Catherine Watson Genna, BS, IBCLC


  • Anatomy and Physiology of Lactation
  • Breastfeeding Dyad Assessment
  • Communication Skills for Breastfeeding Specialists
  • Infant Assessment for Breastfeeding
  • Lactation Management for the Health Care Professional
  • Latching Theory and Techniques
  • Maternal Assessment for Breastfeeding
  • Products for Breastfeeding
  • Professional Education for Breastfeeding
  • Special Needs Breastfeeding Babies
  • Suck Dysfunction
  • Tongue-Tie Assessment and Treatment

Upcoming Conferences

Previous Conferences

About the Speaker

In addition to speaking (on 4 continents so far) conducting research and writing, Catherine maintains a busy private lactation consulting practice. An LLL Leader for 24 years and IBCLC for 22, she believes that clinical expertise must go hand in hand with empathy and compassion for breastfeeding dyads. Her teaching grew out of a strong desire to understand the science underlying breastfeeding and lactation in an effort to find solutions to her clients’ difficulties. Though many of her offerings are designed as continuing education for experienced lactation consultants and health care professionals, her repertoire includes talks for peer helpers as well. A visual learner herself, Catherine illustrates her often technical topics with clinical photographs and videos. Catherine makes her home in Queens County, New York City with her husband Dave. They both enjoy the company of their adult son and daughter.

Official Bio for Brochure

Catherine Watson Genna has been an IBCLC in private practice in NYC since 1992. She has a special interest in the anatomical, genetic and neurological influences on infant sucking skills, and writes and speaks on these topics. She serves as associate editor of Clinical Lactation. Catherine has performed research using ultrasound and cervical auscultation to study sucking and suck:swallow coordination in infants with ankyloglossia. She is an avid clinical photographer and the author of Supporting Sucking Skills in Breastfeeding Infants (Jones and Bartlett Publishers, 2013 and 2008) and Selecting and Using Breastfeeding Tools (Hale Publishing, 2009).


This speaker is pleased to provide presentations on the following topics to professional and parenting conferences. Presentations on other topics may be available upon request and subject to sufficient development lead-time. (For CERP topics, required paperwork will be provided promptly to meet CERP deadlines.)

Synthesizing Sucking Research

60 - 75 minutes

Do babies use suction or expression during breastfeeding? What role do tongue movements play in breastfeeding? This presentation shares the various imaging studies on sucking in breastfeeding infants to build a coherent picture of how the tongue and oral structures work in normal sucking.

This presentation is about normal suck.

Breastfeeding Babies with Torticollis

75 - 90 minutes

Many infants with unilateral breast refusal and asymmetrical tongue movements have a tight neck muscle from their intrauterine position. This presentation discusses torticollis and related craniofacial asymmetries and the effect on breastfeeding, as well as creative ways to position babies at the breast and support normal feeding.

Preventing Failure to Thrive in Breastfeeding Infants

75 - 90 minutes

Case studies of dyads affected by failure to thrive due to breastfeeding mismanagement or unrecognized risk factors provide the context for identifying gaps in health professional education. Recent research on how lactation works and the impact of various maternal and infant conditions is presented to allow physicians, NPs and PAs, nurses, midwives and lactation consultants to give safe, consistent information to breastfeeding mothers.

Using Supportive Techniques for Biomechanical Sucking Challenges

90 - 120 minutes

Misalignment of oral structures, poor strength and coordination due to neurological problems and other biomechanical challenges can reduce sucking effectiveness. This presentation introduces the very basics of biomechanics that are applicable to breastfeeding and then details specific techniques using compensatory support (touch pressure) that can improve sucking effectiveness in infants with anatomically or neurologically based feeding difficulties.

IBLCE Blueprint: Discipline       A. Anatomy B. Physiology E. Pathology  L. Techniques

Facilitating State Control in Non-Latching Infants

60 - 75 minutes

Maintaining neurobehavioral organization in dyads that are struggling with latching difficulties is a challenge for lactation professionals. Maternal interpretations of infant behavior and signs of frustration can affect her motivation to breastfeed and available psychosocial resources. This presentation explores how lactation consultants can scaffold maternal functioning by providing support, interpreting and framing normal infant behaviors, and modeling and teaching ways to scaffold the infant’s organization to improve the dyad’s ability to work through breastfeeding difficulties.

IBLCE Blueprint: Disciplines  G. Psychology, L. Techniques

Clinical Practice Workshop

Half Day - Full Day minutes

Live clinical workshop with breastfeeding dyads. Participants or organizers refer dyads with continuing breastfeeding difficulties for assistance in a small group setting. Ideal for groups of up to 12-14 IBCLCs. Each dyad will be seen individually in front of the group. At the end of the session, group discussion re: alternative approaches, clinical reasoning, psychosocial issues and further information about the issues revealed.

