About the Speaker

Hope became an International Board Certified Lactation Consultant (IBCLC) in 2017, completed her PhD in nutritional biochemistry in May 2018, and became a Registered Dietitian Nutritionist (RDN) in September 2020. In 2022, Hope earned the FARE Certificate of Training in Pediatric Food Allergy and now also provides comprehensive care for families struggling with food allergies. In addition to owning and operating Hope Feeds Babies, Hope is employed full time at Winthrop University as an Associate Professor in the Department of Human Nutrition. At Winthrop, Hope runs a research lab that focuses on helping mothers to reach their infant feeding goals, improving access to human milk, and analyzing the nutritional content of human milk.

Official Bio for Brochure

Dr. Hope Lima (she/her) is a nutrition and lactation educator and clinician who wants to help raise the bar for how we care for clients in the field of maternal and child health. She is trained as a nutrition researcher, an International Board Certified Lactation Consultant (IBCLC), and a Registered Dietitian Nutritionist (RDN). Hope has advanced training in pediatric food allergies, metabolism, and utilizing an Internal Family Systems-informed counseling approach to support families.

Hope has experience in curriculum development, program planning and research methods as a professor in a university-level dietetics department. Hope also has experience in clinical counseling through her private practice, Hope Feeds Families, based in Rock Hill, SC. She uses these experiences to provide meaningful, engaging learning experiences for professionals in the fields of nutrition, dietetics, and lactation.

Hope founded Feeding Families Education and Consulting in 2023 with a vision of changing the way that we train clinicians and raising the bar for continuing education. When she is not working on her professional endeavors, Hope can be found playing with her 3 dogs, hiking in national parks with her husband, or riding roller coasters with her step-kids.

Bio for Introduction

Dr. Hope Lima (she/her) is a nutrition and lactation educator and clinician who wants to help raise the bar for how we care for clients in the field of maternal and child health. She became an International Board Certified Lactation Consultant (IBCLC) in 2017, completed her PhD in nutritional biochemistry in May 2018, and became a Registered Dietitian Nutritionist (RDN) in September 2020. She is also a wife, step-mother to three, dog lover, and nature enthusiast.




Presentations

The landscape of lactation education

Time-frame: 60 minutes
CERP:

The field of lactation currently uses breastfeeding rates to measure effectiveness. While monitoring breastfeeding outcomes can provide insight into the successes of lactation consulting as a profession, the improvement of breastfeeding outcomes is a multifactorial issue. In order to facilitate growth of lactation education processes, an understanding of experiences during training and perceptions of readiness of current lactation consultants for clinical practice are necessary. A retrospective, cross-sectional study design was used to assess the experiences of practicing International Board Certified Lactation Consultants. This presentation will overview the information gathered in this survey.

To wean or not to wean? Cow’s milk protein allergy management in human milk fed infants

Time-frame: 60-90 minutes
CERP:

Non-IgE- (immunoglobulin E) mediated cow’s milk allergy presents diagnostic and management challenges despite guidelines due to knowledge gaps amongst clinicians. Given that 60% of food protein-induced allergic proctocolitis (FPIAP) cases occur in breastfed infants, maternal elimination diets are routinely prescribed to manage allergy symptoms. The implications of maternal dietary eliminations extend beyond maternal nutrition to consideration of infant nutrition and feeding skill acquisition. We conducted a retrospective, cross-sectional survey to identify dietary triggers and symptom management techniques practiced by lactating mothers of infants with confirmed and suspected cases of non-IgE mediated allergic disorders (n=59) in the United States. Based on the number of mothers eliminating cow’s milk from their diets, there are nutritional concerns for mother-infant dyads experiencing non-IgEs. Dietitians can play a crucial role in the dietary management of non-IgEs through individualized nutrition support.

Supporting lactation as a dietitian

Time-frame: 60 minutes
CERP:

Dietitians provide care to patients across the lifespan. Inevitably, this means supporting human milk fed infants and lactating parents. This presentation will go through the basics of breastfeeding support, including physiology of milk production, what to expect with breastfeeding, how maternal diet impacts milk composition, and more.

Provider perceptions of IBCLCs in primary care settings

Time-frame: 60-90 minutes
CERP:

While breastfeeding initiation rates in the United States have increased to 84%, breastfeeding exclusivity rates at 6 months are only 25%. Prenatal and postpartum breastfeeding support can drastically improve breastfeeding exclusivity. Primary care providers in outpatient settings are well positioned to provide breastfeeding education, support, and medical management due to frequent interactions with expectant and current breastfeeding parents. Despite this, inconsistent or lack of professional support is a common barrier to breastfeeding. We utilized a retrospective, cross-sectional study design to assess primary care provider perceptions of lactation practices and the role of International Board Certified Lactation Consultants in outpatient, primary care settings.

Prevention of chronic disease: can breastfeeding change outcomes?

