Tag Archives | breastfeeding

2 Weeks until ILCA 2012! {Running the Conference Marathon}

Written by Amber McCann, IBCLC

I am getting to the point in my preparation for this summer’s ILCA Conference where I’m starting to feel the pressure…the pressure to start packing, to make sure I have all the business cards I need and to think through the details of my flight and lodging, food and fun activities.  The heat is on…and quite literally as my part of the United States has been under an incredible heat wave for the past week!

The conference is 5 days of non-stop action, networking, education and FUN.  Here are some great tips for “running the conference marathon” so we don’t lose endurance.

Stay Hydrated

Photo by RLHyde via Flickr Creative Commons

Looking at the projected forecast for conference week, the heat I’ve been getting used to will continue in Orlando.  Highs around 90F (32C)!  Even in a cool hotel, it will be important that we be aware of our hydration.  Just like we tell the mothers we serve, “Drink to thirst”.  You might consider tossing a reuseable water bottle into your suitcase so you’ll always have access without needing to purchase expensive bottled water.

Get your ZZZZZZZ’s

Photo by HaoJan via Flickr Creative Commons

Me with too little sleep = grumpy IBCLC.  I’m sure many of you are the same.  It will be incredibly tempting to stay up until all hours of the night (or awake before Mickey Mouse) to cram in every last moment of connecting with your colleagues.  One, even two nights of that can be overcome with adrenaline but quickly, our bodies will descend into a place where will start to not retain any of the wonderful information being shared with us.  Grab a late afternoon nap.  Recharge with a quick snooze.  Set a solid bedtime for yourself and STICK TO IT.

Make Time to Build Relationships

A wise IBCLC once said to me, “This can be a very lonely profession if we don’t support each other.”  One of the most significant parts of the career for me has been “finding my tribe”…those people with whom I share a connection, those that “get me”.  “Get” the constant breast references.  “Get” the never-ending concern for a mother we encountered.  “Get” the quest for one more tip or technique for that mother in pain.  The JW Marriott Orlando Grande Lakes will be teaming with your “tribe”.  Find them.  Strike up a conversation with the IBCLC seated next to you in the lobby.  Make a comment about a pin on someone’s nametag.  Ask a fellow passenger in the elevator where they are from and in what setting they practice.  Be bold and walk up to your favorite speaker and tell them what their session meant to you.

Try Something New

Photo by Lorenia via Flickr Creative Commons

Never tried sushi?  Do it!  Not so sure about taking a taxi? Do it!  Never volunteered at a major conference?  Do it!  Never used the Spanish you learned in high school?  Do it!  Never been to Disney World?  Do it! Never “hunted” an alligator?  Do it! Never worn a breastfeeding advocacy shirt? Do it! Never used Twitter? Do it! Never had a facial? Do it!  Make a memory at this year’s conference.

Get ready to run the conference marathon.

See you in two weeks!

Amber McCann, IBCLC

Amber McCann, IBCLC is a  board certified lactation consultant in private practice with Nourish Breastfeeding Support, just outside of Washington, DC and the co-editor of this blog.  She is particularly interested in connecting with mothers through social media channels and teaching others in her profession to do the same.  In addition to her work here, she has written for a number of other breastfeeding support blogs including The Leaky Boob and Best for Babes and served on the Communications Team for GOLD Conference . She also is a regular contributor to The Boob Group, a weekly online radio program for breastfeeding moms.  When she’s not furiously composing tweets (follow her at @iamambermccann) or updating her Facebook page, she’s probably snuggling with one of her three children or watching terrible reality TV. 

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Increasing breastfeeding duration: One Sling at a Time!

Written by Jennie Bever Babendure, PhD, IBCLC

Author Jennie Bever Babendure with her little one

By now, most of us in the lactation field have heard of Kangaroo Mother Care (KMC). Maybe you’ve even been lucky enough to hear Nils Bergman speak passionately about the work he’s done using KMC, and its benefits for premature infant thermal regulation and brain development. Most importantly for those of us in the lactation world, the skin-to skin contact (SSC) used in KMC is associated with increased breastfeeding duration. Despite all the attention SSC and KMC have received, no one has yet looked at the impact on breastfeeding of mother/infant body contact beyond the first hours after birth in term infants.

A recent article in Acta Paediatrica by Continisio, Continisio, Filosa and Tagliamonte, set out to remedy this by designing an intervention to increase mother/infant body contact in the first month of life. 100 Italian mothers were given information on breastfeeding as well as a cloth baby carrier. They were shown how to put their (clothed) infants into the carrier and asked to wear the baby in the carrier as often as possible, and for at least 1 hour per day during the baby’s first month. Control mothers were given information on breastfeeding only.

What they found surprised even me, a sling-wearing, card-carrying member of the babywearing fan club.

Photo by hugabub via Flickr Creative Commons

Mothers in the intervention group were 1.8 times more likely to still be breastfeeding at 2 months and 2.9 times more likely to still be breastfeeding at 5 months and breastfed their babies significantly more often (times per day/ night) at 1 and 2 months. Mothers in the intervention were also more likely to be exclusively breastfeeding at 2 and 5 months. In addition, the majority of the mothers who used the baby carrier felt it was useful for breastfeeding as well as bonding, understanding of baby needs, and getting things done.

Wow!

