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Joint Position On Separation of Parents and Children from IBLCE, ILCA, and LEAARC

The International Lactation Consultant Association® (ILCA®), the International Board of Lactation Consultant Examiners® (IBLCE®), and the Lactation Education Accreditation and Approval Review Committee (LEAARC) stand together in opposition to policies that unnecessarily separate a parent from their infant or young child.

The unnecessary separation of parents and young children has lifelong physical, psychological, and emotional impacts that have been well documented by health organizations worldwide, including UNICEF and the American Academy of Pediatrics, regardless of feeding status. In addition to these serious consequences, separation also disrupts breastfeeding, leading to further potential harm.

For breastfeeding to occur, mothers and babies must have unrestricted access and physical proximity to one another. The importance of breastfeeding for both infants and parents is well documented. These health protections extend into adulthood.1,2 Because of the range of health benefits conferred on the breastfeeding dyad, breastfeeding is recommended by the World Health Organization3 for up to two years of age or beyond. Separating parents from their breastfeeding children during this critical time has long-term consequences.

As organizations committed to ensuring worldwide health through support of parents and young children, we stand in opposition to policies that unnecessarily limit access to or separate parent and child.

Maternal, newborn, child, and adolescent health: Breastfeeding. World Health Organization. Retrieved from Date accessed 6/20/2018.
Victora, C., Bahl, R., Barros, A., França, G., Horton, S., Krasevec, J., …Rollins, N. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. The Lancet, 387(10017), 475-490.
3 Nutrition: The World Health Organization’s infant feeding recommendation. World Health Organization. Retrieved from Date accessed 6/20/2018.

ILCA Announces New Directors

The International Lactation Consultant Association (ILCA) Board of Directors is pleased to announce two new Directors: Stephanie George and Angela Love-Zaranka. Stephanie comes to the Board through election by ILCA membership. Board member Lisa Akers is stepping down from her second term as Board Treasurer so she can devote more time to the newest member of her family. Angela has been appointed by the Board to finish the last two years of Lisa’s term. Both of our new Directors will begin their terms in July 2018 at the Annual Conference. We look forward to working with them to continue ILCA’s mission: to advance the International Board Certified Lactation Consultant® (IBCLC®) profession worldwide through leadership, advocacy, professional development, and research.

Stephanie is an IBCLC and Aboriginal Midwife from Jarvis, Ontario, Canada. She is passionate about honoring and empowering all women through her healthcare practice. She also advocates for this platform through her roles on the National Aboriginal Council of Midwives, the Baby-Friendly Initiative Strategy of Ontario, and the Expert Panel of the Registered Nurses Association of Ontario. She hopes to continue this important work as a Board Member at ILCA, specifically through increasing access to education for lactation consultants around the world. Stephanie has served ILCA in the past as a member of the Conference Program Task Force.

Angela has always enjoyed both serving breastfeeding families in a clinical setting and doing behind-the-scenes work to support the profession. She began her career as a mother-to-mother breastfeeding support professional in 1990. As she worked to earn her IBCLC, Angela began volunteering for the Virginia and West Virginia Chapter of La Leche League International, eventually serving as their Finance Director and President. Another project she completed on the state level was serving as faculty for the Virginia Maternity Quality Improvement Collaborative, which supported hospitals in moving towards baby-friendly accreditation. Her next step was to the international level. She joined the International Board of Lactation Consultant Examiners as a Board Member in 2006. Some of her duties included chairing the Finance, Audit, and Governance committees and overseeing the revision of several documents key to the lactation consultant profession. Angela is originally from Oklahoma and is proud of her Native American ancestry. She has resided in the Washington D.C. Metropolitan area for the past thirty years.  Her current passion is learning about integrative medicine and traditional medicine from around the world.

We are proud to have Stephanie George and
Angela Love-Zaranka join the ILCA Board of Directors.

The ILCA Board would like to thank each of you for your continued support. To find out more, please visit our website at


Ramadan and Breastfeeding


by Nor Kamariah Mohamad Alwi, BE, MIT, IBCLC

Ramadan is the most holy month of the year for Muslims. During the month, those who follow Ramadan abstain from eating, drinking, and sexual activities between sunrise and sunset. Additionally, they practice being extra patient, kind, and generous throughout the four weeks. These observances can have an impact on breastfeeding so it is important that International Board Certified Lactation Consultants® (IBCLCs®) understand how to best provide guidance to families.

