Breastfeeding Promotion and Management Speaker

Breastfeeding Topics (Full Topic Descriptions)

Breastfeeding:  A Public Health Priority

This introductory presentation reviews the dose-related, infant and maternal, compelling health benefits of breastfeeding that provide the rationale for current infant feeding recommendations, the Healthy People 2020 breastfeeding objectives, and the widespread promotion of breastfeeding as a national public health priority. Dr. Neifert will briefly review diverse national breastfeeding initiatives, including the USDA WIC Program; the CDC annual Breastfeeding Report Card and biennial Survey of Maternity Practices in Infant Feeding and Nutrition (mPINC); the TJC Core Measure of Exclusive Breast Milk Feeding; The 2011 Surgeon General’s Call to Action to Support Breastfeeding; the CDC Guide to Strategies to Support Breastfeeding Mothers and Babies; the Baby-Friendly Hospital Initiative, and the recent Best Fed Beginnings nationwide quality improvement initiative to increase the number of “Baby-Friendly”-designated hospitals in the United States; the U.S. Breastfeeding Committee; and new breastfeeding mandates in the Patient Protection and Affordable Care Act. Participants will be inspired to identify their ownprofessional keynote speaker breastfeeding “piece of the breastfeeding puzzle” and strengthen their professional commitment to partner with multidisciplinary colleagues in improving support for breastfeeding mothers.

Baby-Friendly Designation! – Implementing the “Ten Steps to Successful Breastfeeding”

Despite the brevity of the post-birth hospitalization, mounting evidence confirms that making institutional changes in maternity care practices can significantly increase breastfeeding initiation and duration rates. The Baby-Friendly Hospital Initiative’s (BFHI) Ten Steps to Successful Breastfeeding have long been recognized as the “gold standard” for maternity care practices that promote successful breastfeeding. Although relatively few U.S. hospitals have been awarded the Baby-Friendly designation, hundreds of maternity facilities have now embarked on the Baby-Friendly journey, and countless more are committed to making incremental changes in implementing supportive maternity practices. This presentation will educate nursing staff, lactation consultants, physicians, mid-level providers, administrators, prenatal educators, and others concerning the “whys” and “hows” of implementing the BFHI Ten Steps. Special emphasis will be given to the “anchor” steps of immediate mother-baby skin-to-skin contact and exclusive breastmilk feeding as strong evidence-based interventions to increase breastfeeding duration and exclusivity. In addition, the program will address effective strategies to prepare expectant mothers for an optimal hospital breastfeeding experience. Let Dr. Neifert’s empowering information and contagious enthusiasm help ensure that your hospital’s Baby-Friendly destination results in the BFHI designation!

Overcoming Early Breastfeeding Challenges

The first postpartum week represents a critical period in the establishment of successful breastfeeding practices and the promotion of an abundant milk supply. This presentation will address various infant biologic variables—including late-preterm birth and neonatal jaundice–that can negatively impact an infant’s ability to latch on to the breast, suckle effectively, extract milk, and promote ongoing production. Dr. Neifert will discuss the endocrine and autocrine control of lactation; the benefits of early hand expression; the role of “prevention” pumping; how to identify at-risk newborns and tailor an individualized breastfeeding plan; strategies, including the use of a nipple shield, for overcoming infant latch-on problems; breastfeeding and neonatal jaundice; delayed lactogenesis; early follow-up of breastfeeding dyads; maternal and infant criteria for assessing the successful onset of breastfeeding; and medical indications for supplementing breastfed infants. Identifying newborns at risk for ineffective breastfeeding and helping ensure that women establish an abundant milk supply are key foundations to promoting exclusive and extended breastfeeding.