For me, these results are staggering. The intervention is simple, requires minimal skill to administer, and mothers and babies are not only getting the health advantages of longer and more exclusive breastfeeding, they’re also getting more bonding time and getting things done! It is for this last reason, I would imagine, that women the world over have chosen to carry their babies in cloth carriers for thousands of years. They, like many mothers who use cloth carriers these days, likely could have told us that babywearing makes breastfeeding easier. Thanks to this study, we now know that it also helps mothers breastfeed longer and more exclusively.

This study provides solid evidence that increased mother/baby contact through the use of a baby carrier can increase breastfeeding duration and exclusivity. Although this study was done with only one type of carrier, I would guess that most carriers that allow mothers to wear their new babies close to their chests (as in KMC) would be of similar benefit.

One of my favorite resources for all things babywearing is www.thebabywearer.com. They have reviews, forums, and information on buying, making, and using baby carriers of all kinds. Be sure to check out the resources on their homepage on safe positioning. Like any type of baby gear, baby carriers must be used properly, and it’s important to check to make sure that any baby carrier you use has not been recalled.

I’m not sure I would have made it through the first few months without a baby carrier. In fact as I finish this post, my son is snuggled against my chest in a carrier while we sway back and forth to Neil Diamond.

Have you or the mothers you work with used a baby carrier? Have you found it to make breastfeeding easier?

Pisacane A, Continisio P, Continisio GI, Filosa C, Tagliamonte V. Use of baby carriers to increase breastfeeding duration among term-infants: the effects of an educational intervention in Italy. Acta Paediatrica 2012:epub ahead of print.

Jennie Bever Babendure, PhD, IBCLC: I am mom to 2 active boys and an Assistant Research Professor in the College of Nursing and Health Innovation at Arizona State University. As breastfeeding researcher, I am constantly scanning the literature for articles that guide my research and inform my clinical practice. One of my goals is to increase the evidence base of our profession as lactation consultants. I feel it is important for lactation professionals to be aware of and contribute to breastfeeding research, especially when so much of it is fascinating! As an ongoing contributor to Lactation Matters, it is my hope that you will find the articles I highlight as interesting and informative as I do, and that you will use them to guide you in the important work of lactation professionals and breastfeeding advocates. For more research news and commentary, check out my blog at www.breastfeedingscience.com.

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Care for a Virtual Cuppa? Australia’s first Online Breastfeeding Café launched.

Written by Maddy Knight

The Australian Breastfeeding Association (ABA) has welcomed the newest addition to its stable of services for breastfeeding families, the Online Breastfeeding Café(OBC).

With so many blogs on the web about breastfeeding (ILCA’s Lactation Matters recently referred to BlogHer’s study where over 98% of respondents said they trusted the information they received on blogs), the Online Breastfeeding Café has been developed by the ABA as an online community where users can share, discover and chat with guaranteed reliable, up to date information.

The OBC also has families in mind. This means the inclusion of  an additional men’s parenting section and private, log-in only forum for Dads.

The new site was launched on behalf of NSW Minister for Health, the Hon. Jillian Skinner by State Member Roza Sage at Glenmore Park Child and Family (NSW real estate Australia) precinct on Tuesday 26 June. Also present at the launch were Cr Greg Davies, Mayor of Penrith and Todd Carney representing Federal Member the Hon. David Bradbury.

The Online Breastfeeding Café was three years in development and was designed with Generation Y parents in mind, knowing that for today’s families both mums and dads want to share in the breastfeeding and parenting journey.

“The OBC can help make sure mother’s and fathers both have a place to go to ask and share about their experiences. It really helps them to parent from the same page” says Nicole Bridges, Australian Breastfeeding Association Assistant Branch President.

“These days dads aren’t passive breastfeeding supporters, they want to know what’s going on and how they can help and support mum in any way they can. If she’s happy then the whole family is happy.”

The Online Breastfeeding Café features many of the Australian Breastfeeding Association’s reliable resources and information, but packaged in a new, vibrant and easy to use website that compliments its existing website.

The concept of the breastfeeding café as a physical venue first took off in the UK a couple of years ago. The OBC is the first attempt to take the concept of a comfortable, relaxed place to share and chat about breastfeeding and turn it into an online community.

A café theme runs through the website, with areas such as The Breastfeeding Couch, full of great tips, latest articles and breastfeeding videos; a dad’s-own section of the website aptly titled Dad’s Espresso Bar; great stories and inspiration in A Cuppa and a Read, as well as a long list of popular tools such as finding your local breastfeeding-friendly café.

More features of the Online Breastfeeding Café:

  • Most asked breastfeeding questions, and tips on making breastfeeding easier.
  • How to find your local breastfeeding class or breastfeeding-friendly café or lactation products.
  • Information on breastfeeding and returning to work.
  • The latest breastfeeding articles from the ABA and other trusted sources.
  • Great forums to get involved in, including a general/mum’s forum and completely private Dad’s forum.
  • In “Dad’s Espresso Bar”, a new father can find some practical ways to develop his own special unique bond with his baby even though mum does the breastfeeding. He can also chat with other dads in a private forum about some of the unique concerns of fathers.

The Online Breastfeeding Café also has forums that are fully mobile (containing every post) so you can take it with you and have a virtual cuppa and chat with other parents, all while you enjoy your latte at your local breastfeeding-friendly café.