Muslims scholars, or “ulama,” have been discussing breastfeeding while fasting for decades. Many rulings or “fatwas” have been issued to address this issue, enabling women to make wise decisions for themselves. Muslim women are encouraged to refer to the rulings of their respective local scholars to determine the options most suitable for their situations.

While fasting during Ramadan is not obligatory for all breastfeeding women, here is some guidance that I have found useful in my practice with clients in Malaysia who choose to fast during this time:

  • STAYING HYDRATED: Daily water intake is very important to keep the body sufficiently hydrated. It is recommended to drink bit by bit throughout the permitted time, from sunset to early sunrise. Drinking too much just before fasting will just fill up the bladder and gets urinated out soon after, resulting in the mother feeling thirstier for the rest of the day.
  • EATING WISELY: Eating well-balanced food, including proteins and complex carbohydrates, during “suhoor” – the meal right before the start of a fasting day – is very essential. This will provide the energy that mothers need for the rest of the day, until the breaking of the fast.
  • BREAKING THE FAST: As the fasting day ends, mothers should break her fast as early as possible, by eating natural high-energy foods, to quickly regain energy. A common option among the muslim community (which is also culturally recommended) are black dates. Mothers can opt for creative preparations such as blending the dates with milk.
  • HANDS-ON BREASTFEEDING: For mothers who are breastfeeding directly throughout the day, some will notice that their baby became a bit fussier at the end of the fasting day, as the mother’s body is impacted by the fast. Additionally, the milk ejection reflex can slow down due to the stress of the fast. When breastfeeding at this point, breast compressions while feeding will help drain out milk from the back of the breast. Mom will notice improved milk transfer, which can satisfy the baby faster.
  • EXPRESSING MILK: Expressing milk (for mothers who have to be separated from their baby) can be a varied experience. Some mothers find no change at all in terms of the quantity of expressed milk, especially in the first half of the day. However, some may find that the yield of milk collected at the end of the day is lower compared to earlier in the day. When this occurs, the mother needs to stay calm and understand how milk supply is produced. When milk is expressed from the breast regularly, a new milk supply will be produced. However, when the amount of body liquid reduces as part of the effects of fasting, the quantity of breast milk can be a bit lower than the usual, and mothers will find that their milk at this point usually looks thicker.

At any point in time during a fasting day that a mom feels too lethargic, it is important for her to carefully consider her condition, as well as her baby’s condition, before deciding to continue the fast. Consult with the local scholars and doctors, on how to deal with such situations.

Are there any religious and/or cultural implications that you find useful in your practice?


Nor Kamariah Mohamad Alwi resides in Bandar Baru Bangi, Selangor, Malaysia. She created the online breastfeeding support forum in 2004 and is a co-founder and President of Malaysian Breastfeeding Peer Counselors. She is on the Local Governance Task Force Coordinator for World Alliance for Breastfeeding Action (WABA). Kamariah is working with IBCLCs to establish a Malaysian Lactation Consultant Association. She is currently a private practice lactation consultant. (Read more about Kamariah in her ILCA Board of Directors nominee profile.) 


Win a FREE #ILCA18 Virtual Conference Registration!

Join Us for the #ILCA18 Virtual Conference:

LEARNING: INNOVATIVE EDUCATION on the topics you need. 12 Continuing Education Units will be available for the Virtual Conference.

CONNECTION: BUILD RELATIONSHIPS with the entire #ILCA18 community by joining our Online CONNECT Community, exclusively for conference participants. Chat with both face-to-face and virtual contributors, get your questions answered by speakers, and find and share resources on the topics discussed at the conference.

BUILD THE SESSIONS YOU NEED: In addition to the scheduled sessions, #ILCA18 virtual attendees get FREE additional continuing education. Choose the content YOU need most by selecting an additional credit from our on-demand learning in the Knowledge Center.

