Abstract:
Who hasn’t heard of the microbiome lately? New research suggests that the microbiome plays an important role in our gut health, communication between the gut-brain axis, mood stability, even cardiac health. This session focuses on how humans seed the gut microbiome during the critical thousand days of a baby’s life and why human milk plays such a vital role in creating a healthy gut and ultimately positive long-term health outcomes.

Learning Outcomes:

• Define microbiome.
• List one way that microbiome can have a positive impact on the health of the infant.
• Identify the difference between prebiotics and probiotics

Abstract:

The estrobolome is a collection of influential bacteria, fungi, and viruses (part of the microbiome) in the gut that impact estrogen release and hormonal function. This delicate balance of bacteria has a significant impact on estrogen creation. This influences the operation of the reproductive system, regulation of body fat, brain function, and cardiovascular and bone health. The estrobolome also plays a major role in the health and function of the mammary gland. As much as we know about the microbiome, not enough attention has been paid to the relationship of the estrobolome and lactation success. Gut dysbiosis is now recognized as playing a role in a baby’s food sensitivities and allergies, but it is now time to look at the microbiome’s impact on lactation itself and the the long-term health of the mammary gland regarding breast cancer. This presentation addresses what we know now about the estrobolome, how it functions, it’s relationship with reproductive organs, potential impacts on the mammary function, and how we can create positive change in the gut for optimal estrobolome performance.

Objectives:

• Define the estroblome.
• List two exposomal influences on the estroblome.
• Discuss two potential ways to improve estroblome for successful lactation.

Name of Topic:
Is Fem Tech Our Friend? The Fabulous and the Frightening Significance in Lactation

• Define FemTech as it relates to the perinatal community.
• Identify at least two examples of perinatal FemTech.
• List one potential implication FemTech could have on privacy issues.

Name of presentation:
Promotion of Breast/Chestfeeding in the 21st Century: Using social media platforms and 21st century technology to promote awareness

Presenter:
Laurel Wilson, IBCLC, RLC, CCE, CLD, CLE, BSc

Timing: 60-90 min.

Abstract:

Outline:

1. How breast/chestfeeding promotion is changing
   1. Review of research
   2. What is currently being done
2. The most common social media platforms for lactation
   1. Top platforms
   2. Emerging platforms
   3. Intersection between health promotion and “marketing”
3. An exploration of how parents are using social media
   1. Data exploration
   2. How to reach parents
4. How artificial milk companies are using social media
   1. WHO Code
   2. Review of marketing strategies by formula companies
5. How healthcare professionals can use social media effectively and ethically.
   1. Tools
   2. Privacy Issues

Abstract:

As the novel Coronavirus, COVID-19 begins to take hold of our international communities, lactation workers have specific concerns. How will lactation support professionals and consultants handle this developing crisis? There are many aspects to consider: keeping oneself and family safe, keeping your clients/families educated, how to provide services safely and robustly if possible, and how to protect your business as much as possible during a crisis.  This presentation will briefly review the basics of what is known about COVID and pregnant people and babies and what your clients may need to anticipate in the event of an infection pre-birth or during the postpartum period. We will review some business practicalities for perinatal professionals, such as effective communication with your clients, screening your clients for COVID-19, protecting yourself during home visits and support groups, alternatives to providing privacy protected care and services when in-person care/support is not recommended or allowed, and so much more. This presentation will have a United States-centric bias. However, the presenter will do her best to obtain as much data as possible from other international sources.

Objectives:

• List at least one trusted reference to use for accurate and current healthcare information regarding COVID-19 during the perinatal period.
• Identify two questions to ask when screening a lactation client before you decide on whether to have an in-person or telehealth visit.
• List two ways a lactation support professional can provide privacy-protected services in a virtual way to support the lactating family.

Objectives:

• Define the term neohormones.
• In which class of vertebrate animals (ie. amphibians, reptiles, birds, mammals) did neohormones evolve?
• Identify three neohormones important for lactation.

