WE BELIEVE EVERYONE CAN SUPPORT BREASTFEEDING

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Relactation/Induced  Lactation (1.5 L CERPs) 

Dinner session with special guest and induced lactation expert, Dr Lenore Goldfarb. 

With  an understanding of how breastfeeding works, the principles of induced and 

re-lactation can be described and demystified. This session will discuss the  varying situations when this might be useful and introduce strategies and resources. 

Exploring re-lactation and induced lactation solidifies the robust nature of   breastfeeding and challenges the commercially constructed belief that breastfeeding is fragile. Confidence in breastfeeding is an essential skill for all health workers. 

 Oral Ties – Identifying the problem (1.0 L CERPs)

 Infant oral anatomy can vary and common genetic concerns such as ankyloglossia and   variations on restrictions within the oral cavity can cause disruption to the dyad. This session will discuss incidence and identification of any variation from normal,

identify subsequent adaptions and/or compensations to feeding and discuss specific and relevant management strategies. 

Taking the lactation history (1.0 E CERPs)

    Identify elements of the medical and social situation to include in a history, observe and record a breastfeed to create a baseline for observing and recording changes resulting from interventions and record findings from physical examination and observation of the infant and mother.

 An Overview of Breastfeeding Challenges (1.0 E CERPs)

    Many infants with oral ties experience breastfeeding challenges. This session will offer an overview of the common challenges of breastfeeding, pain, supply/growth concerns, mastitis, explore simple strategies to support breastfeeding and overcome difficulties and briefly discuss the prudent use of lactation aids. 

Oral Ties – Effective Management (1.5 L CERPs)

      This session will describe and discuss the various tools and methods of releasing frenula and identify the functional desired outcome and the impact on the infant. 

Discuss strategies to support maintenance of breastfeeding before and after any intervention, describe what parents need to know, including potential risks, 

and discuss facilitating decision-making. 

Oral ties and non-breastfed infants (0.5 L CERPs)

  Discuss the impact of oral ties on non-breastfed infants. Explore strategies to support these dyads before, during and after interventions to treat oral ties. 

Managing Milk Supply (1.0 LCERPs)

     This session will characterise the elements of adequate milk supply at different stages of lactation, discuss strategies to determine if milk supply is normal, compromised  or overabundant and discuss strategies to manage concerns 

about milk supply.      

 Using Galactagogues Effectively   (0.5 L CERPs)

 This session will describe both prescribed and non-prescribed galactagogues and

identify when and how to use prescribed galactagogues such as domperidone. 

Re-lactation  (1 L CERPs)

This session will differentiate between re-lactation and induced lactation and

discuss the varying situations when this might be useful, 

eg regretted early weaning, emergencies etc

 Nipple Pain and Damage  (1.5 L CERPs)  

 This session will discuss the various types of nipple pain and their causes, including mechanical trauma, discuss infections and possible treatments, and explore practical strategies to support the breastfeeding mother and the decision to limit time at the breast. Then the merit of available lactation aids/treatments will be discussed and medical conditions that may contribute to nipple pain will be reviewed. 

 Medication for pain and damage (0.5 L CERPs)  

      This session will describe the available prescribed and non-prescribed topical and systemic treatment of nipple infections and identify when, if, and how to use prescribed and unprescribed topical preparations. 

 Lumps and blockages (1.0 L CERPs)

This session will explore duct blockages, breast lumps and white spots and practical management strategies and discuss when and if to seek medical assistance 

or blockages.  

  Mastitis and Abscess (1.0 E CERPs)

    This session will differentiate between infective and non-infective mastitis and identify non-medical management strategies as well as knowing when to seek medical assistance. Then current prescribing recommendations for mastitis will be discussed followed by a discussion on the characteristics of an abscess, including diagnosis, treatment and referral pathways for abscess. 

Australian and international guidelines on health Worker responsibilities related to  Infant feeding. (1.0 E CERP)

An   overview of the NHMRC Infant feeding Guidelines for Health Workers, World   Health Organization International Code Marketing of Breastmilk Substitutes   (The International Code), Marketing   in Australia of Infant Formulas (MAIF)

Australian National breastfeeding Strategy 2019 and Beyond (ANBS 2019) 

The normal course of breastfeeding  (3.0 L CERPs)

This session will cover the anatomy,   physiology, and endocrine features of the normal course of lactation. We will  explore milk composition, infant and maternal contributors to initiating and maintaining breastfeeding such as skin to skin, feeding frequency, and   attachment and discuss how these elements are impacted by health workers.

