Chance for a FREE MEMBERSHIP with Each One, Reach One & ILCA Membership

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Want to earn a FREE STANDARD MEMBERSHIP while advancing World Health Transformed through Breastfeeding and Skilled Lactation Care?

Participate in the Each One Reach One program! We respectfully request your help in encouraging your fellow lactation professionals to become members of ILCA.

 

Participate in the Each One, Reach One Campaign:

This campaign honors those who encourage others to join ILCA. New this year, we are offering a FREE STANDARD MEMBERSHIP to the ILCA member, in each of three categories, who refers the most members. Simply ask your colleagues who chose to join ILCA to include your name in the “Each One, Reach One” section.

Here’s other ways you can help advance the ILCA mission:

Let your colleagues know about ILCA membership and its benefits:

Encourage those who desire to enter the field that they might consider Student Membership:

ILCA offers membership to students enrolled with educational institutions or with lactation course providers at a significantly reduced rate. These student members have access to the full menu of benefits and can access the online Journal of Human Lactation. A member can qualify for student membership for up to two years.

Share how you have benefited from ILCA membership with your networks:

Connect with those in the lactation field via email, Facebook, Twitter, or other social media platform and encourage them to join.

If you have questions or need more information concerning ILCA member benefits, student membership, or the Each One, Reach One campaign, please contact us at membership@ilca.org or visit the ILCA website at www.ilca.org.

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Speakers: Deliver Presentations With Greater Impact

In an ongoing effort to bring ILCA members the tools you need to spread evidence-based information about breastfeeding and advocate for the IBCLC, ILCA partners with organizations that bring training, skills, tools, and more.

ILCA is partnering with Aspire Communications again this year to teach visually interactive presentation techniques. You may have already seen these methods used in various training platforms, such as the WIC Peer Counselor materials, the Business Case for Breastfeeding collection, the Vermont Birth and Beyond platform and the new Coffective Baby Friendly Hospital training initiative.

ILCA has developed a number of opportunities for you to work with Aspire Communications *and* support ILCA.

Aspire book shadowWebinars. Watch this year for free webinars designed to introduce the concepts of visually interactive presentation techniques. These webinars will give you the tools you need to more effectively communicate with your audiences.

New! Aspire Communications Retreat. If you’ve taken the short webinar intro course in the past, this is an opportunity for a deeper, hands-on immersion so you can confidently use the principles right away. Experts onsite will walk you through the learning process with individual attention, regardless of your level of presentation experience.

Even better, you’ll master these skills while basking in Arizona’s balmy, sunny winter weather at the Hilton Tucson El Conquistador Resort, February 25-27, 2015. The training includes valuable supporting materials—Aspire’s new Visual Language book series and template package. The book series documents everything you’ll be learning and the template package contains three pre-built master shows you’ll use to quickly assemble what’s known as a presentation platform—a flexible, powerfully visual collection of all your presentation content.

Enrollment in this 3-day event is limited to the first 30 registrants. When enrolling, be sure to use ILCA’s promotional code of ILCA050 and register before January 5th to receive special discounted registration for ILCA members. See more details, costs and registration information here: http://www.aspirecommunications.com/training-visual-language-western-retreat-tucson-2015.html

You’ll master:

  • All aspects of making and delivering PowerPoint presentations, including little known secrets that transform your talks into truly effective and engaging visual communication
  • Converting bullet points into entertaining and memorable visuals that captivate audiences
  • Building a flexible, hyperlink-based structure called a presentation platform that helps you organize and dynamically display any presentation topic at any moment
  • Including video, meaningful animations, and documents in your presentation materials
  • Building picture stories, picture roles, content graphics and other essential visual strategies
  • Key photography techniques for capturing and building a personalized visual content library

ILCA receives a portion of the proceeds from this event. So, support your organization and sign up today to get these fantastic, career-enhancing skills!

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New Strategies For Relieving Engorgement: Tips and Tools From Maya Bolman, BA, BSN, IBCLC

By Christine Staricka, BS, IBCLC, CCE, ILCA Medialert Team

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When Maya Bolman was a young girl in Russia, her godmother was known to all the women in her village as the one who could help with breastfeeding. People said her hands were “like magic.”

A young Bolman paid attention. She is now a well-respected clinical lactation care provider in the U.S. who uses her hands to help nursing mothers relieve the breast fullness that can interfere with their breastfeeding. In July, she brought her skills, clinical knowledge, and time-tested wisdom to the International Lactation Consultant Association® (ILCA®) 2014 Conference, and attendees returned home with a skill they could use immediately to help their own clients and patients.

Bolman observes that, since the breast has no fascia or muscle to aid in movement of fluids other than breast milk, congestion of the breasts is common during early lactation. As a new mother’s body sheds fluids from pregnancy and those given intravenously during hospital labor and childbirth, milk production begins in earnest. The breasts can become uncomfortably full or even swell to the point that milk ceases to flow. In addition, the skin covering the breast can become so taut and the areolae so swollen that the baby cannot latch. The simplest solution is a combination of gentle massage and manual milk expression, which softens the breasts and eases infant latch.