Keeping Breastfeeding Going: Troubleshooting Common Problems

While nearly 80% of U.S. mothers choose to breastfeed, many encounter lactation difficulties that prevent them from achieving optimal infant feeding recommendations or their own breastfeeding goals. Health professionals need to know how to prevent and manage common breastfeeding difficulties that arise during the course of lactation. This presentation covers the prevention, recognition, and clinical management of the common maternal and infant breastfeeding concerns that often lead to early weaning. Maternal problems to be addressed include: anatomic breast variations; postpartum breast engorgement and delayed lactogenesis; acute and chronic sore nipples, including infection with bacteria and/or candida and Raynaud’s Phenomenon; plugged ducts and mastitis; insufficient milk; maternal employment; and medications and mother’s milk. Infant breastfeeding problems include: breastfeeding-related jaundice; the late-preterm infant and other at-risk newborns; infant latch-on and suckling difficulties; slow infant weight gain; and misinterpretation of infant crying. This session will empower and equip health care workers who serve pregnant women and breastfeeding mothers to effectively address common lactation concerns.

Keys to a Plentiful Milk Supply

While nearly 80% of U.S. mothers begin breastfeeding their newborns, less than 20% of infants are being fully breastfed by six months of age, as recommended. In a large U.S. survey of new mothers, two of the most common reasons mothers gave for stopping breastfeeding before their baby was a year old were: “I didn’t have enough milk” and “Breastmilk alone did not satisfy my baby.” Concerns about producing enough milk prevent many women from reaching their breastfeeding goals. This presentation will offer strategies to help women establish and maintain a plentiful milk supply throughout their baby’s first year. Topics to be discussed include: the critical importance of the first two weeks in establishing an abundant milk supply; the essential role of “prevention pumping” among mothers of infants at risk for inadequate breastfeeding; the role of exclusive breastfeeding in extending breastfeeding duration; the variability of breast storage capacity among breastfeeding women and its influence on recommended feeding and pumping routines; and avoiding common “insults” that can decrease a previously generous milk supply, such as a long night interval without draining the breasts; early introduction of complementary foods; infectious mastitis; combined hormonal contraceptives; and maternal employment. This presentation is relevant for all health care workers who are committed to promoting exclusive and extended breastfeeding.

“Just a Few Weeks Early:” Breastfeeding Challenges in Late-Preterm Infants

Infants born at 34, 35, or 36 weeks gestation make up 8% of all U.S. births. These babies are referred to as late-preterm infants to emphasize that they are physiologically immature and have special health care needs compared to full term infants. Currently, late-preterm births account for more than 70% of all preterm births (<37 weeks gestation). Although hospital personnel and parents often treat apparently healthy late-preterm infants as if they were developmentally mature newborns, babies born even a few weeks early have an increased risk of a variety of neonatal complications, including feeding problems, severe jaundice, and excessive weight loss after birth. Smaller, developmentally immature late-preterm infants often have trouble latching on to the breast correctly and breastfeeding effectively at first, due to fewer awake-alert periods, immature oromotor skills, lower muscle tone, and a tendency to tire easily. This presentation will address the special breastfeeding challenges among late-preterm infants and offer helpful guidelines to ensure a plentiful milk supply and a thriving baby. The extra investment of time and effort to safeguard early breastfeeding among these vulnerable newborns can set the stage for long-term breastfeeding success.

The Important Role of Lactation Consultants and Breastfeeding Proponents in Reducing SIDS and Other Sleep-Related Infant Deaths

Each year in the United States, approximately 4,000 infants die suddenly of no immediately obvious cause. Nearly half of all Sudden Unexpected Infant Deaths (SUID) are attributed to Sudden Infant Death Syndrome (SIDS). While SIDS rates have dropped significantly since the national Back to Sleep campaign was initiated, SIDS still remains the leading cause of death for infants aged 1–12 months.

Accidental suffocation and strangulation in bed (ASSB) is a potentially preventable subgroup of SUID that has quadrupled in the last two decades and accounts for another 500 sleep-related infant deaths annually. Lactation consultants and other health professionals who work with expectant and new mothers have the opportunity and ethical responsibility to help reduce preventable sleep-associated deaths in infancy. This session will explore the environmental, biologic, and social risk factors for SIDS and ASSB and review the latest American Academy of Pediatrics Policy Statement and Technical Report on “SIDS and Other Sleep-Related Infant Deaths.” Dr. Neifert will also discuss the newly launched NIH “Safe to Sleep Campaign,” which builds on the success of the long-standing Back-to-Sleep campaign, and provides additional strategies—including the recommendation to breastfeed—to reduce all sleep-related, sudden unexpected infant deaths. Participants will be challenged to begin incorporating evidence-based, uniform safe sleep guidelines as a routine part of their breastfeeding counseling of expectant and new mothers.