We would love new mothers (and dads) to know all about this great new online community.

Log in today at www.onlinebreastfeedingcafe.com.au or contact the community manager@onlinebreastfeedingcafe.com.au for more information.

Maddy Knight is Project Director of the Online Breastfeeding Café. She is an experienced journalist, media advisor, publicist and graphic designer and has worked extensively with non-profit organisations including the Australian Breastfeeding Association. The Online Breastfeeding Café was her brainchild for which she developed the website plan and layout, edited and wrote much of the content and even designed the logo and slogan. She spends her spare time singing and writing her blog Bondi Sourdough 101. She lives in Bondi Beach with her husband and cat, Luna.

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The Best and Worst Places in the Industrialized World for Breastfeeding Support

Editor’s Note:  While Lactation Matters typically publishes original material, occasionally we encounter a blog post that we feel especially deserves to be read by all IBCLCs and breastfeeding supporters.  This is just such a post.  It was originally published by Canadian RN and IBCLC Fleur Bickford on her blog Nurtured Child and she has graciously allowed us to republish it here.  You will have the opportunity to hear Fleur speak at this year’s ILCA Conference on the topic “Social Media as a Means to Protect, Promote and Support Breastfeeding”.

Written by Fleur Bickford

Photo via Save the Children

Every year, the non-profit organization and registered charity Save the Children looks at the health status, nutrition, education, economic well-being and political participation of women around the world to come up with their annual State of the World’s Mothers report. Along with providing rankings for 165 countries around the world, each report has a different theme.

This year, the report focuses on the critical impact of nutrition in the first 1000 days of life, starting with pregnancy. The report also contains an Infant and Toddler Early Feeding Score for 73 developing countries and a Breastfeeding Policy Scorecard which looks at breastfeeding practices, support and policies for 36 industrialized countries. You can read more about the best and worst places in the world to be a mother and the Infant and Toddler Early Feeding Score in this companion blog post.

The Breastfeeding Policy Scorecard for Developed Countries is new this year, and it provides an interesting look at support for breastfeeding in the industrialized world. Rankings are based on maternity leave laws, right to daily nursing breaks, percentage of hospitals that are baby friendly, state of policy support for the International Code of Marketing of Breastmilk Substitutes and breastfeeding practices. Of the 36 countries listed, Norway ranks first with a score of 9.2 and the USA ranks last with a score of 4.2. Canada ranks 31st with a score of 5.4.

From the report, we see that Norway is doing a wonderful job of supporting breastfeeding
mothers:

“Norway tops the Breastfeeding Policy Scorecard ranking. Norwegian mothers enjoy one of the most generous parental leave policies in the developed world. After giving birth, mothers can take up to 36 weeks off work with 100 percent of their pay, or they may opt for 46 weeks with 80 percent pay (or less if the leave period is shared with the father). In addition, Norwegian law provides for up to 12 months of additional child care leave,  whichcan be taken by both fathers and mothers. When they return to work, mothers have the right to nursing breaks as they need them. Nearly 80 percent of hospitals have been certified as “baby-friendly” and many provisions of the International Code of Marketing of Breast-milk Substitutes have been enacted into law. Breastfeeding practices in Norway reflect this supportive environment: 99 percent of babies there are breastfed initially and 70 percent are breastfed exclusively at 3 months.”

Compare this to the USA:

“The United States ranks last on the Breastfeeding Policy Scorecard. It is the only economically advanced country – and one of just a handful of countries worldwide – where employers are not required to provide any paid maternity leave after a woman gives birth. There is also no paid parental leave required by U.S. law. Mothers may take breaks from work to nurse, but employers are not required to pay them for this time. Only 2 percent of hospitals in the United States have been certified as “baby-friendly” and none of the provisions of the International Code of Marketing of Breast-milk Substitutes has been enacted into law. While 75 percent of American babies are initially breastfed, only 35 percent are being breastfed exclusively at 3 months.”

The differences between Norway and the United States is staggering (and Canada isn’t doing much better than the United States). For all the talk about “Breast is best”, North America is doing a very poor job of providing parents with the support they need to actually give their babies the “best”. Most mothers want to breastfeed. Breastfeeding initiation rates are high, but breastfeeding drops off rapidly in the early weeks after birth. This happens not because mothers don’t want to breastfeed anymore, but because they haven’t received the support they need to continue. Breastfeeding is natural, but it is also something that requires community support. Conditions during birth and the first 72hrs after birth are critical for establishing breastfeeding (hence the importance of hospitals being Baby Friendly) and it is important that mothers have sufficient time off of work to establish their breastfeeding relationship which encourages a longer duration of breastfeeding.

Although not specifically about breastfeeding, below are some other key points about the United States from the report that should really be cause for alarm:

In the United States, mothers face a 1 in 2,100 risk of maternal death – the highest of any industrialized nation. In fact, only three developed countries – Albania, Moldova and the Russian Federation – perform worse than the United States on this indicator. A woman in the U.S. is more than 7 times as likely as a woman in Ireland or Italy to die from a pregnancy- related cause and her risk of maternal death is 15 times that of a woman in Greece.

