Pathology Lecture Package for IBCLCs - 3 CERPs

IBCLCs, often with limited education in newborn medicine and obstetrics, care for the infant-parent dyad within the context of a complex healthcare system staffed by providers with variant training in breastfeeding medicine. This is an interaction filled with knowledge gaps and fraught with the possibility for misunderstanding and dangerously missed diagnoses. I plan to combine my training in general pediatrics and my clinical experience as a pediatric ER physician with my IBCLC training. I will teach conference participants about medical emergencies when caring for the breastfeeding newborn and the post-partum parent so that they can recognize clinical scenarios presenting to their care that require immediate medical assessment. The presentation will focus on high-yield topics in newborn medicine and postpartum obstetrics to deepen the IBCLCs recognition and ensure appropriate ongoing care for common and life-threatening complaints. It will include a discussion of neonatal jaundice, neonatal fever, severe weight loss, pyloric stenosis, congenital birth defects and genetic disorders; the lecture will also address postpartum depression, post-operative infections, and postpartum preeclampsia. Armed with this understanding of clinical red flags, IBCLCs will be empowered to better care for their breastfeeding patients, while also understanding when immediate medical assessment is imperative.

With the increase in the prevalence of obesity internationally, the world is turning its attention to effective forms of treatment. As a result, surgical techniques are increasingly being used in an attempt to ensure weight loss, reduction of comorbidities and hormonal balance in young patients of childbearing age. However, as a restrictive and disabsortive surgery, its impacts on pregnancy, childbirth and postpartum outcomes have been increasingly studied closely. Scientific studies provide substantial data on lactation after bariatric surgery, with common outcomes such as greater use of supplementation, less exclusive breastfeeding, shorter duration of breastfeeding and a higher rate of nutritional and vitamin deficiencies. Less studied, however, are its emotional effects on the lactating person, as well as the impacts on body recognition and the difficulties in dealing with the new morphological breast/chest configuration. Therefore, it is essential that the health professional who is dedicated to working in support of breastfeeding is specially trained to support families for the proper management of breastfeeding in the presence of substantially increased risks, as demonstrated after bariatric surgery.

Craniofacial anomalies (CFA) are a common anatomical malformation that affects the craniofacial region; they present either as cleft lip (CL), cleft palate (CP), or cleft lip and palate (CL/P) with varying degrees of severity. The incidence depends on the population’s ethnicity and geography. Infants with CFA can experience feeding difficulties either at the breast or at the bottle because they can have issues with their suck, swallow, breathe sequence and milk transfer.

This presentation will provide an overview of the anatomy of CFA. Techniques on how best to support families with CFA infants who wish either to breastfeed, maintain lactation or transition towards breastfeeding post-surgery will be discussed. Health care professionals involved in the care sometimes lack the expertise of supporting breastfeeding and often only recommend maternal pumping and specialised bottles. There is limited research about feeding infants with CL/P directly at the breast. A clinical case will be presented to illustrate clinical techniques and sequence of care.