Breastfeeding Conference · and periodontal disease sees her treating patients as young as 4 days...

LCANZ 2015 Breastfeeding Conference

6 – 8 March 2015Mercure Brisbane, QLD

FINAL PROGRAM

& ABSTRACT

BOOK

ACKNOWLEDGEMENTS

The LCANZ 2015 Conference Organising Committee is very grateful to the following organisations who have given their support to the conference.

EXHIBITORS

SUPPORTERS

LCANZ 2015 CONFERENCE – MORE THAN MILK

Dear LCANZ More than Milk conference participants,

On behalf of the organising committee of the 2nd transnational

LCANZ breastfeeding conference, I am excited to welcome

you here to the Mercure, Brisbane for what should be 3 days

of interesting and informative presentations by our invited

international and national speakers. In addition, we have our

abstract presentations selected by our scientific committee,

speaking on current breastfeeding research and clinical topics.

A combination of plenary, workshop and concurrent sessions, as

well as poster presentations, means our days here together will be

packed solid with learning and interaction.

The conference is also a place for networking and socialising, and

we hope you will enjoy meeting other participants at our welcome

reception and ice-cream social, followed by the special screening of

the award-winning movie Microbirth. Our ‘Mmmore than Mmmilk’

conference dinner with our international speakers on Saturday

night will have us tapping our toes and dancing to the stunning

local all-girl quartet Quatro.

We are grateful to our sponsors and exhibitors for their support,

and encourage you to visit the booths and tables in the breaks

with your exhibitor bingo cards. I would also like to thank the LCANZ

Board, the organising committee, the scientific committee, and

Jade Riolo and Patricia Chew from The Association Specialists for all

their hard work in putting this second LCANZ conference together.

We hope when you return home you will be able to share the

learning experienced here with your colleagues, and in the

wonderful work you do with breastfeeding families.

Iona Macnab2015 More than Milk Conference Convenor

FINAL PROGRAM & ABSTRACT BOOK 3

WEL

COM

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Organising Committee• Iona Macnab IBCLC (Conference Convenor), Lactation Consultant

in Private Practice & Founder, iLactation, VIC

• Colleen Hickey IBCLC Clinical Nurse, Primary Care Program, Children’s Health Services District, QLD

• Karen Hayes IBCLC Clinical Midwife, Lactation Consultant Royal Brisbane Womens’ Hospital, QLD

• Naomi Hull IBCLC Lactation Consultant, Private Practice, QLD

Scientific Committee • Carol Bartle, RN, RM, IBCLC, MHSc Canterbury Breastfeeding

Service Coordinator, Te Puawaitanga ki Otautahi Trust & Policy Analyst, New Zealand College of Midwives, NZ

• Gillian OPIE MBBS FRACP IBCLC, Head of Unit, Mercy Health Breastmilk Bank, & Staff Neonatologist, Mercy Hospital for Women VIC

• Jennifer Naudé, MBChB IBCLC Lactation Consultant in Private Practice, NSW

• Anita Moorhead RN, RM, IBCLC, Clinical Midwife Consultant (Lactation), Royal Women’s Hospital, VIC

• Jillian Hanson RN, RM, IBCLC, Grad Dip Adv Nursing, Clinical Nurse Consultant: Lactation, Women’s & Children’s Services Launceston General Hospital, TAS

• Dale Hansson RN IBCLC IATP Lactation Consultant, Premier Health, NSW

LCANZ 2015 SECRETARIAT

Level 3, 33-35 Atchison StreetSt Leonards, NSW 2065T: +61 2 9431 8600F: +61 2 9431 8633E: [email protected]: www.lcanzconference.com

Lactation Consultants of Australia

and New Zealand Secretariat

Level 3, 33-35 Atchison StreetSt Leonards, NSW 2065T: +61 2 9431 8621F: +61 2 9431 8633E: [email protected] W: www.lcanz.org

conference

committee

LCANZ 2015 CONFERENCE – MORE THAN MILK4

Prof Uwe EwaldUwe Ewald has over 30 years experience as a paediatrician and has been a professor in Neonatology for nearly 20 years. During his career he has produced 160 peer reviewed publications and has been involved in many organisations and projects on improvements of neonatal care. He has been an international speaker at many conferences and supported a multitude of students during his career.

His recent research projects are focused on research on knowledge translation to resource poor settings, change processes of culture/climate in the NICU, and the implementation of new care routines, family centered care, kangaroo mother care and breastfeeding.

Dr Jenny ThomasDr. Jenny Thomas is a pediatrician and breastfeeding medicine specialist at Lakeshore Medical Clinic in Franklin, Wisconsin and is a Clinical Assistant Professor of Community and Family Medicine and Pediatrics at the Medical College of Wisconsin. She currently serves on the Executive team for the American Academy of Pediatrics (AAP) Section on Breastfeeding and on the Executive Board of the Wisconsin

Chapter of the AAP. She is a founder and past Chairperson of the Wisconsin Breastfeeding Coalition. She is the author of Dr. Jen’s Guide to Breastfeeding. She has received awards for teaching, advocacy for children, and innovation within her practice and community. She is one of only a few physicians internationally to be recognized as a Fellow of the Academy of Breastfeeding Medicine (FABM) for her expertise on breastfeeding. Dr. Thomas’ interests and research have focused on issues related to the use of social media to support breastfeeding mothers.

Nancy MohrbacherNancy is the author of Breastfeeding Answers Made Simple and its pocket guide edition, which are used by breastfeeding specialists worldwide. For parents, she co-authored with Kathleen Kendall-Tackett Breastfeeding Made Simple. Her 2013 tiny problem-solving book, Breastfeeding Solutions, is now available as the ground-breaking Breastfeeding Solutions app for Android and

iPhones. Her new book, Working and Breastfeeding Made Simple debuts July 2014. She speaks at events around the world.

Nancy lives in Chicago and began helping breastfeeding families there as a volunteer in 1982. She became board-certified in 1991, and from 1993 to 2003 she founded and ran a large private lactation practice. In 2008 the International Lactation Consultant Association officially recognized Nancy’s contributions by awarding her the designation FILCA, Fellow of the International Lactation Consultant Association. Nancy was one of the first group of 16 to be recognized for their lifetime achievements in breastfeeding.

KEYNOTE

SPEAKERS


NATIONAL INVITED SPEAKERS

Dr Elaine BurnsElaine is a Registered Midwife and Lecturer at The University of Western Sydney. Elaine has worked in the areas of midwifery and women’s health as a clinician,

researcher and educator for the last 20 years. Elaine completed her doctoral studies in 2011 where she explored the language and practices of midwives and lactation consultants when interacting with breastfeeding women. The findings from this doctoral work have influenced practice based changes in language used during breastfeeding support as well as contributing to the education of midwives and lactation consultants. Elaine is currently exploring the similarities and differences in communication styles between privately practicing midwives and ABA peer support counsellors, when supporting breastfeeding women, during the first six weeks after birth. Elaine is passionate about improving the support provided to women during the early establishment phase of breastfeeding.

Dr Marjan JonesHaving worked as a dental surgeon for 17 years in private practice in Brisbane and Sydney as well as lecturing at the University of Qld, Dr Jones is now

owner and principal dentist at Enhance Dentistry on Park Rd, Milton.

Her interest in ensuring a preventative approach to adult issues including snoring, sleep apnoea, decay and periodontal disease sees her treating patients as young as 4 days old.

With her strong conviction that breast-feeding is nature’s first and most potent orthodontic treatment, her 12 years experience with lasers has culminated in a focus on laser treatment of lip and tongue ties – thus providing an opportunity for assisting with optimisation of breastfeeding for Mother/Infant dyads with breastfeeding challenges.

Dr Jones has now treated close to 1000 infants and has a particular perspective on the benefits of laser revision of lip and tongue tie.

Lauren PorterLauren Porter is the co-Director of the Centre for Attachment, a family therapist and a PhD student at the University of

Canterbury. She obtained her Masters Degree in Social Work from New York University, USA in 1995 and has since been dedicated to working with individuals, dyads and families in the field of mental health counselling and training. Lauren has worked in a wide range of settings and communities, including Germany, the US and New Zealand. Her experience has focused on families struggling with issues pertaining to conflict and trauma, as well as integrating attachment theory into mainstream settings of many kinds. She is a Lifetime Member of the Infant Mental Health Association Aotearoa New Zealand (IMHAANZ) and is a member of Brainwave’s Scientific Advisory Committee as well as the Australian Association of Buddhist Counsellors and Psychotherapists. She is the mother of two children and lives in Queensland.

Dr JULIE SMITHDr Julie Smith is an economist at the Australian National University (ANU), and holds an ARC Future Fellowship for her research on markets in mothers’ milk. Dr Smith

has over 20 years experience as an ABA Counsellor and Community Educator, and was an ABA board director from 2002 to 2010. Her research on economic aspects of mothers’ milk has examined the time costs of breastfeeding, and trends in commercial baby food sales and marketing. She has led research with ABA on supporting breastfeeding in workplaces and childcare. She was an invited advisor on the economics of breastfeeding for the US Surgeon General’s 2011 Call to Action on Breastfeeding, the Australian Parliament’s Best Start Inquiry on Breastfeeding, and the WHO/UNICEF Western Pacific 2007 Regional Consultation on Breastfeeding. In 2014, she was economics advisor on the IBFAN official delegation to the Sixty Seventh World Health Assembly. Dr Smith serves on the editorial board of the International Breastfeeding Journal, and is a member of the ILCA Research Committee.