The U.S. under-5 mortality rate is 8 per 1,000 births. This is on par with rates in Bosnia and Herzegovina, Montenegro, Slovakia and Qatar. Forty countries performed better than the U.S. on this indicator. This means that a child in the U.S. is four times as likely as a child in Iceland to die before his or her 5th birthday.

The United States has the least generous maternity leave policy of any wealthy nation. It is the only developed country – and one of only a handful of countries in the world – that does not guarantee working mothers paid leave.

The United States is also lagging behind with regard to preschool enrollment and the political status of women. Performance in both areas places it among the bottom 10 in the developed world.”

An interesting (and again alarming!) point about Canada from the Save the Children Canada website:

“Norway’s under 5 mortality rate is half that of Canada (3 deaths per 1000 live births vs 6 deaths per 1000 live births).”

The risks of not breastfeeding are well documented, and there is plenty of research on the best ways to encourage breastfeeding duration and exclusivity. The statistics from this report for the countries at the top of the Breastfeeding Policy Scorecard show that interventions such as requiring hospitals to be Baby Friendly, providing adequate paid maternity leave and supporting the International Code of Marketing of Breastmilk Substitutes DO work. This report should be a wake-up call for the countries at the bottom of the scorecard!

Below is the full list of where the 36 countries placed on the Breastfeeding Policy Scorecard. For the full details, and to see the score for each country, please refer to section 1:43 of the full report:

  1. Norway
  2. Slovenia
  3. Sweden
  4. Luxembourg
  5. Austria
  6. Lithuania
  7. Latvia
  8. Czech Republic
  9. Netherlands
  10. Germany
  11. Estonia
  12. Poland
  13. Portugal
  14. France
  15. Belgium
  16. Ireland
  17. Italy
  18. Switzerland
  19. New Zealand
  20. Cyprus
  21. Denmark
  22. Greece
  23. Slovak Republic
  24. Spain
  25. United Kingdom
  26. Finland
  27. Israel
  28. Japan
  29. Hungary
  30. Liechtenstein
  31. Canada
  32. Iceland
  33. Monaco
  34. Australia
  35. Malta
  36. United States
Fleur Bickford is a mother of two, an RN, IBCLC and retired LLLL. She worked in obstetrics as an RN for several years before taking time off to raise her family. During that time she gained experience in labour and delivery, post partum care and pediatrics. As a Leader for La Leche League Canada, she served as a member of both the Professional Liaison Department and the Social Media Advisory Committee. Currently, Fleur works in private practice in Ottawa, Ontario as owner and operator of Nurtured Child, and she is President of Ottawa Valley Lactation Consultants. Fleur maintains a blog, and is very active on both Twitter (@NurturedChild) and Facebook (NurturedChild).
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What Do Undergraduates Think about Breastfeeding?

Written by Robin Kaplan, M.Ed., IBCLC

Photo by j.o.h.n. walker via Flickr

It is well known that in the United States, breastfeeding rates are somewhat discouraging. With only 35% of babies exclusively breastfeeding at 3 months and 44.3% receiving any breast milk at all at 6 months, as a nation we are not meeting the standards set forth by the American Academy of Pediatrics nor the World Health Organization. As we continue to look at ways in which we can increase our breastfeeding rates, one suggestion has been to examine the breastfeeding education taught to nonpregnant youth.

An article in the upcoming issue of the Journal of Human Lactation explores this issue. Kavanaugh, et al. surveyed 248 nonpregnant undergraduate youth at a large research university in Tennessee to determine their breastfeeding knowledge, attitudes, prior exposure, and breastfeeding intent (For subscribers to The Journal of Human Lactation, you can read the full text of the paper here).

The most significant findings from the study were:

  • Over 90% of the participants agreed that breastfeeding should be started soon after birth and that breast milk and formula were not the same. However, only about 50% of the participants knew that breastfeeding can reduce a mother’s risk of cancer and that formula-fed infants are ill more often than breastfed babies.
  • While a majority of the participants believed that breastfeeding was cheaper and healthier than formula, an astounding number felt that breastfeeding in public was embarrassing and unacceptable (71% female, 47.7% male) as well as inconvenient and painful (47.8 female, 33.8% male).
  • Those who had been breastfed as infants scored significantly higher on breastfeeding knowledge and positive attitude towards breastfeeding than those who were unsure or had not been breastfed.
  • The majority of the participants (80%) intended to breastfeed/support a partner to breastfeed in the future.

So where do we go from here? How do we change the attitudes of children, adolescents, and young nonpregnant adults about breastfeeding?

  • This research study is limited in its generalization due to the sample of the participants, therefore we need more wide spread, longitudinal studies of adolescents and young adults’ breastfeeding knowledge and attitudes.
  • We need better support and legislation to protect breastfeeding in public. If breastfeeding in public becomes the norm, as it is in MANY other countries, it should decrease the perception that it is embarrassing, unacceptable, and inconvenient. It’s time we start seeing more of this:

    Photo via blondebutbright.blogspot.com

    and less of this:

    Photo by Kate Gulbranson (@hygeiakate)

  • Additional curriculum, like the one pioneered in NY State, that promotes breastfeeding as the norm, in human development and nutrition classes for children, adolescents and college students. The bulk of the content could focus on the benefits of breastfeeding (for both mother and baby), the hazards of formula, and the superior nutritional components of breast milk.
  • A recommendation, per the authors (which I personally think is brilliant), it also to educate our youth about appropriate infant development and behavior. The authors concluded that if our youth understood how often an infant/toddler needed to breastfeed and that covering with a blanket was not always feasible (especially with an older infant who wants to see the world around him/her), that they might stop viewing a breastfeeding mother as being immodest when breastfeeding in public. Also, since an infant typically breastfeeds every few hours, it is irrational to expect this mother to stay at home for every feeding.

