IBCLC Detailed Content Outline: Pharmacology and Toxicology Focused CERPs - Section IV
Access CERPs on Pharmacology and Toxicology for the IBCLC Detailed Content Outline recertification requirements. Enjoy convenient on-demand viewing of the latest Pharmacology and Toxicology focused IBCLC CERPs at your own pace.
To fully support their clients’ health throughout gestation, birth, and nursing, midwives need to know about herbs. Not a lot; in fact, what most midwives need to know can be learned in few hours. Wise use of herbs is especially important during pregnancy and lactation. Using herbs instead of drugs to allay problems protects both mom and fetus from harm. Even more importantly, the abundant nutrition available from select herbs – like stinging nettle, oatstraw, comfrey leaf, and red clover blossoms–has a much more profound influence on maternal health than any supplement and can make the difference between an easy birth and a complicated one. Herbal medicine is simple, safe, and effective at all times in a woman’s life, including during her childbearing years. Here are the things I think it most important that a midwife know about herbs and herbal medicine.
To fully support their clients’ health throughout gestation, birth, and nursing, midwives need to know about herbs. Not a lot; in fact, what most midwives need to know can be learned in few hours. Wise use of herbs is especially important during pregnancy and lactation. Using herbs instead of drugs to allay problems protects both mom and fetus from harm. Even more importantly, the abundant nutrition available from select herbs – like stinging nettle, oatstraw, comfrey leaf, and red clover blossoms–has a much more profound influence on maternal health than any supplement and can make the difference between an easy birth and a complicated one. Herbal medicine is simple, safe, and effective at all times in a woman’s life, including during her childbearing years. Here are the things I think it most important that a midwife know about herbs and herbal medicine.
Topic: The Recreational Drug-Marijuana Dilemma - [View Abstract]
It is quite apparent that in our current society, pregnant and breastfeeding women do use and ingest recreational substances (in both a wisely manner and unwisely manner) and drugs of abuse, natural and/or synthetic. Marijuana use is of special concern currently, especially considering the ethical and legal concerns of its use. The objectives of this presentation are to effectively evaluate recreational drug use during breastfeeding and pregnancy; to counsel mothers who are pregnant or breastfeeding and using recreational drugs, including marijuana; and to discuss and address ethical concerns regarding marijuana use.
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Therapeutic Care of the Opioid-Impacted Mother-Infant Dyad
Dr. Lisa Cleveland is a Pediatric Nurse Practitioner and a tenured Associate Professor at UT Health San Antonio, School of Nursing. Her innovative research with mother-infant dyads impacted by opioid use has contributed to changes in clinical practice and improved outcomes. Her recovery residence, Casa Mia, is a collaborative partnership between the School of Nursing and the nonprofit, Crosspoint, Inc. Casa Mia provides safe and supportive housing for pregnant and parenting women with opioid use disorder where they can recover with their children.
In addition, the findings of Dr. Cleveland’s Maternal Opioid Morbidity Study are providing insight into the contextual factors surrounding maternal opioid use relapse and overdose deaths; the leading cause of maternal mortality in TX and a growing cause nationwide. Dr. Cleveland is now developing and psychometrically analyzing a brief screening instrument to help identify women at-risk for overdose death so they may be referred to life-saving resources. Further, Dr. Cleveland is leading the Texas Targeted Opioid Response to ensure access to Narcan: https://www.morenarcanplease.com/, and opioid overdose identification and reversal education. She is also leading a community paramedicine project to prevent overdose, increase the use of peer recovery services, and improve access to treatment.
Between the 2000 and 2009, the use of opioids, such as heroin or prescription pain relievers, during pregnancy increased fivefold. Prenatal opioid exposure can result in newborn withdrawal symptoms often called Neonatal Abstinence Syndrome (NAS). NAS can include inconsolable crying, sleeplessness, and poor feeding. National rates of NAS have tripled since 2000. Opioid detoxification during pregnancy is not recommended and is linked to preterm labor and fetal distress. Therefore, it is recommended that pregnant women with opioid use disorder be stabilized on medication assisted treatment (MAT). However, these medications may still result in newborn withdrawal.
Treatment of NAS is typically focused on symptom management using soothing techniques and medications. Soothing techniques are non-pharmacological comfort measures and are considered the first line of care for infants with NAS. However, these techniques can be difficult to implement in a busy nursery environment. Medications may alleviate some NAS symptoms but, the use of medication is linked to a longer and more costly hospital stay and prolonged separation of mother and infant. As such, the purpose of this presentation is to explore best practices in the care of the opioid impacted mother-infant dyad with an emphasis on the important role of the biological mother.
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Amy Holmes has practiced as a pharmacist for 21 years with the last 9 years being focused in neonatal critical care at Novant Health Forsyth Medical Center in Winston Salem, NC. She holds degrees in pharmacy from University of North Carolina (BS) as well as the University of Maryland at Baltimore (PharmD). Amy serves as the Residency Program Director for the acute care PGY1 program at Novant Health Forsyth Medical Center. She is active in state and national pharmacy organizations including the Pediatric Pharmacy Advocacy Group (PPAG) and the American Society of Health-System Pharmacists (ASHP).
Topic: Updates in Pharmacotherapy for NAS - [View Abstract]
This presentation will provide a general overview of neonatal abstinence syndrome (NAS) followed by a more detailed discussion of some of the more recently published approaches to treatment. This will include review of alternative dosing strategies for morphine as well as the use of buprenorphine for management of NAS symptoms.
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Lia Bello is a Family Nurse Practitioner, educated at the University of Virginia, and is Certified in Classical Homeopathy. Lia is the founder of the Homeopathic Nurses Association www.nursehomeopaths.org and past president of the Council for Homeopathic Certification. As America’s foremost homeopathic nurse educator, Lia loves to open up the world of Homeopathy to mothers, nurses and other healthcare practitioners and teaches courses around the U.S. which award CE’s for nurses. Her website, www.learnhomeopathy.org, features video courses and many informative articles. Residing in Santa Fe, New Mexico, Lia has had a private practice specializing in holistic and homeopathic acute and chronic healthcare for over 43 years.
This presentation would start with a brief explanation of what homeopathy is, how it works and why it is safe for mother and infant (over the counter ). I will give info on remedy use for nausea of pregnancy, threatened miscarriage, insomnia, mal-positioning, emotional upsets/fear of giving birth/grief/post partum depression, physical trauma of giving birth, prevention of prolonged labor, natural induction, after-pains, mastitis, engorgement, jaundice, milk supply problems. I will include how remedies are dosed and administered for mother and infant.
Carol Smyth is an IBCLC and Cognitive Behavioural Psychotherapist working in both Primary Care and in private practice in Northern Ireland. With a background in psychology she is driven by a passion to promote attachment based and trauma informed care to families and babies. She is the author of the Why Infant Reflux Matters book, both an HCP education resource and a self-help book for families worried about their baby’s reflux and unsettled behaviours. When working with parents she aims to increase understanding of normal (often misunderstood) baby behaviours and to explain why these are often different from what we expect. This understanding helps to lower parental anxiety and promotes attachment strategies proven to reduce crying.
Topic: What Does Breastfeeding Mean for Fertility? - [View Abstract]
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.