LCANZ 2015 CONFERENCE – MORE THAN MILK6 LCANZ 2015 CONFERENCE – MORE THAN MILK6

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Preliminary Program Please note the program is subject to change

Friday, 6 March 2015Welcome & Opening Plenary – Chelsea Room

Chair: Iona Macnab

0830 – 0835 Welcome to Country

0835 – 0845 Opening of the Conference, Susan Cluitt

0845 – 0945 Keynote 1: The normal newborn and why breastmilk is not just food, Dr Jenny Thomas

Research Round Up 1 – Chelsea RoomChair: Colleen Hickey

0945 – 1005 ABA research: The EMBER project, Dr Susan Tawia

1005 – 1025 Effective online tools for supporting breastfeeding mothers, Dr Julie Green

1025 – 1045 Cumulative risks and the cessation of exclusive breastfeeding; Australian cross-sectional survey, Jennifer Ayton

1045 – 1115 Morning Tea

Plenary Session 2 – Chelsea RoomChair: Karen Hayes

1115 – 1200 Keynote 2: Breast, bottle and childhood obesity, Nancy Mohrbacher

Concurrent Session A1Chelsea Room

Chair: Karen Hayes

Concurrent Session A2Leichhardt Theatre

Chair: Virginia Thorley

Concurrent Session A3Wills Theatre

Chair: Gwen Moody

Concurrent Session A4Burke Theatre

Chair: Camilla McCauley

1200 – 1245 What’s in the can? Breastmilk substitutes and

their useRos Escott

Recognising allergy issues in breastfed babies

Robyn Noble

Improving breastfeeding outcomes for women with

diabetes in pregnancyCarmel Kelly

Milk banks vs milk sharingKerri McEgan

1245 – 1400 Lunch

Workshop 1Chelsea Room

Chair: Karen Hayes

Workshop 2Leichhardt TheatreChair: Susan Cluitt

Workshop 3Wills Theatre

Chair: Cheryl Ganly-Lewis

Workshop 4Burke Theatre

Chair: Helen Adams

1400 – 1530 Simplifying Breastfeeding – the first 36 hours

Nancy Mohrbacher

Breast and nipple pain associated with

breastfeeding: A simple tool to capture the

complexity of influences and determinants of painDr Lisa Amir, Lester Jones

and Miranda Buck

Larger breasted women and breastfeeding

Decalie Brown

The use of supplemental line feeding in

breastfeeding: Short term usage to maximise breastfeeding outcomes

Katie James

1530 – 1600 Afternoon Tea

Concurrent Session A5Chelsea Room

Chair: Karen Hayes

Concurrent Session A6Leichhardt TheatreChair: Sally Rickards

Concurrent Session A7Wills Theatre

Chair: Colleen Hickey

1600 – 1645 Lip tie- a breastfeeding challenge in its own rightRuth O’Donovan and Vicki

Patterson

Milk matters: More than women are ever told

Maureen Minchin

Weight faltering in infancy – failure to thrive in three

breastfed infantsCarole Dobrich

Plenary Session 3 – Chelsea RoomChair: Iona Macnab

1645 – 1730 Keynote 3: Breastfeeding & epigenetics, Dr Jenny Thomas

1730 – 1830 Welcome Reception & Icecream Social

1900 Special screening: Microbirth the movie


Please note the program is subject to change Preliminary Programsaturday, 7 March 2015

Plenary Session 4 – Chelsea RoomChair: Naomi Hull

0830 – 0930 Keynote 4: Family centre care in a Swedish NICU, Prof Uwe Ewald

0930 – 1030 Keynote 5: Breastfeeding communication: Does relationship matter? Dr Elaine Burns

1030 – 1100 Morning Tea

Concurrent Session B1Chelsea Room

Chair: Naomi Hull

Concurrent Session B2Leichhardt TheatreChair: Sally Rickards

Concurrent Session B3Wills Theatre

Chair: Karen Hayes

Concurrent Session B4Burke Theatre

Chair: Camilla McCauley

1100 – 1145 Exploring breast pump use amongst mothers of healthy term infants in

Melbourne: The Mothers and Infants Lactation Cohort (MILC) study

Dr Lisa Amir

Case study – improving pre-term infant’s growth

rate by harnessing breastmilk composition

Christina Galloway

Women’s experiences of breastfeeding support:

Results from the supporting breastfeeding in

local communitiesRhian Cramer

Milk siblingship – implications for human milk

bankingVirginia Thorley

Opportunity for delegates to change session rooms

1145 – 1230 Feeding in NICU – it’s time to be more accurate

Anita Moorhead

Nurturing potential future IBCLCs-are we eating our

young before they hatch?Carole Dobrich

Milk banking is a food business

Kerri McEgan

1230 – 1400 Lunch and PostersPlenary Session 5 – Chelsea Room

Chair: Susan Cluitt1400 – 1530 Keynote 6: Understanding breastfeeding behaviours, Nancy Mohrbacher

1530 – 1600 Afternoon TeaPlenary Session 6 – Chelsea Room

Chair: Gwen Moody1600 – 1645 Keynote 7: What mothers say: Untangling research on first time mothers of premature babies, Lauren Porter

1645 – 1730 Keynote 8: Promoting breastfeeding of pre-term infants in a Swedish NICU, Prof Uwe Ewald

1900 Gala Dinner

sunday, 8 March 2015Plenary Session 7 – Chelsea Room

Chair: Helen Adams0830 – 0930 Keynote 9: Treatment of lip and tongue ties for optimal breastfeeding – what are the potential implications

in future life? Dr Marjan JonesResearch Round Up 2 – Chelsea Room

Chair: Colleen Hickey0930 – 1000 Baby-Friendly hospital initiative: An evaluation of a quality certificate within the maternity care context,

Kathleen Biessmans

1000 – 1030 Breastfeeding problems and maternal psychological wellbeing: Evidence from an Australian prospective study, Dr Lisa Amir

1030 – 1100 Morning TeaPlenary Session 8 – Chelsea Room

Chair: Naomi Hull1100 – 1145 Keynote 10: Is breastfeeding economical, and for whom? Dr Julie Smith

Short Presentations – Chelsea RoomChair: Cheryl Ganly-Lewis

1145 – 1215 Factors associated with delayed onset of lactation in BFH, Anita Moorhead

1215 – 1245 Softening our language, Cynthia Peterson

1245 – 1345 LunchPlenary Session 9 – Chelsea Room

Chair: Gwen Moody1345 – 1430 Keynote 11: The intersection of community and technology: Using social media to connect your practice to

your families, Dr Jenny Thomas

1430 – 1500 Conference Closing & Awards

The posters will be displayed in the pre-conference area, along with the trade exhibition, opening on Friday, 6 March 2015 at 1045, and closing on Sunday, 8 March 2015 at 1345 hours.

Poster authors will be present at their posters on Saturday, 7 March 1230 – 1400.

Tea breaks and lunch will be served in this area to enable you to visit the poster presentations.

1. Ankyloglossia in Breastfeeding Infants: Stretching exercises post-frenotomy and the efficacy of the procedure

Lenore Goldfarb

2. Do first expressions count? A simple approach to improve outcomes for high risk babies

Rachel Jones

3. Emotion and promotion Maureen Minchin

4. Breastfeeding: Biologically normal yet culturally an intervention? Virginia Thorley

5. Breastfeeding Support – teaching about universal support for breastfeeding mothers and babies

Gabrielle Wilson

poster presentations

10

social program

Live entertainment for our Mmmore than

Mmmilk Dinner

Exquisite vocals, edgy choreography, spine-tingling

harmonies and breathtaking instrumental renditions of your

favourite tracks. This is the fabulous all-girl quartet that is QUATRO.

Chosen by Johnny Young to Open the Young Talent Time Show from over 30,000 auditions

Australia Wide, Quatro have won a Golden Fiddle Award in Tamworth where they raised much

needed funds following the devastating Bundaberg floods. The girls toured the Outback raising money

for the charity Angel Flight. They have performed at Parliament House, and delighted festival audiences

from Mackay to Coffs Harbour. Recently the band won the promoters choice at the Australian Street Entertainment

Championships at Surfers Paradise.

Be Impressed, be very Impressed!

Ice cream Social - Welcome Reception

Venue: Hopewell and Glanworth Room, Mercure BrisbaneDate: Friday, 6 March 2015Time: 1730 – 1830 hours Cost: Included in Full Delegate Registration Fee Day Delegate or Guest Tickets: $50.00 per personDress: Smart Casual

Directly following the first day of conference sessions we invite all delegates and trade exhibitors to come together for drinks and “more than milk” canapés in the exhibition area. This is a great way to network, catch up and celebrate the official opening of the conference.

Special Screening: MicrobirthVenue: Chelsea RoomDate: Friday, 6 March 2015Time: 1900 – 2000 hours Cost: Included in Full Delegate Registration Fee Guest tickets: $10.00 per person

“MICROBIRTH” is a 60 minute scientific documentary that looks at birth in a whole new way, through the lens of a microscope. Exploring the latest scientific research, the film suggests modern birth practices could be interfering with critical biological processes increasing the risk of our children developing immune-related diseases. Made by One World Birth filmmakers, Toni Harman & Alex Wakeford.

Mmmore than Mmmilk DinnerVenue: Burke and Wills Room, Mercure Brisbane

Date: Saturday, 7 March 2015

Time: 1930 – 2330 hours

Cost: $99.00 per person

Dress: Smart Casual

11

participants or their accompanying persons or loss of or damage to their personal property as a result of the meeting or related events.

Lost PropertyPlease report all lost or found property immediately to the staff at the registration desk.

Wi-Fi & Internet AccessThe Mercure Brisbane does not have complimentary Wi-Fi options. Delegates may purchase an access code from the hotel reception desk at a cost of $24.50 per device per 24 hours.

Name BadgesAl delegates will be given a name badge at registration. For security reasons, we ask that you wear your name badge at all times. This name badge is also the official entrance to all Conference sessions, exhibition, catering areas and social functions.

Registration Desk & TimesRegistration material for the event (name badge, function tickets & detailed program) may be collected from the LCANZ 2015 Registration Desk during the below times.

The Registration Desk for the LCANZ 2015 Conference will be located in the pre function area of the Mercure Brisbane. Staff at the Registration Desk will be happy to help with any queries.

Opening hours will be as follows:Thursday, 5 March 1400 – 1700Friday, 6 March 0700 – 1930Saturday, 7 March 0700 – 1730Sunday, 8 March 0730 – 1500

Smoking PolicyThe Mercure Brisbane is a non-smoking venue. Smoking is strictly prohibited in all enclosed public spaces. This policy also applies to restaurant, shopping centres and bars in Sydney.

