Lactation Management Training: From Novice to Expert

Lactation Education Resources Blog


Submit Blog Entry here to submit your essay about why you became a
Lactation Consultant, we can't wait to hear all about it!

The Core Curriculum for Lactation Consultant Practice, Third Edition, is now out of print and limited supplies of the existing copies are all that is available until the new edition is released in mid 2018.  If you wish a copy to use for studying for the IBLCE exam, or for your reference, purchase it quickly before supplies run out.

The publisher  Jones and Bartlett  $124
 http://www.jblearning.com/catalog/Details.aspx?isbn13=9780763798796

Amazon via the LER virtual bookstore $73
https://www.amazon.com/Core-Curriculum-Lactation-Consultant-Practice/dp/0763798797/ref=as_sl_pc_tf_til?tag=lactaeducares-20&linkCode=w00&linkId=6c676a1909a26ccdf7bfba6d1f5b69e6&creativeASIN=0763798797

Hits: 34
0

Continuing our series on the landscape of breastfeeding in the US, we’re shifting our focus Eastward to Pittsburgh, Pennsylvania. We’ll quickly assess the challenges that exist, then highlight a lactation support group that is working to close gaps and reach families in innovative ways.

While it’s true that no other area is consistently underperforming as significantly as the South when compared to the CDC’s Breastfeeding Score Card, there is room for improvement in every direction. At a glance, the US Eastern seaboard is packed with major metropolitan cities with large hospitals and no shortage of outpatient lactation support. Once you zoom in a bit inland or into more urban or rural areas, a different story begins to emerge. Many of the same challenges we encountered in the South exist in the East, including lack of access to support, lack of breastfeeding education among parents, and lack of breastfeeding supportive healthcare providers. Adding other factors such as demographics only compounds the issues.

For example, states in the Appalachian Region are woefully underperforming compared to their neighbors. Why? We know that socioeconomic levels directly impact quality of care. Breastfeeding disparities are, therefore, not surprisingly lower in areas that are economically depressed. We also know that race is a further compounding factor that drives breastfeeding disparities. Using almost any breastfeeding metric in the US, White mothers outperform their Latinx and Black counterparts. This is even truer in communities that are segregated, which often translates into differing levels and quality of care for those mothers in underserved groups. Black mothers lag the general US population, white mothers, and Latinx mothers, no matter how you slice the data. This creates a dire situation in cities with large Black populations where ill newborns could be greatly helped by the benefit of mother’s milk, and Black mothers could also be helped by the benefits of breastfeeding. For more on this, see our previous installments in this series.

Having relatable, culturally competent support is a major key to closing the disparity gaps in areas where breastfeeding is not the norm. What does success look like in a major eastern city? Is anyone reaching the families who are doubly hit with economics and race?

Yes. We had the opportunity to speak with Ngozi Walker-Tibbs, co-founder of the Pittsburgh Black Breastfeeding Circle (PBBC) which provides a safe space for encouragement, community and breastfeeding support. In our discussion, she illuminated the breastfeeding support needs in Pittsburgh, and detailed her journey to craft a suitable solution.

Can you tell us a bit about how PBBC was started?

The PBBC began in August 2014 during Black Breastfeeding Week. I had just finished graduate school in May of that year and this vision had been on my heart for many years but I wasn't sure where to start. I was overwhelmed with ideas and vision but lacked insight into how to make it work. As one of only 2 black LC's in the entire city; I was well aware of the lower rates of breastfeeding amongst women of color. I wanted to make a difference. A sister who is an activist in the community approached me and asked me to speak for the BBW 2014. I spoke from my heart as to why breastfeeding matters to us and how we can support each other as a community. After this event, the organizers and I discussed how to keep this momentum going. We had no money but wanted to feed the families. For the most part, we went into our pockets and found a spot, purchased food, and had our meetings. We are so grateful for some food donations that we received early on. We began to meet 1x per month at local libraries and women began to come. We discussed lots of topics including how to practice skin to skin after delivery, avoiding and resolving nipple pain, working and pumping, nursing toddlers and many more. We got our first grant in 2015.