What recommendations would you add to this list? How does your community make breastfeeding the norm?

Robin Kaplan received training to be a Certified Lactation Educator and an International Board Certified Lactation Consultant from UCSD. She holds a Masters in Education from UCLA, a multiple-subjects teacher credential from UCLA, and a BA in Psychology from Washington University in St. Louis, MO. In 2009, Robin started her own business, the San Diego Breastfeeding Center, where she offers in-home breastfeeding consultations, free weekly support groups, breastfeeding classes, and online support through her business blog.  In addition to her private practice, Robin was the founding Co-editor of the International Lactation Consultant Association’s (ILCA) blog, Lactation Matters, and a regular contributor to ILCA’s E-Globe newsletter.  She also is the host/producer of The Boob Group online radio show, which launches on July 2, 2012, and the Director of Marketing for NaturalKidz.com.  Robin lives in her native San Diego, where she enjoys cooking, hiking, trying new trendy restaurants, and traveling with her family.

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6 Weeks until ILCA 2012! {thoughts from a conference newbie}

Written by Amber McCann, IBCLC

Photo via edailypost.com (Permission requested)

When I think of conferences, especially those with my fellow supporters of mothers and babies, I imagine it as one big PARTY!  When I found out that I would be attending this year’s ILCA conference in Orlando, I promptly went and packed my party clothes!  The conference brochure states,

The ILCA Annual Conference is the premier lactation learning event of the year. The Conference provides a rich learning environment for lactation professionals and others who assist mothers and babies with breastfeeding. It offers current and aspiring lactation consultants information on cutting-edge lactation practices and research to equip them in giving optimal breastfeeding care and support to mothers and babies.

Sounds like a celebration to me!  Apparently, I’m not the only one who shares this sentiment…

[youtube=http://www.youtube.com/watch?v=W35H_43gTss&feature=bf_prev&list=ULoD0JXmBuGUY]
I’ve never attended an ILCA conference (though I enthusiastically watched from afar last year on both Facebook and Twitter) so I had to dig in quickly to find out everything I could to get my registration submitted, travel plans made and conference itinerary set.  I will also, over the next several weeks, need to figure out how to get myself to the hotel (taxi? shuttle?), navigate the venue (where’s the spa?), figure out what I’m going to eat (sushi anyone?), determine what I’m going to do with my down time (I vote for the pool and a drink with a tiny umbrella), pack a suitcase (don’t forget your business cards!) and network, network, network…and all while preparing to “run the conference marathon”! WHEW!

But, first things first, registration!  June 15th is the deadline for standard registration. You can still register after June 15th, but the fee goes up, so if you have not already done so, register NOW! You can register online or download the registration form and either fax or mail it to our ILCA staff.  And don’t forget, you can also register on site in Orlando (but at a significant price increase…wouldn’t you rather save that money to spend on a speaker’s latest book instead?).

As a part of crossing that task off my list, I printed off page 4 of the conference brochure and spent several hours pouring over it.  Seriously, choosing which sessions to attended was proving to be the hardest job ever! Many of the speakers were familiar to me and even more were brand new.  It made me wish I had a clone.

I methodically went through choosing my sessions, starting with the Wednesday Workshops.  These are a series of sessions, over the course of the first conference day, on a particular area of interest including Working with Spanish Speaking Families (sessions are presented in spanish), Health Promotion, Global Advocacy, Research Skills/Methods and the very popular Clinical Skills Rotations.  As a fairly new IBCLC, I immediately jumped on the opportunity to attend the Clincial Skills session but, unfortunately, it is a “hot ticket” and already has a waiting list.  I’m on it and hoping for a spot but, in the meantime, I’ve signed up for the Health Promotion sessions and honestly, as I read through all the session descriptions, you really can’t go wrong with any of the Wednesday Workshops.

Choosing sessions for the rest of the conference proved to be challenging to me as well.  There is simply so much relevant and exciting information being offered that I’m afraid to miss any of it.  Be watching this blog, over the next weeks, for profiles of some of our conference speakers for opportunities to get to know them better and to highlight the information they will be sharing with us.

So, now I’m registered.  And now I need YOU!  If you have attended an ILCA conference in the past, what are your “best tips”?  What “don’t miss moments” should I make sure to experience? What piece of advice would you give to someone who has never before attended an ILCA conference?  I would love to hear your thoughts and suggestions in the comments section, on Facebook or Twitter.

Next week, I’ll be exploring the realms of both Orlando International Airport and the JW Marriott Grande Lakes!  Stay tuned!

P.S. – Do you have business cards?  They are a great way to connect with others at the conference but, if you don’t already have some ready for your suitcase, now is the time to order!  I have often ordered from VistaPrint in the past and they are currently offering 250 business cards for FREE!