Planning: Plan for about 1 dyad per hour, and at least one hour for wrap-up discussion of clinical reasoning, choice of interventions, and psychosocial issues that are illustrated by the dyads seen. The dyads can be selected on a theme (sucking difficulties, special needs infants) or dyads with intractible issues can be seen. Dyads should give informed consent to be assisted in front of the group of participants. Consider providing some water and snacks for the mothers.

Venue characteristics:  Comfortable furniture for the mother (upholstered chair, recliner), a surface to examine and change the baby, a sink nearby for hygeine. Seating for the participants that allows all to see the dyad.

Helpful tools: Test-weighing scale, gloves, breastfeeding tools (syringes, feeding tubes, supplementers, nipple shields, etc).

For advanced practice workshops: have participants bring gloves for suck exams, stethoscopes for cervical auscultation.

Reflux, GERD and Breastfeeding

90 - 120 minutes

Irritable infants are commonly diagnosed with reflux, but might also be suffering from feeding related difficulties or allergy. This presentation explores the recent research on regurgitation, reflux and GERD in infants and their relationship to feeding problems. Clinical evaluation and management of breastfeeding issues that can contribute to reflux are also covered.



IBLCE blueprint: Disciplines A. Anatomy, D. Immunology, E. Pathology, L. Techniques

Evidence Based Lactation Support: Anatomy, Physiology and Function

90 - 120 minutes

An overview of recent research on breast anatomy, how the breast calibrates milk production, infant sucking and feeding behaviors, and how to work with them for optimal results.

Facilitating Infant Competence: Hand Use During Breastfeeding

60 - 75 minutes

Infants use their hands in predictable, constructive ways during breast seeking, latch and feeding. Learn how to faciliate and redirect these behaviors as necessary while assisting breastfeeding dyads.

Promoting Normal Feeding in Cleft-Affected Infants

60 - 75 minutes

Infants with orofacial clefts are challenging to feed. Babies with cleft palate may be unable to create negative pressure to remove milk from the breast. In-utero motor patterning of tongue movements and swallowing is often altered. Lactation consultants can help mothers protect milk production and assist the infant in being as active a participant in feeding as possible. Some families may choose special bottles, others may use modified supplementers to feed their infant at breast to promote normal breastfeeding after repair. This presentation reviews strategies and tools to promote normal tongue and swallowing function in infants with clefts.

Anatomical Contributions to Infant Sucking Skills

90 - 120 minutes

Many infants who present to lactation consultants with feeding difficulties have anatomical variations of the oral cavity and airway. Issues such as micrognathia, ankyloglossia, macroglossia, larygomalacia, and velopharyngeal insufficiency can lead to persistent feeding difficulties, and greatly increase the risk of early weaning and/or failure to thrive. Through the use of clinical photographs and videos, participants will gain an understanding of how these anatomical variations impact sucking and breastfeeding skills, and learn some initial measures to use to help mothers and infants compensate.

Major overlap with Tongue-tie and Sucking Skills and Respiratory Issues and Breastfeeding. Can be shortened for pairing with Resp.

The Non-Latching Infant: The First 48 Hours and Beyond

90 - 90 minutes

One of the biggest challenges of lactation consultant practice is the non-latching infant. Optimized for mixed groups of hospital and private practice lactation consultants and health care providers, this presentation provides equal emphasis on in patient and out patient issues for non-latching infants. Advanced strategies employed by IBCLCs to help infants who don’t latch are covered in the final half of the presentation. This presentation is copiously illustrated with clinical photos and some video.

Includes emphasis on latching infants over one month old.

Helping Mothers Initiate Breastfeeding

75 - 90 minutes

The ten steps to successful breastfeeding of the baby friendly hospital initiative form the backbone of evidence-based care for breastfeeding dyads. This presentation provides practical strategies for nurses and student nurses to use to facilitate optimal breastfeeding in the context of the 10 steps, as well as basic breastfeeding assessment skills to allow identification of dyads who may require additional support.

Assessing Suck:Swallow Patterns

60 - 60 minutes

Skillful lactation consulting requires the ability to interpret sucking speed, suck:swallow ratios, and coordination of swallowing and breathing. This session presents recent research on normal sucking rhythms of breastfeeding infants. Compensatory strategies used by infants with prematurity and cardiorespiratory anomalies are discussed, and are illustrated with clinical videos.

