Breastfeeding: Navigating the bumps – September/November 2013

 

More Rock Stars of Lactation™ presented at our third online breastfeeding conference, Breastfeeding: Navigating the bumps. This was held online during September – November 2013 and had delegates from 45 countries.

 

Denise Altman RN IBCLC LCCE

Denise Altman is a private practice lactation consultant and nurse educator, and the owner of All The Best in Columbia, South Carolina, USA. She has worked in a variety of roles in the healthcare system from staff nurse to clinical educator, with twenty years experience in Maternal/Child Health. She is also a freelance writer with numerous articles for parents and healthcare professionals in print, as well as two medical textbooks, History and Assessment: It’s All in the Details and Mentoring Our Future.


Mentoring our future

Many professionals recognize the need for mentoring newcomers, but often have no idea where or how to get started. This session began with an overview of mentoring, an examination of existing programs, creation of a program, as well as elements of a good mentor. The heart of the session covered choosing individuals for mentoring (finding a good fit), identifying learning needs, individualized teaching modalities, and setting limits. There was also a review of mentoring options, from simple role shadowing to internships.

 

Lisa Amir MBBS MMed PhD IBCLC FABM FICLA

Dr Lisa Amir is a general practitioner and has been an International Board Certified Lactation Consultant since 1989. She is the author of over 40 peer-reviewed articles on breastfeeding. She works in breastfeeding medicine at The Royal Women’s Hospital in Melbourne, and in private practice. She is a Principal Research Fellow at Mother & Child Health Research, La Trobe University and is the Editor-in-Chief of the open access journal, International Breastfeeding Journal.


A new way to think about nipple and breast pain

Nipple and breast pain are common problems experienced by breastfeeding mothers. The causes may be complex: incorrect attachment, trauma from infant tongue-tie, infection with bacteria or fungi (yeast), nipple vasospasm, other factors – alone or in combination. In this presentation, current concepts of pain were introduced, and a new model for understanding nipple pain was presented. Using a model developed for musculoskeletal pain, three categories can contribute to the nipple pain associated with breastfeeding: local stimulation, regional influences and central sensitisation. Case presentations were interpreted using the model.

 

Amal Aly El-Taweel MD IBCLC

Dr El Taweel graduated from the Cairo Faculty of Medicine in 1986, obtained a Master’s of pediatrics in 1992 and a Doctorate of Pediatrics in 2002. She is devoted to breastfeeding promotion and became an IBCLC in 2003. She is a board member and treasurer, executive manager and educational coordinator of the Egyptian Lactation Consultants’ Association (ELCA). She is responsible for the reputable pre-exam educational program conducted by ELCA. She is on the ILCA multilingual committee, a member of IBCLC clinical instructor task force, a member of Academy of Breastfeeding Medicine and International Baby Food Action Network (IBFAN) and a member of the advisory committee of IBFAN Arab World. She has presented at several international conferences, both in person and online.


Breast feeding culture, trends and support in Egypt

This presentation addressed the Egyptian breastfeeding culture from antiquity to modern days, the current situation and the efforts to support breastfeeding. It also discussed the achievements breastfeeding supporters have accomplished led by the Egyptian Lactation Consultants Association (ELCA).

 

Adelina Garcia RN IBCLC

Adelina Garcia is a nurse specializing in Primary Care Public Health. She currently works in the Basque Health Service, Osakidetza, Spain. Since 2007 she has been the president of La Leche League of Euskadi (Spain) and is active in the promotion and protection of breastfeeding at both community and state level. Adelina became an IBCLC in 2003 and has been the IBLCE Coordinator in Spain since 2004. She works vigorously to promote the role of the certified Lactation Consultant in Spain. She has spoken at various national conferences and has taught in numerous training courses on breastfeeding for health professionals as part of BFHI training. She is part of the Technical Committee of the Strategy for Pregnancy Care, Birth and the Neonatal Period organized by the Spanish Ministry of Health team and a research project for the development of recommendations for breastfeeding, a step towards the development of a clinical practice guideline on breastfeeding.


Breastfeeding, ethics and legality

Our work as lactation consultants must abide by ethical principles that facilitate the mother-baby relationship and are based on respect for the laws and in compliance with the Code of Professional Conduct of the IBCLC. This presentation defined the responsibilities of the IBCLC in relation to ethical issues such as conflicts of interest, professional and client autonomy, confidentiality, accountability, evidence-based practice and intellectual property rights. It also offered participants information on the ethical principles that govern our clinical practice, so as to facilitate the understanding of their responsibilities in relation to the Code of Professional Conduct of the IBCLC and the International Code of Marketing of Breastmilk Substitutes.