How has PBBC grown or evolved since it first began?

We now meet two times per month and we are bursting at the seams! We have discussed meeting 3x per month and looking for a larger venue. Its a beautiful challenge to have.

How is the Pittsburgh community better off due to PBBC’s presence?

We have been featured twice this year in our local newspapers and the community is responding so positively. Physicians, Midwives, Nurses, LC's and other providers are recommending our circle to mothers in the community. They understand that we are an evidence based organization and mothers are learning about breastfeeding, parenting and bonding with their babies. Mothers in the circle have said they would have stopped nursing if it were not for the support of the PBBC. We know we are making a difference; one mother and baby at a time.

Can something like PBBC be duplicated elsewhere? How?

A black breastfeeding circle can be duplicated anywhere where there is an established need. First, the potential organizer should find what groups are already in operation in town, who do they reach, are there underserved communities? Find providers who are willing to partner with you to make a difference. Be prepared to share data and research. Find a spot, look for other likeminded organizations, talk with them, seek donations for food and space, develop and agenda based on the health needs of the community. 

Wherever there are breastfeeding disparities, local activists and parents are rising up to meet the need. Solutions come in various forms, from cafes to library meet ups to online support. We’ll highlight other such groups as this series continues in the coming months.

Meanwhile, PBBC is growing by leaps and bounds, and even supports their group mothers via Facebook in a closed support group that has blossomed to over 300 members. For more information about PBBC, Ngozi can be reached at 412-638-1580.

Hits: 1043

Posted by on in Uncategorized

We need your Feedback! How did you do on the various topics? If we know the weak spots, we can improve coverage of these areas. 

Please provide feedback with this form:

https://lactationtraining.formstack.com/forms/iblce_exam_report_form

 

Thank you for your participation.

Hits: 720
0

Posted by on in Uncategorized

Lactoferrin is one of the miraculous substances found in breastmilk which helps the infant kill bacteria and fight infection.  It is the major whey protein in human milk and has its highest concentrations in colostrum.  While it is important for all infants, it is especially important in the prevention of necrotizing enterocolitis (NEC) in preterm infants.   Lactoferrin has an anti-inflammatory action that may mitigate the pro-inflammatory states present in the gut before the onset of NEC.  This highlights the importance of mothers providing early feedings of colostrum and fresh mature milk to prevent necrotizing enterocolitis in their premature infant.

Researchers are experimenting with recombinant lactoferrin use in preterm infants and showing a benefit in reducing NEC.  In recombinant DNA, molecules of DNA are recombined into sequences that would not otherwise be found in the genome.   Recombining DNA is possible because DNA molecules from all organisms share the same chemical structure. They differ only in the nucleotides, the subunits of DNA and RNA, in the gene sequence.

Lactoferrin is present in cow’s milk in lower levels than found in human milk.  And the process of creating formula lowers those levels even further.  So, exogenous sources of lactoferrin must be added to formula if it is to match human levels.  Recombinant human lactoferrin can now be obtained from yeast, transgenic cows, and rice which have structural similarity to endogenous lactoferrin. 

There is already an infant formula manufacturer which is marketing Enspire™ containing lactoferrin in the range found in mature breastmilk.  This formula uses bovine sourced lactoferrin and is being marketed for use in any baby, not necessarily NICU infants.

Why are research dollars being spent on developing a protein that mothers can provide to their own infants?  Why don’t we spend the research dollars refining our techniques on how to best help mothers of premature infants provide their own lactoferrin, provide the best breast pumps, a place to pump, “rooming in” in the NICU and facilitate lots of skin-to-skin holding? In addition, when the mother is supplying her own lactoferrin, she is also colonizing the newborn's GI tract with beneficial bacteria and lowering stress levels in both herself and her infant. 