Evidence supporting the effectiveness of hand expression continues to mount. In locations lacking electricity for breast pumps, hand expression allows mothers to sufficiently maintain milk for premature and sick infants who are unable to feed directly at the breast. Teaching all new mothers to hand express ensures compliance with Step Five of the Ten Steps to Successful Breastfeeding, part of the Baby-Friendly Hospital Initiative.

“There is no right way to do hand expression, only the way that is gentle and that works,” Bolman explains. She has created a free video which she encourages to be shared with mothers (with appropriate credit to Bolman). Her work with Breast Feeding Medicine of Northeast Ohio confirms that even mothers who have already attempted these techniques on their own can still benefit from in-office treatment. The video provides an excellent introduction for new mothers and clinicians to hone their hand expression technique.

 

In her clinic, Bolman and her colleague, Dr Ann Witt, MD, FABM, IBCLC, teach mothers to use these techniques when they come in for hands-on treatment of engorgement and plugged ducts. She finds that mothers of the youngest babies typically ask for help with engorgement, while plugged ducts seem to peak around 10 weeks postpartum. During the session, Bolman shared videos of herself and her colleagues providing gentle, sweeping massage of the breasts. In a motion toward the axilla, they use the sides of their hands and a generous amount of olive oil mixed with a few drops of an essential oil. Mothers are encouraged to lie back at an angle similar to the position used for prone breastfeeding. If their babies are present and hungry, they feed on the opposite breast during treatment as desired.

Results of these treatment sessions are overwhelmingly positive. They produce relief of overall pain, resolution of plugged ducts immediately in at least half the cases, decreased levels of nipple pain and tenderness, reduced periareolar edema, and easier latching/feeding. This type of customized “touch care” of breastfeeding mothers is derived from the wisdom of the ages. It is also very appropriate and relevant for today’s mothers who frequently have little experience with physical touch to their breasts other than during intimacy.

Bolman firmly believes that mothers are empowered when they are taught techniques for hand expression and massage to relieve engorgement on their own. She insists that we cannot teach it enough times to the mothers in our care, regardless of the age of their babies.

“They really want to learn these techniques for self-care,” Bolman stated, “because they are not necessarily instinctive.” She firmly believes that lactation care providers should guide mothers’ hands through the process of hand expression by placing a hand over the mother’s hand rather than directly on mother’s breast. She observes that we can often find solutions to common challenges by looking to other cultures. Bolman’s background and personal experience of blending her native and adoptive cultures has provided the lactation field with a priceless treasure in her techniques.

For more information, please see Recapturing the Art of Therapeutic Breast Massage during Breastfeeding by Bolman, Saju, Oganesyan, Kondrashova, & Witt in the Journal of Human Lactation HERE.

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Maya Bolman, BA, BSN, IBCLC, was born and raised in Minsk, Belarus. Certified as  IBCLC in 2001. She has worked in both inpatient and outpatient settings and, since 2009, also worked as lactation consultant in a large pediatric practice and breastfeeding medicine practice. Bolman traveled to Russia in 2009, 2010 and 2012 to work with breastfeeding consultants and as the IBLCE Country Coordinator for Russia, Belarus, Ukraine and Latvia, helped to prepare 14 IBCLC candidates to pass certification exam and became the first IBCLCs in their countries. 

 

christineChristine Staricka is a hospital-based IBCLC. She became a Certified Lactation Educator through UCSD while facilitating local breastfeeding support groups. She studied independently while accumulating supervised clinical hours and passed the exam in 2009 to become an IBCLC. She holds a BS in Business Management from University of Phoenix. Christine is the co-owner of Bakersfield Breastfeeds, which provides lactation education to professionals and expectant parents. She has contributed to USLCA’s eNews as well as this blog. She enjoys tweeting breastfeeding information as @IBCLCinCA and maintains a blog by the same name. She is a wife and mother of 3 lovely and intelligent daughters and aunt to 4 nephews and 2 nieces, all of who have been or are still breastfeeding. She is partial to alternative rock and grunge music, especially Pearl Jam, and attends as many concerts as financially able with her husband of 18 years.

Posted in Breastfeeding, Breastfeeding Videos, Clinical Practice | 3 Comments

What Members Say About ILCA Membership…

We believe that International Lactation Consultant Association® (ILCA®) membership gives you valuable tools for providing evidence-based care to breastfeeding families. But don’t trust us – listen to your fellow members! We reached out to members from all over the world and asked:

WHY are you an ILCA member?

From Nicola O’Byrne (Ireland):

I’m very proud to be an ILCA member. Their membership represents a great example of leadership in our profession. They give wonderful support, guidance and knowledge to all of us as International Board Certified Lactation Consultants® (IBCLCs®). Thank you ILCA!