 

Foteini Hassiotou BSc(Hons) PhD PhD

Dr Foteini Hassiotou graduated from the Aristotle University of Greece in 2005 with a BSc in Biology and First Class Honours in Microbiology. She then completed a PhD in Plant Physiology at The University of Western Australia (UWA, 2009). Shortly after, Dr Hassiotou joined the Hartmann Human Lactation Research Group of UWA, commencing a second PhD on breastfeeding physiology and the cellular composition of breastmilk, including stem cells and immune cells. She completed her second PhD in 2012, which included ground-breaking reports, such as the discovery of pluripotent stem cells in breastmilk, and the development of tools to assess the health status of the lactating breast.

Dr Hassiotou is now an Assistant Professor leading the Cell Biology Team of the UWA Hartmann Group. Her research concentrates on the maternal cells that are present in breastmilk and their involvement in health and disease. Her projects include research on (a) the properties of breastmilk stem cells and microRNAs, their function in the development of the breastfed infant, and their use in regenerative medicine; (b) the use of breastmilk stem cells as models in breast cancer; (c) the aetiology and management of low milk supply, such as in mothers of preterm infants; (d) tools to successfully and rapidly diagnose mastitis, understand its causes, and develop potential clinical management avenues; and (e) how breastfed infants regulate their appetite.


How breastmilk immune cells respond to infections of the mother or infant

Breastmilk is the optimal source of nutrition, protection and developmental support for the infant. In addition to a plethora of molecules with bioactive immunological functions, breastmilk contains immune cells. Although these cells have been studied in colostrum and in the milk of other species, such as the bovine, little is known about their numbers and properties in human milk. We conducted an extensive analysis of immune cell numbers and populations in human colostrum and breastmilk from different lactation stages. We found that although colostrum contains high proportions of immune cells out of total cells, this drops significantly in the first two weeks after birth to a low baseline level of up to 2% of immune cells out of total cells. This is maintained throughout lactation unless the mother and/or her baby have an infection. During infections, immune cell numbers significantly increase, and then return to the low baseline level of mature breastmilk upon recovery. This stipulates the importance of breastfeeding for the protection of the infant, and can be used as a diagnostic tool for infections of both the infant and the lactating breast.

 

Pam Heselev RN RM DipAppSci(CHN) MHS IBCLC

Pam Heselev is a maternal & child health nurse and lactation consultant who has worked extensively with babies experiencing feeding difficulties due to positional/tonal problems both in private practice and in a large Melbourne teaching hospital. She has conducted a trial of an assessment tool and treatment program for these babies and completed her Master of Health Science (Nursing) at Deakin University in 2009. Pam is a casual lecturer at Deakin University, Holmesglen TAFE and RMIT University, lecturing to midwifery students, maternal & child health nurses and early childhood development students.


Flat heads, stiff necks and breastfeeding

This presentation provided an overview of plagiocephaly and torticollis and the effect these conditions may have on breastfeeding. The results of a literature search undertaken as part of a Master of Health Science was presented. Plagiocephaly and torticollis were defined and an overview of diagnosis and management discussed. The development of normal sucking was also presented. The importance of the prone position for normal motor development of the infant was outlined.

 

Kathleen Kendall-Tackett PhD IBCLC FAPA

Dr Kathleen Kendall-Tackett is a health psychologist and an International Board Certified Lactation Consultant. She is the Owner and Editor-in-Chief of Praeclarus Press, a small press specializing in women’s health. Dr. Kendall-Tackett is a Research Associate at the Crimes against Children Research Center at the University of New Hampshire, Clinical Associate Professor of Pediatrics at Texas Tech University School of Medicine in Amarillo, Texas, USA. She is a Fellow of the American Psychological Association in both the Divisions of Health and Trauma Psychology, Editor-in-Chief of US Lactation Consultant Association’s journal, Clinical Lactation, and is President-Elect of the American Psychological Association’s Division of Trauma Psychology.