An overview of breastfeeding challenges (1.0 L CERP)  

This session   will offer an overview of the common   challenges of breastfeeding, pain, supply/growth concerns, mastitis, explore simple strategies to support breastfeeding and overcome difficulties and briefly discuss the prudent use of lactation aids. 

Effective communication to support breastfeeding (1.5 CERPs)

Communication skills, both verbal and non-verbal are critical tools for a health worker who is interested in supporting a mother’s decision to breastfeed. This session will cover questioning, empathy, and ways to offer information using counselling style language. This differs from the normal way health workers are expected to manage communication with unwell patients. 

 Supporting Initiation of Successful Breastfeeding (1.0 L CERPs)  

 Discuss infant and maternal contributors to initiating and maintaining breastfeeding such as birth, skin to skin, feeding frequency, and attachment and discuss how these are impacted by health workers. 

An overview of breastfeeding challenges (1.0 L CERPs)  

This session   will offer an overview of the common   challenges of breastfeeding, pain, supply/growth concerns, mastitis, explore simple strategies to support breastfeeding and overcome difficulties and briefly discuss the prudent use of lactation aids. 

Taking the lactation history (1.0 L CERPs)

    Identify elements of the medical and social situation to include in a history, observe and record a breastfeed to create a baseline for observing and recording changes resulting from interventions and record findings from physical examination and observation of the infant and mother.

 Positioning and attachment (1.0 L CERPs)  

     This session will briefly recap breast and infant anatomy and innate reflexes,

identify the elements of optimal attachment for milk transfer and discuss strategies for positioning to achieve optimal attachment using video as a visual aid.

 Hand Expressing (1.0 L CERPs)  

Hand expressing   is an essential skill for mothers and health workers. This session will:

§ Describe and discuss technique,   collection, and storage. 

Explore antenatal expressing of colostrum including safety, timing, storage, pros and cons will also be discussed. 

 Evaluating Growth  (1.0 L CERPs)  

      This session will discuss WHO growth criteria, practice charting the elements of growth and development and describe the purpose a screening tool in growth measurement. Then discuss clinical observation and its role in evaluating growth, and review communication about growth that supports breastfeeding and 

parental self-efficacy. 

Australian and international guidelines on health Worker responsibilities related to  Infant feeding. (1.0 E CERPs)

An   overview of the NHMRC Infant feeding Guidelines for Health Workers, World   Health Organization International Code Marketing of Breastmilk Substitutes   (The International Code), Marketing   in Australia of Infant Formulas (MAIF)

Australian National breastfeeding Strategy 2019 and Beyond (ANBS 2019) 

Background of Breastfeeding Protection  (0.5 E CERPs)

 This session will describe the international effort that led to the Code’s drafting and adoption at the World Health Assembly (WHA), explain how subsequent resolutions fit into the interpretation of the International Code and describe how the International Code has been applied.  

The Aim and Scope of the International Code (0.5 E CERPs)  

This session   will offer an overview of the common   challenges of breastfeeding, pain, supply/growth concerns, mastitis, explore simple strategies to support breastfeeding and overcome difficulties and briefly discuss the prudent use of lactation aids. 

Who is responsible for the Code? (1.0 E CERPs)

This session will define health care workers and health care facilities under the International Code, define manufacturers and distributors under the International Code, describe the products covered by the International Code and how “novel” products (such as probiotics) should be treated and name other entities who have responsibilities under the International Code 

Beyond the Code – undermining Breastfeeding for Profit (1.0 E CERPs)

This session will  examine specific examples of advertising  that create confusion about application of the International Code and Identify specific action that can be taken by health workers to protect and support breastfeeding. 

Conflicts of Interest in Lactation (1.0 E CERPs)

This unit will define a Conflict of Interest (CoI), explain why they need to be identified and declared and discuss examples and explore their effect on health workers, their advice to mothers and the subsequent impact on infant feeding.