Time-frame: 60-90 minutes
CERP:

We know that human milk is the gold standard for feeding infants under 6 months of age, and can continue to complement solid foods as long as mutually desired by the parent and child. What, though, do we know about the mechanisms of protection that human milk provides against chronic disease? In this presentation, we will discuss how breastfeeding can protect against obesity, hypertension, hypercholesterolemia, and diabetes. We will also explore how the metabolic impacts of both human milk and formula can inform supplementation approaches.

Latch assessment and management of milk supply

Time-frame: 60 minutes
CERP:

A painful latch and subsequent low milk supply is the is a huge reason why lactating parents don’t meet their stated breastfeeding goals. But assessing a latch is more complicated than checking to see if the baby’s lips are flanged. In this presentation, participants will be learning what to look for in an infant global assessment and oral assessment to determine the root cause of painful latch and appropriate interventions for each cause. Participants will also learn how to support milk supply in the lactating parent while working towards pain free breastfeeding.

Lactation support for parents with anorexia nervosa

Time-frame: 60 minutes
CERP:

Anorexia nervosa (AN) is a clinical condition characterized by restriction of energy intake, fear of gaining weight or becoming fat, and body dysmorphia. As pregnancy and subsequent lactation are associated with changes in weight and body shape, it is important to consider the implications of a pre-existing or current diagnosis of AN during the postpartum period. The research examining the impact of body changes during pregnancy on individuals with a history of AN has mixed results; some show AN symptoms regress during pregnancy, while other results show a resurgence of AN symptoms. While there is limited evidence of the impact of AN on milk production, milk composition, and breastfeeding experiences of the parent, the evidence that we do have can help guide lactation consultants when providing care for the dyad during the fourth trimester. In this presentation, participants will learn about the diagnostic criteria and screening tools for AN, the impact of energy restriction and AN on milk supply and composition, and will participate in a exploration of the implications AN may have on dyad care.

Impact of multiple freeze/thaw cycles on the composition of human milk

Time-frame: 60 minutes
CERP:

Current CDC guidelines require that all human milk be either fed or discarded after thawing. This can result in human milk waste, both in hospital settings and in home settings. In this study, we explore the impact of multiple freeze/thaw cycles on the nutritional and bacterial content of human milk and what that might mean for options for breastfeeding parents in the future.

Inclusivity in lactation

Time-frame: 1-3 hours; can include hands-on activities
CERP:

As a field dominated by white, cis, heterosexual, able-bodied, women, we have a lot of learn about being allys to individuals who are from underrepresented communities. In this presentation we explore the importance of cultural humility in lactation care, tools for exploring personal implicit bias, how whiteness has become codified into our systems, terminology for supporting Queer individuals, and ways to destabilize systems in favor of inclusion.

Evidence-based donor human milk feeding

Time-frame: 60-90 minutes
CERP:

To maintain an exclusively human milk diet during incidents of separation, occurrences of low maternal milk supply, or absence of maternal breast milk, donor human milk can be provided to the infant. Despite best efforts, there are concerns with retaining the nutritional content of human milk during expression and storage. In this presentation, we will look at human milk sources other than the parent and discuss available research on the impact of pasteurization and storage containers on the nutritional integrity of human milk.

Elimination diets: When should a nursing mother try one?

Time-frame: 60 minutes
CERP:

Occult blood in the stool of an exclusively breastfed infant can indicate a cow-milk/soy protein allergic colitis. In some instances, pediatricians may recommend moving the symptomatic infant to infant formula to help provide a resolution. Research shows, though, that elimination of the appropriate allergens from the maternal diet can improve or resolve infant symptoms. As not all infant allergic colitis is due to a cow-milk/soy protein intolerance, this presentation will overview clinical differences between food protein-induced allergic proctocolitis (FPIAP), food protein induced enterocolitis syndrome (FPIES) and gastroesophageal reflux disease (GERD), as well as the difference between IgE and Non-IgE mediated allergic responses in breastfed infants. Then, the basics of an elimination diet and criteria warranting introduction of an elimination diet will be summarized

Developing skills for reading and evaluating research

Time-frame: 60-90 minutes
CERP:

Being able to read and truly understand peer-reviewed research allows a provider to ensure they are giving the highest level of care. However, many times, there is a disconnect between what we see in the literature and clinical practice because the information is getting lost in translation. In this presentation, participants will learn to analyze peer-reviewed literature to determine if appropriate study design and statistical analyses are utilized, evaluate conclusions of peer-reviewed articles for appropriateness and accuracy with regards to study design and statistical analysis, and compare and contrast studies to determine whether outcomes are meaningful for clinical application.

Bon appe-teat! Breastmilk substitutes during the first year of life

Time-frame: 60-90 minutes
CERP:

When families are unable to exclusively breastfeed, supplementation with formula may be medically necessary. While any infant formula can meet the minimum nutritional standards for an infant, it is important for IBCLCs to be able to guide the families that they work with on choosing an appropriate infant formula to use for supplementation. Considerations when counseling families on formula supplementation include current infant nutritional status and health history, infant nutritional needs, and infant sensitivities or allergies. This presentation will provide the necessary information for screening infant nutritional status, choosing an appropriate formula for supplementation, and adjustments families can make once complementary foods are introduced.