Dr. Kendall-Tackett is author of more than 320 journal articles, book chapters and other publications, and author or editor of 22 books in the fields of trauma, women’s health, depression, and breastfeeding, including Treating the Lifetime Health Effects of Childhood Victimization, 2nd Edition (2013, Civic Research Institute), Depression in New Mothers, 2nd Edition (2010, Routledge), The Psychoneuroimmunology of Chronic Disease (2010, American Psychological Association), and Breastfeeding Made Simple, 2nd Edition (co-authored with Nancy Mohrbacher, 2010).

Dr. Kendall-Tackett received a Bachelor’s and Master’s degree in psychology from California State University, Chico, and a Ph.D. from Brandeis University in social and developmental psychology. She has won several awards including the Outstanding Research Study Award from the American Professional Society on the Abuse of Children. She was named Distinguished Alumna, College of Behavioral and Social Sciences, California State University, Chico. In 2011, she received the John Kennell & Marshall Klaus Award for Excellence in Research from DONA International (with co-recipient Thomas Hale), and the Community Faculty Award from the Department of Pediatrics, Texas Tech University School of Medicine.


A new paradigm for depression in new mothers

Recent research has revealed a surprising link between inflammation and depression. Although inflammation was first identified as a risk factor for postpartum depression in the late 1990s, researchers have recently learned that it underlies all the other risk factors. All other known causes of depression, such as pain, psychological trauma, lack of social support, or sleep problems, trigger the inflammatory response. This presentation explained why women are vulnerable to depression in the last trimester of pregnancy and postpartum. It also told of the link between depression in pregnancy and preterm birth, and why breastfeeding protects maternal mood because it downregulates the stress and inflammatory response.

Treatment options for depressed, breastfeeding mothers

The negative effects of postpartum depression, on both mother and baby, are too serious to ignore. Fortunately, there are a number of treatments for depression with empirically demonstrated efficacy, including a wide range of non-pharmacologic treatments. Almost all are compatible with breastfeeding. This session summarized research findings on omega-3s, exercise, bright light therapy, cognitive and interpersonal psychotherapy, St. John’s wort, and antidepressant medications. It also described the implications of each for breastfeeding.

 

Noura Khoori Bsc

Noura Khoori was born in Abu Dhabi, the capital city of the United Arab Emirates and eldest among seven siblings. She has been a La Leche League Leader since 2010, mother of 3 kids, 2 girls and a boy, whose ages range from 3.5 – 7.5 years. She is an environmentalist by degree and worked in that field for 4.5 years before deciding to quit work and stay home with her children. She now couples LLL work (which she loves and finds very fulfilling) with home-making as well as writing and publishing story books for children.

Breastfeeding in the UAE: past, present and future

This presentation gave a brief history of the importance of breastfeeding in the UAE culture, and how that has changed in modern days with the evolving dynamics of the society. It also discussed some challenges currently faced by breastfeeding mothers, and the role of hospitals and support groups in improving the status of breastfeeding in the UAE. La Leche League Leaders of the country gave some insight into ideas that can be adapted to spread more awareness about the importance of breastfeeding among mothers and families here.

 

Miriam Labbok MD MPH MMS FACPM IBCLC FABM

Dr Labbok is the Director of Carolina Global Breastfeeding Institute (CGBI) and CGBI Professor, Department of Maternal and Child Health, Gillings School of Global Public Health, Chapel Hill, North Carolina, USA.

She previously served as the Senior Advisor for Infant and Young Child Feeding and Care, UNICEF HQ. In this post, she supported international consideration of infant feeding approaches, weaning foods and young child feeding. In her section, she oversaw all related issues, including breastfeeding support in hospitals, in the community, and through support of the International Code of Marketing of Breast-milk Substitutes and subsequent WHA resolutions, a code designed to reduce false and misleading marketing practices of the commercial infant formula industry. Prior to this posting, she served as Chief, Maternal Health and Nutrition at USAID and as Director of Breastfeeding at the Institute for Reproductive Health at Georgetown University. There, she developed and led the WHO Centre of Excellence in breastfeeding and she served as Technical Secretariat for the Innocenti Meeting, where the Innocenti Declaration was developed. Recently, she co-authored on article on international women’s and children’s rights, achieving exclusive breastfeeding in the US, and a systematic review of community-based breastfeeding support in developing countries. She also has written extensively on the issues of breastfeeding and family planning, guilt, maternal health outcomes, hospital practices, and support in child care.

