Author Archive | lactationmatters

World Breastfeeding Week 2021: Lactation Consultants Critical to the Chain of Support


As a lactation professional, you know that successful breastfeeding or chestfeeding rarely happens in isolation.

Parents providing human milk to their babies need the support of healthcare providers, partners and extended families, employers, and wider communities to thrive. 

Every person a parent contacts forms a link in the chain. The more solid the links, the greater the likelihood they will meet their goals.

This year, World Breastfeeding Week will focus on how to create stronger links for a better chain. 

WBW 2021

Where do you fit into the chain that protects and promotes breastfeeding worldwide?

As the globe is preparing to celebrate World Breastfeeding Week 2021, 1 August through 7 August, lactation support professionals are being invited to think about that question.

The theme for this year’s World Breastfeeding Week (WBW) is Protect Breastfeeding: A Shared Responsibility.  

The celebration’s organizers, the World Alliance for Breastfeeding Action (WABA), chose this theme to emphasize that efforts and collaboration across all levels are needed to support and protect human milk feeding, particularly in the midst of the COVID-19 pandemic.  

As WABA shares, “Although support at the individual level is very important, breastfeeding must be considered a public health issue that requires investment at all levels.” 

WABA stresses that efforts are needed at the national, health systems, workplace, and community levels.

WABA has outlined goals at each level, from strengthening enforcement of the WHO Code to improving parental leave and workplace lactation support to scaling up implementation of the Baby Friendly Hospital Initiative to implementing a continuing education curriculum for healthcare workers and building the capacity of community-based breastfeeding support programs and much, much more.

(To read a detailed discussion of the challenges and action steps WABA is calling for at each level, and learn more about WBW, head here.)

The Warm Chain

By focusing on shared responsibility, WBW aims to inspire each person to find their spot in the warm chain.

The warm chain WABA envisions includes people across levels and settings—those working in health systems, workplaces, and in the community.

“A warm chain of support will help build an enabling environment for breastfeeding and protect against industry influence,” WABA writes. “It is time to inform, anchor, engage and galvanise action to protect breastfeeding at all levels.”

Put Yourself on the Map

IBCLCs connect with parents and influence policy across all settings around the globe—hospitals, doctors’ offices, clinics, in private practice, as policy makers and as advocates and educators.

IBCLCs are a critical link in the chain with a unique ability to move the goal of protecting human milk feeding forward.

How can you get involved with World Breastfeeding Week 2021?

For one thing, you can put yourself on the map.

WABA offers a Pledge Form and a Pledge.

Use the map and form to add your community or workplace’s plans and to find events near you.

Watch the ILCA blog for more details on how you can take action for World Breastfeeding Week.

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Questions about Cannabis: Thomas Hale to Discuss New Research at Upcoming Conference

Data indicates that as many as 10 to 15 percent of lactating parents use some kind of cannabis product while they are breastfeeding or chestfeeding.

Chances are, this includes some of the parents you care for.

When it comes to the safety of cannabis use during lactation, what do we really know for sure?

At the upcoming ILCA Conference 2021, Dr. Thomas Hale, Professor of Pediatrics, Assistant Dean of Research, and Director of the Clinical Research Unit at Texas Tech School of Medicine in Amarillo, Texas, USA, will address this important topic.

Hale has spent the last 20 years teaching pediatric drug therapy in pregnant and breastfeeding parents and is considered by most to be the world’s leading authority on the use of medications and human milk.

In this Q&A, Hale provides a preview of his upcoming talk—and shares thoughts on the critical importance of basing the cannabis discussion on kinetics, not hysteria.

Thirty-six states in the United States have legalized marijuana in some form. Are you getting more questions about its use in lactating parents?

Hale: Many, many hospitals are having discussions about this topic right now, and I get calls every week.

What do lactation professionals need to understand about cannabis use and human milk?

They need to know that right now, many of the suggestions and recommendations are based on hysteria, not reality.