Speaker Preparation Area All speakers are asked to check their audiovisual material before presenting. We ask that you check-in with the audiovisual technicians at least 2 hours prior to your presentation. The speaker preparation area will be located in the exhibition area.

GENERAL INFORMATION

Accommodation & Luggage

Mercure Brisbane85-87 North Quay, Brisbane, QLD, AustraliaP: +61 7 3237 2300 www.mercurebrisbane.com.au

Ibis Brisbane27-35 Turbot Street, Brisbane, QLD, AustraliaP: +61 7 3237 2333www.ibis.com/gb/hotel-2062-ibis-brisbane/index.shtml

All delegates are reminded that aside from pre-paid room charges all incidentals and charges at the hotel are to be settled upon check out. Please also note that the Conference Registration Desk has no storage facilities – please leave your luggage with the hotel concierge if attending the conference after you have checked out of your hotel room.

Credit CardsCredit cards accepted at the registration desk are MasterCard, AMEX and Visa. The majority of hotels, restaurants and shops will accept all major credit cards.

Car ParkingUndercover, off street parking is available at Secure Car Park located at the front of Mercure Brisbane hotel or at Tank Street neighbouring Ibis Brisbane. Hotel & event guests are encouraged to validate parking tickets at hotel reception or concierge desks to receive the discounted rate of $27 per vehicle, per 24 hours when not pre-booked online. Secure Car Park is not owned by Accor, and is independently run of both Mercure Brisbane & Ibis Brisbane along with being open to the general public. Mercure & Ibis are unable to guarantee availability of vehicle spaces.

Disclaimer of LiabilityThe Organising Committee, including the LCANZ 2015 Conference Secretariat, will not accept liability for damages of any nature sustained by


FLOOR PLAN


TRADE EXHIBITION

Exhibitors (in alphabetical order)

Organisation Stand Number

ABA 5

Bio-Oil® 4

Health-e-Learning 1

IBLCE 6

iLactation 3

New Baby 101 2

LCANZ 7

Exhibition Open:

Friday, 6 March 0700 – 1930

Saturday, 7 March 0700 – 1730

Sunday, 8 March 0730 – 1345

Tea breaks and lunch will be served in this area to enable you to visit all exhibitors whose support of LCANZ 2015 is invaluable and much appreciated.


EXHIBITOR PROFILES

Australian Breastfeeding Association (ABA)

Contact (for BD enquires): Sarah Goddard

Address: PO BOX 4000, Glen Iris VIC 3146 Australia

Telephone: +61 3 9885 0855

Email address: [email protected]

Website: www.breastfeeding.asn.au

Organisation overview: The Australian Breastfeeding Association (ABA) is Australia’s largest breastfeeding information and support service. Breastfeeding is a practical, learned skill and ABA help more than 80,000 mothers each year. ABA also provides up-to-date information and continuing education for thousands of health professionals working with mothers and babies. Through a range of services, ABA supports and encourages women who want to breastfeed or provide breast milk for their babies, and advocates to raise community awareness of the importance of breastfeeding and human milk to child and maternal health. Services include membership for both mothers and health professionals, a 24-hour Breastfeeding Helpline, an informative website, local support groups, antenatal classes, retail shops and numerous print and digital resources.

Bio-Oil®

Contact (for BD enquires): Felicity Darcy

Address: 34–36 Chandos Street, St Leonards NSW 2065 Australia


Website: www.bio-oil.com

Organisation overview: Bio-Oil® has been used safely by pregnant women for over 20 years to maintain skin elasticity and thereby help reduce the possibility of stretch marks forming. A specialist skincare product that helps improve the appearance of scars, stretch marks and uneven skin tone, Bio-Oil®’s advanced formulation contains the breakthrough ingredient PurCellin Oil™, which also makes it highly effective for numerous other skin concerns, including ageing skin and dehydrated skin

Health-e-Learning

Contact (for BD enquires): Trinity Mas

Address: 5764 Monkland Avenue Suite 424, Montreal, Quebec CanadaH4A 1E9

Telephone: +61 7 3103 2765


Website: www.health-e-learning.com

Organisation overview: Health e-Learning-IIHL provides high-quality LEAARC Approved online lactation courses for those who are preparing to sit the IBLCE examination for certification or re-certifying by CERPs.


EXHIBITOR PROFILES

International Board of Lactation Consultant Examiners (IBLCE)

Contact (for BD enquires): Karolyn Vaughan

Address: Po Box 1533, Oxenford QLD 4210 Australia

Telephone: +61 7 5529 8811


Website: www.iblce.org

Organisation overview: International Board of Lactation Consultant Examiners (IBLCE), is a non-profit organisation that certifies health professionals who provide lactation and breastfeeding care to mothers, infants and their families worldwide. There are now over 27,450 currently certified IBCLCs worldwide, in 101 countries.To become certified one must meet the eligibility criteria and pass a psychometric exam. Once certified the International Board Certified Lactation Consultant (IBCLC) is able to use the acronym IBCLC to identify as a professional who has demonstrated their lactation knowledge. The IBCLC certification program is accredited by National Commission for Certifying Agencies (NCCA) of the Institute of Credentialing Excellence (ICE).

iLactation

Contact (for BD enquires): Iona Macnab

Address: International - Online


Website: www.iLactation.com

Organisation overview: iLactation provides international online continuing education for midwives, nurses, lactation consultants and others who work with breastfeeding mothers and babies. Our online breastfeeding conferences bring global experts and current research to you in English, Spanish and Dutch. Access conference presentations at work or home – convenient, affordable, continuing education credits

New Baby 101

Contact (for BD enquires): Lois Wattis

Address: 5 Elouera Drive, Ninderry QLD 4561 Australia

Telephone: +61 404 857 272


Website: www.newbaby101.com.au

Organisation overview: Lois Wattis is a Midwife, IBCLC and Author who works as a Clinical Midwife Lactation Consultant with Qld Health as well as providing private Lactation Consultancy services via ‘Babymooon Home Visits’ on the Sunshine Coast Qld. Lois’ experience is broad, and her focus is now on supporting parents negotiating the steep learning curve of caring for their new baby. Lois’ book “New Baby 101 – A Midwife’s Guide for New Parents” is available from her website. New Baby 101 is also an App for smartphones and all resources are supported by videos on New Baby 101 YouTube channel.


oral abstracts

FRIDAY, 6 MARCH 2015

Opening PlenaryThe Normal newborn and why breastmilk is not just food

Dr Jenny Thomas

Many women do not believe that the body that created their beautiful baby is capable of feeding that same child and we are supplementing more and more with infant formulas designed to be food. In this session we explore why breastmilk is more than just food, knowledge which we can use to empower mothers who believe they cannot satisfy their baby. A baby at the breast is getting their immune system developed, activating their thymus, staying warm, feeling safe from predators, having normal sleep patterns and wiring their brain, and (oh by the way) getting some food in the process.

Research Round Up 1ABA research: The EMBER project

Susan Tawia1 , Elizabeth McGuire1, Cate Bailey2, Jennifer James3 1. Australian Breastfeeding Association, Malvern East,

VIC, Australia2. Deakin University, Melbourne3. RMIT University, Melbourne

The personal lactation histories that ABA trainees write, as part of their training, have been identified as a valuable resource, providing information about the experience of lactation and breastfeeding in Australian women. The Engaging Mothers: Breastfeeding Experiences Recounted (EMBER) project was initiated to study the information obtained from ABA volunteer lactation histories. The EMBER study is a collaboration between ABA’s Breastfeeding Information and Research team and RMIT University researchers.

A pilot study was undertaken using lactation histories written as an assessment task for the Cert IV in Breastfeeding Education. ABA trainee counsellors were asked to consent to the researchers reading a de-identified copy of their personal lactation histories. Key themes were identified and the information collected was used to design a more comprehensive and detailed research project based on lactation histories.

From the pilot study, a lactation history questionnaire was developed which was given to prospective trainees to complete as part of their application to train as an ABA counsellor in 2014. The design of the questionnaire has allowed more rigorous collection of quantitative data, as well as qualitative data, and asked questions on pregnancy, birth and breastfeeding topics.

The design and implementation of the EMBER project and data obtained at the half-way point of the project will be presented.

Effective online tools for supporting breastfeeding mothers

Dr Julie Green

Abstract not submitted.

Cumulative risks and the cessation of exclusive breastfeeding; Australian cross-sectional survey

Jennifer Ayton1

1. University of Tasmania, PO Box 195 Sandy Bay, TAS, Australia

We estimated the prevalence and cumulative risk of key risk factors associated with cessation of exclusive breastfeeding within the first six months using a national representative sample of 22,202 derived from the 2010 Australian Institute of Health and Welfare cross sectional survey, the Australian Infant Feeding Survey. Among those who initiated exclusive breastfeeding at birth, 49% of infants ceased exclusive breastfeeding before they had reached two months of age. In the final Cox-Proportional hazards multivariate model, the factors most strongly associated with cessation were: preterm infants (HR=1.41, 95% CI 1.26, 1.57), regular dummy use (HR=1.28, 95% CI 1.23, 1.34), and partner indifference to infant feeding method (HR 1.26, 95% CI 1.20, 1.32) having the highest risk of cessation. Living within the most disadvantaged areas of Australia (SEIFA quintiles 1-2) was not strongly associated with cessation (HR=1.06, 95% CI 1.01, 1.12). The cumulative effect of 4 risk factors increased the risk of cessation by 54% (HR=1.54, 95% CI 1.26,1.88) when compared to mothers with no risk factors.

The prevalence of early cessation of exclusive breastfeeding is alarmingly high with 50% of mothers interrupting exclusive breastfeeding


within the first 2 months. It is the accumulation of three or more risk factors that poses the highest risk of cessation for the mother and baby. Exclusive breastfeeding is challenging feeding practice for all women across the social gradient and should be the focus of intensive support. Public health impact is likely to be achieved when multiple risk factors are modified or prevented.