Amber McCann, IBCLC is a  board certified lactation consultant in private practice with Nourish Breastfeeding Support, just outside if Washington, DC and the co-editor of this blog.  She is particularly interested in connecting with mothers through social media channels and teaching others in her profession to do the same.  In addition to her work here, she has written for a number of other breastfeeding support blogs including The Leaky Boob and Best for Babes and served on the Communications Team for GOLD Conference . When she’s not furiously composing tweets (follow her at @iamambermccann) or updating her Facebook page, she’s probably snuggling with one of her three children or watching terrible reality TV. 

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Journal of Human Lactation Launches New Podcast Feature!

Written by Karen Wambach

In the first of a new regular feature, The Journal of Human Lactation and Sage Publications has just launched its FIRST PODCAST entitled “On the TRAIL of cancer fighting cells in human milk: The latest research” . These podcasts will feature the author of a JHL paper in a 10-15 minute interview and will be available from the JHL website. The goal is to have at least 1 podcast per JHL issue.

In the current podcast, Editor-in-Chief Anne Merewood PhD, MPH, IBCLC, interviews Italian researchers Riccardo Davanzo MD PhD, and Giorgio Zauli MD PhD, about their paper “Human Colostrum and Breast Milk Contain High Levels of TNF-Related Apoptosis-Inducing Ligand (TRAIL)”, published online in the Journal of Human Lactation. The researchers, in a first-time effort to measure TRAIL in human milk, took samples of colostrum and mature breast milk from new mothers. Researchers then obtained samples of blood from healthy women, and various ready-to-feed infant formulas. The colostrum, mature breast milk, blood and formula were then all tested to measure their level of TRAIL. The researchers found that colostrum and breast milk contained 400- and 100-fold, respectively, higher levels of TRAIL than blood. No TRAIL was detected in the formula.

In the podcast, the authors discuss the implications of their findings with regard to the cancer prevention properties of human milk, and areas of ongoing and future research. High levels of TRAIL protein in breast milk might contribute to anticancer activity.

For subscribers to the journal, read the full study here: “Human Colostrum and Breast Milk Contain High Levels of TNF-related Apoptosis-Inducing Ligand (TRAIL)” by Riccardo Davanzo, MD, PhD; Giorgio Zauli, MD, PhD;Lorenzo Monasta, MSc, DSc; Liza Vecchi Brumatti, MSc; Maria Valentina Abate, MD;Giovanna Ventura, MD; Erika Rimondi, MSc, PhD; Paola Secchiero, MSc, PhD; and Sergio Demarini, MD. Journal of Human Lactation

Karen Wambach is the Director of Research and Special Projects for ILCA. Karen received her nursing degrees from the University of Minnesota in 1982 (BSN), and her MS (1989) and PhD in Nursing (1993) from the University of Arizona. A nurse educator, researcher, and IBCLC, Karen is Associate Professor at the University of Kansas. She has been active in ILCA at the local, regional, and international levels as a presenter, regional conference planner, and member and chair of the ILCA Research Committee. She is a member of the Missouri and Kansas Breastfeeding Coalitions and involved in evaluation of the Kansas Breastfeeding Coalition’s Business Case for Breastfeeding project. A recipient of NIH funding for a randomized clinical trial; her program of research has evolved over the years and now focuses on promotion and support of breastfeeding in vulnerable populations including adolescent mothers and ethnic minorities.

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Does Breastmilk Neutralize HIV?

Written by Diana Cassar-Uhl, IBCLC

Photo by DFID – UK Department for International Development via Flickr

As an IBCLC, I’m always thrilled when a new study comes out and affirms what I already know about human milk – that it’s amazing and we’re constantly learning something new about it.

Last summer, one of the first classes I took toward my Master of Public Health was Introduction to Epidemiology. Because it was online, class discussions were held to a strict standard – our professor required us to back up any claims with peer-reviewed evidence.  No matter what the topic was, I did my best to bring it around to breastfeeding, often to the chagrin of the other rising students of public health, who learned quickly just how much they didn’t know about breastfeeding. Naturally, no class about epidemiology (according to Merriam-Webster: the study of the incidence, distribution, and control of diseases in a population) would be complete without discussions of HIV, but the topic of HIV and breastfeeding wasn’t one I ever needed more than an elementary understanding about, given the population I serve as an IBCLC.

A classmate remarked that while breastfeeding might be the best thing to do for most mothers in most parts of the world, in nations where the prevalence of HIV is high, only those mothers with access to highly-active anti-retroviral therapy (HAART) were advised to breastfeed. She had worked with a population that was not advised to breastfeed their babies, and was frustrated by the fact that access to uncontaminated water (both for mixing formula and for cleaning feeding vessels) was nearly as difficult as access to the HAART drugs – making minimization of all risk impossible for these babies born to HIV+ mothers. I had read that, for HIV+ mothers, exclusive breastfeeding, rather than mixed feeding (breastfeeding plus formula) was the safest way to feed her infant, perhaps due to the protective effect of SIgA and other human milk components on the infant’s gut (shown by reduced incidence of transmission in the exclusively breastfed groups in studies cited below). However, a newly-released study offers another explanation, one that adds to the “wow factor” of human milk: antibodies in the milk of HIV-infected mothers actually help neutralize HIV itself.

The study by Friedman, et al. at Duke University in North Carolina, U.S.A. is part of ongoing efforts to develop a vaccine against HIV. Researchers isolated an immunological component of colostrum of HIV+ mothers – HIV-specific B-cells, and noted that they neutralized the virus.