LIVE OR ON YOUR TIME: Participate LIVE 20 – 21 July or watch on YOUR time – 60 full days of ACCESS to your content.

EASY TO USE + HELP WHEN YOU NEED IT: We are here to help! You will receive a direct link to our EASY-TO-USE conference platform with dedicated and patient tech support. During the live sessions, our professional tech support is staffed by skilled moderators. We love bringing your online questions to the floor of #ILCA18!


Equity Access Pricing:

ILCA is committed to ensuring the lactation community has access to #ILCA18, even in low-resource countries. Live streaming pricing is based on the same equity pricing model as our annual membership dues:

Category A: Standard/Clinical Members – $165, Students/Breastfeeding Supporters – $89, Retired – $66

Category B: Standard/Clinical Members – $32, Students/Breastfeeding Supporters – $19, Retired – $13

Category C: Standard/Clinical Members – $8, Students/Breastfeeding Supporters – $5, Retired – $4

Category D: Standard/Clinical Members – $4, Students/Breastfeeding Supporters – $2, Retired – $2

Non-Member Pricing: $241

To find which category your country is in, click here.


FREE registration for the #ILCA18 Virtual Conference winner announced!

Thank you to all those who left comments on Lactation Matters and in this ILCA Facebook post letting us know from whom you are most looking forward to learning during the #ILCA18 Virtual Conference!

Congratulations to our contest winner, Gina Tseka! Gina will have the opportunity to learn from her top picks, James McKenna and Tom Hale, as well as participate in the rest of our #ILCA18 Virtual Conference lineup.


Announcing the 2018 IBCLC Care Award Recipients


The IBCLC Care Awards have been announced! Congratulations to the Community-Based Care Award and Hospital-Based Facility recipients!

What are the IBCLC Care Awards?

Hospital-Based Facilities and Community-Based Health Agencies that staff currently certified International Board Certified Lactation Consultant (IBCLC) certificants, host dedicated lactation support programs, and have completed specific projects promoting breastfeeding, can apply online to become a recognized IBCLC Care Award facility and be included in the IBCLC Care Directory.

The IBCLC Care Awards are promoted to new families and the general public which means Care Award facilities can enjoy the benefits of positive public relations in your community, including:

  • Enhanced attractiveness to potential patients
  • Competitive edge in recruiting lactation consultants, nurses, midwives, mother support counselors and other medical staff
  • General good will in the community by providing excellent care in helping new families reach their breastfeeding goals

Who are this year’s recipients?

To see a full list of the Care Award Recipients, click here.

The award was created by International Board of Lactation Consultant Examiners® (IBLCE®) and International Lactation Consultant Association® (ILCA®). Learn more and apply here.


International Kangaroo Care Day: An Interview with Dr. Nils Bergman


In just two months, Dr. Nils Bergman, one of the world’s experts on the impact of skin-to-skin contact between an infant and their new family, will present at TOGETHER: Changing YOUR Community and the World, ILCA’s annual conference, in Portland, Oregon, United States, which will be held 18 – 21 July. Attendees at both our in-person and virtual conferences will be able to hear his presentation Skin-to-Skin Contact: Current Research and Mediating Mechanisms.

Dr. Bergman, who has shared his expertise on six continents, worked with Midwife Agneta Jurisoo in Zimbabwe to develop and implement Kangaroo Mother Care (KMC) for premature infants right from birth. This resulted in a five-fold improvement in survival of very low birth weight babies. He introduced KMC to South Africa in 1995, and after 5 years, KMC became official policy for care of premature infants in the hospitals of the Western Cape province. Dr Bergman continues to live and work in Cape Town as a Consulting Public Health Physician. He is also an Honorary Research Associate at the Karolinska Institute, Stockholm, Sweden.

In celebration of International Kangaroo Care Awareness Day, celebrated this year on 15 May, we’ve reached out to find out more about what drew Dr. Bergman to this work, why skin-to-skin contact is critical for infants, and what we can look forward to in his presentation.


Lactation Matters (LM): How did you come to be interested in early skin-to-skin contact between infants and their parents?