When it comes to drugs in human milk, the real story about kinetics.

If a person has a positive urine test for marijuana, it tells you that there is a little bit in the urine. This does not tell you much of anything.

It’s like looking at the Mississippi River and seeing that a stone has been tossed in.

When someone smokes marijuana, it goes into the plasma compartment. It peaks in the plasma at about six to eight minutes. It troughs and is completely gone at about 22 minutes.

The vast majority of it goes to adipose tissue, where it resides for up to a month. It is inactive. It doesn’t do anything. It just leaks out a drop every now and then.

In low to moderate use, the levels that pass into the milk are exceedingly, exceedingly low.

The rest of the story is, when you take marijuana orally, as a baby would in breastmilk, only one to five percent is absorbed. Ninety-nine percent is picked up by the liver and never gets to the plasma.

What is real is that even if the baby nurses right after the parent smokes marijuana, the baby will get at very most 8.7 percent of the parent’s dose. And they will only absorb one percent of that.

What are the downsides of healthcare professionals not understanding the level of risk?

Recently, I was recruited to give a lecture about cannabis and other drugs and breastfeeding at a big NICU in the Northeast. The hospital had a policy that if you were drug-screened positive for marijuana, you could not breastfeed. The policy was causing disagreement among the doctors, the neonatologists, and the nursing staff.

The doctors, like me, realized that just because a mother drug-screens positive doesn’t mean there is a clinical amount in the milk. They also know that, with premature babies, if you breastfeed, you reduce the risk of necrotizing enterocolitis by fourteenfold.

The doctors said, “We know that we can save babies’ lives simply by giving them mom’s milk. We want to give them mom’s milk.”

But the policy said no.

If you were an IBCLC advising a client on the safety of marijuana use, what would you tell them?

I am not trying to promote its use.

I think what I would say is, it is not advisable to use it while you are breastfeeding at all. We do not know all of the long-term consequences.

But I am a pharmacologist. My work is based on reality: How much is absorbed by the parent, how much gets into breastmilk, and what is the dose to the baby?

Our data shows that five to 15 percent of breastfeeding mothers use cannabis. Seventy percent of those in our sample use it for an anxiety disorder, and others use it for chronic pain.

If a parent is told they cannot breastfeed and use cannabis, and they discontinue breastfeeding, that is a significant loss with big risks.

If you are working in a hospital setting with premature babies, it can be the difference between life and death.

It is a judgement call. If a mother uses it moderately, if she can wait a few hours afterward to breastfeed, the risks are relatively low.

What are your thoughts on the L-level of marijuana in the next edition of Hale’s Medications in Mother’s Milk?

Right now, it is an L4. I think I will probably drop it to an L3.

What will you and your team be sharing at the ILCA Conference?

Some of my crew will share much more about the data on marijuana, including new research we have done and more that is underway.

Another will present about breastfeeding and nutrition.

And, we are going to present something so brand new that no one even knows about it yet! It has to do with the endocannabinoid system and human milk. We have made a tremendously exciting new discovery and I am excited to unveil it at the conference.

It’s a wonderful area to be in. It’s really a lot of fun. I’m looking forward to showing you my whole team!

Learn more about Dr. Hale and his team and their role at #ILCA21 and the Infant Risk Symposium here.

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Call for Videos: Impacts of Skilled Breastfeeding Counselling

The Global Breastfeeding Collective is creating a video highlighting the impact of skilled breastfeeding counselling on mothers’ ability to start breastfeeding, breastfeed exclusively (avoid formula), or keep breastfeeding their babies for as long as they planned or wanted to and we need your help.

Research shows that more mothers breastfeed when they receive good breastfeeding counselling at least six times in their breastfeeding journeys. Sadly, breastfeeding counselling is not available everywhere and many mothers find that the health workers they work with do not have the knowledge and skills they need to help mothers overcome common breastfeeding challenges.  

We need you to help us change this by telling us your story. 

