Lactation & Breastfeeding Online Course(s) & Continuing Education

The body’s ability to process sensory information provides the basis of all function. Interestingly, our most foundational sense of movement is often overlooked as a component of lactation support. In this presentation, we will tie together research in neurology, primitive reflexes, mental health, and sensory integration to demonstrate the significant impact vestibular function has on the quality of lactation and infant/caregiver relationships. Participants will enhance their observational skills and explore ways to provide support for body/breastfeeding dyads using a vestibular processing perspective. Experiential activities will offer participants the opportunity to play with movement and reflect on personal experiences to enhance self-awareness and compassionate care.

Unless access to clean water and appropriate infant formula is reliable, the World Health Organization does not recommend HIV-infected mothers stop breastfeeding. Remarkably, only about 15% of babies exclusively breastfed by their HIV-infected mothers become infected with HIV. This suggests that although breast milk is a vehicle for HIV transmission, the milk itself exhibits a strong protective effect against infection. Breastfed babies ingest 100,000 - 100,000,000 maternal cells every day via breast milk; what remains largely unclear is the contribution of these cells to the milk’s anti-viral qualities. A large study has been undertaken to isolate cells from human milk in order to measure the ability of these cells to engulf and destroy HIV by a mechanism known as phagocytosis. Over 50 samples of breast milk obtained from healthy women have been analyzed. Phagocytosis of HIV was detected in all samples. Activity did not appear to correlate with stage of lactation. Various cell types known for phagocytic capacity were identified and measured, including granulocytes, monocytes, macrophages, and dendritic cells. All samples exhibited strong granulocyte activity.These data further demonstrate that phagocytosis of HIV by immune cells from breast milk can be measured. This information will be critical for design of therapeutic vaccines capable of reducing the likelihood of mother-to-child transmission of HIV in areas where breastfeeding is essential.

Within the lactation world, it is widely accepted that optimizing infant feeding practices and normalize breastfeeding, we must frame breastfeeding as the physiological norm and not breastfeeding as the risk behaviour. For example, breastfeeding does not reduce the risk of type II diabetes, but rather not breastfeeding increases the risk of type II diabetes. Most of us have had this framing drilled into us during our training and can deftly turn around any headline to reflect the correct wording.

It is, indeed, scientifically correct that breastfeeding is the physiological norm for human: artificial feeding is no more “normal” for the human baby than using a wheelchair to be mobile. However, health communication is about more than delivering scientifically accurate facts to the target population. In motivating parents to initiate breastfeeding and then maintain exclusive breastfeeding for 6 months and alongside complementary foods for at least 2 years and beyond, the science of health behaviour is often overlooked.

In this session, we will discuss some of the major models of health behaviour change and how risk is perceived and acted up on within these models, drawing from both maternal-child health and other public health. We will review the rationale for using risk-based language as well as the evidence for different perspectives, including the use of social marketing strategies.

Skilled support for weaning from the breast is often overlooked. Most policies and programs focus on initiation of breastfeeding, the continuation of lactation and support for overcoming challenges. In practice it can be harder for families to find information, support, and guidance to wean, whatever stage of their breastfeeding journey. Often it is perceived that support for breastfeeding is all about continuing. Like breastfeeding, weaning has socio-cultural, biological, immunological, physiological and anthropological considerations, and affects the physical and mental health of both mother and child. This talk will explore the many considerations, and complex interplay between multiple factors, that the infant feeding support workforce need to understand to meet the support needs of families. We will explore: the child’s developmental readiness, emotional, immunological, and nutritional needs, and what the milk and relationship mean to them. We will also look at the impact on the mother: what we know about how the pace of weaning may impact the lactating parent’s breast health and wellbeing and how to meet the evolving needs of their baby. And finally, we look at the dyad collectively. Supporting a positive ending to breastfeeding is an essential part of the skills and knowledge of lactation professionals.

While lactation support spans the time from the prenatal period through weaning, there is less available information about the process of weaning. We know that there are a variety of reasons why families need or desire to stop lactation. We also know that there are emotions and logistics involved in ending a breastfeeding/chestfeeding relationship. Depending on the goals, timeline, and individual context of each dyad there are a variety of factors that need to be considered by the family. Unfortunately, these families often feel that the clinical information and emotional support available for weaning is lacking.

Evidence-based support presented in a compassionate manner can make a world of difference to the individual's decision-making process and overall weaning experience. For lactation supporters and professionals, being able to support families who are stopping lactation and/or ending their breastfeeding/chestfeeding relationship is a vital skill. This presentation will offer research-based information about the reasons for weaning, steps lactation supporters and professionals can take when working with families, and scripts for compassionate phrasing while offering this important information and support.