Nils Bergman (NB): Way back in 1988, I began working in a remote mission hospital in a low income country, with no incubators or realistic means to transfer small babies for care. We had learnt of Kangaroo Mother Method before we came. Since we had no incubators to stabilise babies, we started skin-to-skin contact immediately after birth. We saw a startling difference, instead of taking 6 days to stabilise, it took 6 hours. And we lowered mortality by 40%. The small babies had clear personas, rather than seemingly amorphous immature protoplasm.


(LM): Why is this such a critical issue for those who support new families to understand?

(NB): Perhaps it was an accidental discovery, but what we have to understand is that skin-to-skin contact is NORMAL, normal biology and part of reproductive fitness. Worse: separating mothers from babies is actually harmful. Toxic stress is defined as the ‘absence of buffering protection of adult support’, and this applies to premature babies more, not less. And it is very much a ‘family’ thing, the family fabric may also be adversely affected.


(LM): What new research or new techniques are you MOST excited to share with us in July?

(NB) Bill & Melinda Gates Foundation have funded a multicentre study, being conducted by WHO in Ghana, India, Malawi, Nigeria and Tanzania. We will randomise 4200 babies weighing between 1000g and 1800g to normal care in warmers and compare them to the same normal care in “Immediate KMC”.

Want to learn more? Join us for #ILCA18!


Warm Chain of Support for Breastfeeding

World Alliance for Breastfeeding Action (WABA), an ILCA Global Collaborator, has introduced a new initiative and vision for quality, consistent pre- and post-natal care: Warm Chain of Support for Breastfeeding. The Warm Chain strives to coordinate efforts at all levels to provide a continuum of care, from pregnancy through a child’s second birthday. There are usually many people providing care and support along the way to new families or families-to-be. The Warm Chain seeks to intentionally connect these “links” with consistent messaging and proper referral systems so that parents and children can benefit from ongoing support and skilled assistance.

International Board Certified Lactation Consultants® (IBCLC®s) play a multidisciplinary role that straddles generalized support for breastfeeding and allied healthcare. This improves maternal and infant survival, health, and well-being rates over the antenatal, birth, and postnatal periods.

As an IBCLC, there are many ways in which the care you provide can serve to further strengthen the links along the Warm Chain. Empowering parents to achieve their breastfeeding goals; providing accurate lactation information and training; and facilitating the establishment of programs, research, and policies in support of breastfeeding and lactation support are ways you can—and probably already DO—encourage connectivity between all actors along the continuum of care.


Find more suggestions on ways IBCLCs can support the Warm Chain HERE.

Take advantage of new Warm Chain of Support for Breastfeeding seed grants for projects “that focus on either starting a project or strengthening an existing effort to create an enabling environment for mother to continue breastfeed.” Seed grants are available up to $3000.00 (USD) per project. Find out more HERE.

Complete the Warm Chain survey to highlight both the links and the gaps between those links in the current model of care. Access the survey HERE.


#ILCA18 Virtual Conference Registration Now OPEN!

Join the International Lactation Consultant Association® (ILCA®) for our #ILCA18 Virtual Conference!

LEARNING: INNOVATIVE EDUCATION on the topics you need. 12 Continuing Education Units will be available for the Virtual Conference.

CONNECTION: BUILD RELATIONSHIPS with the entire #ILCA18 community by joining our Online CONNECT Community, exclusively for conference participants. Chat with both face-to-face and virtual contributors, get your questions answered by speakers, and find and share resources on the topics discussed at the conference.

BUILD THE SESSIONS YOU NEED: In addition to the scheduled sessions, #ILCA18 virtual attendees get FREE additional continuing education. Choose the content YOU need most by selecting an additional credit from our on-demand learning in the Knowledge Center.

LIVE OR ON YOUR TIME: Participate LIVE 20 – 21 July or watch on YOUR time – 60 full days of ACCESS to your content.

EASY TO USE + HELP WHEN YOU NEED IT: We are here to help! You will receive a direct link to our EASY-TO-USE conference platform with dedicated and patient tech support. During the live sessions, our professional tech support is staffed by skilled moderators. We love bringing your online questions to the floor of #ILCA18!


For more information about the #ILCA18 online conference, a full schedule of events, and registration information, visit the virtual conference webpage!