What advice were you given by health workers when you sought help for breastfeeding? Did breastfeeding counselling help you? How do you think it affected your ability to breastfeed, breastfeed exclusively, or breastfeed for as long as you planned? Did it affect the advice or support you received from others? What do you wish your health workers had known? If you didn’t get breastfeeding counselling, how do you think it would have helped you? 

We want to make a video to show governments and other health policy makers how receiving breastfeeding counselling helps families and what happens when it is not provided. We want to inspire governments and health services to provide good breastfeeding counselling to every family for the first two years of their children’s lives. 

We will edit the video submissions and bring them together to tell a global story about why breastfeeding counselling is important to families all around the world. We will use the video in a webinar and on social media.

You can help by recording a short video (no more than 2 minutes) telling us about your experience of breastfeeding counselling. We’ve created a list of questions to help you tell us your story.   

Questions to help tell your story

Please say the following:

My name is [first name/given name] and I live in [country name].

Please tell us your story. Please include these details:

Why did you need skilled breastfeeding care? What challenges were you experiencing?

If you received care:

Who helped you? (For example, your midwife, a peer supporter, an IBCLC)

How many times did you have breastfeeding counselling? 

Where did you have breastfeeding counselling? (For example, at a health care facility, at your home, in the community)

How did receiving/not receiving breastfeeding counselling impact your ability to breastfeed?

Why was breastfeeding counselling important to you?

How did breastfeeding counselling make you feel? OR How did you feel when you couldn’t access breastfeeding counselling? 

Please tell us in one word:

What did having skilled breastfeeding counselling mean to you?

How to submit your video

Please note that all participants will also need to complete a release form. You can download a copy of the release form here.  

Questions? Please contact Jeanette McCulloch at the International Lactation Consultant Association (ILCA) at media@ilca.org.

Please send your video and a video release form to media@ilca.org by 25 June 2021 [EDITED TO ADD: deadline extended to 1 July]. Please also find our tips for making your own videos using a phone or tablet here.

The Global Breastfeeding Collective is a partnership of prominent international agencies, including ILCA, calling on donors, policymakers, philanthropists and civil society to increase investment in breastfeeding worldwide.

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A Letter from the ILCA President: Our Shared Obligation to the Code


As we honor how much has been accomplished in the 40 years since the adoption of the International Code of Marketing of Breast-milk Substitutes (“the Code”), we must also recognize that our work to enact and enforce the Code is far from complete.

Of the 194 countries in the world, only 25 countries have enacted laws that are substantially aligned with the Code. Even where the Code is enacted, enforcement of the Code continues to be uneven. Commercial milk formula companies are exploiting these gaps and using their massive marketing budgets to spread their influence at an ever-increasing scale. The recent video by Global Breastfeeding Collective partner Save the Children highlights how sales of commercial milk formula is growing eight times as quickly as the world’s population.

The Code recognizes the critical role that healthcare workers play in “guiding infant feeding practices, encouraging and facilitating breast-feeding, and providing objective and consistent advice to mothers and families” and provides guidance on how we can help avoid being influenced by the marketing of commercial milk formula.

One insidious way that formula companies attempt to influence healthcare workers is through “free” educational opportunities. These so-called “free” opportunities represent a Conflict of Interest on the part of formula companies, as described in one of the subsequent resolutions to the Code.

Recently, an ILCA member alerted us that a formula company is posing as a “health institute,” offering no-cost CME and nursing credits to health care providers, and using ILCA’s name to confer legitimacy to their efforts. 

We immediately investigated, and learned that the Abbott Health Nutrition Institute had taken advantage of a relationship ILCA shares with InJoy, with whom we had partnered to educate healthcare workers that serve breastfeeding and chestfeeding families. (InJoy Health Education is a company in the field of maternity education that produces and provides educational videos and other multi-media content to health care facilities and health educators.) 