Plenary Session 2Breast, bottle & childhood obesity

Nancy Mohrbacher

This talk provides an overview of the research on the association between infant feeding during the first year and the risk of childhood obesity. Discover what we’ve learned about the effects of feeding method on milk intake and feeding dynamics (breast versus bottle), how milk composition affects body function and appetite (human milk versus infant formula), and whether what’s in the bottle makes a difference. Learn also about other factors that may affect the risk of obesity during childhood and beyond.

Concurrent Session A1What’s in the can? Breastmilk substitutes and their use Ros Escott1

1. Independent, South Hobart, TAS, Australia

As many as 85% of Australian babies are given breastmilk substitutes (BMS) in their first year of life. Some are artificially fed from birth, some are supplemented in the early days or weeks of life, some are mixed-fed and many are fully weaned onto BMS before 12 months, around 50% before 6 months. This presentation will address some of the issues that health professionals need to know when counselling clients on the use of BMS. Where and how are commercial infant formulas made? Where are the ingredients sourced? How might food miles, storage and shelf life impact on nutrients? Which formula is best for my baby? Are ‘Gold’ formulas worth the extra cost? Despite the International Code, there are many promotional claims about the benefits of particular components in some infant formulas. What are the evidence-based facts about these components and where can you get independent information? The preparation instructions on cans, especially water temperature and storage, are not standardised. Bacterial contamination from the can, from preparation or from storage is a known risk. The recommended

water volume and number of scoops differs between products, as does the scoop size, so there is a risk of over/under dilution by caregivers with even average health literacy levels. Because of scoop variation, the number of feeds per can also varies, so price can be deceptive. And then there’s follow-on formula, toddler formula, home-made formula (including meat-based) and other animal milks. Is there a place for them in infant and young child feeding?

Concurrent Session A2Recognising allergy issues in breastfed babies

Robyn Noble1

1. Bayside Breastfeeding Clinic, Manly West, QLD, Australia

Worldwide, there is a rapidly escalating problem with allergies. Nowhere is this being more felt than here in Australia, especially in our children. However, despite its now common presence, it is like an invisible rampaging elephant in the room – unseen, unrecognised but causing increasing levels of distress. The impact of allergies on breastfeeding mothers and babies can vary greatly in intensity, but far too often creates difficulties that reduce women’s pleasure in breastfeeding and their capacity to continue, even to the extent of weaning. Formula feeding can be expected to unleash even worse symptoms in these babies. The first step in dealing with such issues is to be aware of the presenting signs of possible allergies in breastfed babies and to be able to identify them. Because allergy presentation can vary so much, it is often not even considered as a possible reason for problems. There is also much confusion with terminology, including the difference between allergies and intolerances. The first step in dealing with such issues is to be aware of the presenting signs of possible allergies in breastfed babies and to be able to identify them.

Concurrent Session A3Improving breastfeeding outcomes for women with diabetes in pregnancy

Carmel Kelly1

1. RPAH Women and Babies, Sydney, NSW, Australia

The incidence of diabetes is increasing the world over including the incidence of gestational diabetes in pregnancy (GDM). Women and their babies are at an increased risk of developing type 2 diabetes and obesity following pregnancy complicated by


GDM(1,2,3,4,5,6). Research on the protective effects of breastfeeding suggests increased exclusivity and duration of breastfeeding lessens this risk(3, 4,

7). However, breastfeeding rates for women with diabetes in pregnancy are lower than for women who do not have diabetes in pregnancy(8,9).

Recognition of the differences for these women and developing effective interventions to improve their breastfeeding rates is an important part of slowing the diabetes and obesity rate.

An antenatal breastfeeding education project specifically for women who had gestational diabetes was introduced at RPAH Women and Babies in 2012. The aim of the project was to increase the duration and exclusivity of breastfeeding by introducing a breastfeeding class specifically for women with diabetes in pregnancy. The project was evaluated through data collection pre and post introducing the antenatal breastfeeding classes.

The content of the antenatal class, recruitment, and the women’s breastfeeding intention and breastfeeding outcomes prior to discharge, at 1 month and 5 months as reported by mothers will be discussed. Reasons women gave for introducing formula and their comments on their breastfeeding experience will also be discussed.

This prospective survey on breastfeeding outcomes for women who have diabetes in pregnancy suggests breastfeeding education classes may increase the intention to breastfeed for longer and improve the exclusivity and duration of breastfeeding.

1. Boerschmann, H., Pfluger, M., Henneberger, L., Zeigler, A. & Hemmel, S. 2010, ‘Prevalence and Predictors of Overweight and Insulin Resistance in Offspring of Mothers With Gestational Diabetes Mellitus’, Diabetes Care, vol. 33, no. 8, pp. 1845 - 9.

2. Baptiste-Roberts, K., Nicholson, W., Wang, N.-Y. & Brancati, F. 2012, ‘Gestational Diabetes and Subsequent Growth Patterns of Offspring: The National Collaborative Perinatal Project’, Maternal & Child Health Journal, vol. 16, no. 1, pp. 125-32.

3. Crume, T.L., Ogden, L., Maligie, M., Sheffield, S., Bischoff, K.J., McDuffie, R., Daniels, S., Hamman, R.F., Norris, J.M. & Dabelea, D. 2011, ‘Long-term impact of neonatal breastfeeding on childhood adiposity and fat distribution among children exposed to diabetes in utero’, Diabetes care, vol. 34, no. 3, pp. 641-5.

4. Gunderson, E.P. 2007, ‘Breastfeeding after gestational diabetes pregnancy: subsequent obesity and type 2 diabetes in women and their offspring’, Diabetes care, vol. 30, pp. S161-8.

5. Hawdon, J.M. 2011, ‘Babies born after diabetes in pregnancy: what are the short- and long-term risks and how can we minimise them?’, Best Practice & Research Clinical Obstetrics & Gynaecology, vol. 25, no. 1, pp. 91-104.

6. Dabelea, D., Knowler, W.C. & Pettitt, D.J. 2000, ‘Effect of diabetes in pregnancy on offspring: follow-up research in the Pima Indians’, Journal of Maternal-Fetal and Neonatal Medicine, vol. 9, no. 1, pp. 83-8.

7. Ziegler, A.-G., Wallner, M., Kaiser, I., Rossbauer, M., Harsunen, M.H., Lachmann, L., Maier, J., Winkler, C. & Hummel, S. 2012, ‘Long-Term Protective Effect of Lactation on the Development of Type 2 Diabetes in Women With Recent Gestational Diabetes Mellitus’, Diabetes, vol. 61, no. 12, pp. 3167-71.

8. O’Reilly, M.W., Avalos, G., Dennedy, M.C., O’Sullivan, E.P. & Dunne, F. 2011, ‘Atlantic DIP: high prevalence of abnormal glucose tolerance post partum is reduced by breast-feeding in women with prior gestational diabetes mellitus’, European Journal of Endocrinology, vol. 165, pp. 953-9.

9. Ip, S., Chung, M., Raman, G., Chew, P., Magula, N., DeVine, D., Trikalinos, T. & Lau, J. 2007, ‘Breastfeeding and maternal and infant health outcomes in developed countries’, Evidence report/technology assessment, no. 153, pp. 1-186.

10. Gouveri, E., Papanas, N., Hatzitolios, A.I. & Maltezos, E. 2011, ‘Breastfeeding and diabetes’, Current Diabetes Reviews, vol. 7, no. 2, pp. 135-42.

11. Taylor, J.S., Kacmar, J.E., Nothnagle, M. & Lawrence, R.A. 2005, ‘A systematic review of the literature associating breastfeeding with type 2 diabetes and gestational diabetes’, Journal of the American College of Nutrition, vol. 24, no. 5, pp. 320-6.

Concurrent Session A4Milk banks vs milk sharing

Kerri McEgan1, Anita Moorhead2

1. Mercy Hospital for Women, Essendon, VIC, Australia

2. Royal Women’s Hospital, Melbourne, Victoria

Background: Worldwide, milk sharing - either directly amongst friends and family or semi- anonymously via milk sharing websites is growing in popularity. Re-establishment of formal milk banks is also slowly occurring and Australia currently has five milk banks.

The ability to access donated breastmilk via either regulated or unregulated sources can create dilemmas for both health professionals and families.

Description: This presentation will explore the issues to be considered in relation to screening criteria for milk banks compared to breastmilk sharing when feeding a baby with milk other than a mother’s own milk. The ethics and potential impact of milk sharing between mothers will be discussed, including directed donation using established guidelines, private arrangements between two or more mothers, and the use of milk from an unknown donor. The issues to consider when counselling families on the use of donor milk or infant formula will be included. A brief practical


overview of establishing and operating a milk bank in Australia will be explained, including selection of both donors and recipients, the pasteurisation process and testing of the donated breastmilk.

Conclusion: As health professionals, we need to be cognisant of the differences between formal and informal use of donated breastmilk and understand the benefits and risks of breastmilk sharing. We will be better able to responsibly assist families with information to make their own informed decision about using donated breastmilk and to counsel families on risk minimisation strategies.

Workshop 1Simplifying breastfeeding: The first 36 hours

Nancy Mohrbacher

Geared for those who work with mothers and babies after birth, this talk focuses on how to make early breastfeeding easier, which postpartum practices have long-term implications, what biology tells us about normal feeding patterns, and the effects of skin-to-skin contact and separation on infant stability.

