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Birth consequences: the impact of fentanyl epidurals during the first hour after birth
Facilitating skin-to-skin contact after caesareans
Birth weight, bilirubin and blood sugar: what do the numbers mean for normal newborn care?
Understanding and supporting early postpartum maternal health needs
Hospital breastfeeding and the need to include paediatrics
Breastfeeding and medication: why are drugs seen as a barrier to ongoing breastfeeding?
Breastfeeding management and medical ethical issues
Hands on examination and assessment of the lactating breast
Breastfeeding strategies for tongue-tied babies
So “big” and still breastfed?
Cultural challenges of breastfeeding and sleep
Using the evidence to support breastfeeding in the face of HIV
Climate change and the sustainability of breastfeeding
Spotlight on infant formula: why action to tackle the harmful practices of companies is needed
Cybernetic communication: media, ethical concerns, and guidance for lactation specialists
Using galactagogues for lactation support—a review of evidence and health provider perspectives
A place at the Bedside: NICU Families on the NICU Team
Does attachment matter? The health impact of bonding to brain development and the epigenome
Supporting mothers who experience breastfeeding / nursing aversion and agitation (BAA)
Nurses’ experience of the work of breastfeeding support on the night shift

 

Birth consequences: the impact of fentanyl epidurals during the first hour after birth

by Kajsa Brimdyr, PhD, CLC

Intrapartum drugs, including fentanyl administered via epidural, have been previously studied in relation to neonatal outcomes, especially breastfeeding, with conflicting results. We examined the normal neonatal behavior of suckling within the first hour after a vaginal birth while in skin-to-skin contact with mother in relation to these commonly used drugs. Suckling in the first hour after birth has been shown in other studies to increase desirable breastfeeding outcomes. Method: Prospective comparative design. Sixty-three low-risk mothers self-selected to labor with intrapartum analgesia/anesthesia or not. Video recordings of infants during the first hour after birth while being held skin-to-skin with their mother were coded and analyzed to ascertain whether or not they achieved Stage 8 (suckling) of Widström’s 9 Stages of neonatal behavior during the first hour after birth.

This presentation includes video clips illustrating newborn behavior across the spectrum of fentanyl exposure. Although more than 80% of mothers in the United States intend to breastfeed, many have discontinued by 10 days postpartum. This research offers potential insight into why mothers are unable to meet their own breastfeeding goals, and has world wide implications as the use of fentanyl as an epidural anesthetic increases around the world.

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Facilitating skin-to-skin contact after caesareans

by Jeni Stevens, RN, RM, IBCLC

This presentation will discuss: What is skin-to-skin contact, what are its benefits and what are the common barriers. It will examine the WHO and UNICEF recommendations in regards to skin-to-skin contact, and also look at maternal reflections of previous Caesarean vs Caesarean with skin-to-skin contact.

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Birth weight, bilirubin and blood sugar: what do the numbers mean for normal newborn care?

by Jennifer Thomas, MD, MPH, IBCLC, FABM, FAAP

Blood sugar, bilirubin and birth weight are among the most common reasons babies get supplemented with something other than their mother’s own milk. But without context, they are nothing more than random numbers flying through the air. In this presentation, learn why health care professionals should avoid acting on these numbers without first learning what they mean for each baby in context of their clinical picture.

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Understanding and supporting early postpartum maternal health needs

by Kristin Tully, PhD

This presentation will present multi-method research methodologies for understanding women’s health experiences in the first three months postpartum, which we conceptualize as the “4th Trimester.” Alongside these strategies for optimizing knowledge, Dr Tully will describe ongoing improvements in patient-centered care through the examples of infant side-car bassinets for postnatal units and a conversations-based approach to patient-provider interactions. The overall message is that maternal and child health issues intersect and can compound one another, so more readily accessible and integrated care is needed. By centering the most marginalized groups, we can get closer to effectively enabling all new mothers and their families to have the care that they want and need.

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Hospital breastfeeding and the need to include paediatrics

by Helen Calvert, BA(Hons)

There will be many breastfed children admitted to paediatric wards. Breastfed babies are on paediatric wards due to concerns over weight gain; breastfed babies are on paediatric wards due to congenital heart defects and other serious conditions; breastfeeding can continue for 2, 3 4 or more years. Breastfeeding and breastmilk provide comfort, pain relief, infection control and immune factors to sick children. Breastmilk can be consumed closer to a general anaesthetic than other milks can. Children’s wards and hospitals need to have the same breastfeeding knowledge and focus as postnatal wards and NNUs.

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Breastfeeding and medication: why are drugs seen as a barrier to ongoing breastfeeding?

by Wendy Jones, PhD, MRPharmS

Sharing decision-making is about being honest about the limits of knowledge and not just about healthcare professionals avoiding risk. All too often it seems that mothers are TOLD that they cannot breastfeed whilst taking medication or undergoing a procedure. There seems to be a patriarchal response from some professionals that breastfeeding is of lesser importance and can be interrupted “just in case”. This presentation also looks at some of the barriers to ongoing breastfeeding and how we can develop a discussion and an understanding of the needs of both professionals, mothers and also the babies.