InJoy was unaware that Abbott Health Nutrition Institute is a subsidiary of Abbott Global, maker of Similac, a longtime code violator. Abbott recently failed to make any commitments to improve their marketing policies and practices to bring them more closely into line with the Code. InJoy allowed Abbott to purchase licenses for the course. We are deeply frustrated to see that Abbott has been offering it for free to healthcare workers, alongside courses like “Handling Human Milk and Formula in Healthcare Facilities: Tried & True and What’s New.”

Based on our efforts, InJoy is now severing its ties with Abbott. ILCA will be donating the proceeds that resulted from InJoy’s license with Abbott. We are doing so out of our deep commitment to upholding the Code, including avoiding conflicts of interest. 

ILCA has a number of processes in place designed to help us ensure that ILCA – and our vendors – are free from Code violations and conflicts of interest. We also recognize that, just as formula companies’ strategies are constantly evolving, so must we. 

We are particularly grateful to our member who brought this matter to our attention. Your ongoing vigilance in spotting and reporting these issues is essential as a part of our efforts to uphold the Code and all subsequent relevant World Health Assembly resolutions. This action is completely inline with the call to health workers and all of civil society to uphold the Code and to address violations through reporting mechanisms.

ILCA and IBCLCs alone cannot stop formula companies from influencing health care providers. We call on all professional health care organizations to stop accepting funding from companies that don’t meet their Code obligations in the form of advertising, sponsorship, and the awarding of CME and other educational credits. We recognize that there are challenges in holding conferences and funding membership benefits without this funding. We believe that you cannot put a price on ensuring that families are served by health care workers that are free from influence from companies that are spending billions to put formula samples into the hands of new families.

Sabeen Adil, MBBS, IBCLC
President, ILCA

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JHL Seeks Submissions on Laws, Policies


Around the globe, parents’ options and choices about feeding their infants and young children are influenced by an ever-changing patchwork of laws and policies. 

Has your work as a lactation professional brought you up close and personal with such a law or policy? And would you like to share what you’ve learned? 

If so, you may want to consider a submission to the Journal of Human Lactation’s (JHL) upcoming special issue covering this topic.

The February 2022 issue of the JHL will be dedicated to the latest information and analysis on laws and policies affecting breastfeeding and infant/young child feeding around the world.

Submissions are due 1 October 2021.

A variety of types of submissions are sought, including:

  • original research
  • literature reviews
  • case studies
  • insights into practice and policy.

The JHL has suggested a wide range of potential topics, including:

  • The WHO Code. How is it applied in 2021? Which countries follow it, and which have enforceable laws? What are the outcomes of these laws? Which companies and organizations operate on the edges of the Code?
  • Paid parental leave. What are the laws in your country? How have laws and policies influenced feeding standards over time, as well as affected initiation and exclusivity rates?
  • Workplace lactation support. How are work environment policies for lactation implemented? What is the employer’s responsibility for making lactation rooms available for employees? How have these and similar policies affected feeding? What are state, provincial, and/or federal laws which do not include provisions for enforcement? Where do laws not even exist? What are the ramifications of each?
  • Government regulations. What are the effects in your setting of the presence or absence of policies intended to increase access to IBCLC care? How can policies enacted for one region actually cause harm if implemented in other areas of the world?
  • Breastfeeding in public. Are new laws needed in your setting? What are the existing laws? What are ongoing issues with complaints about public indecency?
  • Education policy. Is there a need for funding to train new IBCLCs in areas with low rates of breastfeeding? Where might such funding come from?
  • Funding regulations or policies for health care practices. What influence do insurance regulations and policies, as well as national healthcare practices,  in your area have on infant and young child feeding?
  • Licensure of IBCLCs. What obstacles have arisen in places where human milk feeding advocates have introduced legislation to license IBCLCs? Where (and how) have these obstacles been overcome?
  • Drug regulations. How do the United State’s regulations concerning Domperidone affect practice? What other global issues are there regarding drug regulation and lactation?