Using Motivational Interviewing Techniques with Breastfeeding Clients

Our clients’ personal motivation for behavior change can be significantly influenced by the way we talk with them about health decisions. The clinical method of Motivational Interviewing (MI), first described in the early 1980s, now has widespread applicability, including discussions with clients about breastfeeding. MI works by triggering patients’ own motivation to change and comply with recommended treatment. Instead of an uneven power relationship (an expert and a passive client), MI involves active collaboration and joint decision-making, respect for the client’s basic worth, recognition of their individual strengths and efforts, and the client’s right to choose their own path. This presentation will help diverse health care workers use MI techniques to draw out their clients’ own resources and motivation for change, by connecting with their personal values and goals. One of the guiding principles of MI is to “resist the righting reflex.” Although the helper’s natural urge is to correct their client’s suboptimal choices or behavior, this approach is seldom effective because an ambivalent client’s natural response to persuasion is to argue the other side, causing them to be even more committed to the status quo. Instead, participants will learn how to use core MI interviewing skills—open questions, affirmations, reflective listening, and summarizing of key themes–to encourage clients to voice their own arguments for behavior change.

Applying Evidenced-Based Strategies to Increase Exclusive and Extended Breastfeeding

A growing body of research evidence confirms that the improved health outcomes associated with breastfeeding are dose-related, with exclusive breastfeeding for about six months conferring the maximum infant and maternal health benefits. Despite a steady increase in breastfeeding initiation rates, a large majority of U.S. infants and mothers do not receive the maximum health benefits associated with exclusive and extended breastfeeding. Furthermore, substantial differences in breastfeeding rates among vulnerable populations contribute to infant and maternal health disparities. This session will briefly summarize the recent literature identifying evidence-based clinical strategies that promote exclusive breastfeeding. Participants will learn specific prenatal, intrapartum, early follow-up, and ongoing interventions linked with improved exclusive breastfeeding outcomes. In addition, Dr. Neifert will share effective counseling strategies targeting the common barriers that undermine exclusive breastfeeding, including: the lack of prenatal preparation; inadequate support; perception of insufficient milk; misinterpretation of infant crying; returning to work or school; and early introduction of solid foods. The empowering information presented will equip lactation consultants, WIC staff, public health nurses, primary care providers, and other health professionals who work in diverse practice settings to implement evidence-based, clinical strategies to better promote exclusive and extended breastfeeding.

Insufficient Milk Syndrome

Although lack of milk is the most common reason women give for discontinuing breastfeeding, this all-too-common complaint is poorly understood. This presentation reviews the magnitude of the problem of lactation insufficiency and distinguishes rare “primary” (non-preventable, non-remediable) causes of insufficient milk (including breast surgery and breast variations) from common, often remediable, “secondary” causes linked to poor breastfeeding management. Participants will learn the mechanisms by which lactation difficulties become complicated by low milk, and review common maternal and infant factors contributing to insufficient lactation. The program will include guidelines for establishing and maintaining a generous milk supply and offer specific management strategies to help increase low maternal milk production and improve the nutritional status of underweight breastfed infants. Dr. Neifert also will discuss the current controversy surrounding the clinical use of pharmaceutical and herbal galactagogues.