Abstract:

As mammals evolved, a new variety of hormones began to develop. The unique demands of having placentas and making milk for babies that required rapid development post-delivery led to this transformation of hormones. These hormones are now identified as neohormones. Neohormones not only facilitate reproduction in the mammal, but they direct the development of mammary tissue and are a significant component of human milk. These specialized neohormones also interact with the epigenome, targeting certain genes to lead to reproductive success for the mammal. Bioactive neohormones significantly contributed to the success of mammals throughout the ages and continue to contribute to the long-term health, development, and fertility of humans. Learn about these fascinating hormones, their role in mammalian fertility and reproduction, and how they play important roles in human milk feeding.

Outline:

1. What is a neohormone?
2. How/why evolution changed hormones for mammals
3. How do neohormones function in the body?
4. The unique neohormones of pregnancy
5. Neohormones involved in lactation
6. Current research on neohormones

Abstract:

As humans evolved, the milk specific to nourishing, protecting, and developing their babies went through an incredible transformation. The unique demands of having placentas, growing large brains, and making milk for infants that required rapid maturation post-delivery led to a unique set of neohormones. Neohormones not only facilitate reproduction in the mammal, but they direct the development of mammary tissue and are a significant component of human milk. Neohormones interact with the epigenome and microbiome, targeting certain genes to lead to reproductive success for the mammal. Human milk prepares the infant’s epigenome and microbiome for long-term health and adaptation to the environment. Learn about these fascinating components in human milk and the extraordinary role they play in human development.

Outline:

1. What is a neohormone?
2. How/why evolution changed hormones for mammals
3. How do neohormones function in the body?
4. The unique neohormones of pregnancy
5. Neohormones involved in lactation
6. Current research on neohormones
7. What are the epigenome and microbiome?
8. Research on epigenetics and the microbiome in human milk
9. Salivary components of human milk
10. Unique protections in human milk
11. Q and A

For more than a decade, most lactation professions have been suggesting to families that diet matters very little in terms of human milk composition. We have told parents that they can essentially eat whatever they want, it does not matter to the bottom line. However, new studies imply that diet does matter in terms of the composition of fatty acids and essential nutrients available in milk that can potentially impact life-long health. Studies also show that changes in diet can lead to gene methylation, which impacts gene expression, and changes the oligosaccharide profile, shaping the microbiome. This presentation takes you on a tour of some recent research to better understand how maternal/parental diet (potentially prenatally through lactation) DOES play a role in human milk and how a parent’s diet can potentially influence a baby’s health.

Objectives:

Identify at least one way that maternal/parental diet can impact fatty acid profile in human milk.

List the primary reason changes in oligosaccharide profile in human milk can have health consequences in baby.

List at least three nutrient changes in human milk that can be influenced through maternal/parental diet.

Lactation education has come a long way in the past few decades yet the research shows that most of what is offered is not what is advantageous for parents in this day and age. Laurel Wilson has been a lactation educator, faculty, and lactation director in the community, in hospital settings, and for professionals for nearly two decades, and she has seen what works and what clearly fails. It is not uncommon today in classrooms to have dozens of parents listening to hours of lecture and watching endless power points without having the opportunity to step in to their own educational experience and OWN their breastfeeding journey. In fact, some parents are foregoing traditional classroom education all together and learning exclusively on You Tube and other social media sites, which comes at the price of accuracy and connection. Come with me on a journey through today’s classrooms, discussing what is and isn’t successful. Learn what works, not just for early initiation and surviving the hospital lactation experience but to help parents meet their own feeding goals. Research has identified that what is efficacious for some families and situations will not work for others. Discover unique strategies to address the specific learning needs of your families. The session will end with some favorite engaging activities to use in lactation classes and support groups, gleaned from two decades on the job and having had the opportunity to learn from and work with the best of the best educators of our time.

Objectives:

List two pros and cons of traditional classroom lactation education in terms of preparing parents for feeding their baby.

List at least two reasons parents are turning to online education instead of classroom education.