The JHL emphasizes that this is not an exhaustive list; other topics may also be suitable.

Wondering whether your idea is a good fit? Contact JHL Editor-in-Chief Joan E. Dodgson, Ph.D., MPH, RN, FAAN, at jlheditorinchief@gmail.com, or visit https://journals.sagepub.com/home/jhl.

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ILCA Statement in Support of the 40th Anniversary of the International Code of Marketing of Breast-milk Substitutes (the Code)


Research tells us that the overwhelming majority of mothers want to breastfeed, but they don’t always reach their breastfeeding goals. Less than half of newborns begin breastfeeding in the first hour of life, and only 44% of infants are exclusively breastfed at six months.1 One of the most significant challenges to improving breastfeeding rates worldwide is the exploitative marketing of commercial milk formulas. 

Around the globe, mothers and other parents experience barriers to lactation, from a lack of skilled support to inadequate workplace provisions. Formula companies are at the ready to exploit these wide gaps. Formula companies’ marketing efforts are aggressive, well funded, and come at families from every angle, including influencing health care providers at sponsoring events and providing branded educational materials, making false claims about the product, providing free samples to hook families (who often can’t afford to continue to purchase the expensive product), and exploiting parents’ desires to do what is best for their children.

The solution to these aggressive marketing tactics exists: the Code.

The aim of the International Code of Marketing of Breast-milk Substitutes and all subsequent relevant World Health Assembly resolutions (which together make up the Code) is to “contribute to the provision of safe and adequate nutrition for infants, by the protection and promotion of breast-feeding, and by ensuring the proper use of breast-milk substitutes, when these are necessary, on the basis of adequate information and through appropriate marketing and distribution.”2

The Code covers four product areas: breastmilk substitutes, which includes all commercial milk formulas (including follow-on formulas and growing up milks), marketed as appropriate for children up to 36 months of age; any other food or beverage marketed as appropriate for children up to 6 months of age; and feeding bottles and teats

It is important to understand that the Code applies to the marketing of these products, their quality, and information about their use, but does not limit sales of these products, recognizing that they may be necessary in some situations. The Code specifies no promotion of these products to the public in any form, including no samples of the products to families or health workers, no gifts or other financial inducements to families or health workers, no promotion in healthcare facilities or to health workers, no promotion of complementary foods before 6 months, no sponsorships of meetings of health professionals, and adequate and appropriate labeling. The Code states that companies have a responsibility to follow the Code independent of any legal measures to implement the Code. 

The market for commercial milk formulas is huge, estimated at US$70.6 billion in 20193, with an estimated US$16 billion in profits.4 What these companies spend on formula marketing FAR outpaces what countries spend on breastfeeding support: One analysis of just the six largest commercial milk formula companies estimated they spent US$7 billion on marketing in 2015 (US$17 billion if spending on sales staff and administrations is included).5 This spending dwarfs the estimated $653 million annual cost to scale up breastfeeding counselling interventions in 34 countries to meet breastfeeding goals, which would save the lives of 820,000 children and add US$300 billion to the economy annually.6 

However, the existence of the Code is not enough. It must be implemented with legal measures, including steps for monitoring and enforcement in every country. As of April 2020, 136 of 194 countries had enacted legal measures with provisions to implement the Code but only 25 of these countries had measures substantially aligned with the Code; 58 countries still have no legal measures at all.7

As we celebrate the 40th anniversary of the enactment of the Code, we are reflecting both upon the gains the Code has made possible, but also upon the work yet to be accomplished by this important protection.

This is why ILCA:

  • Calls on governments to enact, enforce, and monitor the Code, or strengthen legal measures already in place.
  • Supports existing efforts, like NetCode, to provide resources and support for monitoring and enactment of the Code.
  • Calls on all ILCA members to fulfill their obligations under the Code, and supports members with education and information to do so.
  • Calls on other health care professional organizations to honor and uphold the Code, including educating health workers and ending the practice of allowing Code-violating corporations to sponsor events.
  • Continues to follow the Code in evaluating advertising and sponsorship in the Journal of Human Lactation and at our annual conference, serving as a model to other health care professional organizations.