A pediatric epidemiologist, she has served as an expert and/or consultant for the US and NC Institutes of Medicine, the World Bank, Centers for Disease Control and Prevention and WHO expert committees related to MCHN/FP, and currently serve on the US Secretary of Health’s Advisory Committee on Infant Mortality. Her research, teaching and service are dedicated to operational research and translation of research evidence into well evaluated service and social change activities have resulted in more than 100 articles in refereed journals, more than 40 chapters and edited books, dozens of monographs, and hundreds of scientific presentations. She has been honored for her work by USAID, LLLI, ILCA, all of her schools of higher learning, and other organizations.


Implementing the ten steps in the US and globally: Introducing quality of care for breastfeeding in the hospital setting

Did you ever wonder where and how the Baby-friendly Hospital Initiative was born? This presentation covered the development and history of the Ten Steps for Successful Breastfeeding, touching on issues relevant globally, with emphasis on some of the special issues in the US. This presentation covered the basics, but also share the genesis and outcomes of the revision of the BFHI materials as well as review progress. Recent findings on issues in implementation and sustainability were also highlighted.

 

Nikki Lee RN BSN MS IBCLC CCE CIMI CST

Nikki started her professional life as a nurse in the Intensive Care Units of Bellevue Hospital, New York City, in 1971. After the birth of her first daughter in 1975, her interest in breastfeeding bloomed. She worked with breastfeeding mothers when she was a public health nurse, and was librarian for her local La Leche League chapter. Her passion for mothers and babies was unleashed in full at Booth Maternity Hospital, in Philadelphia, Pennsylvania. Since 1986, Nikki has made mothers and babies the focus of her career. The birth of her second daughter in 1990 strengthened her dedication.

Her publications include Complementary and Alternative Medicine in Breastfeeding Therapy, the monographs Benefits of Breastfeeding and Their Economic Impactand Sexuality and Breastfeeding and the educational pamphlet How to help yourself through labor. She is a frequent contributor to Lactnet, the international list-serve for breastfeeding helpers and writes reviews for both the Journal of Human Lactation and the Old-Time Herald, a magazine dedicated to old-time music.

Nikki is a childbirth educator, a lactation consultant, an infant massage instructor, a craniosacral therapy practitioner, a writer, and a public speaker. She was the Film Reviews Editor for the Journal of Human Lactation from 1994 to 2006. At present, she maintains a private practice as a consultant (with a wide range of clients, including a health department), is adjunct faculty in the distance learning lactation program at Union Institute and University, and teaches infant massage classes. Other interests include figure skating, back-up rhythm guitar (Irish,Cajun and old-time), and bodhran.

Nikki imagines clean air, clean water and fresh wholesome food being major international goals. She imagines that the pursuit of armaments and war is dropped, because it isn’t good for babies. She sees everyone, everywhere, caring for and about babies.


Connecting the dots: birth and breastfeeding

When birth is traumatic or technologically driven, breastfeeding can suffer. Breastfeeding helpers often have to pick up the pieces after a traumatic birth, when mother and baby are disconnected from each other. This presentation connected the dots between current industrial birth practices and their impact on breastfeeding. It was as excellent for health care professionals who work with laboring and birthing women as it was for those who are working with breastfeeding women and babies.

 

Kathleen Marinelli MD IBCLC FABM FAAP

Dr Marinelli is an Associate Professor of Pediatrics at the University of Connecticut School of Medicine, and a neonatologist and director of Lactation Support Services at Connecticut Children’s Medical Center, Hartford, CT, USA. She graduated from Cornell University and Cornell University School of Medicine and was a pediatric intern, resident, nephrology fellow and neonatology fellow at Children’s National Medical Center, George Washington University, Washington DC.

She was in the first group of 20 physicians to be recognized internationally with the designation of “Fellow of the Academy of Breastfeeding Medicine” (FABM), and is serving her tenth year on the ABM Board of Directors, also chairing the Protocol committee. She represents ABM on the United States Breastfeeding Committee, where she Chairs the Media/Public Relationship Committee and was elected USBC Chair-elect in August 2012. She is a member of the American Academy of Pediatrics (AAP) Section on Breastfeeding, and since 2000 has served as the AAP Connecticut Chapter Breastfeeding Coordinator. She was instrumental in drafting and passing comprehensive breastfeeding in the workplace legislation in Connecticut in 2001, and Jury Duty Legislation in 2012. She volunteers on a medical advisory committee to Baby-Friendly USA. While serving on many state and local committees and organizations she is also active in the Connecticut Breastfeeding Coalition. She has authored a number of chapters, monographs, research articles, and ABM protocols. She lectures extensively in the United States and abroad.