From Leigh Ann O’Connor (USA):

Being a member of ILCA is essential to my profession as a Private Practice IBCLC. It keeps me “in the know” in my field and keeps me connected to my peers around the world. I believe membership in my professional organization is important as it lets my voice be heard and I believe it is important to support the organization that supports me.

From Roberta Graham de Escobedo (Mexico):

Membership in ILCA means belonging to my “tribe.” Like minded, similarly focused, with shared passions, and fervently dedicated . . . those are some of the characteristics I have found in my fellow ILCA members. I am an ILCA member because I need to know that I am not working in a vacuum, but am a part of a worldwide network of change agents, movers, and shakers.

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From Opal Horvat (USA):

I believe, as part of our profession, one SHOULD belong to our organization of associates and colleagues. It unites us in a way that can be a mighty force. ILCA gives a voice to be heard that is much larger than just my own. I expect that ILCA will speak for us, defend us if needed, and promote us so that we can promote breastfeeding. They are our ambassador in the healthcare field, promoting better policies for a healthier, stronger, and more brilliant world.

Elvis Ngala (Cameroon):

I can’t be any more thankful to be an ILCA member. It has changed so much in my career and professional pursuit. Cameroon is gradually getting the lactation consultant on the map!

Inma Mellado (Spain):

When I passed the IBCLC exam 3 years ago, I decided to look for ways to connect with other IBCLCs. First, I started with the ones in my local and national areas but felt the need to be connected with something more global, which I found with ILCA membership.

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Jo Gilpin (Australia):

Working in isolation in a rural area in South Australia, I consider my ILCA membership essential to my private lactation consultant practice. I appreciate the fact that it is international in focus, therefore giving me the opportunity to view universal breastfeeding information and is a useful connection point with other lactation consultants world wide. My ILCA membership, with all its benefits and services, helps me maintain a high professional standard of service delivery to parents with their babies.

Christine Staricka (USA):

As a hospital-based IBCLC, my ILCA membership is a valuable tool in many ways.  My quick access to the latest research and the archives of the Journal of Human Lactation keep me current and help me educate hospital staff and update hospital lactation policies to reflect the best evidence base.  The articles also give me an international perspective that helps me consider lactation issues from a global scope. Our facility has benefited from my membership when I used my member discount to purchase items for World Breastfeeding Week.  The Members-Only section of the ILCA website provides me with skill-building tools for improving my value as an educator.  As a member of the professional association which supports my credential, I am able to represent the value of the IBCLC when participating in multi-disciplinary projects and teams in the hospital. I am providing better quality clinical care to our patients because of my member benefits. 

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Do you like what you see? Consider ILCA membership.

The new membership package for 2015 includes benefits that allow you to:

If you are new to ILCA and are joining for the first time, you will have full access to all of ILCA’s member benefits as soon as you join.

Join Now

If you are a current ILCA member, your membership expires on 31 December 2014. If you would like to continue your membership and receive the new benefits for 2015, including access to earn up to 10 FREE CERPs, you must renew by 1 January 2015.

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In addition to our standard membership, also consider our Student membership and Retired membership. Each comes at a reduced cost to encourage all those supporting breastfeeding families to be an ILCA member. Click HERE for more information.

Want to take advantage of our GROUP discounts? These offer you a 10% discount for each individual participating in a group. Group memberships require a minimum of five (5) people to submit their membership applications via mail to the ILCA Office.

We hope you will consider ILCA membership. If you have any questions, please contact membership@ilca.org.

Posted in ILCA News | 3 Comments

Substance Use Disorders in Pregnancy and Lactation: What IBCLCs Need To Know

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Lisa Cleveland, PhD, RN, PNP-BC, IBCLC, is an expert in the impact of Substance Use Disorders (SUDs) on pregnancy and breastfeeding. She was recently interviewed by Sara McCall, a member of the ILCA Medialert team. Together, they explored Dr. Cleveland’s research, work with families, and what IBCLCs need to know to support families in the NICU with SUDs.

You have an active program of research focused on substance use disorders in pregnancy. What brought you to this particular work?

My dissertation study was focused on the mothering experiences of women whose infants had been hospitalized in a neonatal intensive care unit (NICU).

I discovered that the NICU experiences of the substance addicted women in my sample were very different from the experiences of the other NICU mothers. The substance addicted women shared their feelings of shame and regret particularly when they observed withdrawal symptoms in their infants.

Further, they described events where they felt stigmatized and judged by the NICU staff. This caused a significant amount of stress for the women. In some cases, the women felt so unwelcome in the NICU that they chose not to visit their infants.

This would be concerning in any NICU mother but particularly troubling for this population who has multiple risk factors including the risk for poor maternal-infant attachment. Based on these findings, I felt compelled to further explore the issues that surround substance addiction in women and their infants. 