Identify three engaging activities to use in the classroom during lactation classes or support groups.

Human milk is known to be a pathway towards long-term health for both parent and child. The specific mechanisms for how this communication works have been studied, and today many researchers believe that messenger RNAs and stem cells contribute in many ways to appropriate developmental pathways for the baby and cause gene activation that promotes health for life. mRNA in human milk can also be influenced by the time of day and even the timing of the baby’s delivery, becoming adaptive for the baby’s unique needs. Not only do these messenger RNA communicate important genetic information to the baby via human milk, changes in the parent’s body via mRNA occur during lactation responding to a new “mothering” focus during the period of lactation. This may impact the parent’s postpartum mental states, adaptation to stress, and changes in fatty acids. This presentation highlights some of the fascinating studies that demonstrate the myriad of ways that stem cells and mRNA during lactation become the ultimate communicators, affecting change for years to come.

Objectives:

1. Identify at least two properties in human milk that act as communication tools within the body.
2. List one way that mRNA in human milk has a protective effect on the baby.
3. List at least one way mRNA shifts occur in the parent during lactation.

With a cesarean rate of 32.2% in the United States, the need for specific lactation support that meets the unique needs of these families is imperative. Parents who have had cesarean section are at risk of edematous mammary glands, sedated or sleepy babies, a delay in lactogenesis, increased pain, and difficulty moving in early postpartum. This presentation looks at the new concept of family-centered cesarean and how this approach changes lactation outcomes and family attitudes about birth. Additionally, techniques and information for better success post-cesarean will be reviewed.

This presentation provides the latest evidence on how and why to express human milk to maximize output and meet parental goals for providing human milk via expression. Attendees can expect to learn how to help families understand the differences between hand and mechanical expression and when each type of expression is the most useful. Discover the specifics of expression science to help families determine the best pump for their situation. Learn about ways that families can potentially increase milk output with expression with techniques like acupressure, music, etc. Finally, understand how equity and insurance practices can limit access to breastpumps for families and what you can do to help them address these predicaments.

Outline

• • • History of expression
    • Reason to express
    • How to elicit best response for optimal milk flow
    • Selection of expression device
      • When, how, what to look for
      • The Affordable Care Act and Breastpumps
    • Breast shield selection
    • Hands On Pumping
    • Power Pumping
    • Hand Expression and outcome
    • Russian/Japanese Breast Massage and Acupressure
    • The Latest in Milk Storage
    • Hands On Testing of Equipment
    • Equity and Expression

Social media has proven to be the main way Millennial and Gen Z parents communicate and get healthcare information, yet privacy practices and guidelines for healthcare use of social media is lagging. To add to this, artificial milk companies and the Fed is Best Organization are using social media against the recommendation of the WHO International Marketing of Breastmilk Substitutes to their advantage, which is increasing misinformation. Many healthcare providers wish to utilize social media to engage, educate, inform, and interact with their patients. However, due to a lack of distinct guidelines and misunderstanding about privacy practices with social media, many healthcare providers are unknowingly sharing personal and private healthcare information. This presentation offers an understanding of the most common social media platforms, exploration of how millennials use social media (particularly during pregnancy and lactation), how artificial milk companies are using social media, and how healthcare professionals can use social media effectively and ethically.

Outline:

1. What is Social Media Today
   1. Popular Platforms
   2. 4 P’s of Social Marketing – Product, Price, Place, Promotion
2. The Millennial Parent Habits and Behaviors
   1. Who is using SM
   2. How are they using SM
3. Babies on SM
   1. How SM Influences Choices
   2. SM and Birth
   3. Advice and Peer to Peer Sharing
   4. Support Systems
   5. Interest and Activist Forums
   6. Rating care and care providers

Abstract:

The session looks at the Ten Steps to BabyFriendly and the science that supports this elevated level of care for the maternal/parental infant dyad. Brain and microbiome development in the first days and weeks in both parent and baby that is influenced by breast/chestfeeding behavior, nutrition, and skin to skin will be discussed. Attachment as it pertains to the Ten Steps and the improved biological outcomes for parent and baby will also be addressed. Finally, how the Ten Steps influence family life post-hospital stay will be examined.