The inter-relationships between pregnancy, obesity and breastfeeding

Research clearly demonstrates a set of complex yet critical links between pregnancy, obesity and breastfeeding. This presentation began to unravel these linked relationships and discuss what health care practitioners can do to promote both healthy patient weight and breastfeeding. Recent research demonstrates short and long-term benefits to breastfed babies of obese mothers. There was a review of the variety of behavioral, physiological, growth and confounding factors that all contribute to breastfeeding’s role in obesity prevention including the inter-relationship between maternal obesity, lack of breastfeeding and childhood obesity. Also reviewed were some of the obesity specific anatomical breastfeeding challenges that result from maternal obesity along with specific practical strategies for helping obese mothers breastfeed.

 

Lawrence Noble MD FABM IBCLC

Since completing his neonatology fellowship at Rainbow, Dr Lawrence Noble has worked as a pediatrician and neonatologist in New York City, currently at Mount Sinai School of Medicine, Elmhurst. At the same time, he has become increasingly involved in breastfeeding medicine. He founded and chaired the Bronx Breastfeeding Coalition and the Breastfeeding Beyond Basics Conferences in NYC. He co-chaired the HHC Taskforce on Breastfeeding, which developed major initiatives to increase breastfeeding at 11 hospitals. He was site director for the AAP Breastfeeding Residency Curriculum. He’s an executive committee member of the Breastfeeding Section of the AAP, the Board of Directors of the Academy of Breastfeeding Medicine and the NYC Breastfeeding Promotion Leadership Committee. He is chair of the ABM Education Committee and Protocol Translation Sub-committee.


What’s really wrong with one bottle?

Whereas great improvements have been made in promoting total breastfeeding rates, exclusive breastfeeding rates remain below national objectives. Recent research has elucidated the importance of initial feeds on both short and long term health. This presentation reviewed current literature on the danger of formula. The role of feedings pertaining to changing the bacteria flora and its effect on infections and inflammatory diseases, including NEC, were explored. In addition, the talk concentrated on the profound effect of breastfeeding on long-term health by slowing initial growth rates in infants. Research has demonstrated the role of rapid infant weight gain on long term obesity, CV disease and type 2 diabetes. Up-to-date research was presented, as well as practical implications from the research on counseling breastfeeding mothers about colostrum, early milk supply and perceptions of poor weight gain. The importance of exclusive breastfeeding at the breast for developing self-regulation of food was explained, as was the importance of the WHO growth charts.

 

Kathy Parkes BSPsy RN IBCLC FILCA

Kathy Parkes is a registered nurse, International Board Certified Lactation Consultant, Fellow of the International Lactation Consultant Association, and has a Bachelors in Science in psychology. She currently practices in a mid-sized rural hospital in Texas, USA as the in-hospital IBCLC for the mother-baby unit and the Level II NICU. Breastfeeding Perspectives is Kathy’s private practice, offering speaking, teaching, and online consultations to mothers. Practicing as both a RN and IBCLC since 1992, Kathy has extensive experience in a wide variety of lactation issues.


Jaundice and the breastfed infant

Neonatal hyperbilirubinemia (jaundice) occurs in approximately 50% of term infants within the first three to four days after delivery, usually dissipating by day six. It can have serious consequences, including bilirubin encephalopathy which is reversible, and kernicterus which is permanent. This session delved into risk factors for hyperbilirubinemia, assessments and treatments for jaundice, and current recommendations for prevention, follow-up, and keeping the breastfeeding dyad together.

 

Amy Peterson BS IBCLC and Mindy Harmer MA CCC-SLP

Mindy Harmer has practiced in the field of speech-language pathology for 17 years as a private practitioner, specializing in pediatrics. Mindy is co-owner of a free standing clinic in Twin Falls, Idaho, USA, where she treats clients with a variety of speech-language and feeding disorders. Some of her tiniest clients are breastfeeding babies who require her knowledge of oral-motor intervention to help them breastfeed successfully. Mindy became interested in breastfeeding when she was encouraged to pump breastmilk for her son who was born with a congenital heart defect. Mindy is also the mother of two breast and bottle-fed children. Mindy often works side by side with her co-author Amy Peterson.