When you educate lactation professionals about the impact of substance use in pregnancy, what tends to be the biggest surprise for your audience?

When I work with International Board Certified Lactation Consultants® (IBCLCs®) and other healthcare providers, they’re often not aware that breastfeeding is considered safe when women are taking an opioid replacement medication, such as Methadone or Buprenorphine, for the management of an opioid addiction.

Furthermore, breastfeeding is recommended by the American Academy of Pediatrics, American College of Obstetrics and Gynecology and the Academy of Breastfeeding Medicine for this population of women and infants as long as the mother is HIV negative and is able to abstain from the use of alcohol or illicit substances.

This recommendation is based on evidence indicating that only very small amounts of Methadone and Buprenorphine transfer into breastmilk and; therefore, produce little effect on the infant.

What kind of breastfeeding education/support does a substance-addicted woman need during pregnancy?

Substance-addicted women need to be assured that as long as they are not HIV positive and are taking only their prescribed opioid replacement medication (no alcohol or illicit substances), breastfeeding is not only safe but recommended and highly beneficial for their infants.

Following delivery, a lactation specialist should be readily available during the infant’s hospital stay as well as following discharge. For infants who are not yet ready to breastfeed, a hospital-grade breast pump should be made available with instruction on its proper use so mothers can express milk for their infants. Further, follow-up outpatient breastfeeding support and services should be offered through local public health offices (such as WIC in the United States) and other community-based agencies.

How does breastfeeding help a substance-addicted woman adapt to the role of mother?

As mentioned, many women who give birth to infants with neonatal abstinence syndrome (NAS) experience significant regret and shame. In addition, infants with NAS can be extremely irritable and difficult to feed as they often experience vomiting and diarrhea. Since breastmilk is better tolerated by infants, it may assist with the feeding difficulties associated with NAS and contribute to improved weight gain. Further, breastfeeding is something that only the birth mother can do for her infant. The breastfeeding mothers who have participated in our research felt that being able to breastfeed was their contribution to their infants’ well-being and this gave them a great sense of satisfaction.

Lastly, breastfeeding, as we know, is extremely important for the health of all infants, but is often essential for the well-being of high-risk infants such as those who are substance exposed. The close, skin-to-skin contact between mother and infant that occurs during breastfeeding may lessen the infant’s withdrawal symptoms and relieve stress in both the infant and mother. Evidence also shows that this skin-to-skin contact improves maternal-infant attachment and supports neurobehavioral growth and development.

In the U.S. and other cultures, there is a high value placed on the mother as the protector of the fetus. This can lead to judgment of mothers who have substance use disorders during pregnancy. How does that impact the care families receive? What do you advise IBCLCs who wrestle with these issues?

The stigmatization and judging that occurs when a pregnant woman has a substance use disorder is one of the most insightful findings we have had from our research.

IBCLCs and anyone who interacts with women and infants must remember that substance addiction does not discriminate by race, gender, ethnicity, etc. In fact, evidence shows that women are more at risk for addiction than men because they experience a shorter time period between first use and addiction. Further, in most cases, the substance-addicted woman is already addicted when she becomes pregnant and her pregnancy was unplanned.

As a former NICU nurse myself, I have cared for infants with NAS and I will say that watching an infant experience the discomfort of withdrawal symptoms is very difficult and heartbreaking. However, what we have found through our research is that the infants’ mothers are suffering as well. Many women with substance use disorders struggle with mental illness and have a history of past trauma such as abuse, sexual violence and loss. For the women in our research, becoming pregnant and giving birth was a powerful motivator to seek treatment for their addiction. Therefore, pregnancy may present a window of opportunity to intervene with substance-addicted women and giving birth can become a part of their healing process.

For mothers who are willing and capable of parenting, family preservation should be a priority. Resources that are often exhausted by the court/legal system and child welfare services might be better directed toward providing substance addicted women with the resources they need for recovery and successful parenting. Further, in cases where a child is inappropriately removed from a mother’s care, early maternal-infant attachment may be compromised and mothers are further traumatized which can lead to a relapse into addiction.

Why does NAS occur with some drugs but not others?

NAS occurs when the neonate, having undergone adaptation in the brain to prolonged intra-uterine drug exposure, is thrown into a withdrawal state following abrupt cessation of this drug exposure as a result of birth; that is, exiting the intrauterine environment.

There are at least two major types of brain adaptations to intrauterine drug exposure. In the more drug-specific of these two types, receptors on the neuronal cell membrane “down regulate,” becoming less responsive to the body’s natural activating neurochemicals. When the drug is abruptly withdrawn, which occurs at birth for the drug-exposed newborn, a deficiency state is created due to this lack of responsiveness on the part of the receptors. This relative deficiency state can result in symptoms that we call drug withdrawal. This is the situation with opioid (or heroin) withdrawal, which is the most severe form of NAS.