The World Health Organization states:

Mothers known to be HIV-infected (and whose infants are HIV uninfected or of unknown HIV status) should exclusively breastfeed their infants for the first 6 months of life, introducing appropriate complementary foods thereafter, and continue breastfeeding for the first 12 months of life.

Breastfeeding should then only stop once a nutritionally adequate and safe diet without breast milk can be provided (WHO, 2010.)

In many developing nations, the criteria “nutritionally adequate and safe” are not possible to meet; therefore, exclusive breastfeeding remains the most protective method of feeding an infant, even one with an HIV-infected mother; the risk of illness or death from causes related to the replacement feeding methods are significant in these areas of the world. Guidance from the Centers for Disease Control (CDC) in the United States mirrors this, but presumes the availability of replacement feeding that is acceptable, feasible, affordable, sustainable, and safe.

While it could be part of the explanation for why the vast majority (over 90% in some studies) of exclusively-breastfed infants of HIV+ mothers do not contract the virus, the discovery of HIV-specific B-cells in the colostrum of HIV-infected mothers is not yet the “green light” for exclusive breastfeeding for all; however, it offers promise toward understanding and hopefully, gaining the upper hand on HIV transmission rates not just for babies, for entire at-risk populations.

Friedman, J., Alam, S. M., Shen, X., Xia, S. M., Stewart, S., Anasti, K., Pollara, J., et al. (2012). Isolation of HIV-1-neutralizing mucosal monoclonal antibodies from human colostrum.

World Health Organization. (2010). Guidelines on HIV and Infant Feeding.

U. S. Department of Health and Human Services, Centers for Disease Control and Prevention. (2010). Breastfeeding, Human Immunodeficiency Virus (HIV), and Acquired Immunodeficiency Syndrome (AIDS).

Diana Cassar-Uhl, IBCLC and La Leche League Leader, enjoys writing to share breastfeeding information with mothers and those who support them.  In addition to her frequent contributions to La Leche League International’s publication Breastfeeding Today, Diana blogs about normalizing breastfeeding in American culture at http://DianaIBCLC.com and has been a guest blogger at Best for Babes and The Leaky Boob.  Diana can be found lecturing at breastfeeding education events around the United States.  She is pursuing a Master of Public Health, and upon graduation hopes to work in public service as an advisor to policymakers in maternal/child health and nutrition.  Mother to three breastfed children, Diana recently retired after serving as a clarinetist on active military (Army) duty in the West Point Band since 1995.

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How can we best support mothers to reach their breastfeeding goals?

Written by Jennie Bever Babendure, PhD, IBCLC

Photo via laurabl @ Flickr

Despite the recent media attention on toddler breastfeeding, a majority of women in the US and many other countries struggle to reach even 6 months of breastfeeding. To help mothers reach their breastfeeding goals, researchers have long created and studied support interventions. On May 16th, a review and meta-analysis was released by the Cochrane Collaboration looking at breastfeeding support interventions at the highest tier of evidence, randomized and quasi-randomized controlled trials. The study, “Support for healthy breastfeeding mothers with healthy term babies” focused on the effectiveness of 52 postnatal support interventions from 21 countries between 1979 and 2011 looking at primary outcomes of breastfeeding duration and exclusivity in healthy full term babies born to healthy mothers. 1

While some of their findings came as no surprise, others are very telling for the future of our efforts to increase breastfeeding duration and exclusivity all over the world.

What we might have expected:

1. Taken as a whole, support interventions reduced the number of women who stopped breastfeeding before 6 months and reduced the number of women who were no longer breastfeeding exclusively at 4-6 weeks and at 6 months.

2. Face to face support was more effective than telephone support

What we might not expect:

3. Support interventions were more effective in populations in which breastfeeding initiation was high.

Support is more effective when women are already motivated to breastfeed.

4. Lay support was more or as effective as professional support in reducing breastfeeding
cessation.

As the most common reason mothers cite for stopping breastfeeding is the perception of not enough milk, encouragement and education from a peer counselor, community health worker, or other lay supporter can be exactly what a mother needs to reach her goals.

Most significantly, the study found that:

5. Interventions in which mothers had to ask for support, travel a distance to access
support, and in which only one interaction was provided were NOT effective at increasing
breastfeeding duration and exclusivity.

The review goes on to conclude that “Support that is only offered if women seek help is unlikely to be effective. This indicates that women should be offered predictable, scheduled, ongoing visits.” For most countries, providing this type of proactive support to all mothers would require systematic change. Most of the reviewed studies provided support by home visits or telephone calls to mothers soon after birth and continuing for many weeks postpartum. Home visits by lactation consultants, nurses, midwives, and peer counselors have demonstrated positive results, as has an intervention to incorporate lactation consultations into the regular pediatric office visits. For a more in-depth discussion of the need for proactive support, see my most recent post at www.breastfeedingscience.com.

Based on the above findings it is clear that if we are to create systematic, sustainable impacts on how mothers feed their children, we need to think about how ongoing proactive support for breastfeeding mothers can best tie into our existing culture. Given the recent movement towards sustainability and health, our community has an opportunity to put forth a unified front and effect change to ensure that routine lactation support is as normal as a pediatric check-up.