Amy Peterson has been working with breastfeeding mothers for 17 years, and has been an IBCLC in private practice since 2001. She also contracts at a local hospital and periodically teaches the Baby Friendly Hospital Initiative to staff. Amy is a retired La Leche League Leader, and breastfed her four children for many years! Amy enjoys being an advocate for mothers who need encouragement to reach their breastfeeding goals. She is the co-author of Balancing Breast and Bottle: Reaching Your Breastfeeding Goals, as well as two tear-off sheets.


Mythbusters lactation style: debunking infant feeding assumptions

When a breastfeeding mother plans to introduce a bottle, are we using evidence-based practice, or misinformation and old wives’ tales, in answering the mother’s questions? In a fun, game-style approach, the presenters highlighted common infant feeding assumptions. Based on evaluation, assumptions were verified as “confirmed, plausible, or busted.” Armed with this new information, professionals are now able to answer mothers’ questions accurately while adhering to the WHO Code.

 

Linda J Smith MPH FACCE IBCLC FILCA

Linda Smith is a lactation consultant, childbirth educator, author, and internationally-known consultant on breastfeeding and birthing issues. Linda is ILCA’s liaison to the World Health Organization’s Baby Friendly Hospital Initiative and consultant to INFACT Canada/IBFAN North America. As a former La Leche League Leader and Lamaze-certified Childbirth Educator, she provided education and support to diverse families over 35 years in 9 cities in the USA and Canada. Linda has worked in a 3-hospital system in Texas, a public health agency in Virginia, and served as Breastfeeding coordinator for the Ohio Department of Health.

Linda was a founder of IBLCE, founder and past board member of ILCA, and is a delegate to the United States Breastfeeding Committee from the American Breastfeeding Institute. Linda earned a Master Degree in Public Health through the Boonshoft School of Medicine at Wright State University in 2011. She owns the Bright Future Lactation Resource Center which is on the internet at www.BFLRC.com, whose mission is “Supporting the People who Support Breastfeeding” with lactation education programs, consulting services, and educational resources.


ABCs of breastfeeding management

This presentation discussed a protocol and model for breastfeeding support in the community. It covered the importance of physical contact between the mother and baby. It went on to explain a three-step approach to ensuring sufficient milk transfer and explains maternal comfort and its relationship to infant breastfeeding.

 

Gonneke van Veldhuizen-Staas IBCLC

Gonneke van Veldhuizen-Staas was born in 1956 as the 5th child in a teacher’s family, she grew up in the rural south of the Netherlands. Her primary professional education was as a Kindergarten teacher(1979), followed by primary schoolteacher (1980). While being a stay-at-home mom for her five children she became a La Leche League Leader (1985) and a Lactation Consultant (1992). When the youngest child was a fourth grader she re-entered the teaching profession, while freelancing as a lactation consultant. Starting on the first of January 2008 she is the owner of Eurolac Lactatiekunde, a private lactation consultant practice, educational center and e-shop for hard-to-get breastfeeding supplies and support goods.


Overabundant milk supply

Milk production is a carefully designed and complicated collage of structures and processes to assure the optimal nurturing and nourishment of a child, while preserving normal behavioral possibilities for the mother. In some women the mechanism of regulation of milk production seems to not automatically work as designed. This can create accumulation of milk in the breasts, and the ongoing production of more milk than needed. For both mother and child this overabundant production and availability of milk can lead to various unwanted symptoms and distress. Although not scientifically studied in depth, there are many kinds of advice circulating for mothers to handle overproduction, with more or less success, and even with opposite effect.

Overabundant milk supply is an often under-diagnosed condition in otherwise healthy lactating women. Symptoms can occur in both mother and child and may lead to pathology in both. This presentation explored “Full drainage and block feeding” (FDBF) as an adequate and user-friendly way to normalize milk production and treat symptoms in both mother and child. Case studies and feedback from health care professionals and mothers, and newly developed additions were also included.

 

Diana West BA IBCLC

Diana West is an international board certified lactation consultant (IBCLC) in private practice, co-author with Teresa Pitman and Diane Wiessinger of the 8th edition of La Leche League International’s The Womanly Art of Breastfeeding. She is also co-author with Lisa Marasco of The Breastfeeding Mother’s Guide to Making More Milk and Dr Elliot Hirsch of Breastfeeding After Breast and Nipple Procedures, and ILCA’s Clinician’s Breastfeeding Triage Tool. She is the author of the Defining Your Own Success: Breastfeeding After Breast Reduction Surgery.