New mothers experience the milk ejection reflex, or “letdown,” in various ways. While some feel no physical symptoms, others experience a tingling sensation and some even have significant pain or sadness. Babies also have different experiences, from the overactive “drink from the firehose” to frustratingly long waiting at feeding time. This presentation explores the multitude of influences on letdown, from internal hormones and chemical signaling pathways to the research related to such external influences as diet, alcohol, stress, and the use of synthetic oxytocin.

Many moms believe that they either do not produce sufficient milk or need a quicker, more effective letdown. Suggestions to deal with these issues range from drinking beer to adding different nutritional supplements to the diet, from hypnosis to oxytocin nasal spray. We will explore the research and unravel the best practices and recommendations we can give to clients related to their concerns about the milk ejection reflex.

We know that responsive feeding gets breastfeeding off to the best start. New parents are told that breastfed babies often feed 8 – 12 times a day, but in practice many new mothers will find themselves breastfeeding more frequently than this. Research exploring breastfeeding frequency is however conducted primarily with younger infants, focuses simply on breast versus bottle, or was funded by industry.

This presentation reports novel findings from a research study of 18,000+ mothers with a baby or child aged 0 – 5 years old. It examines how often babies feed during the day and night for each age range by milk feeding type, mode, and approach (e.g. schedule versus responsive) and how frequent day and night feedings remain the norm for breastfed babies into the preschool years. The data also explores differences in maternal perceptions of infant variations in hunger e.g. in response to growth spurts, variations over different days, and cluster feeding, highlighting how breastfeeding mothers describe a more varied pattern of infant feeding compared to those formula feeding.

Together the findings challenge notions that most babies breastfeed between 8 – 12 times per 24 hour and that irregular patterns or varied numbers of feeds are normal for breastfed infants. Although many breastfeeding practitioners will recognise this pattern, these findings will provide both an addition and challenge to the scarce existing research literature on infant feeding patterns.

The impact of breastfeeding on fertility has been neglected by research in recent years. There can be significant variation in when the menstrual cycle returns for parents, which can impact their plans for family expansion. Some who conceived easily before breastfeeding, can find it much more difficult to conceive while breastfeeding. Some who struggle with recurrent miscarriage can wonder if breastfeeding is impacting their ability to carry to term. Many are left wondering whether to wean their nursling in order to conceive again, which can be a very difficult decision to make, when that conception is uncertain. This presentation will review the research on how breastfeeding affects the menstrual cycle, how fertility is initially suppressed and how it returns, the ongoing effect that breastfeeding can have on fertility, how to use breastfeeding as a contraceptive method (if desired), how to maximise chances of conception (if desired) and whether it may affect a pregnancy after conception has occurred.

Male breastfeeding support is evidenced to influence breastfeeding behaviors. Fathers play a vital role in determining women's choice to breastfeed. Many studies regarding fathers' breastfeeding influence included participants from a variety of ethnic backgrounds. Only a few studies examined African American men's breastfeeding attitudes. Within the U.S. disparity context, Black African immigrant breastfeeding experiences have not been measured.

The social and cultural breastfeeding experiences of Congolese Immigrants compared to those of African Americans were explored, analyzed, and contrasted. In the immigrant study, the breastfeeding cultural practice's visibility enables the breastfeeding perceptions of Congolese fathers. They identify their Congolese origin as a warrant for breastfeeding decisions and practice. Breastfeeding is a natural process that does not require prior deliberations between expectant couples. Breastmilk is valued for its God-given virtues rather than its medical benefits.

In the cultural context of African American, family, and friends enable breastfeeding support perceptions. Personal experiences and knowledge of breastfeeding benefits are predictors of breastfeeding decisions. However, there is not a cultural, existential framework supporting breastfeeding. This study's findings and recommendations guided the development of a dynamic African American men breastfeeding support toolkit designed to utilize existing public health structures.

As Lactation professionals we are taught and often reminded of the “laid back breastfeeding position” or “biological nursing” and how this can best facilitate a great latch. While this can be very useful and helpful in most cases, there will be circumstances where this position does not lead to a better latch and leaves the professional, the mother and the baby continuing to struggle.

This presentation will explain other useful and practical tips on how to help facilitate a baby to get the best latch possible, why the “look” of the latch does not matter, all while empowering the mother and baby to do it themselves, without physical help from the professional. The techniques covered include self-attachment in the side-lying position, self-attachment in the koala hold and trying the flipple technique to get as much breast tissue into the baby’s mouth as possible. This can be helpful for all babies struggling with latch including babies with tongue and/or lip ties. This presentation will include video examples and practical tips.