Workshop 2Breast and nipple pain associated with breastfeeding: A simple tool to capture the complexity of influences and determinants of pain

Dr Lisa Amir1, Lester Jones1, Miranda Buck1

1. Judith Lumley Centre, La Trobe University, Melbourne

This workshop will introduce a new model to enhance clinical reasoning and support management of breastfeeding women with breast and nipple pain. Management will be enhanced by (1) developing and consolidating knowledge of the influences and determinants of breast and nipple pain, (2) employing a simple tool to categorise these influences and determinants, and (3) collaborating with peers to respond to authentic case information and formulate management plans. Participants will then be supported to adapt the simple clinical reasoning tool to best support their personal clinical practice or to support others (e.g. students, other health professionals) in the assessment and treatment of breast and nipple pain associated with breastfeeding. The workshop will consist of several parts. Part 1 is a presentation and discussion on the influences and determinants of breast and nipple

pain, including factors from biological, psychological and social domains. In particular, alterations to neural sensitivity will be addressed. In part 2, a simple clinical reasoning tool will be described. The tool enables the clinician to categorise complex information and promotes inclusion of all domains influencing breast and nipple pain. In part 3, participants will be given the opportunity to apply the clinical reasoning tool to a number of authentic case studies. Discussion will include what strategies might be appropriate for the management of each case. The final part of the workshop, part 4, will allow participants to adapt and modify the tool to best suit their personal professional needs (i.e. clinical application; educational tool).1. Jones L, Amir LH, Buck M. Nipple pain associated with

breastfeeding: incorporating current neurophysiology into clinical reasoning. Aust Fam Physician (in press).

Workshop 3Larger breasted women and breastfeeding

Decalie Brown1

1. NBMLHD, Katoomba, NSW, Australia

Large-breasted women have special breastfeeding needs and problems; this practical and interactive session will empower clinicians to be able to be supportive of this group of women to successfully breastfeed.

This session enables clinicians to utilize practical techniques, explore the challenges, manage various situations and develop the advanced breastfeeding counselling skills needed when supporting this group of mothers, and their babies to reach their desired goals.

The research shows if mothers with above average weight are provided with the appropriate breastfeeding management and support early, their breastfeeding experience will be enhanced and sustained.

This practical and sensitive interactive session is designed for clinicians to develop, their own practical Breastfeeding support toolbox and to develop specific skills for a positive outcome when supporting these larger breasted women, and all in a safe learning environment.

Outline: Practical session and Interactive session, defining ‘Voluptuous breasts’

• whataretheissuesforlargerbreastedmotherswhat are the difficulties with breastfeeding –mother and baby Interview with 2 mothers and 2 IBCLC supporting )


2 settings – In the hospital setting and at home

• introductions.

• exploringthestrategiestomanagetopromote,support and protect breastfeeding and to the overcome the challenges for these mothers.

Exploring the IBCLC’s Counselling skills our language, dealing with the sensitive topic, empathy comfort to breast feed for the mother and baby

• Theresearch–whatdoesitsays

Workshop 4The use of supplemental line feeding in breastfeeding: Short term usage to maximise breastfeeding outcomes

Katie James

Babies requiring supplementation, either breast milk or artificial formula, whilst in the hospital are at an increased chance of being fed with a bottle and teat. The use of bottles and teats are discouraged for short term use in breastfeeding babies due to the risk of earlier cessation of breastfeeding, reduction of milk supply and potential for breast refusal from the baby. The use of a supplemental feeding line whilst continuing to breastfeed can have a positive impact on longer term breastfeeding goals and a reduction in the common use of bottles and teats and provide an alternative to other ways of feeding infants such as bottle or cup feeding. The workshop will give participants knowledge in understanding when a supplemental feeding line feed is appropriate, safe and helpful, and understanding of the skills required to assist a mother to initiate and use a supplemental feeding line. This interactive workshop will use different case study examples to demonstrate the use of the supplemental feeding line such as late preterm infants learning to breastfeed, infants who have a large initial weight loss requiring supplementation and those infants with initial poor sucking ability.

Concurrent Session A5Lip tie – a breastfeeding challenge in its own right

Ruth O’Donovan1, Vicki Patterson1

1. Rural Canterbury PHO, Christchurch, New Zealand

Since September 2012, we have assisted a local dentist in releasing tongue and/or lip ties with the use of a Waterlase laser. Internationally there has been an increased awareness of the significance of posterior and submucosal tongue ties and their potential impact on breastfeeding. At times there is reference in the literature to the presence of lip ties (labial frenums) and their contribution to breastfeeding issues. It appears that lip ties are only associated with tongue ties and are not seen as a separate feeding issue for mother and baby. As a result, they are not acknowledged and not treated.In these two years we have carried out over 350 releases. As lactation consultants (IBCLC) our rationale for tongue and/or lip tie releases is specifically to improve breastfeeding challenges. Throughout this time we have become more aware of the potential impact that a tight labial frenum can have on breastfeeding. This is mainly when we note the absence of a lingual tie and the specific breastfeeding challenge that the mother and/or baby presents with. American ENT specialist, Dr. Ghaheri quotes that 90% of babies presenting with tongue ties will also have a lip tie. Our statistics over the last two years would support this. We will present (at least) four case studies of labial frenum release in the absence of a lingual tie. We will discuss the maternal symptoms and infant behaviour before and after release. We will discuss the procedure and follow up care that we provide within our service.


Concurrent Session A6Milk matters: More than women are ever told

Maureen Minchin

Theories to explain epidemics of NCDs (non-communicable diseases) focus on the environment: the hygiene hypothesis is being succeeded by the biodiversity hypothesis. This paper will argue that these theories can be subsumed into the milk hypothesis; that NCDs are in fact inter-generationally-communicated diseases (IGCDs), the result of an acquired immuno-reactive syndrome (AIRS) brought about principally by the artificial feeding of infants since 1900. The paper will review the evidence for early and intractable differences in infant development that are relevant to distorted metabolic programming in infancy and for health lifelong.

Concurrent Session A7Weight faltering in infancy – failure to thrive in three breastfed infants

Carole Dobrich1 1. Health e-Learning-IIHL, Outremont, QC, Canada

This presentation will review the literature on growth faltering, failure to thrive (FTT), and breastfeeding infants. An attempt will be made to address the type and use of supplementation, how it is given, and how to maintain the breastfeeding relationship while working through diversity. The presentation will examine the importance of the understanding of normal breastfeeding behaviour and normal infant development, thereby providing information on how weight faltering in infancy is not just about nutrition.

The possible causes of FTT (both maternal and infant) will be discussed as well as the lactation management of such dyads. The three cases that will be discussed are all dyads that have been followed at the Goldfarb Breastfeeding Clinic, Montreal, Quebec, Canada over the past 10 years. The initial BFC first visit weights were as follows:

1. Exclusively breastfed boy, born at five pounds 12 ounces and at five months weighed eight lbs 10 ozs.

2. Exclusively breastfed boy, born at 3500gms and at seven weeks weighed 3800gms.

3. Exclusively breastfed boy, born at 3350 and at three months weighed 3840gms.

All three of the infants required medical intervention. Two of the three infants physically appeared wasted and one of the infants was admitted to hospital due to his condition. This presentation will endeavor to show why it is important to observe the dyad’s breastfeeding behavior prior to assuming that breastfeeding is the cause of the FTT without consideration of other possible causative factors.

Plenary Session 3Breastfeeding & epigenetics

Dr Jenny Thomas

We know that our babies are created from genetic material provided by both the mother and father and that our genes are inherited from out parents. Some of the most exciting research being done today is focusing on what regulates the work done by our genetics. “Epigenetics” is the study of how proteins are made or not made, how those changes can be altered through factors like diet, and even how those factors can and be inherited by our grandchildren! We will take a look at the basics of epigenetics and then explore the (unsurprising) critical role that breastmilk plays not just for that baby but for that baby’s descendants.


saturDAY, 7 MARCH 2015

Plenary Session 4Family centre care in a Swedish NICU

Prof Uwe Ewald1

1. Uppsala University

Evidence is growing concerning the benefits of family centered care (FCC) in Neonatal intensive care units. However, many challenges remain hindering its implementation. Still most mothers, fathers and families are separated most part of the time from birth from there fragile and sometimes life-threatening sick newborn infant.

An example from a Swedish NICU is presented on strategies to change care culture. A adult bed for the mother and/or father adjacent to the incubator allowed one of them to practice early and almost continuous skin to skin care, thus preventing separation.

Breastfeeding communication: Does relationship matter?

Dr Elaine Burns

Abstract not submitted.

Concurrent Session B1Exploring breast pump use amongst mothers of healthy term infants in Melbourne: The Mothers and Infants Lactation Cohort (MILC) study

Dr Lisa Amir1, Helene Johns1, Della Forster1, 2, Helen McLachlan1, Anita Moorhead1, Kerri McEgan3 1. Judith Lumley Centre, La Trobe University,

Melbourne2. Maternity Services, Royal Women’s Hospital,

Melbourne3. Mercy Hospital for Women, Melbourne

Aim: To explore breast pump use in a prospective cohort of women in Melbourne, Australia, and the implications of the increasing technicalisation of breastfeeding.

Background: Using a pump to obtain breast milk is not a new phenomenon, but the practice is increasing. Data for this paper were collected as part of the Mothers and Infants Lactation Cohort (MILC) study.

Methodology: We recruited over 1000 women from three Melbourne hospitals, two public and one private, between 2009 and 2011. Women needed to have a healthy singleton term infant, be intending to breastfeed and speak English to be eligible. Recruitment was undertaken face-to-face 24 to 48 hours postpartum, and telephone interviews conducted three and six months later.

Results: At 6 months postpartum, 47% of women possessed a manual breast pump and 55% an electric pump. Incidence of frequent expressing (defined as several times a day) decreased over time: from 40% (186/466) in the first 2 weeks postpartum to 7% (49/716) at six months. Of the women who expressed, 17% (117/703) reported that the main reason for expressing was not having enough milk. Other reasons for expressing included expressing in order to avoid breastfeeding in public (n = 24), to store milk (n = 51), and to measure amount of milk (n = 46). Approximately 13% of women who used a breast pump reported an adverse reaction to the pump (94/754), mostly pain.

Conclusion: Expressing breast milk is common, with a high prevalence of electric pump usage in the community.