Objectives:

Identify the Ten Steps to Successful Breastfeeding

Identify three reasons why exclusivity is critical to long-term health.

Identify at least one risk to baby of ingesting infant formula during critical periods of development.

List two reasons skin to skin can impact brain development in mother and baby.

Outline:

1. Brief History and Current Status of BFHI in US
2. What Ten Steps Are
3. Risk Reduction
   1. Infant Risk Reduction – Dose Dependent
   2. Maternal Risk Reduction – New Data
4. Importance of Exclusivity
   1. Joint Commission
   2. Infant Critical Period of Gut Development
5. Science Behind Step Four – Breastfeeding In First Hour
   1. 9 Stages of Development
   2. Brain Development
   3. Sense of Smell
   4. Attachment and Health
6. Supplementation Risks to Brain Development and Microbiome
   1. Microbiome
7. Rooming In- More than a nice thing to do
   1. Skin to Skin updated data
8. Pacifiers and Hormonal Release, Brain Development and Satiation

Many peer counselors and lactation professionals are taught basic counseling skills without any knowledge of body language or mindfulness skills which does not contribute to deep listening or the ability to fully understand the depth of the clients issue and need. Attendees will be able to use proper listening skill, appropriate body language, and mindfulness while employing Three Part Listening Skills to better understand and address the needs of their patients.

1. What is Deep Listening?
   1. Qualities
2. How do you know when you are not listening?
3. Listening Skills
4. Body Language
   1. Cultural Issues
   2. Images to judge
5. Bias and Its Impact on Listening
6. The Brain and Listening
   1. Mirror Neurons
   2. Neural Altruism
   3. Pregnancy and Mom’s Brain
7. Mindfulness and Understanding
   1. Definition of Mindfulness
   2. Practicing Mindfulness

• Can A Baby Be Allergic to Human Milk? – Sensitivities, Allergies, Galactosemia, and Lactose Intolerance

Lactation professionals often hear from their clients that their human milk fed babies have been diagnosed as lactose intolerance. This lack of understanding regarding types of lactose intolerance and potential issues with human milk involving the newborn gut often lead to a cessation of breast/chestfeeding. This session will cover the three main types of lactose intolerance, as well as galactosemia. Maternal gut damage and protein sensitivity and how that can impact the breast/chestfed baby will also be addressed. Attendees will also learn about the most common foods that cause food sensitivity and allergy and what referrals are best made with these issues.

• • Objectives
    • Identify three main types of lactose intolerance.
    • List two reasons lactose intolerance as a diagnosis in a healthy, term newborn is unlikely.
    • Define galactosemia.
    • List four most common foods that can cause food sensitivity/allergy for the breast/chestfeeding newborn.

Attachment begins during pregnancy, not in the moments, weeks, and years post birth. This attachment, the motherbaby bond, is forged through an awareness of the biological and emotional connection between mother and child from the very earliest moments of conception. The internal world of the mother and child is now known to be a strong influence in the behavior, health, and personality of a child. This crucial prenatal period is impacted by emotional and nutritional experience of the mother and has a lot to do with who babies turn out to be. The prenatal attachment that occurs, regardless of a mother’s conscious awareness, is changing the brain development, personality, and genetic expression of her baby. At no other time in their child’s life do parents influence who that child will be, both emotionally and physically, than during the 0-3 period of life. We now know that prenatal chronic stress leads to babies who cry more, sleep less, and are anxious. A mother’s thoughts create chemical signals that literally form her baby’s brain and lead to a happy or anxious child. Mothers have the ability to influence healthy brain development and genetic expression during pregnancy through the motherbaby bond. This presentation discusses epigenetics, brain development, molecular messaging between mother and baby, and the impact of stress on the baby’s future health.

