Académique Documents
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Breastmilk Power!
Premies, priorities & practice
ONLINE BREASTFEEDING CONFERENCE
Online: 6th March 2013 6th April 2013
at
www.iLactation.com
Speakers Biographies
Alice Allan MA IBCLC
Alice Allan is a trainer who retrained as a lactation consultant after the birth of her second daughter. She worked with the UKs Breastfeeding Network in London as a peer-supporter at the Whittington hospital and in the community. In Addis Ababa she volunteers at a large government hospital and trains doctors and nurses from a variety of institutions including midwives from the Hamlin Fistula midwifery school. Elsewhere in remote, rural Ethiopia she trains health workers about lactation. She is also a La Leche League leader.
After graduating from the University of Cape Town, Dr Bergman started his medical career as a mission doctor in Manama Mission, Zimbabwe. It was there that he began his work with KMC. During his seven years in Zimbabwe he completed a doctoral dissertation (Clinical Pharmacology, MD = unsupervised PhD) on deadly scorpion stings. He initiated Home Based Care programmes for HIV/AIDS. He introduced KMC to South Africa in 1995, and after 5 years, KMC became official policy for care of prematures in the hospitals of the Western Cape province. During this time he completed a Masters in Public Health. He was for 6 years Senior Medical Superintendent of the Mowbray Maternity Hospital and five Midwife Obstetric Units, overseeing 18,000 births per year. His last posting was as a technical advisor to the health department on health reform. He enjoys sharing the wildlife of Africa with his wife and three children.
local committees and organizations she is also active in the Connecticut Breastfeeding Coalition. A long-time believer in the use of pasteurized donor human milk when needed, she was founding Medical Director of the New England Mothers Milk Bank and is currently co-Medical Director of the developing Mothers Milk Bank of the Western Great Lakes. She has authored a number of chapters, monographs, research articles, and ABM protocols. Her research interests center on breastfeeding and the use of human milk in the neonatal intensive care unit, cup feeding, donor milk and donor milk banking, and the education of medical professionals. She lectures extensively in the United States and abroad. She lives in Glastonbury, CT, with her husband of 28 years, and has 4 children.
Presentation Abstracts
No Mother Left Behind: Reducing Racial Disparities in Breastfeeding Rates
by Kimberly Seals Allers BA, MS (60 minutes) For over 40 years, breastfeeding rates among African American women have significantly lagged white women. The impact of fewer breastfed babies in the African American community cannot be ignored when you consider that the infant mortality rate among African American babies is 2.4 times higher than for white babies. The CDC has said that increasing the number of breastfed babies could reduce this disparity by as much as 50%, because a higher majority of African American babies are born pre-term. These infants, born too small, too soon or too sick need mothers milk the most to increase their chances of survival and future health. Increasing breastfeeding among African American women is a critical priority and can help reduce infant mortality and improve the health and vitality of all African American babies. This presentation will explore the cultural nuances of breastfeeding in the African American community to better help lactation specialists connect with and communicate with African American clients. It will improve competency in the barriers affecting African American women. Eight specific barriers will be discussed along with practical information on messaging to African American women. I will also present findings of my recent project in Jackson, Mississippi, Birmingham, Alabama, and New Orleans, Louisiana examining the critical role of community as it relates to breastfeeding success among African American women. The presentation seeks to give breastfeeding supporters the knowledge and cultural competency so that no mother is left behind.
Maternal and infant rights in the NICU: Mother-Care, lactation, breastfeeding and issues of ownership
by Carol Bartle RN, RM, IBCLC, MHSc (60 minutes) This session will present data from a qualitative research project and interviews with mothers who had babies admitted into a neonatal intensive care unit. It will also examine issues with mother-baby separation, authoritative knowledge, NICU culture, mother knowledge and mother-well-being and argue that caring for a baby in a NICU setting also requires attention be paid to Mother-Care as a part of best practice. The theory of salutogenesis, or the generation of well-being, will be presented in the context of how mothers (and fathers) may achieve the three components of meaningfulness, manageability and comprehensibility, suggested as being necessary for well-being, while their baby is in a neonatal unit. This presentation will explore how application of the Baby Friendly Hospital Initiative and the Ten Steps to Successful Breastfeeding could provide more protection, not only for lactation and breastfeeding, but also for maternal bonding and infant attachment, within a human rights and ethics framework.