Feeding in NICU: It’s time to be more accurate

Anita Moorhead 1, 2, Dr Lisa Amir1, 2, Laura Bignell2, Kerri McEgan3, Susan Jacobs2, 4, 5, Gillian Opie3, 5, Willie Dolan6, Katie James2, Theresa Arnold3 1. Judith Lumley Centre, La Trobe University,

Melbourne2. Royal Women’s Hospital, Melbourne3. Mercy Hospital For Women, Heidelberg4. University of Melbourne, Parkville5. Murdoch Childrens Research Institute, Parkville6. Monash Health, Clayton

Breastfeeding is the normal way to feed babies. When a baby is born sick or preterm there are significant challenges for mother and baby to initiate and maintain lactation and breastfeeding. Infants in the Neonatal Intensive Care Unit (NICU) are less likely to be exclusively breastfed and are likely to breastfeed for a shorter duration than healthy term infants. At one tertiary hospital, 2014 data identified that just 46% of infants were transferred or discharged home receiving only breast milk, and only 15% were discharged home fully breastfeeding. It was also identified that data about which type of milk NICU infants are fed and how they are fed was not collected consistently or accurately.


Currently the Australia and New Zealand Neonatal Network (ANZNN) data collection tool collects feeding data only for infants born < 32 weeks and < 1500g, thus leaving large gaps in the data.

Three tertiary maternity hospitals each with large NICUs/ SCN units have formed a working group to work towards data sharing of type and mode of feeding for all infants admitted to SCN/NICU, using agreed definitions for data collection. Standardized feeding definitions for the preterm population are currently lacking.

This presentation includes current feeding data of this working group and the discussion of the challenges of accurate feeding data collection in the NICU environment. Our experience may serve to inform better infant feeding data collection for Australian and New Zealand babies admitted to neonatal units.

Concurrent Session B2Case Study – improving a preterm infant’s growth rate by harnessing breastmilk composition

Christina Galloway, Janet Howells

The mothers who birth preterm infants face exceptionally trying times, not least of which is establishing lactation. Supporting women to achieve an optimal lactation at such a time requires support, counselling, motivation, routine, equipment, time, sometimes even a cheer squad! Outlined here will be the typical mother’s journey at the Royal Hobart Hospital (RHH) in working to establish her supply. One mother’s journey is further explored. She was encouraged to manipulate her breastmilk, some might call it a form of lactoengineering to achieve improved growth in her premature infant. This innovative approach used a novel feeding plan and an improved rate of growth was achieved in a preterm infant despite fluid restriction. The improved growth rate was from an average weight gain of 16.6 grams/kg/day to 24.9 grams/kg/day. The novel feeding plan involved alternating stored preterm milk, which is known to be high in protein, with fresh hindmilk, which is high in fat. The intervention was only in place for a period of two weeks in this infant, but has been used in further cases of slow growth with some success. A review of the literature following this case found that this particular approach had not been described elsewhere. It raises a number of questions and possible research possibilities for the future. Amongst others:

If there is an adequate breastmilk supply in the first three weeks of life, should mothers be encouraged to separate it into fore and hindmilk fractions?

Concurrent Session B3Women’s experiences of breastfeeding support: Results from the supporting breastfeeding in local communities

Rhian Cramer1, Helen McLachlan1, 2, Della Forster1,

3, Touran Shafiei1, Lisa Amir1, Rhonda Small1, Meabh Cullinane1 1. Judith Lumley Centre, La Trobe University,

Melbourne, VIC2. School of Nursing and Midwifery, La Trobe

University, Melbourne, VIC3. Royal Women’s Hospital, Melbourne, VIC

Background: We conducted a cluster randomised trial to explore whether early home-based breastfeeding support for women by a Maternal and Child Health Nurse (SILC-MCHN), with or without access to a community-based breastfeeding drop-in centre, increased the proportion of infants receiving ‘any’ breast milk at four months. This sub-study explored women’s experiences of infant feeding support within the ten participating Local Government Areas in Victoria, Australia.

Method: Women were sent a survey once their babies reached 6 months of age, exploring their views about breastfeeding support. Descriptive statistics were used for closed-ended questions and open-ended questions were analysed thematically.Results: 998 of 4127 women (24%) responded to the survey. Women reported they received infant feeding support from various sources, the most common: MCHN (84%), midwives (69%), family members (62%), books (59%), internet (59%), other mothers (52%) and friends (52%).21% of respondents felt there were not enough breastfeeding support services available in their LGA. Women identified a need for increased access to support, and wanted more information about available services. Some raised concerns about the costs of breastfeeding support. Women were ‘particularly happy’ with professional breastfeeding support; support received in drop-in centres; hospital lactation clinics and support received at home. Respondents were ‘particularly unhappy’ about limited accessibility and availability of support, conflicting advice and pressure to breastfeed. The themes were consistent across all SILC LGAs.


Conclusion: Women felt that their breastfeeding experience was best supported by accessible, available, flexible, professional breastfeeding support provided in an encouraging and non-judgmental way. Australian Clinical Trial Registry number: ACTRN12611000898954.

Nurturing potential future IBCLCs-are we eating our young before they hatch?

Carole Dobrich1

1. Health e-Learning-IIHL, Outremont, QC, Canada

I will explore the history of the IBCLC profession from my professional view point and discuss the experience of supporting candidates on their journey towards becoming an IBCLC over the past 15 years. I will discuss the different clinical pathways that have been used at the Goldfarb Breastfeeding Clinic and our lactation education training programmes namely the Montreal Institute for Lactation Consultants (MILC), the International Institute of Human Lactation (IIHL) education. I will discuss the challenges faced by many who are currently struggling to find any pathway and also my concerns about the current direction the profession is heading. I will reflect on many of our current IBCLC worldwide leaders who are well respected and remind ourselves that some would not have qualified to be candidates for the IBLCE exam under the present day pathways. I will also ask the question of why many IBCLCs are not recertifying at both the 5 and 10 year marks. Professions such as nursing and midwifery have had the discussion about how they treat each other. So often as IBCLCs we discuss the importance of mothers needing a village to support them with raising their children. We need to also realise that it takes a village to support our IBCLC profession. When changes occur in a young profession we need to be able to nurture our colleagues not “eat them!”

Concurrent Session B4Milk siblingship – implications for human milk banking

Virginia Thorley1

1. University of Queensland, The University Of Queensland, QLD, Australia

Milk siblingship can be religious or secular and occurs when an infant receives the milk of someone other than the biological mother, which creates a familial relationship. In Islam similar prohibitions to marriage exist as those for blood relationships

and, as milk siblings, the milk donor’s children and the recipient infant are forbidden to marry each other. Thus, the mothers involved need to know each other. The religious and practical importance of this relationship to Muslim families is poorly understood in Western cultures, such as Australia, where hospital staff may encounter it when they offer banked human milk to NICU infant and seek parental consent.

This presentation provides an introduction for hospital staff. Milk siblingship has been a barrier to use of human milk milks by Muslim families as milk from several mothers is usually pooled anonymously. Nevertheless, donor milk has been used for premature neonates in two Islamic countries by applying the religious requirements. A 2004 interpretation by the European Council for Fatwa and Research permitting milk banking may be acceptable to some families, but others may heed different rulings as Muslim families in Western countries come from a variety of traditions. This paper emphases the need for sensitivity and respect to explore these issues with families.

Milk banking is a food business

Kerri McEgan1, Gillian Opie1 1. Mercy Hospital for Women, Heidelberg, Melbourne,

Victoria, Australia

Background: Mercy Hospital for Women is one of only four neonatal intensive care units in metropolitan Melbourne with over 1300 admissions to the neonatal intensive and special care nursery.

Mercy Health Breastmilk Bank (MHBMB) was officially opened in February 2011 and is the third milk bank in Australia.

Objective: To highlight responsibilities required for the operation of a milk bank by both hospital protocols and specific Food Standards Codes.

Description: Utilisation of international guidelines for the establishment and operation of the milk bank presented unexpected challenges when linking with Australian regulations. Despite an extensive planning process, these barriers necessitated far greater clarification of the jurisdiction from which our milk bank would operate under.

Consideration was given to classification of breastmilk as food, a therapeutic good or donor tissue and whether testing of donor milk occurs in a laboratory accreditated as medical or biological.

The subsequent registration of the milk bank as a food premises under the Food Act 1984 has


required the development of significant supporting documentation which is vastly different to familiar hospital policies and procedures. Annually, two external agencies must monitor and confirm compliance with this Act. A certificate of compliance must be issued in order for the milk bank to remain operational.

Managing equipment and maintaining food safety requirements has resulted in the attainment of a complete new skill set and requires considerable time to maintain.

Conclusion: MHBMB operating guidelines are very specific and currently differ from other Australian milk banks.

Plenary Session 5Understanding breastfeeding behaviors

Nancy Mohrbacher, IBCLC, FILCA

The video-packed session describes “tools” for your “lactation toolbox” from an international cast of characters. Provides a chronological summary of recommended approaches to latch/attachment, with a discussion on what we got right and which assumptions were later proven wrong. Includes an overview of research on hands-on versus hands-off help and the hardwiring both mothers and babies bring to breastfeeding. Also included is a checklist for evaluating basic breastfeeding dynamics and anatomical issues that can interfere.

Plenary Session 6What mothers say: Untangling research on first time mothers of premature babies

Lauren Porter

In 2012 I conducted a qualitative research study on first time mothers of premature infants, examining how mothers processed the experience of developing maternal identity, a mother-infant bond, and a sense of their infants in the face of giving birth prematurely. The research was focussed on semi structured interviews with women in NZ who had birthed in NZ, Australia and the UK. The research is part of my PhD at the University of Canterbury and the final thesis will be submitted by January of 2016. All the data has been analysed and findings have been written up and supervised by Associate Professor Kate van Heugten and Dr Patricia Champion. The talk will outline the major themes that emerged in the research, including how the mothers experienced the role of breastfeeding in their experiences.

Promoting breastfeeding of pre-term infants in a Swedish NICU

Prof Uwe Ewald1

1. Uppsala University

Human milk provides adequate nutrition for term infants, but infants born preterm and provided human milk only, might receive lower than recommended amounts of nutrients. Fortification is thus commonly used in NICU´s of preterm infants in order to ascertain adequate nutrient intake, growth and development.