The 203 page study is freely accessible in its entirety here.

1. Renfrew MJ, McCormick FM, Wade A, Quinn B, Dowswell T. Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database of Systematic Reviews 2012; 5.

Editor’s Note:  Please take the opportunity to read Jennie’s companion post to this one on her blog. In it, she highlights how formula companies have figured out how to make their product available to mothers in the ways mentioned above and makes suggestions for ways that lactation professionals could change their thinking on such matters.

Jennie Bever Babendure, PhD, IBCLC

I am a mother of 2 active boys and an Assistant Research Professor in the College of Nursing and Health Innovation at Arizona State University. As breastfeeding researcher, I am constantly scanning the literature for articles that guide my research and inform my clinical practice. One of my goals is to increase the evidence base of our profession as lactation consultants. I feel it is important for lactation professionals to be aware of and contribute to breastfeeding research, especially when so much of it is fascinating! As an ongoing contributor to Lactation Matters, it is my hope that you will find the articles I highlight as interesting and informative as I do, and that you will use them to guide you in the important work of lactation professionals and breastfeeding advocates.

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Call to all IBCLCs: Equip yourselves with your Advocacy Piece

Written by Shakira Henderson MS, MPH, RNC-NIC, IBCLC

Prior to the 2011 release of the International Lactation Consultant Association (ILCA) Position Paper – The Role and Impact of the IBCLC – there was no single evidence-based advocacy document that defined the role and impact of the International Board Certified Lactation Consultant (IBCLC): a cross-disciplinary role that straddles generalized support for breastfeeding, and allied healthcare. As the preeminent professional organization for IBCLCs worldwide, ILCA was charged with developing a paper that outlined the unique expertise and influence of the IBCLC on breastfeeding care for mothers, infants, children, families, and communities.

The profession had entered its 26th year of existence, and IBCLCs were still struggling to differentiate themselves from other breastfeeding care providers – peer counselors, breastfeeding counselors, registered nurses, physicians, etc. IBCLCs continued to battle the need for justification of their duties and/or outcomes. This is not surprising for a relatively new profession: many of the allied health care professions have a history of the struggle to be universally recognized, valued, and compensated. To add another layer of complexity, while the IBCLE certification is international, IBCLCs practice in work environments based on the legal and socio-cultural traditions of their countries. Consequently, there was confusion as to the common threads of the profession. IBCLCs needed a position paper.

With the explosion of research and public interest in human lactation over recent years, this position paper came at an opportune time. Breastfeeding was not just the optimal mode for infant feeding that had health benefits for mothers and infants but evidence associated breastfeeding with tangible economic benefits to families and communities. Immediately, breastfeeding topped the list as a preventative measure for cost savings in healthcare. When considering measures to improve breastfeeding care and outcomes at an institutional, local, regional, national, and global level, the IBCLC is central to that plan
as the only internationally certified healthcare professional in the clinical management of breastfeeding and human lactation. But how were IBCLCs communicating this to the world? The release of the position paper came in the summer of 2011.

The position paper on “The Role and Impact of the IBCLC” is intended for use by IBCLCs,
administrators, policy makers, and members of the public. The document describes the rigorous professional standards of the IBCLC, and the mandated demonstration of specialized knowledge and skill through international certification. The IBCLC is the gold standard for provision of breastfeeding care in any setting. Every IBCLC should be equipped with this paper. Administrators and policy makers who need evidence for justification of an IBCLC on staff to deliver breastfeeding care to mothers, infants,
children, families, and communities must first consult this position paper. The multi-role capacity of the IBCLC cannot be overlooked, nor can the economic and social impact of having an IBCLC on staff be ignored. Lastly, members of the public can use this paper as an educational piece to make decisions regarding whom and where to seek breastfeeding support and care. Mothers and families of the world have a right to know the role and impact of the only internationally certified healthcare professional in the clinical management of breastfeeding and human lactation.

The ILCA Position Paper on the Role and Impact of the IBCLC is available in English, Spanish, Croation, and Japanese. Watch for the future translations into German, French, Russian and Arabic. on the ILCA website.

Shakira Henderson MS, MPH, RNC-NIC, IBCLC is a neonatal nurse by training but her passion is to improve breastfeeding outcomes for mothers and infants. Shakira is currently, the South Miami Hospital Research Specialist. She has previously served as a staff nurse, nurse specialist, and breastfeeding coordinator in the Level III Neonatal Intensive Care Unit (NICU) at South Miami Hospital. She is a second career nurse, and holds other degrees such as a Bachelor of Science in Biology and Microbiology, Master of Science in Anatomy, and Master of Public Health. She is currently pursuing her PhD in nursing and her DNP in neonatal nursing. Her research focus is improving breastfeeding outcomes for women and infants.

Ms. Henderson’s nursing support model for breastfeeding in the NICU has won her many awards – National Association of Neonatal Nurses (NANN) Leadership Award, South Miami Hospital Patient Educator of the Year Award, the Cherokee Comfort Inspired Award, the March of Dimes Nurse of the Year Award, and most recently Association of Women’s Health and Neonatal Nursing (AWHONN) Clinical Practice Excellence Award. She is a 2012 Sigma Theta Tau International Maternal-Child Health Leadership Fellow. Her project will focus on strategies to implement the ten steps to successful breastfeeding in the acute care setting.

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