(*訳注:BFHIネットワーク、乳児用食品国際行動ネットワーク (IBFAN)、国際ラクテーション・コンサルタント協会(ILCA)、ラ・レーチェ・リーグ・インターナショナル、世界母乳育児行動連盟(WABA))























・  各国政府はBFHIの全国的実施に関与すべきであり、国際標準を国内制度に統合する努力を行うべきである。

・  現場に出る前の教育を担う職能団体は、「母乳育児を成功に導く10のステップ(改訂版10カ条)」に具体化されている科学的根拠と実践をカリキュラムに組み込むべきである。

・  母乳育児の重要性、人工乳のリスク、母乳育児を保護し、推進し、支援するのに役立つ実践に人々の関心を引く努力が行われるべきである。

・  母乳育児、家族やスタッフを商業的なマーケティングや非倫理的な圧力から保護するための努力が必要である。

・  BFHIは、他の介入、既存の国際的・国家的プログラムと統合され、地域社会および職場における母乳育児支援への努力と協調されるべきである。

・  産科施設と新生児医療施設の大多数に対して、よく機能する認定プログラムが全国的に行き届いているような国では、この新しい実施ガイドがあるからといって、現在成功しているプログラムを中止する理由にはならない。




・  身体的・神経学的な成長と発達に必要な、養育・栄養・エネルギーを提供するために、生後6ヵ月間母乳だけで育てることの重要性を強調している。

・  明確な一連の世界共通評価基準を含み、国内基準への適用に合わせて調整するというオプションもある。

・  10のステップは元の10カ条の順序と項目のままとしている。文言を変えて、より一般化し、新しい科学的根拠が出たり更新があったりした時に、それを組み込むことができるようにデザインされている。


・  母乳育児支援の改善に、10のステップ1つひとつが寄与していることを示し、母乳育児の実践に最適な影響を与えるために10のステップすべてを1つのまとまりとして実施する必要性を強調している。

・  実践の安全な実施と患者のモニタリングのための最新のガイダンスを提供している。医療保健従事者に、個別化された注意とケアの重要性について確認を促している。

・  母親にやさしい出産の実践の重要性と母乳育児への出産の実践の影響について説明している。医療保健専門家が母親にやさしい出産の実践についての知識を持つことと母親を教育する責任があることの重要性を強調している。具体的な実践の詳細については、WHOの他のガイドラインを参考としている。

・  これまで健康な正期産児が対象だったガイドライン、指標、基準に、早産児の母乳育児支援のためのガイドライン、指標、基準を含めることで、施設内でケアを受けるすべての乳児の母乳育児と母乳栄養の重要性を強調している。

・  10のステップに具体化された科学的根拠と実践を、サービスにつく前の教育のカリキュラムに含める義務を設定している。現場スタッフの教育が達成され、学生が卒業して現場に入るまで教育の必要性は継続する。

・ 保健医療施設や専門家が「国際規準」を実施する責任を説明し、それを目立つようにステップ1に配置し、「国際規準」が保健医療サービスのあらゆる面に具現化するように設定している。

・  実践をモニタリングし、維持するためのシステムの重要性を強調し、提案している。

・  評価が容易で、国と国との比較が可能な、明確に定義された指標を提供している。すべての指標を80%レベルに保持している。

・  変化の主要な推進要因として、認定などの公的認知の重要性を認めている。質の改善の重要原則の1つとして外部評価やアセスメントの必要性を指摘し、赤ちゃんにやさしい(病院)になる過程が、乳児栄養に関連する環境全体に影響を与える、変化させる力のあるものと認めている。これには、よりお母さんと赤ちゃんを中心とするケアをすること、乳児栄養に関するスタッフの態度やスキルレベルを飛躍的に改善すること、人工乳および新生児室の使用を大幅に減少させることを含んでいる。母乳育児に対するケアの質は、「赤ちゃんにやさしい」と認定された施設ではっきりと改善したことを明言している。