Hyunjeung and White-Traut describe mothers experiences in the neonatal intensive care unit as hovering around the edges of mothering. As ordinary acts of mothering, lactation and breastfeeding endeavours become challenging within the neonatal unit a process of unbonding is an ever present possibility. Neonatal environment system changes and ways of supporting mother-[parent]-well-being, lactation and breastfeeding will be discussed.
Small Wonders: A Catalyst for Change towards More Family Centred Care
by Alison Baum MA, MSc (60 minutes) The child health charity Best Beginnings has developed the Small Wonders Change Programme to support cultural shift towards more family-centred care in neonatal units in ways which will improve health and wellbeing outcomes with a particular focus on increasing breastmilk expressing and breastfeeding as well as Kangaroo Care. At the heart of the Small Wonders National Change Programme is the Small Wonders DVD that follows fourteen families with premature and sick babies on their journey from birth, to first contact with their baby, to one year on. Amongst the 12 films on the DVD are films on expressing breastmilk, transition to independent feeding, holding your baby and preparing for home. Best Beginnings went through a rigorous process of consultation and piloting to develop the Small Wonders DVD to ensure the DVD delivers to both the evidence of effective practice and the needs of parents of sick and premature babies. This included consulting more than 200 professionals and over 100 parents during the production process and then piloting the DVD with staff and parents in Yorkshire and Humber and Scotland. Due to the in depth process of engagement and consultation that underpinned the production process, the DVD is endorsed by 28 organisations including several Royal Colleges and UNCIEF. To maximise the impact of the Small Wonders DVD, Best Beginnings has recruited a network of 417 Small Wonders Champions (mostly neonatal staff and midwives) who have volunteered their time to champion the Small Wonders DVD and Change Programme in their hospitals. The DVD was officially launched in June 2012. To-date the charity has distributed 76,000 copies of the DVD across 141 neonatal units in the UK. In addition the Small Wonders DVD is being used in pre-registration and post-registration training of healthcare professionals. In her talk, Alison Baum will share clips from the DVD, talk about the consultation process that underpinned its production and share insights from market research with parents who viewed rough-cuts that informed the content and style of the final DVD. She will highlight how equal effort has been put into the effective embedding of the DVD as into the making of the resource and outline how Best Beginnings has recruited and is supporting Small Wonders Champions to be catalysts for change in their hospitals. .
Mother Care (KMC). This includes several components, chiefly Skin-to-skin contact (SSC), then breastfeeding, and then support with early discharge. KMC is becoming increasingly accepted, but a coherent scientific rationale is lagging. I will present such a rationale, built on the central dogma of all biological processes: the DNA makes proteins, which make the brain, which with more DNA makes everything else. The adaptation in epigenetics, sensory experience for developmental neuroscience, and reproductive fitness in evolutionary biology converge holistically in this understanding. The common thread in all these is the environment. The Environment of Evolutionary Adaptedness (EEA) for humans is the mothers chest, defined in essence as maternal-infant skin-to-skin contact (SSC). The environment is never static, and the EEA spans a spectrum from expected through harsh to hostile. Genetic and neurological adaptations in harsh environments allow the organism to achieve reproductive fitness, by trading optimal development and well -being for a shorter lifespan with rapid reproduction. The mechanisms whereby this is achieved have recently been revealed, they are triggered by maternal separation, leading to toxic stress, autonomic activation with high cortisol. The concept of allostasis further elaborates how long term adverse effects follow from early life events. The basis of this understanding comes from mammal research on maternal neonate separation models. My own recently published research will be presented showing that separation from mother trebles autonomic nervous system tone, and dramatically impacts quality of sleep, compared to SSC. These finding are consistent with the science presented. In terms of our evolutionary biology, this suggests that infants should not sleep alone, and any clinical care in the absence of mother may be experienced as toxic stress. SSC is currently seen as a non-invasive intervention; the challenge for the future is to view it as the normal care environment. Working with nature in this way, even very preterm infants will better tolerate any needed invasive care. Early in 2012, the AAP published a summary of the above scientific rationale, entitled Early adversity, Toxic Stress and the role of the Paediatrician (Garner). This fails however to emphasise the relevance of this research to the neonatal period. I will explain this, arguing that the smaller and younger a newborn is, the less resilience it has, and the more in need of mothers body it is. The required technology should then be added as required. Amazingly, in this environment infants at 28 weeks show suckling behaviours, and can exclusively breastfeed by 32 weeks.