These efforts are critical to ensuring that formula companies do not continue to put profits before the health of mothers, infants, and young children.


References

1: SEVENTY-FOURTH WORLD HEALTH ASSEMBLY A74/14 Provisional agenda item 16 Committing to implementation of the Global Strategy for Women’s, Children’s and Adolescents’ Health (2016-2030), Report by the Director-General. (2021). https://apps.who.int/gb/ebwha/pdf_files/WHA74/A74_14-en.pdf

2: International Code of Marketing of Breast-milk Substitutes. (n.d.). https://www.who.int/nutrition/publications/code_english.pdf

3, 6: Rollins, N. C., Bhandari, N., Hajeebhoy, N., Horton, S., Lutter, C. K., Martines, J. C., Piwoz, E. G., Richter, L. M., & Victora, C. G. (2016). Why invest, and what it will take to improve breastfeeding practices? The Lancet, 387(10017), 491–504. https://doi.org/10.1016/s0140-6736(15)01044-2

4, 5: Don’t Push It: Why the formula milk industry must clean up its act. (2018). Resource Centre. https://resourcecentre.savethechildren.net/node/13218/pdf/dont-push-it.pdf

7: Marketing of breast milk substitutes: national implementation of the international code, status report 2020. (2020). Www.who.int. https://www.who.int/publications/i/item/9789240006010

Image credit: UNICEF

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Promote the International Code of Marketing of Breast-milk Substitutes: Add a 40th Anniversary Frame To Your Profile Image


Friday, 21 May 2021 marks the 40th anniversary of the adoption of the International Code of Marketing of Breast-milk Substitutes (the Code) by the 34th World Health Assembly.

Show your support for the implementation and monitoring of these critical efforts to limit the aggressive and predatory marketing of breastmilk substitutes, including commercial milk formula. Change your profile frame today.

How to Add a Profile Frame on Desktop 

  1. Navigate to your profile page by clicking your name on top blue bar. 
  2. Hover over your profile picture. 
  3. Click “Update”. 
  4. Click “Add Frame”. 
  5. In the search box, type “Celebrating the Code’s 40th Anniversary”. 
  6. Click the frame to select it. 
  7. Use the editing box on the right to adjust the size and placement of your profile picture. 
  8. On the bottom row, next to “Switch back to previous profile in”, click on the drop down menu. 
  9. Choose how long you would like to keep your frame. 
  10. Click “set”. 
  11. Click “Use as Profile Picture”. 
  12. You’re all done! If you want, make a post about your new profile frame to your followers. 

How to Add a Profile Frame on Mobile (iOS)

  1. Navigate to your profile by tapping the person icon on the bottom of the screen.
  2. Tap the photo icon on your profile picture. 
  3. On the menu that pops up at the bottom of the screen, tap “Add Frame”. 
  4. At the top of the screen, click on the search bar. 
  5. Search “Celebrating the Code’s 40th Anniversary”. 
  6. Choose your style by tapping on it. 
  7. Tap the button that says “Make Temporary” and choose “Custom” in the drop-down menu. 
  8. Choose how long you would like to keep your frame. 
  9. Tap “Set”. 
  10. Tap “Save” in the upper right hand corner of the screen. 
  11. You’re all done! If you want, make a post about your new profile frame to your followers. 
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Talking Tongues: New Lingual Frenulum Research Challenges Previous Beliefs


How would it change your practice if you learned that just about everything you think you know about the lingual frenulum is wrong?  

New research to be presented at the International Lactation Consultant Association’s Annual Conference in Texas in July suggests exactly that, with serious implications for lactation professionals’ work.

As a Pediatric ENT Consultant at Starship Children’s Hospital in New Zealand, Nikki Mills, BHB, MBChB, FRACS, Dip Paeds, IBCLC, sees a lot of baby’s tongues. And, she is often asked to perform frenotomies.