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Breastfeeding management and medical ethical issues

by Khalid Iqbal, MD, IBCLC

It is a fact that many health care professionals inadvertently undermine breastfeeding. Even a piece of bad advice from a clinician is enough to throw lactation completely off track. In many cases, the breastfeeding failure is due to medical mismanagement. It must be realized that the attitude and advice of health professionals are significant factors in the success or failure of breastfeeding. The consequences of the mismanagement can be serious health problems among infants.

Medical ethics emphasizes that medical professionals should practice medicine with good scientific and technical abilities focusing on reaching a right and good decision. Medical ethics is a system of moral principles that apply value and judgement to the practice of medicine.

We can conclude from many practical examples that a bad advice leading to lactation failure should be labelled as a medical malpractice. All medical professionals must be aware of the proven fact that even decreasing the dose of breastfeeding will increase the risk of morbidity and mortality in infants.

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Hands on examination and assessment of the lactating breast

by Bryna Sampey, IBCLC

This presentation covers how to do a very thorough assessment and evaluation of the lactating breast. This includes: identifying anatomy appropriately, using language to help your client feel comfortable before, during, and after a manual assessment, how to identify and discuss any problems, tips and tools for expert palpation of mammary tissue, and next steps once your assessment is complete. In 60 minutes, you will learn to become warm, inclusive, competent and confident in your hands-on assessment of the breast.

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Breastfeeding strategies for tongue-tied babies

by Catherine Watson Genna, BS, IBCLC

How do we help infants to breastfeed when they have a mild to moderate tongue-tie? This presentation focuses on the management of breastfeeding in tongue-tied infants. Includes positioning and latch strategies, assessment of breastfeeding, addressing problems with milk transfer and coordination of swallowing and breathing, and exercises that might help improve sucking problems.

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So “big” and still breastfed?

by Alenka Benedik, IBCLC

This presentation is based on practical experience in counseling nursing mothers regarding weaning, and acceptable duration of breastfeeding, with the purpose of exploring the expert evidence regarding the duration of breastfeeding, the value of human milk, and the potential harmfulness of breastfeeding for the mother or child. In many industrialized countries, breastfeeding after a certain age is considered less acceptable, breast milk is assumed to have no value, and breastfeeding in public is not always acceptable. Lactation specialists and other health professionals play an important role in supporting nursing mothers and raising public awareness on the risks of early weaning on child and maternal health.

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Cultural challenges of breastfeeding and sleep

by Cecilia Tomori, PhD, MA

Why do so many new parents struggle with nighttime breastfeeding and sleep? The presentation will address this key question and examine nighttime challenges in a broader socio-cultural context. It will draw on Cecilia’s ethnographic research in the USA as well as other research to show that parents who intend to breastfeed frequently find learning how to breastfeed and getting some rest challenging. Moreover, in negotiating nighttime breastfeeding they find themselves at odds with medical advice and cultural expectations to prevent babies from falling asleep at the breast, avoid bringing them into their bed, limit nighttime feedings as quickly as possible, and train babies to “sleep through the night”. It will show that the tensions surrounding nighttime breastfeeding and sleep are relatively recent in history, and reflect particular cultural concerns. Finally, I will outline paths towards better nighttime guidance and support for families that is informed by the evolutionary origins of and cross-cultural approaches to nighttime infant care.

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Using the evidence to support breastfeeding in the face of HIV

by Pamela Morrison, IBCLC

The discovery in 1985 that a lethal virus could be transmitted through mothers’ milk led to fear about the wisdom of universal promotion of breastfeeding. What research influenced global HIV and infant feeding policy and how was the risk characterized? In Europe and America, where formula feeding was seen as safe, breastfeeding by HIV-positive mothers was banned outright. But global promotion of maternal choice to formula-feed gradually faltered in the face of growing evidence of unacceptably high rates of morbidity and mortality in developing countries. Thirty years later, today’s antiretroviral regimes greatly reduce the risk of vertical transmission of HIV and have been described as transformational. Breastfeeding for all is once again promoted and such a turnaround profoundly affects the information we can share with our HIV-positive clients.

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Climate change and the sustainability of breastfeeding

by Carol Bartle, RN, RM, IBCLC, PGDip (Child Advocacy), MHSc

Naomi Klein, in her book, This Changes Everything: Capitalism vs. the Climate discusses how corporate interests have exploited disaster situations and turned climate change catastrophes into business opportunities (Klein, 2014). Climate change has been described as a threat to a bottom line of sustainable development – human health (Neira, 2014). As the quest to sell more breast-milk substitutes intensifies and marketing becomes ever more aggressive, the continued decline of breastfeeding is of major concern. Global warming contributes to rising rates of climate disaster (McGuire, 2012), threatens population health, and contributes to poverty, income inequality, and pollution. However, the negative impact on the planet of industrial dairying and the increasing amount of milk powder is not always included in analyses of climate change risk. It has been suggested that the dairy industry is not only unsustainable but that the externalities resulting from the industrial dairy model results in more cost than profit (Foote & Joy, 2014). How the world’s babies are fed is of great significance to our collective future.