The other type of adaptation occurs when the brain, in its never-ending effort to self-regulate or achieve homeostasis, produces extra chemicals that correct the imbalance in chemicals caused by drug exposure. When the drug is stopped, the remaining extra chemicals can cause withdrawal symptoms-the abstinence syndrome. This happens with cocaine and antidepressants as well as with many other drugs and psychoactive compounds.

It is important to note that NAS can be caused by a great number of drugs ranging from selective serotonin reuptake inhibitor (SSRI) antidepressants, certain antihistamines, opioids, sedatives, antianxiety medications and sleeping pills. Even substances such as nicotine and caffeine can cause withdrawal syndromes in neonates. As mentioned, opioids (heroin and synthetic opioids or prescription pain killers) have perhaps the most dramatic withdrawal effects when intrauterine exposure is abruptly discontinued. In the case of the affected neonate, prolonged hospitalization may be required to treat the resultant abstinence syndrome. For this reason, and because of the ever-increasing numbers of opioid exposed neonates, the diagnosis of NAS tends to be used primarily with newborns withdrawing from opioids/heroin.

Want to learn more? Dr. Lisa Cleveland will be delivering a webinar “Substance Use Disorders in Pregnancy and Lactation” on 10 December, 2014.

In the webinar, she’ll address:

  1. The US national epidemic of opioid addiction and its impact on pregnant women and infants.
  2. Substance use disorders in women and the multiple co-morbidities that often accompany them (trauma, mental illness, etc.).
  3. Best practices related to the management of substance use disorders in pregnancy and their impact on breastfeeding.
  4. Review of a collaborative, inter-professional program for opioid addicted pregnant women here in San Antonio and some of this program’s outcomes.
  5. Their past and on-going research with substance addicted women and infants with NAS.

For more information and to register, click HERE.

Cleveland LisaDr. Cleveland is an International Board Certified Lactation Consultant as well as a practicing Certified Pediatric Nurse Practitioner. In addition, she is an Assistant Professor at the University of Texas Health Science Center at San Antonio in the Department of Family & Community Health Systems. Dr. Cleveland has an active program of research focused on substance use disorders in pregnancy. She has published on this topic and has presented at numerous national and international conferences.

McCall headshotSara McCall, MPH, CHES, IBCLC became a lactation consultant in 2012 while working in a military hospital in England. She currently works on the education/outreach team at Best for Babes Foundation and lives in Texas with her husband and two sons. You can read more about Sara at www.youareagoodmama.com.

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Australian College of Midwives Releases Statement on the Use of Donor Human Milk

The Australian College of Midwives (ACM) recently released their “Position Statement on the Use of Donor Human Milk.” This statement was developed in collaboration between ACM members, experts, and the ACM Baby Friendly Health Initiative (BFHI) Advisory Committee. The ACM provides a unified voice for the midwifery profession in Australia. They set professional practice and education standards and are committed to being the leading organization shaping Australian maternity care so that all Australian women have the best possible maternity outcomes. In addition, the ACM is also the governing body for BFHI in Australia.

Eds. note: In Australia, the initiative is referred to as the Baby Friendly Health Initiative instead of the Baby Friendly Hospital Initiative due to their community health service accreditation.

You can read the entire statement HERE.

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Photo via The Milk Bank. Used with permission.

We spoke with Marjorie Atchan, one of the lead writers along with Dianne Haworth, to ask more about the development of the statement and to better understand the use of donor milk in Australia.

What led your organization to write this statement? 

The BFHI Advisory Committee, as its name implies, provides advice to the Australian College of Midwives on a range of matters pertaining to breastfeeding, infant feeding and the BFHI.

We (the committee members) have long been aware of the use of donor milk in Australia – both regulated and non-regulated. We were concerned on two levels. One concern was that midwives may be placed in a position of providing support or advice to women/other health professionals without access to current and accurate information on which to base their practice.

We were also deeply concerned that mothers may be placing their babies at risk by using milk from sources that were not properly screened and safe if they did not have access to current and accurate information. As no such resource existed in Australia and the ACM provides position statements on a number of issues, we decided to develop this and place it on the ACM website where it is accessible to midwives and consumers.

There were several rounds of consultation with community stakeholders, content experts, and midwife academics to ensure accuracy, clarity and professionalism and the finished product met the standards of a publishable position statement. The process took well over 12 months to complete.

What is the current state of milk banking in Australia?

Milk banking is not currently regulated at a national level in Australia. Each state/territory has local jurisdiction and may have a slightly different interpretation to the issue of whether human milk is a bodily fluid or a food.

Consequently, there are few “official” milk banks. The World Health Organization is quite clear about the viability of donor  breastmilk as the first option if a mother is unable to fully meet her infant’s nutritional needs. Amongst many women, especially those with sick or premature infants, there is increasing acceptance of and demand for donor milk. Neonatologists have also long encouraged the use of breastmilk for the improved health outcomes. Facilities where neonatal nurseries occur are also aware of the cost savings attached to the decrease in morbidity and mortality.