Approaching supplementation: Options outside of formula

Time-frame: 60-90 minutes
CERP:

There are many clinical situations where supplementation is medically indicated. What many don’t know is that there are safe ways to supplement without having to provide infant formula. In this presentation, we explore current evidence on both pasteurized donor human milk options and milk sharing in the community and discuss safe ways to facilitate supplementation with these options when needed.

Hope Lima, PhD, RDN, IBCLC


Country: United States
Phone number: 860-682-0135
Email: hope@hopefeedsfamilies.com
Site: http://www.feeding-families.com
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Publications

Surgical Performance of En Bloc Total Capsulectomy Breast Implant Removal With Uninterrupted Breastfeeding

A 28-year-old woman was able to maintain lactation for her 21-month-old child through the process of an En Bloc Total Capsulectomy Breast Implant Removal. This case study is important as it exemplifies collaborative care to achieve maintenance of lactation through a surgical procedure. The lactation management began 3 weeks prior to the procedure with the participant expressing enough milk prior to the surgery to allow for human milk feeding from a bottle during the 7-day recovery period as desired. The surgical team and IBCLC selected an appropriate bra for recovery to allow for both appropriate surgical site healing and ease of access for pumping. Exclusive pumping was utilized until surgical drains were removed, after which the participant was able to reintroduce breastfeeding.

Comparison of the Effectiveness of Four Commercial DNA Extraction Kits on Fresh and Frozen Human Milk Samples

For-profit donor human milk organizations have DNA-based proprietary methodology for testing incoming milk for adulteration with other species’ milk. However, there is currently no standardized methodology for extracting DNA from human milk. Microbiome research has shown that DNA purity and quantity can vary depending on the extraction methodology and storage conditions. This study assessed the purity and quantity of DNA extracted from four commercially available DNA extraction kits-including one kit that was developed for human milk. The Plasma/Serum Circulating DNA Purification Mini Kit (Norgen Biotek, ON, Canada) provided significantly more DNA, and consistent purity as measured by 260/280 and 260/230 ratios. DNA quantity and purity were similar between fresh and frozen human milk samples. These results suggest that DNA purity and quantity is highest and most consistent when extracted from human milk using the Plasma/Serum Circulating DNA Purification Mini Kit amongst the kits tested in this study.  Future studies are recommended for optimization of DNA extraction from human milk using larger sample sizes and multiple donor parents.

The Associations Between Light Exposure During Pumping and Holder Pasteurization and the Macronutrient and Vitamin Concentrations in Human Milk

During pumping, storage, and pasteurization human milk is exposed to light, which could affect the concentrations of light-sensitive vitamins. Currently, milk banks do not regulate light exposure. The aim of this paper was to determine the influence of light exposure during pumping, storage, and pasteurization on (1) macronutrients, (2) select water-soluble vitamins, and (3) select fat-soluble vitamins. This study showed that if milk is exposed to excessive amounts of light, Vitamins B1 and B2 concentrations may degrade below the current Adequate Intake recommendations for infants 0-6 months of age, increasing the risk of insufficient vitamin supply to the exclusively human milk-fed infant. Thus, pumped or processed human milk should be protected from light to preserve milk vitamin concentrations.

Nutritional Comparison of Raw, Holder Pasteurized, and Shelf-stable Human Milk Products

We aim to assess the nutritional composition of shelf-stable (SS) human milk and compare the nutritional profile to Holder pasteurized (HP) and raw human milk from the same pool.  Percent fat, percent solids, and lactose were similar between raw, HP, and SS samples. This study found that macronutrient content is relatively unaffected by processing; Holder pasteurization and retort processing maintain similar fat, lactose, and total protein levels. Lysine and thiamine were significantly decreased by retort processing, but not by Holder pasteurization. Thiamine losses are clinically significant, and fortification may be necessary if SS donor milk is a long-term feeding choice.

Bacteria and Bioactivity in Holder Pasteurized and Shelf-Stable Human Milk Products

We aimed to assess the ability of retort processing to eliminate bacteria and to quantify the difference in lysozyme and secretory immunoglobulin A (sIgA) activity between Holder pasteurized (HP) and SS human milk. One raw sample and 3 HP samples contained B. cereus at the time of culture. There were no detectable bacteria in SS samples at the time of culture. Raw samples had significantly greater lysozyme and sIgA activity than HP and SS samples (P < 0.0001). HP samples retained significantly more lysozyme and sIgA activity (54% and 87%, respectively) than SS samples (0% and 11%, respectively). Human milk processed using Holder pasteurization should continue to be screened for the presence of B. cereus. Clinicians should be aware of the differences in the retention of lysozyme and sIgA activity in HP and SS products when making feeding decisions for medically fragile or immunocompromised infants to ensure that patients are receiving the maximum immune protection.

Supplemental Feedings for High-Risk Preterm Infants

Comment and response for a publication that came out in 2016.