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Spotlight on infant formula: why action to tackle the harmful practices of companies is needed

by Alison McFadden, PhD, RM, ADM, Cert Ed

Based in part on research conducted in 2014, this presentation will highlight how promotion and marketing activities of breastmilk substitute companies undermine breastfeeding. More specifically it will explore challenges in implementing the International Code on Marketing of Breastmilk Substitutes providing specific examples from six countries: Bangladesh, Brazil, Indonesia, Nigeria, the Philippines and the UK. The presentation will emphasise the need for co-ordinated action to address these challenges and make suggestions for how this could be achieved.

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Cybernetic communication: media, ethical concerns, and guidance for lactation specialists

by Lourdes Santaballa, BA(Hons), MS, IBCLC

This presentation will discuss different ways in which cybernetic communication can be used by lactation specialists both personally and when working with clients and colleagues. it will detail the ethical concerns that may arise when using cybernetic media in the field of breastfeeding support and explain how the IBLCE Code of Professional Conduct for IBCLCs and the IBLCE Advisory Opinion: Professionalism In the Social Media Age provide guidance for the professional use of cybernetic media in the field of breastfeeding support.

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Using galactagogues for lactation support—a review of evidence and health provider perspectives

by Alessandra Bazzano, PhD, MPH

This presentation will present a recent literature review exploring published research on galactagogues, outlining the literature review process, results, limitations and conclusions. Secondly, the results of a survey of health providers (including physicians, lactation consultants and nurses) on use and knowledge about galactagogues will be presented. The survey methodology, findings and recommendations will be described in detail. Participants will gain an understanding of the current biomedical knowledge base on galactagogues and perceptions of health care providers about including galactagogues for lactation support.

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A place at the bedside: NICU families on the NICU team

by Naomi Bar-Yam, ACSW, PhD

This presentation will use research literature and hospital policies and programs to explore ways for families of babies in the NICU to be meaningful and active members of the NICU care team. We will define what a team is, who is on the NICU care team, the short and long term goals of the NICU care team as well as many tools and strategies that team members and the team as a whole have at their disposal to reach those goals.

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Does attachment matter? The health impact of bonding to brain development and the epigenome

by Laurel Wilson, IBCLC, BSc, CLE, CLD, CCCE, CPPI

Attachment begins during pregnancy, not in the moments, weeks, and years post birth. This attachment, the motherbaby bond, is forged through an awareness of the biological and emotional connection between mother and child from the very earliest moments of conception. The internal world of the mother and child is now known to be a strong influence in the behavior, health, and personality of a child. This crucial prenatal period through the first few years of life, often referred to as the Critical 1000, is impacted by the emotional and nutritional experience of the mother and has a lot to do with long term health and personality expression of the child. The prenatal and postpartum attachment that occurs, regardless of a mother’s conscious awareness, is changing the brain development, personality, and genetic expression of her baby. At no other time in their child’s life do parents influence who that child will be, both emotionally and physically, than during the 0-3 period of life. We now know that prenatal chronic stress leads to babies who cry more, sleep less, and are anxious. A mother’s thoughts create chemical signals that literally form her baby’s brain and lead to a happy or anxious child. Mothers have the ability to influence healthy brain development and genetic expression during pregnancy through the motherbaby bond. This presentation discusses epigenetics, brain development, molecular messaging between mother and baby, and the impact of stress on the baby’s future health.

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Supporting mothers who experience breastfeeding / nursing aversion and agitation (BAA)

by Zainab Yate, BSc, MSc, Doctoral Student

This presentation will cover what Breastfeeding / Nursing Aversion and Agitation (BAA) is, and what it is not (using published research studies, as well as mother-to-mother narratives), what may help a breastfeeding mother who experiences it, including brief assessment, options for what to try based on anecdotal evidence, and what to do if it doesn’t work. It then outlines the social media campaign to raise awareness of BAA, what the response is, and why it is important to raise the profile.

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Nurses’ experience of the work of breastfeeding support on the night shift

by Jane Grassley, PhD, RN, IBCLC

Nurses’ work of breastfeeding support on the night shift encompasses a complex interplay of interpersonal interactions with new families and visitors around priorities and expectations as well as negotiating institutional structures such as feeding policies and staffing. This presentation will identify characteristics of the night shift that impact nurses’ breastfeeding support; describe challenges to encouraging exclusive breastfeeding at night; and discuss strategies for managing these challenges.

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