It is an amazing feat that the female human can grow and nourish another human body. The two main organs that support this incredible venture are the placenta and breastmilk. There are some research theories that suggest that the maternal link between baby and mother created by the placenta is continued beyond pregnancy through the next vital maternal/baby organ, breastmilk. These two unique organs have many similar properties. They take cues from the maternal environment to change nutrition, hormones, and other developmental and immunological properties that are being sent to the baby. The placenta and breastmilk deliver properties to the baby solely based on its needs and changing environment. The role of both organs is to protect, defend, and support the development of the child. Each organ is perceptive and continuously fine tunes the delivery of essential molecules to the baby. They are intelligent organs, deciphering the environment and using that information to the benefit of the child. The placenta detects the mother’s emotions, nutritional state, and state of anxiety and sends messenger molecules and hormones to the baby to aide the baby’s development in a way that allows it to thrive in its future home outside the womb. Breastmilk has similar capabilities, using GALT and MALT and SIgA to help the baby’s brain, body, and immune system function in its unique world. This presentation takes you on a journey inside these organs to give you a profound lesson in the physical ties between mother and baby.

Research shows that many mothers are afraid of experiencing pain in breastfeeding due to two common challenges, sore nipples and engorgement. Even more concerning is the fact that many women shorten their duration of breastfeeding due to these common issues. In fact, some practitioners still believe (and counsel new moms) that sore nipples and engorgement are a normal part of breastfeeding. Many women also experience early lactation challenges due to plugged ducts, mastitis, and thrush. Current strategies to minimize the risk, as well as manage treatment are not grounded in current evidence. Discover what the latest meta-analysis and research says about how to prevent and treat these early breastfeeding issues and begin to implement practices that really work to keep the motherbaby dyad breastfeeding longer and more comfortably.

As the use of cannabis increases, the concern for families has expanded. Many countries and states have recently legalized or decriminalized the consumption of cannabis. This trend has led to more healthcare professionals being faced with the question, “Is it safe to use cannabis during lactation?” The answers given vary widely and this is due largely to myth, bias, and poorly conducted research. Differing recommendations lead healthcare professionals to scratch their heads and face the knowledge that they just don’t know what to say to families. Additionally, there are reports of social services removing babies from homes due to parental cannabis use while breast/chestfeeding. The human endocannabinoid system interacts with cannabis and is largely responsible for brain development, homeostasis, and much more. Unfortunately, a risk reduction instead of evidence-based harm reduction has been the standard of care. Discover what is known about cannabis chemicals and baby’s short and long-term health when cannabis is used during lactation. This presentation looks at the most recent research, policies, harm reduction practices, and equity issues surrounding this controversial herb.

Participants will review the biological basis for how primates and specifically human’s breast/chestfeed, according to biological need. Discover how the unique properties of human milk, as well as the biology of the human newborn and physiological responses from the parent, are designed to optimize breast/chestfeeding when skin to skin and laid back breastfeeding occurs.

Objectives:

Identify at least two benefits of skin to skin in early postpartum period on both mother/parent and baby.
Describe why biological breastfeeding is the “norm” for the baby.
Identify at least two reasons that baby led/laid back breast/chestfeeding benefits the couplet.
Describe how to facilitate relaxed/laid baby breast/chestfeeding and extended skin to skin in the postpartum period in the hospital.