In three states, hospitals have been able to successfully open milk banks that primarily service their own neonatal nurseries: King Edward Memorial Hospital in Perth Western Australia; the Mercy Hospital in Melbourne, Victoria and the The Royal Brisbane and Women’s Hospital, in Brisbane, Queensland. Some large tertiary hospitals in other states have “in house” milk banks using known donor milk attached to their neonatal nurseries.

All hospitals with operating milk banks follow very strict protocols and quality assurance standards. There is also one community milk bank based in northern NSW, the Mothers Milk Bank that ships milk out across the country. This milk bank follows the protocols of the King Edward Memorial Hospital’s milk bank.

Are families in Australia participating in peer-to-peer milksharing?

As many families do not have access to the services of our milk banks, other services are often utilized. This is where the potential for risk increases. Other pathways include known websites such as Humanmilk4Humanbabies and informal sharing amongst family and friends.

In some cultures, it is acceptable and expected that milk sharing will occur. Some research has been published such as those pieces from Virginia Thorley and Karleen Gribble. There is unfortunately also a culture of scaremongering that is media driven and only serves to fuel ignorance and bigotry. Headlines scream out the fear of mothers that their baby might have contracted HIV/AIDs after having been accidentally given another mother’s breastmilk (usually by human error in a hospital setting) – despite the risks of this being almost negligible as the mother would have been screened thoroughly during her pregnancy. One might speculate at the underlying  reason for such a reaction: to garner media attention for the tabloid/station and vicariously support the use of commercially produced baby milks.

To find out more about the Australian College of Midwives, visit their website at www.midwives.org.au.

*Disclaimer: Milk sharing is a complicated issue. Readers should adhere to the standards in effect in their own regions.

Posted in Donor Milk | 2 Comments

ILCA Releases Statement on the 25th Anniversary of the United Nations Convention on the Rights of the Child

Supporting global policies that protect children’s health is a priority for the International Lactation Consultant Association® (ILCA®). We are proud to provide liaisons to the United Nations and stand with them on this important occasion. Watch on Facebook and Twitter for updates from our team who will be attending celebration events in New York City, New York USA this week.

ILCALogo_full_text (2)As we celebrate the 25th anniversary of the United Nations Convention on the Rights of the Child (CRC) on 20 November, the International Lactation Consultant Association (ILCA) is reminded of how far advocacy for children has come—and how much work remains ahead for us to do. We have seen improvements in infant mortality rates, educational possibilities for all children, regardless of gender or socioeconomic status, and better access to quality health care. Yet, a significant number of infant deaths still occur due to poor maternal health and suboptimal breastfeeding practices.

The treaty, which has been ratified and used to drive policy in many nations worldwide, makes a promise to protect the rights of children, which include the right to live, the right to the best healthcare possible, food and safe water to drink, clothing, and a safe place to live. These and other important rights seem like concepts every government would want to adopt and enforce, but there are still nations that have not signed onto the treaty, and not all those nations that have ratified it have fulfilled their obligations under the treaty.

The impact of the business sector on the human rights of the child cannot be underestimated, and the CRC maintains that it is the responsibility of the state to protect children from predatory business practices, to implement and enforce internationally agreed standards concerning children’s rights, health and business, including the World Health Organization International Code of Marketing of Breast-milk Substitutes and relevant subsequent World Health Assembly resolutions.

In observance of this important anniversary, ILCA calls upon its members and partner organizations worldwide to encourage ratification and implementation of the Convention on the Rights of the Child, so that we may all continue to improve the health and safety of children everywhere.

Posted in ILCA News | 1 Comment

Moving Forward: Establishing Partnerships, Mentoring Organizations, Creating Equity and Diversity

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In July 2014, the International Lactation Consultant Association® (ILCA®) announced a new vision: World health transformed through breastfeeding and skilled lactation care. ILCA’s mission remains the same: Advancing the IBCLC profession worldwide. Out of this new vision have emerged three distinct pathways to help champion the ILCA member and make more relevant the IBCLC Profession in the global arena: establishing partnerships, mentoring developing organizations and creating equity and diversity.

Recognizing the obligation to advance the IBCLC profession worldwide and locally, ILCA has set a new course to extend our global outreach to all IBCLCs.

Establishing Partnerships

ILCA has long had relationships with other organizations. ILCA is a non-governmental organization (NGO) in official relationship with the United Nations (UN) and World Health Organization (WHO). ILCA is a core partner of World Alliance for Breastfeeding Action (WABA). ILCA provides official representatives to Codex Alimentarius, Food and Agriculture Organization (FAO), World Health Assembly (WHA), and WHO National Baby Friendly Hospital Initiative (BFHI) Coordinators of Industrial Countries. These relationships are strong, and provide opportunity to keep breastfeeding and skilled lactation care in the forefront of the work of these organizations.