Over time, Mills began to have more questions than answers about the procedure.

Why did some of her patients seem to get great benefit from the procedure, breastfeeding more successfully afterward, while others saw no benefit at all?

“As a surgeon who was being asked to divide frenulums in babies, I really wanted to know what it was that I was cutting,” Mills says. “I wanted to understand exactly what tissues I was dealing with and what they did.

“I believed that understanding should be the basis for deciding when a frenulum should be cut—and when it should not,” Mills continues. “For me, it was a fundamental question.”  

But when she went looking for research to answer her questions, Mills came up empty handed.

“No one had ever looked at the anatomy and function of the lingual frenulum in detail,” she says.

She decided it was high time someone did.

So she scaled back her clinical practice and spent the next four years researching.

As part of her investigation, she dissected fresh neonatal cadavers to better understand the anatomy and function of the lingual frenulum.

What she discovered was out of sync with everything she had been taught.

“What I found was very different from what has been the popular understanding of the lingual frenulum,” she says. “It’s challenging because when I present my research, it makes everyone who thinks they understood the lingual frenulum rethink and reframe what they thought.

“We have started to think of any lingual frenulum as a tongue tie,” Mills continues. “We’ve created a situation where normal anatomy is called an anomaly.”

At the ILCA conference, she will explain her published research in detail, as well as its implications for evaluating and treating breastfeeding problems.

In addition, she will present research she has recently published on the effect of positioning on babies who are having difficulty with swallowing and breathing during breastfeeding.

Mills placed breastfeeding parents and their infants inside MRI machines, capturing dynamic MRI images of what happens during sucking and swallowing.

Because most previous research has been done with bottle-feeding infants, these MRI studies represent a leap forward in understanding what happens during breastfeeding.

“We wanted to understand and define the impact of different breastfeeding positions on tongue position and dynamic airway collapse with the tissues above the voice box, and also with milk flow,” she explains. “What happens when the baby is positioned in different ways?

“When a baby is having trouble breathing, breastfeeding is often the first thing to go,” she continues. “Parents are told they must bottle feed. I wanted to know, what can be done to modify positioning to create a greater possibility of supporting safe breastfeeding in at least some of those babies?”

Mills will present these findings, along with tips for how IBCLCs can apply them when working with babies with Laryngomalacia and other challenges.

From her unique perspective as a clinician and a researcher, Mills will discuss:

  • How the field of lactation support is getting it wrong when it comes to the lingual frenulum.
  • Why assessing lingual frenulum in isolation is a costly mistake.
  • How her new data inform decisions about when frenotomy is indicated and when it is not.
  • The results of her dynamic MRI studies of babies feeding at the breast, the first of their kind, and implications for using positioning to help babies with sucking and swallowing difficulties.

This year’s conference will be hybrid, offering both online and in-person options in Houston, Texas, US. To learn more about the #ILCA21 conference, offered both virtually and in person, visit here.

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ILCA Board Nominations Now Open


The perspective of each IBCLC is unique. Your viewpoint is shaped by whether you practice in the community, in a health-care facility, or as a researcher. In your region of the world, you may hold a different vantage point based on the cultural needs and practices of the families that you serve. And yet there are common threads we all hold as providers and for the breastfeeding mothers and chestfeeding parents we serve. 

The ILCA board is where we weave together all of these perspectives to inform the best possible support for you, the lactation profession, and the global breastfeeding community.

Board nominations are now open. We welcome you to take a moment to consider who in your community can best represent your unique needs while holding the vision for our diverse global profession. Our goal is to ensure a board that can truly capture all the threads that make up the lactation consultant field.

Candidates must self-nominate. Required qualifications include:

  • Membership in good standing for two years (immediately prior to the date nominations are called)
  • IBCLC in good standing
  • Strong interest in the growth and development of ILCA
  • Demonstrated leadership

Learn about all of the qualifications and time commitment here in the job description and complete the application here.