This talk works well with Cervical Auscultation for Lactation Consultants for a 75-90 minute combined session.

Cervical Auscultation for Lactation Consultants

60 - 60 minutes

Cervical Auscultation (listening with a stethoscope over the baby’s neck or chin during feeding) is a useful tool for lactation consultants in assessing suck:swallow:breathe rhythms. Inaudible swallowing sounds become audible, and difficulties coordinating swallowing and breathing are more easily identified. This advanced practice presentation uses recorded sound files of cervical auscultation of breastfeeding infants to illustrate difficulties that can be identified using this method. Use of this information in clinical problem solving is stressed.

This session works very well when combined with Assessing Suck:Swallow Patterns for a 75-90 minute session.

Sensory Integration, Sensory Processing Disorders, and Breastfeeding

90 - 180 minutes

Sensory processing is important for successful breastfeeding, and is less developed in infants. This lecture gives a brief overview of sensory integration theory, explains how dysfunctional sensory integration can make breastfeeding challenging, and gives strategies for working with infants and mothers with these issues. Extensive discussion (illustrated by clinical photographs and videos) of infant state, stress cues, and methods of helping infants re-organize apply to neurotypical (normal) infants as well.

Ninety minutes for only the most sophisticated audiences, three hours for peer counsellors, 2 hours is good for most IBCLCs and experienced La Leche League Leaders.

Good Latch/Bad Latch: Nuances of Attachment

60 - 75 minutes

The understanding of infant sucking has burgeoned in recent years with the continued development of cineradiographic and ultrasound techniques. A clear understanding of how infants use the tongue during breastfeeding as well as triggers for infant feeding behaviors helps the lactation consultant understand how to optimize attachment for each mother-baby pair. A wide variety of approaches to both mother and infant led attachment are illustrated by video clips from lactation consultations. Extensive clinical photos illustrate the subtle signs of suboptimal vs. optimal attachment. The longer version includes latching to bottle nipples to support breastfeeding skills, optimizing attachment when using at-breast supplementers, and latching to nipple shields in a way that promotes direct breastfeeding in the future.

This presentation is good for a mixed audience, when there is a wide range of experience levels or professional titles. 60-75 minutes. Substantially revised for 2009.

Choosing and Using Breastfeeding Tools: A Clinical Reasoning Approach

60 - 120 minutes

How does the lactation consultant choose between the various supplementers, nipple everters, nipple shields, cups and bottle nipples? Infants differ in their skills and needs, and mothers differ in their capabilities and resources. A strategy for clinical observation and decision making is detailed, using case studies, clinical photographs, and videos to show how different devices are used to achieve individualized feeding goals. This is an advanced practice presentation, and the cases profiled are complex.

For smaller groups, a “hands on” practice with the various tools covered can be provided. If desired, use a longer time frame.

Breastfeeding Infants with Respiratory Issues

60 - 90 minutes

Infants who can’t breathe well have difficulty feeding. Breastfeeding is generally easier for these infants, especially if modifications are made to accommodate their reduced stamina and ability to manage flow. The most common developmental respiratory difficulties(laryngomalacia, tracheomalacia, transient tachypnea of the newborn) and malformations (velopharyngeal insufficiency, subglottic stenosis) are discussed, along with ways to optimize breastfeeding for each condition. Clinical photos and videos illustrate the conditions and techniques covered.

60-75 minutes.

How Milk is Made: Implications for LC Practice

120 - 120 minutes

The control of milk synthesis depends on a complex interaction of autocrine and endocrine factors. The contributions of these two systems are continually being clarified by research. This presentation explains the two systems, their interactions, and what this means for the advice we give to mothers. Should an engorged mother pump? How do we best help a mother increase milk supply? How do we control oversupply without increasing the risk of mastitis? The scientific background is clearly delineated in understandable language, and these quandaries discussed.

Good for a wide range of audiences, gives the scientific background necessary for clinical decision making.

Tongue-tie and Sucking Skills

90 - 120 minutes

The tongue is the major player in sucking, and even subtle variations in tongue attachment can cause suckling difficulties. This presentation covers normal tongue movements and normal sucking, effects of different degrees of tongue restriction on tongue mobility, sucking compensations in tongue tied infants, and strategies to preserve breastfeeding. Richly illustrated with clinical photographs and videos, this presentation is suitable for health care professionals as well as lactation consultants.

A 120 minute version with details on surgical technique is co-presented with Elizabeth V. Coryllos, MD, IBCLC, FAAP, FACS.