From the perspective of the mother, fortification of a mother´s own milk might indicate that her expressed milk is of inadequate quality and thus interfere with the establishment of breastfeeding.

The experience from our unit on milk banking and targeted fortification is presented with emphasis on using concepts of non-separation, skin to skin and family centered care in order to promote the use of human milk and thus promote breastfeeding.


sunday, 8 MARCH 2015

Plenary Session 7Treatment of lip and tongue ties for optimal breastfeeding – what are the potential implications in future life?

Dr Marjan JonesEnhance Dentistry

After breathing, the most imperative physiological need in life is the ability to take in fluids. For infants this fluid is breastmilk, and yet effective breastfeeding also has a critical role to play in the development of the physiological structures that optimise breathing.

Breastfeeding provides more than vital nutrients or a unique bonding opportunity between mother and child or an aid toward better emotional, cognitive and physiological development. Breastfeeding influences anatomical development and the functional pattern of the orofacial region. Put simply, optimal breastfeeding influences how we look, how we speak, how we eat and how we breathe.

The important repercussions of this remarkable feeding technique are no less than a miraculous operation in nature’s design when we consider its life-long effects. Craniofacial development is largely complete by the age of twelve. Any correction of abnormal development in this area should therefore be initiated during the early years of life.

Optimal breastfeeding is nature’s first beautifier and orthodontic treatment and as a result of its broad reaching impact on development, is a key enabler of social wellbeing. Breastfeeding facilitates a proper swallow pattern as well as optimal development of muscles around the face and jaw. Proper swallowing and the avoidance of excessive sucking on objects are the keys to correct occlusion (the dental relationship when teeth are closed). It is rare to find malocclusions in prehistoric skulls or in current tribal society unaffected by Western influences because breastfeeding in both settings is the only form of infant nurturing.

Malocclusions and abnormal swallowing patterns are major contributing factors to many dental issues including dental decay, gum disease, tooth wear and crowding. Breastfeeding reduces the risk of obstructive sleep apnoea by assisting in the proper development of the oral cavity and airway.

Ankyloglossia – a tight lingual fraena - can interfere with optimal breastfeeding and may result in

unfavourable oral habits. If the far reaching implications and benefits of breastfeeding for dental and general health are to be fully realised, a tight fraena must be closely examined and, where indicated, treated as early as possible in order to optimise occlusion, breathing, speech and eating.

Research Round Up 2Baby-friendly hospital initiative: An evaluation of a quality certificate within the maternity care context

Kathleen Biesmans1, Eva Eelen2, Erik Franck1, 3 1. Karel de Grote University College, Antwerp,

Belgium2. GZA Hospitals, Antwerp, Belgium2. Univerisyt of Antwerp, Antwerp, Belgium

Aim: To examine the association between level of baby-friendly care, perceived by mothers, their choice to breastfeed and the duration of breastfeeding.

Method: from October 2012 until September 2013 data were collected in seven Flemish maternity wards. All mothers who met the inclusion criteria and consented (N=619), completed a questionnaire about the perceived care. The breastfeeding mothers were followed up until seven months after birth. The level of baby-friendly care was defined by a factor analysis with principal axis factoring and varimax rotation. The results made clear how mothers perceived the baby-friendly principles and demonstrated which factors were important. Factor scores were used for further analyses to answer the research questions.

Results: 492 mothers (79,5%) started breastfeeding. 24,5% of those mothers were still breastfeeding seven months after birth (loss to follow-up: 25,8%). The perception of antenal information in line with BFHI principles doubled the chance to choose for breastfeeding at the start (OR 1,98; 95%CI 1,24-3,16) even after controlling for covariables. None of the baby-friendly principles showed any impact on the duration of breastfeeding (long term). However, mothers who stopped breastfeeding within three days after birth scored significantly worse (p=.001) on the score for ‘contact with a pacifier or artificial feeding’ (mean -1,53) than mothers who continued breastfeeding (mean 0,07). The presence of the official BFHI certificate showed for neither of the two outcomes an effect.

Conclusion: Antenatal information appeared to be the most important factor. According to this study, obtaining the BFHI certificate did not show an added value.


Breastfeeding problems and maternal psychological wellbeing: Evidence from an Australian prospective study

Dr Lisa Amir1, Amanda Cooklin1, Meabh Cullinane1, Jane Fisher2, Cattram Nguyen1, 3 1. Judith Lumley Centre, La Trobe University,

Melbourne2. Monash University, Melbourne3. Murdoch Childrens Research Institute, Melbourne

Background: Anecdotally, it is known that breastfeeding problems are distressing for new mothers, yet there is little empirical evidence to describe the nature of the relationship between breastfeeding problems and mothers’ wellbeing, including fatigue, distress, anxiety and depression symptoms.

Objectives: The aim of this study (MOAT) was to investigate the contribution of breastfeeding problems (including mastitis, nipple and breast pain) on maternal psychological wellbeing at 4 and 8 weeks postpartum, adjusting for other known determinants of maternal mood and wellbeing.

Methods: MOAT is a prospective study nested within a larger cohort study of breastfeeding mothers (CASTLE, n=360). CASTLE participants were recruited from a public and a private maternity hospital in Melbourne during late pregnancy. Mothers participating in the CASTLE study were invited to participate in MOAT as a separate, additional study. Those consenting to participate in MOAT (n=229) were followed-up at 1, 2, 3, 4 and 8 weeks postpartum. Data were collected via self-report written questionnaire (pregnancy, 1-4 weeks) and telephone interview (8 weeks). Participants completed standardised assessments of mood and wellbeing and information about breast symptoms and breastfeeding problems were collected.

Results: At 4 weeks postpartum, 58% (n= 132) of women reported at least one breastfeeding problem; at 8 weeks, 41% (n=93) reported one or more breastfeeding problems. While the mood scores for the total sample were comparable with Australian norms, women with breastfeeding problems reported significantly more symptoms than those without breastfeeding problems across several mood indices. Full results will be presented.

Plenary Session 8Is breastfeeding economical, and for whom?

Dr Julie Smith1

1. Australian National University, Canberra

Background: Economic values and incentives are important influences on infant and young child feeding practices and public policies which affect them. In Australia, more than 85% of babies are not exclusively breastfed for six months, and more than 95% are not breastfed into toddlerhood, as per WHO and NHMRC recommendations. There has been little progress on optimal breastfeeding in Australia, and worldwide, for around a decade. Around the world, fewer than 52 of the 135 million children are now optimally breastfed. In some middle and low income countries, breastfeeding is declining very rapidly. Formula sales are booming in Asia Pacific countries. For example, in China sales have risen from $5 billion a year five years ago to $13 billion in 2012, while exclusive breastfeeding has halved.

Aims and approach: This presentation aims to illustrate the economic incentives affecting breastfeeding practices, and why governments and agencies need to invest more in breastfeeding protection, promotion and support. Firstly, a review of studies on the economic benefits of breastfeeding will illustrate the potential financial and economic motivations for society and governments worldwide to invest in breastfeeding protection, support and promotion. Secondly, we will look at the main ‘investors in breastfeeding’, and the form that their ‘investments’ take. This covers the value of the time invested by mothers, as well as the incentives created by the baby food industry and governments. Thirdly, we consider what this means for priorities, regarding breastfeeding protection, support and promotion. Finally, the presentation introduces a tool for health practitioners and managers to estimate the cost of implementing a local, regional or national breastfeeding program.

Conclusions: Breastfeeding is economically important because it minimises the costs of nutritional deficiencies, illness and chronic disease in babies, young children and mothers. Protection, support and promotion of breastfeeding, and infant and young child feeding practices are influenced by economic and financial incentives. These incentives affect decisions and behaviours of individual mothers, health professionals and


health decision makers, baby food companies and governments. Public and international agency investment in breastfeeding is needed to balance market incentives for increasing commercial baby food sales. The WHO/UNICEF Global Strategy on Infant and Young Child Feeding identifies priority areas for governments and agencies to invest in breastfeeding. The cost of programs to implement the Global Strategy can be estimated using a new WBCi tool.

Short PresentationsFactors associated with delayed onset of lactation in BFH

Anita Moorhead1, 2, J De Bortoli3, L H Amir1, D A Forster1, 2, F McLardie-Hore2 1. Judith Lumley Centre, La Trobe University,

Melbourne2. Royal Women’s Hospital, Melbourne3. University of Melbourne, Parkville

Aim: To describe the factors associated with delayed onset of lactation in a Baby Friendly Hospital.

Background: Lactogenesis II, the onset of copious milk secretion, usually occurs 24 to 48 hours postpartum. Maternal perception of onset of lactation > 72 hours postpartum is considered delayed onset of lactation.

Methods: This project is a supplementary study to the DAME (Diabetes Antenatal Milk Expression) randomised controlled trial. DAME is investigating the efficacy and safety of antenatal colostrum expression for mother, fetus and infant. This supplementary project compares lactogenesis II in women in the comparison arm of the DAME trial to a sample of women who do not have diabetes in pregnancy. As the DAME trial is still underway, only results of women without diabetes in pregnancy will be presented.

Women without diabetes in pregnancy were recruited in the postnatal wards at the Royal Women’s Hospital, Melbourne, between 24 and 72 hours postpartum (February to April 2014). Data were collected via structured questionnaires at recruitment (in person) and 7-10 days postpartum (telephone).

Results: 210 women were recruited; 74% had skin-to-skin contact within one hour of birth. At follow-up, 70% were fully breastfeeding at the breast and only 1% were fully formula feeding. The following

factors were associated with delayed onset of lactation: primiparity, induction of labour, caesarean birth, spinal/epidural analgesia and infant’s first feed not directly from the breast.

Conclusion: It is important to understand factors related to delayed lactation, in particular potentially modifiable factors such as not feeding directly from the breast.