ILCA is launching a new initiative by reaching out to like-minded national and regional organizations within the lactation community. The focus of this effort is twofold: to define a formal relationship with global partners and to forge a collaborative network of organizations committed to expanding the reach and impact of the IBCLC profession worldwide. Currently, 21 entities have expressed interest in establishing a formal relationship with ILCA. As this number grows, we anticipate that a more coordinated and collaborative approach to expanding breastfeeding education and services will simultaneously advance the profession and amplify a common voice on the global stage.

Mentoring Developing Organizations

A second important element of ILCA’s global outreach effort is the plan to help foster developing organizations at the local and regional level. Small groups of IBCLCs throughout the world looking for help in moving to the next level are emerging daily. Most lack resources, infrastructure and direction. ILCA plans to serve as the catalyst for these aspiring organizations so they too may help grow the IBCLC profession and become active partners within the breastfeeding community.

Creating Equity and Diversity

Perhaps the most critical pathway to achieving ILCA’s vision rests in our ability to do our part to help create a culture within the field of breastfeeding that truly values equity and diversity. The first lactation summit sponsored jointly by IBLCE, ILCA and LEAARC: Addressing Inequities Within the Lactation Profession was an important step in identifying the barriers to equity and diversity in the profession. The next steps involve training, systematic analysis and strategic planning and the development of action plans to identify and implement the revisions necessary to create equity and diversity within the IBCLC profession.

Recently Cynthia Good Mojab, a member of the 2014 summit design committee, pointed out in her recent commentary entitled Pandora’s Box is Already Open: Answering the Ongoing Call to Dismantle Institutional Oppression in the Field of Breastfeeding that “Every organization that is committed to eliminating inequity in the field of breastfeeding must identify, dismantle, and re-create policies, procedures, practices, customs, and structures in which institutional oppression is encoded.” If we are to overcome these barriers, we must contribute to the creation of a culture of acceptance of the critical importance of equity and diversity. She also stated, “…it’s going to be difficult and we need to have a long-term, big picture outlook. We have much to learn and much to do” (email communication, October 2014).

The Journey Ahead

From many angles, the journey before us appears challenging—from others, exhilarating. ILCA is excited to be part of an initiative to expand and strengthen the global network of breastfeeding organizations within the IBCLC community. Likewise, reaching out to those previously unheard voices to join ILCA on this journey holds great promise. If you are in need of help to organize and inspire those around you to join this cause, we encourage you to contact ILCA today and let us help you create new opportunities for breastfeeding and lactation care in your community or region. Finally, it is only through our collective efforts to build a culture of acceptance of the importance of equity and diversity that the lactation community can realize the global impact needed to truly transform world health. Together we can create a profession that is open to all, reflects and effectively responds to the diversity of people/needs/communities, and creates support for each of us to do the work we love, so together we can transform world health through breastfeeding and skilled lactation care.

If you have questions or comments for our Board of Directors, you may contact them directly or comment here.

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Current Global Recommendations Regarding Breastfeeding with Ebola Virus for Mothers and Infants

By Kathleen Marinelli, MD, IBCLC, FABM
ILCA Board of Directors Director of Professional Development

Screenshot 2014-11-07 20.10.02As the global community comes to grips with the Ebola epidemic, most of the press and information available pertains to surveillance, recommendations for quarantine, containing the geographic spread, determining risk of exposure, protection of health care workers, and support and treatment of those diagnosed with the deadly virus. Of particular concern to those in the maternal-child health, nutrition, and lactation fields is the effect of potential exposure and proven infection with the Ebola virus on pregnant and lactating women and their infants.

Compounding the difficulty with finding this information is the simple fact that we don’t really know the answers at the level of evidence-based medicine. This is our first experience with an Ebola epidemic of this proportion. Decisions are being made to direct clinical practice by authorities like the Centers for Disease Control and Prevention (CDC) and UNICEF and the World Health Organization (WHO) based on our knowledge of how other viruses act, anecdotal stories from the field, and an occasional clinical report. While we all want the answers yesterday, authorities are doing their best to guide practice to save lives, while not panicking health authorities into making decisions that will cause more harm than good.

