed to promote beneficial flora while simultaneously discouraging pathogens. This presentation will explore the relevant theories and understanding of these processes.
We will delve into the long-term health outcomes associated with the microbiome, including obesity, diabetes, brown-to-white fat ratio, gastrointestinal concerns, and allergies. This presentation will also explore the impact of breast milk storage and pasteurization techniques on its microbiologic activity. Additionally, we will look at other aspects of the microbiome as they relate to skin-to-skin contact, vaginal birth and breastfeeding.
Finally, we will describe bacterial roles in infant neurological development, allergies, digestion, immunity, and future obesity. Healthcare practitioners need to be aware of the benefits of microbial diversity in order to effectively counsel new parents, especially those with infants at risk for immunological or digestive concerns.

With breast surgery becoming more common, it's important for professionals to understand how it can affect lactation and the experience of breastfeeding or chestfeeding parents. Both an IBCLC and Mum who breastfed her daughter after having breast reduction surgery, Anna Le Grange talks through the implication of breast reduction surgery on lactation, covering both the physiological and psychological challenges that parents face. As well as sharing the experiences of those who have had breastfed after surgery, Anna introduces practical steps that supporters and professionals can take to help their clients define and strive for their breastfeeding or chestfeeding goals in a gentle and realistic way.

Birth workers are usually the first contact with parents and are therefore the people who are best placed to influence them in their choice of infant feeding method. Adults only retain information on a ‘need to know’ basis, so meeting the needs of individuals in your interactions is important. Whether you provide a formal breastfeeding class or just have 5 mins to chat during a prenatal visit, what is the best way for you to provide evidence, which information is important. How can you help parents to make an informed decision about feeding. Adult education theory, learning styles, aims and learning outcomes for your interactions, as well as breastfeeding information will be presented and ideas for how you can make your clients learning fun and interactive.

Aversion to breastfeeding or agitation while breastfeeding is known to occur in some women who breastfeed while pregnant, or who tandem feed a newborn and a toddler. However, it is a little researched area, and the paucity of published literature around breastfeeding aversion and agitation reveals a significant gap in the literature. My presentation presents the findings of an exploratory online survey that sheds light on what appears to be a commonly experienced phenomenon of aversion and agitation whilst breastfeeding, which varies in form, severity and duration. BAA is characterised by feelings of anger or rage, a skin crawling sensation and an urge to remove the suckling infant, but can also be feelings of agitation and irritability whilst the infant is latched. Mothers who experience BAA still continue to breastfeed, but have feelings of guilt and shame about BAA and are often confused about having feelings of BAA. Research is needed to understand the reasons for BAA, its causes, triggers and strategies to minimize the experience in breastfeeding mothers.

Breastfeeding a baby with Down syndrome can bring many challenges to both mother and baby and many women are told they will be unable to breastfeed. This presentation will give examples of women who have faced different challenges breastfeeding their babies with Down Syndrome, yet had successful breastfeeding outcomes with the right support and information. This will include case studies with specific tips and suggestions that will help the lactation professional in offering support to these families. These women have faced many challenges including; prematurity, low muscle tone, breastfeeding into toddlerhood and a toddler who did not start breastfeeding until his mother had another baby when he was 2 ½ years old! This presentation will cover the most common challenges that families face when breastfeeding a baby with this condition and the possible solutions for them.

Breast/chest feeding is a biological, emotional, and social process. There is an undeniable link between human milk and behaviors associated with feeding. Breast or chest feeding provide the perfect environment for babies’ development, such as bonding, attachment, mutual regulation, security, etc. But what happens when parents can’t access effective, culturally competent, compassionate lactation services? What happens when over generations lactation support has been lacking?

Every parent deserves the chance to meet their feeding goals and enjoy the short and long term benefits of human milk feeding. Social inequities augment the effects of not experiencing those benefits making it even harder for parents and babies to have their physical, emotional and social needs met. Outcomes of lactation impact the dyad, the family, the community beyond the nutritional needs of the infant.

Advocacy efforts at local, regional and national levels create meaningful opportunities for health equity, so those with no power or resources can reach optimal health. Lactation consultants are in a unique position to advocate and partner with others to support policies and programs that focus on equity as a systems approach to benefit marginalized communities and impact their physical and mental health in the long-term.

Anticipatory care plays an essential role in achieving desirable outcomes after the revision of tethered oral tissues. Tethered oral tissues are a common and underdiagnosed problem that impacts potentially 10% of the United States population. Lack of a universally accepted approach to diagnosis, treatment, and management creates confusion for the public and prohibits optimal care. This lecture dissects current research, trends, and information to present a deeper connection between oral function and anatomy during breastfeeding and tethered oral tissue revision management. Discover the interdisciplinary approach to restoring a functional and healthy breastfeeding relationship to the dyad and the critical importance of setting families up for success by providing adequate anticipatory care and guidance prior to revision.

When a baby is born with a cleft lip, cleft palate, or cleft lip and palate, how the infant will be fed is an immediate and compelling issue to resolve. Once the baby is feeding competently at the breast or with a bottle, the family may receive little to no feeding support between the early weeks after birth until the recovery period following lip or palate surgery. While full breastfeeding (directly at the breast, without compensations or devices) is theoretically possible once the lip and palate are repaired, some babies have difficulty returning to direct breastfeeding or chestfeeding, and babies who have never been breastfed or chestfed, lack the oral skills to do so. In this presentation, I will discuss what “scaffolding for success” means in the context of breastfeeding and chestfeeding with an oral cleft. I will cover how to counsel parents at each significant stage of the baby’s cleft care timeline, how to support a parent’s unique feeding goals, how to break down a feeding goal into smaller, achievable steps, techniques for supporting at the breast feeding for babies with unrepaired clefts, best practices for achieving a full milk production, mixed feeding, feeding tools, and how to support developmentally appropriate feeding skills before and after cleft repair surgery.