Whatcha Say Baby? Infant Communication

60 - 90 minutes

This humorous presentation focuses on infant communication strategies. Many basics of infant needs and breastfeeding management are covered. The presentation conveys a respect for the competence of the human infant. Infant state, hunger cues, feeding behaviors, stress signals, satiety cues, and normal neurobehavioral modulation are all included. Includes a brief introduction to conditions that might impact breastfeeding through the lens of infant facial expressions and motor responses.

75 minutes. Richly illustrated with sparse text, it is designed for an audience of peer counselors, WIC personnel, and postpartum and pediatric nurses.

Breastfeeding Red Flags

75 - 90 minutes

Some conditions require further scrutiny and referral to a health care professional. This presentation uses clinical photographs to illustrate signs of insufficient milk intake, cardiac and respiratory problems, and tongue-tie in infants; as well as signs of breast cancer or risk factors for insufficient milk production in mothers.

This presentation is most suitable for La Leche League Leaders, peer counselors, postpartum doulas, lactation educators and lactation counselors.

Assessing for Tongue-tie

75 - 90 minutes

Subtle difference in tongue attachment can cause feeding difficulties in infants. Traditional guidelines such as requiring a heart-shaped tongue-tip or complete inability to extend the tongue over the gum ridge miss these more subtle cases of ankyloglossia. This presentation uses extensive clinical photography to illustrate a systematic assessment strategy that examines tongue mobility and tongue attachment in light of recent research.

Conference Committee: The 90 minute version of this talk includes a module on helping tongue-tied babies to breastfeed.

Minimally Invasive Treatment for Posterior Tongue-Tie

60 - 60 minutes

Posterior tongue tie is a frequent cause of oral motor dysfunction and is frequently missed by even experienced physicians and lactation consultants. Extensive clinical photos and video demonstrate evaluation and simple frenotomy for posterior and submucosal tongue tie. Ultrasound videos document the changes in tongue function produced by this treatment. This presentation can stand alone or can be used with Research Update.

Can be presented with Elizabeth Coryllos, MD, IBCLC, FAAP, FACS.

Research Update: Ultrasound Study of Tongue Function during Breastfeeding Before and After Treatment of Partial Ankyloglossia (Tongue-tie)

60 - 75 minutes

Ultrasound is a non-invasive tool for studying tongue and swallowing function during breastfeeding. Infants with tongue tie are unable to perform normal wavelike tongue movements, and use compensatory and less efficient strategies to transfer milk from the breast. Ultrasound videos show these strategies in action, and are correlated with clinical video of infants using the same compensations. Normalization of sucking motions and rhythms are documented after treatment.

This presentation is best for an audience of physicians, therapists and experienced IBCLCs.

Throw Out the Cookbook: Individualizing Care Using Systematic Assessment and Treatment Probes

75 - Full Day minutes

There are few resources for a detailed assessment of infant breastfeeding competency. This presentation will provide a framework for systematic evaluation of breastfeeding, including: • global functioning (muscle tone, aerobic capacity, state stability, and energy) • oral structure and function • functioning of related systems (cardio-respiratory and nervous) • presence and effectiveness of feeding behaviors. Clinical photos and videos will detail how the use of treatment probes (brief application of facilitative or compensatory strategies) can increase the validity of the assessment and guide the formulation of an effective care plan.

Conference committee: This talk was developed with Lisa Sandora, CCC-SLP, IBCLC, and is ideally presented as a full day workshop for a multidisciplinary or IBCLC audience by Lisa and I as a team. It is a modular presentation, where the audience can choose the topics to be covered.

Infant Oral Assessment

60 - 75 minutes

Normal human variation can sometimes be difficult to distinguish from minor anomalies that can impact feeding ability. This presentation uses clinical photographs to illustrate a systematic assessment of infant anatomy for optimal breastfeeding. Minor oral anomalies that may affect breastfeeding are highlighted, including tongue-tie, mandibular asymmetry due to torticollis, natal teeth, hemangioma, and palatal problems. Minor conditions are differentiated from those that might put infants at risk for significant feeding difficulties.

Fingerfeeding as Oral Motor Therapy

60 - 120 minutes

This talk presents the nuances of fingerfeeding as both an alternative feeding method to help preserve breastfeeding behaviors and as a way to facilitate sucking skills in infants currently incapable of breastfeeding correctly. Theoretical justification is briefly reviewed, and then specific devices and techniques are discussed and illustrated along with indications and contraindications for each. The techniques are presented in case context, with clinical video of each technique in use.

60 minutes to a sophisticated audience well versed in normal sucking, and 120 minutes with a review of normal sucking for less experienced audiences. Good for both therapists and IBCLCs.

Contact Info

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+1 (718) 846 2323

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