The CDC has recently issued guidelines for field and partner organizations regarding how to advise breastfeeding women with likely or confirmed Ebola infection (1), as has the Emergency Nutrition Network (ENN) in collaboration with UNICEF/WHO/CDC/ENN, which has significantly more detail. (2)

Important points are:

  1. Pregnant women have a much higher mortality rate with Ebola than non-pregnant women. At this time, there have not been any reported cases of a pregnant woman infected with Ebola virus surviving.
  2. Data from the field are spotty. WHO, CDC, ENN and other agencies are trying to aid in improving data capture so that we can better understand the history of Ebola in different types of patients and thus make informed determinations such as related to breastfeeding.
  3. Ebola virus has been found in human milk (1 sample). (3) In earlier outbreaks, no infants born to infected women and/or who were breastfed have survived. Presence does not equal infectivity, but at this point we do not know in the case of Ebola.
  4. Virus remains in some bodily fluids, like semen and human milk, after the blood has cleared. For lactating mothers who recover from Ebola, and are able to maintain or resume lactation (another issue to be considered and dealt with due to the illness severity), it is not known when it is safe to resume breastfeeding. Recommendations are to have the milk tested every 2-3 days in a laboratory that tests blood. For many women this is not feasible related to where they live. The recommendation then being made is to refrain from breastfeeding for 8 weeks, although not based on any evidence.
  5. For detailed instructions on feeding, please refer to reference 2. Essentially, when safe alternatives to breastfeeding and infant care exist, mothers with probable or confirmed Ebola virus disease should not have close contact with their infant, which includes breastfeeding.
  6. If mother must stop breastfeeding, the mother must be helped to express her breastmilk to alleviate pain and prevent inflammation. The expressed milk must be treated as an infected bodily fluid and discarded as such. There are some suggestions to heat treat (pasteurize) the expressed milk for the baby, but equipment and thermometers to make sure the milk is heated to the proper temperature for the correct amount of time to destroy virus and preserve nutrients and immune factors are not readily available. Most mothers become rapidly so sick that expressing milk becomes very difficult.
  7. In resource-limited settings, non-breastfed infants are at increased risk of death from starvation and other infectious diseases. These risks must be carefully weighed against the risk of Ebola virus disease when deciding to breastfed or feed a substitute.(2)
  8. Wet nursing is very common in West Africa. However do not allow wet-nursing to avoid any possibility of infection of the infant by the wet nurse, or of the wet nurse by the infant.
  9. If both mom and child have confirmed Ebola, if mom is able, breastfeeding should continue. If mom becomes too ill, a safe alternative should be used.
  10. Orphans should be fed with a safe alternative.

ILCA recommends following the guidance for feeding of infants and young children given in these documents and continuing checking for updates to the CDC (1) and the ENN (2) papers as more information becomes available.

References

  1. http://www.cdc.gov/vhf/ebola/hcp/recommendations-breastfeeding-infant-feeding-ebola.html (accessed 11/5/2014)
  2. http://www.ennonline.net/infantfeedinginthecontextofebola2014 (accessed 11/5/2014)
  3. http://jid.oxfordjournals.org/content/196/Supplement_2/S142.full.pdf (accessed 11/5/2014)

Kathleen Marinelli has been a neonatologist for over 25 years, an IBCLC since 2000 and is a Fellow of the Academy of Breastfeeding Medicine (FABM). Although unable to practice clinical neonatology for over a decade due to a significant water-skiing accident, she has continued her life-long commitment to improving breastfeeding, the use of human milk, and the use of donor milk, everywhere but especially in the NICU through all of her volunteer roles, research, teaching both here in the US and abroad, and publishing papers, monographs and chapters.

She is an Associate Professor of Pediatrics at the University of CT Medical School, and a member of the Human Milk Research Center at CT Children’s Medical Center, in Hartford, CT. She graduated from Cornell University & Cornell University School of Medicine; and was a pediatric intern, resident, nephrology and neonatology fellow at Children’s National Medical Center, George Washington University, Washington DC.  Additionally, she is founding Medical Director of the New England Mother’s Milk Bank and is currently co-Medical Director of the Mothers’ Milk Bank of the Western Great Lakes.  She is a founding and current member of the Connecticut Breastfeeding Coalition, has been on the Board of the Academy of Breastfeeding Medicine for many years, and chairs its Protocol Committee.  She has served as Chair of the United States Breastfeeding Committee, and was chosen to Chair the new US Baby-Friendly Hospital NICU Initiative. 

Posted in Breastfeeding Around the Globe, Breastfeeding in Emergencies, Current Events | 7 Comments

How Do You Obtain Your Continuing Education? {SHORT SURVEY}

ILCALogo_full_text (2)Each International Board Certified Lactation Consultant® (IBCLC®) is required to gain and update their knowledge of lactation and the infancy period. One of the best gifts we can give to the families we serve is to be up to date on the latest in evidence-based care. IBCLCs are required to either retake the certification exam or recertify with Continuing Education Recognition Points (CERPs) every five years (recertification by exam only is required every ten years). CERPS can be obtained through conference attendance, webinar viewing, study modules, in-person education, eCourses, and a variety of other means.

Please share with us...

We have developed a short survey to better understand how you are receiving your required continuing education and to learn how we can better help you to obtain it. Click on the button to participate in this quick poll. It should take less than 5 minutes to complete.

You do not need to be an ILCA member to participate in our quick poll. We are interested in hearing from everyone in the professional lactation community.

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If you have any questions about ILCA’s continuing education offerings, please email education@ilca.org.

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