All human babies have the right to receive exclusive human milk. This can be accomplished in a variety of ways – exclusive feeding at the parent’s breast/chest, exclusive expressed human milk delivered to the baby via a feeding device, or pasteurized donor human milk delivered via a feeding device. However, there has been much attention placed on the traditional practice of cooperative infant feeding, sometimes referred to as informal milk sharing or community milk sharing. Cooperative feeding is when lactating individuals provide human milk directly to another family in need, without going through the donor milk bank process. The increasing popularity of cooperative infant feeding via social media, the growing attention on the importance of human milk exclusivity, the increasing awareness of the potential health risks of artificial milk, and the inability for donor milk banks to provide milk for more than those in critical need has led professionals and families to an impass. While cooperative infant feeding is gaining popularity among families, finding policy and recommended practices can be difficult. The Academy of Breastfeeding Medicine only references mother’s own expressed milk, donor human milk, or hydrolyzed or standard infant formulas for breastmilk feeding in regards to supplemental feeds. The World Health Organization, states in its Global Strategy for Infant and Young Child Feeding, “for those few health situations where infants cannot, or should not, be breastfed, the choice of the best alternative – expressed breast milk from an infant’s own mother, breast milk from a healthy wet-nurse or a human-milk bank, or a breastmilk substitute…depends on individual circumstance.” There are also significant equity issues at stake. Many families live in food deserts, without proper access to health care and lactation support or donor milk, who need human milk for their babies. There are also family structures whereby access to milk at the breast/chest may be limited. Many families are told by healthcare professionals to avoid cooperative feeding in all cases, even though the data is not supportive for that recommendation. Most cooperative infant feeding organizations recommend the practice of using The Four Pillars of Safe Milk Sharing. These are informed choice, donor screening, safe handling, and home pasteurization. This presentation will cover in detail the myriad of concerns of professionals, the information all families need to know about cooperative infant feeding, milk sharing and social media, and lactation professionals’ scope of practice issues regarding community milk sharing.

Abstract: Recent research on epigenetics, literally meaning above the gene, has led medical professionals to query about how the environment impacts the developing baby both in utero and throughout its lifetime. The genome is the genetic information inherited from one’s parents, but the epigenome is what deciphers the genome for each cell throughout the body. This deciphering process is impacted by both the internal and external environment of an individual. The external environment can include nutrition, chemicals, toxins, etc. The internal environment would include neuropeptides (emotional molecules) and stress hormones. The environment changes the proteins in the body that help the epigenome translate DNA. This finding has increased awareness of the importance of nutrition on the epigenome. Studies now are finding that the changes in the epigenome can influence not only that individual but can be passed along to future progeny, sometimes four generations out. The first nutrition for a human outside the womb is breastmilk, and thus its epigenetic impact is potentially expansive. New research has expanded the field of epigenetics to include breastmilk and how it potentially changes the epigenome and can affect the lifelong health of a baby. This presentation focuses on some of the latest published research- milksharing/wet nursing and the epigenome, breastmilk, and changes in gene expression and gut flora.

Learning Objectives:

Define genome and epigenome.
Identify at least one way breastmilk can potentially influence the epigenome of a baby.
Identify one way that epigenetics can influence gut flora.

This course is designed to introduce newer concepts and research findings form the past few years to certified breastfeeding professionals. Topics will include laid back breastfeeding, the importance of skin to skin and breastfeeding, manual expression and pump expression and supplementation risks and alternatives, the late pre-term infant.Objectives: Identify at least two benefits of skin to skin in early postpartum on both mother and baby. Describe why biological breastfeeding is the “norm” for the breastfed baby. Identify at least two reasons that baby led/laid back breastfeeding benefits the breastfeeding couplet. Describe how to facilitate relaxed/laid baby breastfeeding and extended skin to skin in the postpartum period in the hospital.Identify three separate types of effective pumping for women needing to maintain milk supply. List at least two reasons non-species specific supplementation can cause long-term health risks for the newborn. Identify at least 2 dose dependent disease risks of formula. Identify the seven reasons supplementation may be indicated, based on the newborn. Identify the three reasons supplementation may be indicated, based on the mother’s condition. List three options for supplementation that offer the least risk to breastfeeding relationship. Identify at least 2 breastfeeding risks for the late preterm infant. Define triple feeding and explain why it is indicated for late preterm infants who are not feeding well. Identify the most important piece of post discharge information for the family with a late preterm infant.

Note:
This course can be customized to your facility’s needs. It can be offered as a half day, 6 hour or 8 hour course. L-Cerps and nursing contact hours can be made available.