Questions about your membership status or the application process? Contact our helpful support staff at info@ilca.org.

The deadline for applications has been extended to 7 June 2021, 23:59 New York EDT; 8 June 2021 5:59 Geneva CEST / 13:59 Sydney AEST.

Our nominations task force, led by Past President Mudiwah Kadeshe, MSN, RN, LNC, IBCLC, looks forward to learning more about you.

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Beyond Borders: Creating Collaborations that Work


What do you do when your job is to help breastfeeding families in your local area—but your local area comprises three states, two countries, and two languages?

If you’re Elsa Quintana, you become an expert in collaboration—in envisioning it, in building it, and in funding it.

Quintana, BA, IBCLC, BCJ, works at the intersection of three locales—far west Texas (United States), extreme southern New Mexico (United States), and Ciudad Juarez, Chihuahua (Mexico). 

She navigates three state governments, two national governments, and two languages in her job of facilitating lactation care for families across multiple borders.

At this year’s International Lactation Consultant Association’s conference, Quintana will share tips and strategies for harnessing the power of collaboration, no matter your setting.

“We are unique in that we have two countries and three states that are all about five minutes from each other,” Quintana says. “But we have all found a way to pull together and it truly works. At the conference, I want to share our story because I believe it has lessons that can be used in many other places. I’m hoping to inspire people to see what’s possible where they are.”

Quintana served for many years as the State Coordinator for the WIC Breastfeeding Peer Counselor Program in New Mexico, where she and her program have received awards and recognition locally, nationally, and internationally for their efforts to increase breastfeeding rates in the state.

She currently contracts with the New Mexico Department of Health to teach a bilingual 100-hour certification course for community health workers.

Working within the Binational Breastfeeding Coalition (BBC), Quintana worked on a three-year grant project called Breastfeeding on the Border.

The project brought together WIC peer counselors, community health workers, and professionals across borders to better serve lactating families.

Breastfeeding on the Border successfully established community lactation support groups, which connected resources and built networks within communities. The result is sustainable, community-driven supports that are culturally informed and not susceptible to rises and falls in government funding.

In addition, Quintana helped create a unique presentation series called “Look Who’s Talking.” These talks brought renown speakers such as Kathleen Kendall Tackett and Laurel Wilson to share information with BBC, whose membership includes lactation professionals, nurses, social workers, pediatricians, therapists, dentists, and others. The speakers presented to packed rooms, while even more attendees watched online.

The Look Who’s Talking presentations and other education efforts under the project shared one simple goal: to get a variety of professionals who serve childbearing families all on the same page about lactation basics.

“That way, the same message is being delivered in many settings across the communities,” Quintana notes.

Bringing together diverse professionals from different states and different countries around the same goal may sound like a huge task, but Quintana says it comes down to perseverance and believing in your mission.

“Every time I talk to other lactation professionals, they ask, ‘How in the world do you guys do it?’” Quintana says. “They are especially surprised that we have been able to fund some of our initiatives, like the high-level speakers we’ve brought in.

“The keys are developing good contacts, networking, and looking for shared goals,” she continues. “Maybe you’re looking for ways to provide lactation support, and another organization in your community is talking about adolescent pregnancy. How can you share resources? You are always looking to partner and invite.

“It can be done, and you can do it,” she encourages. “When you have a passion to help families, you don’t see bridges and interstate lines and borders. You just see a parent who needs help.”  

From her unique perspective, Quintana will share tips on:

  • Networking and finding shared goals
  • Finding your setting’s unique opportunities
  • Understanding your audience’s needs
  • Collaborating to find funding
  • Navigating bureaucracy
  • Not getting discouraged

This year’s conference will be hybrid, offering both online and in-person options in Houston, Texas, US. To learn more about the #ILCA21 conference, offered both virtually and in person, visit ilca.org/conference.

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