You want it; They own it! Copyright Law and Ethics
by Liz Brooks JD, IBCLC, FILCA (75 minutes) How can you get your hands on some excellent breastfeeding pictures for the client handout you are writing? Why not just download that great photo from that nifty website? This session defines the four areas of intellectual property (IP) law, focusing particularly on copyright law around the world. The iLactation attendee will learn about IBLCE Code of Professional Conduct Principle 2.5, requiring IBCLCs to respect IP laws. Learn how to protect your own materials from unauthorized use, and how to obtain permission to use copyright-protected materials from others. You will also learn the websites and links for several sources of permission-for-use-granted lactation materials, available for immediate use.
outcomes. Clinically based articles often discuss strategies for breastfeeding multiples, but many focus mainly on breastfeeding mechanics rather than on the physiological and psychosocial issues that profoundly influence the woman breastfeeding multiples. Lactation Consultants and other members of the familys healthcare team must put all the puzzle pieces together in a holistic manner if they are to offer effective yet sensitive strategies for managing the typical, yet multiples-specific, breastfeeding challenges this special situation presents. This session will offer an overview of the recent literature addressing breastfeeding multiples and related factors, synthesize the findings into a cohesive whole, and consider the process for developing clinical interventions for breastfeeding issues associated with multiple-birth infants.
Human Milk and Breastfeeding for Very Low Birth Weight Infants: Nature's Contribution to Technology's Miracles
by Kathleen Marinelli MD, IBCLC, FABM, FAAP (60 minutes) The historical importance of human milk in the survival of premature babies is recognised and I will discuss the current evidence-based rationale for the key role of human milk in the therapeutic regimen of VLBW (Very Low Birth Weight) infants. I will look at the use of both mothers own milk and donor milk for VLBW infants and consider the challenges of breastfeeding a VLBW infant in the NICU. As we explore the developmental transitions toward exclusive breastfeeding in this population, we need to identify supportive practices in a NICU environment which value the use of human milk in VLBW infants.
Game-changing Research about Breastmilk Expression: Early Hand Expression and Hands-on Pumping
by Jane Morton MD, FAAP, FABM (60 minutes) In considering milk production in mothers of preterm and term infants, I will review the research on hand expression used in the first 3 postpartum days and hands-on pumping used after lactogenesis and the influence of these techniques on milk production and composition. I will discuss the clinical implications and subsequent research. The scope of the problem of insufficient milk production in mothers of both term and preterm infants will be covered, followed by the rationale for hand expression used in the first postpartum days and the influence of this technique on subsequent milk production.
Baby-Friendly Bedside Care for Low and High Risk Infants: A Shared, Sustainable, Proactive Model
by Jane Morton MD, FAAP, FABM (60 minutes) There is a need for change in early breastfeeding management practices. I will look specifically at the low risk mother-infant dyad and the high risk mother-infant dyad, and discuss my Share the Care: 5-point Plan. There is convincing evidence that change is needed and the rationale for re-prioritizing 3 objectives, A, B, and C A attachment (latch and transfer) B breastmilk production
C calories (to meet appropriate nutritional parameters) to C, B and A for high risk mother-infant dyads will be discussed. Finally I will consider how a sustainable model of care can provide efficiency, a stable, expanded skill base, and accountability.
Ten Ps for Premies: Best Practice Guidelines to Support Breastfeeding in the NICU
by Mary Kay Smith RN, IBCLC, FILCA (60 minutes) Breastfeeding of premature or sick babies offers unique challenges. The development of the Ten Ps for Premies identifies ten practices to support breastfeeding in the Neonatal
Intensive Care Unit (NICU). It includes practices that promote human milk as the primary source of nourishment and help transition the baby to effective breastfeeding. These guidelines are for sick full term infants as well as preterm infants. Due to improved technology in the area of preterm birth, the age of viability has become lower year by year. Mothers face unique challenges; those related to the situation of prematurity as well as the stress of a life event with an uncertain outcome. The provision of breast milk supports superior nutrition as well as improved physical and cognitive development of the prematurely born infant. The stress of a complicated pregnancy, the need for extended bed rest to delay delivery, and the potential for experiencing a cesarean birth combined with a lack of knowledge and social and economic factors, all impact the success of initiating and maintaining milk production and the ability for mother and baby to bond and nurture each other as baby grows.
Keeping Faith in the Essentials: Supporting premature babies in low resource settings Ethiopia
by Alice Allan MA, IBCLC (45 minutes) Working with prem babies in low resource countries can blind carers to the richest resource of all, the mother. Alice Allan, a lactation consultant working in Addis Ababa looks at the progress being made, and the challenges still facing premature babies in Ethiopia. According to the recent WHO Born too soon report, Ethiopia is ranked 172 out of 184 countries for deaths due to complications of preterm babies. It is reported that 2,612,700 preterm babies are born in Ethiopia, of which 32,700 die from complications, including an inability to breastfeed.