Comprehensive Lactation Management Training for Multi-Disciplinary Health Professionals

Consistent breastfeeding messaging and management on the part of all health professionals is essential to enable women to achieve optimal breastfeeding recommendations. This two-day Comprehensive Lactation Management training will provide up-to-date, evidence-based, clinically-relevant information to help equip diverse health professionals to effectively assess and manage lactation challenges in expectant mothers, breastfeeding women, and nursing infants. The primary goal of this multidisciplinary training is to increase rates of exclusive and extended breastfeeding by ensuring that nursing mothers receive consistent and knowledgeable breastfeeding counseling, management, and support from the varied health professionals with whom they interact throughout their course of lactation. By bringing primary care providers, public health staff, and other community partners to the same educational venue, participants can better recognize their piece of the “breastfeeding puzzle” and appreciate the contributing roles played by diverse colleagues.

Comprehensive Breastfeeding Training for WIC Professional and Paraprofessional Staff

This comprehensive 2- or 3-day training is designed to prepare WIC professional and selected paraprofessional staff to provide effective assessment and counseling for expectant women and breastfeeding clients who have been identified as high risk per the NRF 52 description. The course will review the scientific basis for breastfeeding promotion, and offer specific counseling techniques in routine breastfeeding management. Emphasis will be placed on: 1) the promotion of exclusive breastfeeding for the first six months; 2) extending the duration of breastfeeding; and 3) the recognition and timely intervention for breastfeeding risk factors in the pregnant woman, the lactating mother, and the breastfeeding infant. Practical, clinically relevant information will be presented and supplemented with a course syllabus of resource materials. A variety of practicum opportunities will be incorporated into the training to give participants hands-on experience with breast pumps, breastfeeding aids and accessories, and a variety of breastfeeding educational resources. In addition, multiple case studies will give participants opportunities to apply their knowledge in troubleshooting a variety of breastfeeding problems.

Life in Balance: Improving the Quality of Your Journey

Virtually every lactation consultant or other health care worker knows the feeling – too much to do and too little time or energy to do it all well. This informative, entertaining, and inspiring session will target those dedicated, and often-depleted, lactation professionals who sometimes forget to re-fill their own emotional tanks as they endlessly respond to the compelling needs of nursing dyads. Juggling professional and personal responsibilities can create unrelenting stress that jeopardizes both roles and contributes to job burnout. Worse yet, toxic role overload threatens to create “compassion fatigue” by draining health professionals of a deeply cherished attribute. Drawing from her own experience of giving birth to five children in seven years, while completing her medical education, Dr. Mom shares hard-earned wisdom gleaned from her personal journey and professional encounters. In addressing the universal quest of contemporary life – finding a balance – Dr. Mom offers timeless practical life-strategies to equip health workers to clarify governing values, establish priorities, reduce stress, downscale and simplify, cultivate healthy coping skills, and promote essential self-care. Reordering our frenzied livestyles can renew our excitement about our life and our work. Furthermore, the same prescription can help our nursing clients re-structure their priorities to accommodate successful breastfeeding. Come prepared to laugh and learn – leave rejuvenated and re-energized!

Keys to Contentment: Insights from Positive Psychology that Increase Happiness and Well-Being (Help your staff “Get Their Happy On” and maintain their well-being while you facilitate hospital change during your Baby-Friendly journey or other challenging transition)

Would you like to reduce your own and your staff members’ stress level and enhance your sense of well-being by learning to live at the upper end of your inborn level of happiness, even when times are tough? In this professional development session, Dr. Mom will review life-changing principles of positive psychology—the scientific study of optimal human functioning–to promote positive emotions, optimism, and well-being. Participants will learn how to experience authentic happiness by using our signature strengths and core virtues in service to a noble purpose much larger than ourselves. Learn to tie your Baby-Friendly journey or other challenging transition to your own and your staff members’ signature strengths and your personal and agency’s mission statements. Discover why cultivating an attitude of gratitude is strongly and consistently linked with greater happiness and how complaining and blaming release a cascade of stress chemicals and diminish both complainers and hearers. Leave the session empowered to begin incorporating happiness-boosting insights, attitudes, and practices into your daily routines to generate positive energy and keep you and your staff more engaged with life. Let your personal example of happiness, fulfillment, optimism and joy serve as a healthy and influential model for team members and clients within your sphere of influence.