She is on the Editorial Review Board for the Journal of Clinical Lactation, a La Leche League Leader and the Media Director for La Leche League International, has a bachelor’s degree in psychology, and is the administrator of the popular BFAR.org, LowMilkSupply.org, and LactSpeak.com websites.


Making more milk

With new research and innovations in the lactation field, there are now many more ways to increase milk production than in previous years. This talk presented the most promising of these new methods, with information about targeting the method to the underlying problem.

Breastfeeding after cosmetic surgery

A comprehensive discussion of breast augmentation and reduction surgeries and their impact upon lactation; discussion of incidence, motivations, surgical techniques, implications for lactation, psychological factors, breastfeeding management, and resources.

 

Barbara Wilson-Clay BSEd IBCLC FILCA

Barbara Wilson-Clay has been in private practice in Austin, Texas, USA, specializing in physician-referred difficult breastfeeding cases since 1987. She helped found The Mothers Milk Bank at Austin, a non-profit community milk bank, and served on its board of directors for 11 years, the last 2 as Vice President. As a volunteer lobbyist in the Texas legislature during each legislative session since 1993, Barbara has been instrumental in helping pass legislation promoting breastfeeding rights. Her corporate clients include Motorola, IBM, and Apple Computer for whom she has developed workplace lactation support and lactation rooms.

Barbara’s research and commentaries have appeared in The Journal of Human Lactation, Current Issues in Clinical Lactation, Birth Issues, Breastfeeding Abstracts, The International Breastfeeding Journal, the ICEA Journal, and Archives of Disease in Childhood. She serves on several editorial review boards. Barbara served as the ICLA representative to the International Board of Lactation Consultant Examiners (IBLCE), and has been a La Leche League Leader since 1981. She was named a Fellow of the International Lactation Consultant Association (FILCA) in 2008. Barbara is co-author of the text book, The Breastfeeding Atlas, and numerous multi-lingual patient and professional educational materials.


Clinical use of nipple shields

Nipple shields have been used for over 500 years to solve various breastfeeding problems. Older shield designs were associated with numerous risks, including exposing the infant to toxins and impairing maternal milk production. Changes in the design of modern nipple shields have reduced risks; however, the evidence-basis for the clinical use of nipple shields continues to lack rigor. The consensus among health care professionals is that additional research is required to establish best practices for the use of the device. This presentation discussed the history of nipple shields, reviewed the risks and benefits of nipple shields, and evaluated the current evidence available to guide practice when using ultrathin silicone nipple shields. Practical issues such as applying, cleaning, and weaning from nipple shields were reviewed.

 

Wendy Wright MBA IBCLC RLC

Wendy Wright has been working with mothers to help them meet their breastfeeding goals since 2007. Wendy is the founder of Lactation Navigation – a corporate lactation support program located in the Silicone Valley, CA, USA In this capacity Wendy helps mothers from Cisco, Apple and Intel return to work without weaning. In the fall of 2013 Wendy will launch The 16 Minute Club – a home delivery lactation support program aimed at providing the right information and products to mothers at the right time to assist mothers throughout the USA in meeting their duration goals.

Prior to lactation consulting, Wendy spent 15 years in the biotech industry. Wendy has a BS in Health Services Administration from the University of Arizona and an MBA with a Marketing emphasis from the University of Cincinnati. Both Lactation Navigation and the 16 Minute Club allow Wendy to combine the business skills she learned in the corporate setting with her love of breastfeeding.


Returning to work without weaning

Women have been combining work outside the home and breastfeeding for centuries. Laws, standards, equipment and expectations have all evolved over time and now the breastfeeding woman can rightfully expect to breastfeed well beyond a year without weaning during full time employment. Lactation accommodations must be made for optimal breastfeeding outcomes; these changes are minimal, provide a positive return on investment for employers and allow the health benefits of breastfeeding to continue beyond the maternity leave.

This presentation discussed the current standards for breastfeeding duration, a variety of lactation accommodation models, an international overview of the laws governing breastfeeding in the workforce, common strategies to combine work and breastfeeding successfully, a review of milk storage and handling requirements and guidelines for determining the quantity of milk required for each absence.