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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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

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.

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.

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.