・  従来型の認定が困難な国に対して、質の改善のための追加オプション用の強力なガイダンスを提供している。

・  産科施設と新生児医療施設が、継続的かつ一貫した母乳育児支援のための適切な地域資源を見つけてそれを提供するという役割を果たすことを強調している。それは家族のニーズに文化的社会的に敏感なものでなければならない。そのような資源を強化するために周辺のコミュニティと関わる責任があることを施設に念を押している。








私たちは、来る世界保健総会での決議に、WHO事務局長がユニセフと協力して、「赤ちゃんにやさしい病院運動」のトレーニング、モニタリング、アドボカシーのツールを開発して加盟国による実施を支援するための条項が確実に入るように働きかけています。 私たちは、決議の進捗、ツールの開発およびBFHIガイドの実施を引き続き監視していきます。


Trish MacEnroe



赤ちゃんにやさしい病院運動ネットワーク(BFHI Network)


Elisabeth Sterken

Co-chair IBFAN Global Council



Michele Griswold




Ann Calandro


ラ・レーチェ・リーグ・インターナショナル (LLLI)


Felicity Savage


世界母乳育児行動連盟 (WABA)


***************  【参考】  *************





1a. 「母乳代用品のマーケティングに関する国際規準」と世界保健総会の関連決議を完全に順守する。

1b. 乳児栄養の方針を文書にしスタッフと親にもれなく伝える。

1c. 継続したモニタリングとデータ管理システムを確立する。

  1. スタッフが母乳育児を支援するための十分な知識、能力、スキルを持つようにする。



  1. 母乳育児の重要性と方法について、妊娠中の女性およびその家族と話し合う。
  2. 出産直後からのさえぎられることのない肌と肌との触れ合い(早期母子接触)ができるように、出産後できるだけ早く母乳育児を開始できるように母親を支援する。
  3. 母親が母乳育児を開始し、継続できるように、また、よくある困難に対処できるように支援する。
  4. 医学的に適応のある場合を除いて、母乳で育てられている新生児に母乳以外の飲食物を与えない。
  5. 母親と赤ちゃんがそのまま一緒にいられるよう、24時間母子同室を実践する。
  6. 赤ちゃんの欲しがるサインを認識しそれに応えるよう、母親を支援する。
  7. 哺乳びん、人工乳首、おしゃぶりの使用とリスクについて、母親と十分話し合う。
  8. 親と赤ちゃんが継続的な支援とケアをタイムリーに受けられるよう、退院時に調整する。

(NPO法人日本ラクテーション・コンサルタント協会 訳)



ILCA Volunteer Spotlight: Wilaiporn Rojjanasrirat

Volunteers are essential to achieving our shared goal: world health transformed through breastfeeding and skilled lactation care.

ILCA’s dedicated volunteers take on important roles, including advocating for breastfeeding on the international stage; vetting educational content for our annual conference; promoting equity, diversity and inclusion; and more. Our volunteers share their time, energy, and significant expertise. We want you to learn more about their meaningful efforts.

Today, we are pleased to highlight Wilaiporn Rojjanasrirat, PhD, RNC, IBCLC, Research Team Leader on the Professional Development Committee. Read below for some insights into her volunteer experience at ILCA.

LM: How did you first get involved with ILCA?

Wilaiporn Rojjanasrirat (WR): I got involved in the Research Committee many years ago through my mentor, Dr. Karen Wambach.

LM: What has surprised you most about working with ILCA?

WR: I’ve learned a lot and have gotten to know many wonderful people from all over the world by serving as a volunteer in working with ILCA.

LM: What do you wish other people knew about the specific work of ILCA and/or the Committee(s) and/or Task Forces(s) on which you serve?

WR: Research Team/Committee members have the opportunity to fulfill professional development and research activities by reviewing and selecting abstracts for oral and poster presentation, contributing to other committee activities, and making recommendations of evidence-based monthly resources for ILCA educational modules.

LM: What would you tell someone who is thinking about volunteering at ILCA?

WR: It’s such a rewarding experience to learn and share knowledge/skills in lactation across multiple disciplines and within the IBCLC® profession.

LM: What do you do when you aren’t volunteering?

WR: I enjoy teaching graduate nursing students and working on my research related to breastfeeding.

Please join us in thanking Wilai for her service to ILCA and the profession!


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