Softening our language

Cynthia Peterson1

1. Sunshine Coast Hospital and Health Service, Nambour, QLD, Australia

When we are talking to mothers about feeding their precious newborns why is it that we use such harsh directive language? How can we approach this differently in order to communicate to parents that feeding their new infant is normal and natural.Sometimes there are difficulties that need extra support and direction but how can we put this into soft ‘loving’ language that can be incorporated into this intimate relationship. Can we provide education without using terms like ‘Positioning and Attachment’, ‘Latching’; terms that suggest a ‘mechanical’ interaction rather than close communication between mother and infant?During this presentation I would like to suggest ways we can educate and support while respecting the very special relationship that is forming between two whole people ; not just a breast and a mouth; not simply the transfer of milk but the connection which sustains new life.

Plenary Session 9The intersection of community and technology: Using social media to connect your practice to your families

Dr Jenny Thomas

Social media represents a critical resource which impacts and influences behavior, policy and culture. This session will help you learn how to incorporate social media into your breastfeeding advocacy, promotion and support. We will talk about the basics of Facebook and Twitter and how to use those platforms to share your message. We may even have a Twitter party!


poster abstracts

poster 1Ankyloglossia in Breastfeeding Infants: Stretching Exercises Post-Frenotomy and the Efficacy of the Procedure

Enass Demyati1 , Lenore Goldfarb2, Meira Stern2, Anjana Srinivasan2, Howard Mitnick2, Carole Dobrich2 1. Emergency and Employee Health Department,

King Saud bin Abdulaziz University for Health Sciences, King Fahad Medical City (KFMC), Riyadh , Saudi Arabia

2. JGH Goldfarb Breastfeeding Clinic, Montreal, QC, Canada

Background: Ankyloglossia, has significant impact on breastfeeding difficulties (Ballard, 2004).Frenotomy is safe, effective, intervention (Buryk, 2011; Argiris, 2011; Edmunds, 2011).

Goals: Tostudy the effect of frenotomy for ankyloglossic infants with breastfeeding difficulties, and the effectof stretching exercises post-frenotomy.

Methods: 398 charts of mother-infant dyads who presentedto the Clinic for breastfeeding complications related to ankyloglossia between January and June2010, and between January and June 2012 were examined/analyzed. Stretching exercises weretaught to parents immediately post- frenotomy, and performed by staff at first follow-up visit (2-4days post-frenotomy) as of 2011.

Results: More posterior ankyloglossia were seen/treated in 2012than 2010. For both latch improvement and decreased nipple pain, in 2012, there was lessimmediate improvement, but more longer-term improvement. There were less repeat frenotomiesin 2012 than 2010. Conclusions: Post-frenotomy stretching exercises by parents and clinic staffmay significantly decrease incidence of repeat frenotomy. 1. Argiris K, Vasani S, Wong G et al. Audit of tongue-tie

divisions in neonates with breastfeeding difficulties: how we do it. Clinical Otolaryingology 2011; 36: 252-279.

2. Ballard J et al. ABM Clinical protocol #11: guidelines for the evaluation and management of neonatal ankyloglossia and its complications in the breastfeeding dyad. The Academy of Breastfeeding Medicine 2004.

3. Buryk M, Bloom D and Shope T. Efficacy of neonatal release of ankyloglossia: a randomized trial. Pediatrics 2011; 128 (2): 280-288.

4. Cho A et al. When should you treat tongue-tie in a newborn? The Journal of Family Practice 2010; 59 (12): 712a-712b.

5. Edmunds J, Miles S and Fulbrook P. Tongue-tie and breastfeeding: a review of the literature. Breastfeeding Review 2011; 19 (1): 19-26.

6. Geddes DT, Langton DB, Gollow I et al. Frenulotomy for breastfeeding infants with ankyloglossia: effect on milk removal and sucking mechanisms as imaged by ultrasound. Pediatrics 2008; 122: e188-e194.

7. Hogan M, Westcott C, Griffiths M. Randomized, controlled trial of division of tongue-tie in infants with feeding problems. J Pediatr Child Health 2005;41:246–250.

8. Srinivasan A, Dobrich C, Mitnick H and Feldman P. Ankyloglossia in breastfeeding infants: the effect of frenotomy on maternal nipple pain and latch. Breastfeeding Medicine 2006; 1 (4): 216-224.

poster 2Do first expressions count? A simple approach to improve outcomes for high risk babies

Rachel Jones1

1. RPA Newborn Care , Royal Prince Alfred Hospital, Sydney, NSW, Australia

Babies born to high risk mothers are more at risk of neonatal complications. Receiving their mother’s breast milk reduces morbidity. Often the volume of milk provided by these mothers is less than optimal and the amount available can be improved by early and frequent expression. Ultimately this presents with higher milk production. It was suggested these women counselled prior to their baby’s birth are aware of the importance of providing their breastmilk but did not always understand what is involved. Education prior to baby’s birth may provide a better opportunity.

Aim: To enhance the breastfeeding education provided to antenatal inpatients at risk of having a baby in the NICU by developing a standardised system. This includes outlining the information to be covered, identification of appropriate women to receive this education and documentation. We wanted to ascertain if it improves self efficacy of the women in terms of early and frequent expressing of their breastmilk.


Method: Base line data of time to first expression after birth was collected for all babies admitted to Newborn Care. After consultation and collaboration across involved departments, a pack was developed outlining standardised information to be covered prior to birth. The trigger for offering the education was decided and staff in-services conducted.

Results: An audit was conducted 12 months after implementation, including parent survey.

Conclusion: Implementing a new initiative involving multiple departments has its own set of challenges. A new intervention often requires “champions” for it to become part of normal practice.

Poster 3Emotion and promotion

Maureen Minchin

Playing on basic emotions to market infant formula has been consistent since the nineteenth century. Anxiety and fear have been and are critical in growing the global market from less than two billion in 1975 to almost forty billion in 2015. Yet many deem it inappropriate to use emotion when marketing breastfeeding, on the grounds that this may distress some parents. This paper will look at some of the issues underlying both timid breastfeeding advocacy and overzealous bottle-feeding promotion. It will argue that refusing to speak the truth clearly in the face of relentless emotive and bullying formula propaganda is doing all parents – and all children – a serious disservice.

Poster 4Breastfeeding: Biologically normal yet culturally an intervention?

Virginia Thorley1

1. University of Queensland, The University Of Queensland, QLD, Australia

For many years I have been interested in definitions and the influence of language. This paper flows from reflections on my historical research. The current practice among breastfeeding advocates and organisations is to foster the use of “normal” to describe breastfeeding. That is, that breastfeeding is “normal” and anything else is an intervention. I now believe that, on the evidence, this is not strictly accurate – biologically yes, culturally sometimes no. Promoting breastfeeding can be an “intervention” in regions and periods with strong traditions to abandon breastfeeding, sometimes for generations.I argue that a more appropriate use of terms is to refer to breastfeeding as “biologically normal” or “physiologically normal”. Unfortunately, it has not always been “culturally normal”. Where there is a long tradition of artificial feeding, with breastfeeding discouraged or only done very briefly (if at all) it can actually be correct to refer to efforts to introduce breastfeeding to the culture as “interventions”. We don’t question using this term in other contexts, such as quitting smoking, where smoking tobacco is an aberration, but quitting requires interventions. The concept of “back to the breast” may also be inappropriate in contexts where returning to tradition would be to implement artificial feeding. It is more realistic to promote breastfeeding - especially exclusive breastfeeding - as a modern application, combining maternity and science.

Use of correct terms assists in correct thinking, and can only aid our efforts to promote, protect and support breastfeeding.1. Castle S, Obermeyer CM. Back to nature? Historical

and cross-cultural perspectives on barriers to optimal breastfeeding. Medical Anthropology: Cross-Cultural Studies in Health & Illness 1996; 17(1): 39-63. DOI:10.1080/01459740.1996.9966127

2. Gartharsdottir O. Saving the child: regional, cultural and social aspects of the infant mortality decline in Iceland, 1770-1920. Report No. 19, The Demographic Data Base, Umea University, Umea, Sweden.


Poster 5Breastfeeding Support – teaching about universal support for breastfeeding mothers and babies

Gabrielle Wilson1

1. Wesley Hospital, Auchenflower, QLD, Australia

Breastfeeding exclusivity and duration requires a multidisciplinary approach. We have identified a potential shortfall within Medical Student training. The Wesley Hospital has developed a Skills Program for Medical Students, which incorporates a two hour session on breastfeeding. The aim of the Program is to teach the students about other members of the health team in order to encourage a multidisciplinary approach. The students learn about the role of the Lactation Consultant, with the research and continuing education involved in

the role. The content of the course is engaging, including all participants in the discussion. Topics covered include the advantages of breastfeeding, anatomy and physiology of the breast, the differences between breastmilk and formula, considerations with prescription medication, as well as discussion of case presentations. Much of the presentation is in the form of group learning and multifaceted delivery of information. A Sue Cox DVD, “The First Week” is shown to participants, with each holding a doll and practicing attachment. Lactation Consultants recognise the need for support across the medical profession for breastfeeding and the future health of the nation. The course is designed to create an interest in breastfeeding, and to leave the medical students with a strong desire to support mothers and babies in order to achieve a favourable breastfeeding outcome.

NOTES

lcanz MEMBERSHIP INFORMATION

Contact (for membership enquires): Patricia Chew

Address: PO Box 576, Crows Nest, NSW 1585 Australia

Telephone: +61 2 9431 8621


Website: www.lcanz.org

Association overview: Lactation Consultants of Australia and New Zealand Ltd (LCANZ) is the professional organisation for International Board Certified Lactation Consultant’s (IBCLC’s) and others who have an interest in lactation and breastfeeding. Our core business is to provide members with information and educational opportunities to enable them to continue to advance their practice as lactation consultants, and enhance the profession of Lactation Consultancy generally in Australia and New Zealand. We also deliver educational opportunities to the wider population of health care professionals, to enable them to provide mothers with the most up-to-date information and expertise available on breastfeeding and lactation.

www.lcanzconference.com

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