Continuing Education
CERPs Approval Number: C21332 CERPs allocated = 16.5L & 2.25E CERPs Please note that if you are thinking of taking the IBLCE exam, our continuing education counts for 18.75 pre-exam education hours. There is no test to claim the education points with iLactation. For CEU, CNE and CME credits, each part of the world has different requirements. We can provide the necessary documentation for individuals to submit for credits to their local authority. Please contact us at info@ilactation.com.
Conference Timeline
1. iLactation Conference Breastmilk Power! Premies, priorities and practice registration begins on 14th January 2013. 2. Early bird registration from 14th January 2013. 3. Full registration begins on 1st February 2013. 4. iLactation Conference Breastmilk Power! Premies, priorities and practice officially begins on IBCLC Day, 6th March 2013. 5. Presentations will not be available after 6th April 2013. 6. Questions asked of speakers on or before 20th March 2013 will be answered by 31st March 2013. 7. Questions asked of speakers on or before 6th April 2013 will be answered by 17th April 2013. 8. CERP certificates to be collected by 30th April 2013.
Registration Information
Early bird registration for our next conference, Breastmilk Power! Premies, priorities and practice, opens on 14th January 2013 at http://www.ilactation.com/register/. The conference begins online with presentations viewable from IBCLC Day, 6th March 2013. Below you will find the registration price according to your country, which is determined by the International Lactation Consultant Association membership categories. Early bird prices apply from 14th January 31st January 2013. From 1st February full registration prices apply. Conference will be online from IBCLC Day, 6th March 2013 6th April 2013.
Delegates will have unlimited access to all of the presentations until the end of the conference on 6th April 2013, including our Ask the Speaker facility and the Handouts. The Conference is a complete package; it is not possible for you to register for individual presentations. iLactation uses PayPal as the main payment method. If Paypal is not available in your country or you encounter other difficulties with PayPal please contact us at info@ilactation.com for an alternative payment method. Membership Categories
Category A: Anguilla, Australia, Austria, Bahamas, Bahrain, Belgium, Bermuda, Brunei, Canada, Cayman Islands, Croatia, Czech Republic, Denmark, Finland, France, Germany, Greece, Hong Kong, Hungary, Iceland, Ireland, Israel, Italy, Japan, South Korea, Kuwait, Latvia, Luxembourg, Macao, Netherlands, New Zealand, Norway, Oman, Poland, Portugal, Qatar, Saudi Arabia, Singapore, Slovenia, Spain, Sweden, Switzerland, Taiwan, Trinidad and Tobago, United Arab Emirates, United Kingdom, United States of America Category B: Albania, Algeria, American Samoa, Antigua and Barbuda, Argentina, Azerbaijan, Belarus, Bosnia and Herzegovina, Brazil, Bulgaria, Chile, China, Colombia, Costa Rica, Cuba, Dominican Republic, Grenada, Ecuador, Iran, Jamaica, Kazakhstan, Latvia, Lebanon, Lithuania, Malaysia, Mexico, Peru, Romania, Russia, St. Lucia, South Africa, Thailand, Turkey, Uruguay, Venezuela Category C: Armenia, Bolivia, Egypt, El Salvador, Georgia, Ghana, Guatemala, Honduras, India, Indonesia, Iraq, Nigeria, Pakistan, Paraguay, Philippines, Sri Lanka, Timor-Leste, Turkmenistan, Ukraine, Uzbekistan, Vietnam Category D: Afghanistan, Bangladesh, Benin, Cambodia, Ethiopia, Guinea, Haiti, Kenya, Kyrgyz Republic, North Korea, Malawi, Rwanda, Tajikistan, Uganda, Zimbabwe
Group Registrations
Group registration will apply to groups of 6 or more delegates registering in one transaction. The organizer of the group needs to contact us at info@ilactation.com with the list of names and email addresses for all your group members, and any purchase order numbers required by your organization. We will invoice the organization or group organizer for one registration payment, which will be the total amount due for the number of delegates multiplied by the group registration price. (eg 6 delegates x $160 = $960) We will provide a group receipt. Only registered paid group members are eligible for continuing education points.
iLactation is developing a sister site called iMothering to be launched in early 2013. It will be an inspiring and informative site built for mothers, by mothers. If you sign up to the email newsletter and refer friends, colleagues and clients, you will all be in the draw for some wonderful prizes. Sign up now at www.iMothering.com.