Liao Y, Jiang R, Lönnerdal B.  Biochemical and molecular impacts of lactoferrin on small intestinal growth and development during early life. Biochem Cell Biol 2012   90: 476–484.

Lönnerdal B, Jiang R, Du X  Bovine lactoferrin can be taken up by the human intestinal lactoferrin receptor and exert bioactivities. J Pediatr Gastroenterol Nutr 2011 53: 606–614.

Satué-Gracia MT, Frankel E, Rangavajhyala N , German JB.  Lactoferrin in Infant Formulas:  Effect on Oxidation.  J. Agric. Food Chem., 2000, 48:10:4984–4990

Sherman MP, Adamkin DH, Niklas V, Radmacher P, Sherman J, Wertheimer F, Petrak K Randomized Controlled Trial of Talactoferrin Oral Solution in Preterm Infants.  J Pediatr. 2016 Aug; 175:68-73.e3

Sherman MP, Sherman J, Arcinue R, Niklas V.  Randomized Control Trial of Human Recombinant Lactoferrin: A Substudy Reveals Effects on the Fecal Microbiome of Very Low Birth Weight Infants.  J Pediatr. 2016 Jun;173 Suppl:S37-42.

Sherman MP, Pritzl CJ, Xia C, Miller MM, Zaghouani H, Hahm B.  Lactoferrin acts as an adjuvant during influenza vaccination of neonatal mice.  Biochem Biophys Res Commun. 2015 Nov 27;467(4):766-70.

Sherman MP, Miller MM, Sherman J, Niklas V.  Lactoferrin and necrotizing enterocolitis.   Curr Opin Pediatr. 2014 Apr;26(2):146-50.

Sherman MP.  Lactoferrin and necrotizing enterocolitis.  Clin Perinatol. 2013 Mar;40(1):79-91.

Sherman MP, Petrak K. .  Lactoferrin-enhanced anoikis: a defense against neonatal necrotizing enterocolitis.  Med Hypotheses. 2005;65(3):478-82.

Sherman MP, Bennett SH, Hwang FF, Yu C.  Neonatal small bowel epithelia: enhancing anti-bacterial defense with lactoferrin and Lactobacillus GG.  Biometals. 2004 Jun;17(3):285-9.b, c

Hits: 840

Posted by on in Uncategorized

The attached survey comes from International Board of Lactation Consultant Examiners to investigate the interest in having a new credential available for people working in the lactation field.  This potential credential is intended for those individuals who are not IBCLCs, but are interested in being recognized by the IBLCE for the training they have accomplished (40 – 89 hours).  

This potential credential is not intended as substitute for the IBCLC but as an enhancement to the IBCLC’s practice.  It would be under the auspices of IBLCE who will develop a scope of practice and entry level exam which would complement and mesh with the IBCLC.  To avoid the appearance of competing with the IBCLC, we see great advantage to having this new recognition developed by the same organization that has oversight of the IBCLC credential, the IBLCE.

Those who may be interested in this new credential include:

  • Those seeking work while completing the rest of the requirements for IBLCE certification
  • Those seeking work without the intention of pursuing IBLCE certification in the future

This credential would be equivalent to the Breastfeeding Specialist certificate given by Lactation Education Resources at the present time.  It would be renewable and internationally recognized.

 We hope all of you will take the time to return this brief survey to IBLCE and tell them of your interest and support.  The survey takes less than five minutes to complete and will close on July 29. 

If you are not yet an IBCLC, please take this survey.

 https://www.surveymonkey.com/r/J79YTH5

If you are already an IBCLC, please take this survey

https://www.surveymonkey.com/r/J82VTPQ

Vergie Hughes RN MS IBCLC FILCA
Program Director
Lactation Education Resources
V 443-203-8553
F 410-648-2570
programdirector@lactationtraining.com

Hits: 1073
0