4 L-CERP, 4 CH/CPD

MA02 Maintaining Baby-friendly Education for Nurses and Midwives, is a condensed 4-hour course for hospital and/or community-based health professionals requiring annual maintenance education. This course is also suitable for staff requiring a refresher course prior to BFI accreditation or re-accreditation, as well as new hires who have previously completed their initial BFI Education to bring them in line with other staff. The package includes a lecture by a world-renowned expert and formal course content in Theoretical and Clinical Skills that will help maintain best-practice knowledge and skills in Maternal Child Health.

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12-month student enrollment period.

1 L-CERP, 1 CH/CPD

Early supplementation of the breastfed infant with infant formula has significant effects on the recipient infant’s gut flora, can provoke sensitivity and allergy to cow’s milk protein and has been identified as an environmental triggering event in the development of diabetes in susceptible families.

In a recent survey in the United States conducted by the Centers for Disease Control and Prevention, 24% of hospitals supplemented more than 50% of their breastfed infants. Supplementation should be undertaken with specific therapeutic goals in mind. However, the vast majority of supplementation in the hospital is done by maternal request based on infant behavior, cultural influences, or due to clinicians’ use of formula to solve breastfeeding problems. Formula supplementation is generally associated with a shorter duration of breastfeeding. Exclusive breastfeeding at hospital discharge is a vanishing entity.

This presentation will explore reasons for supplementation, look at true medical indications for supplementation, discuss what to supplement, when to supplement, how to deliver the supplement, how much supplement to give, and how to stem the flow of supplements in the hospital. Some hospitals have successfully helped staff reduce inappropriate supplementation by placing infant formula in a medication distribution system such as Pyxix. Others require infant formula to be logged out to help identify usage and where additional staff education and skill areas need improvement.

Marsha Walker, RN, IBCLC. Marsha is a registered nurse and international board certified lactation consultant. She has been assisting breastfeeding families in hospital, clinic, and home settings since 1976. Marsha is the executive director of the National Alliance for Breastfeeding Advocacy. NABA is the US IBFAN organization that monitors the International Code of Marketing of Breastmilk Substitutes. As such, she advocates for breastfeeding at the state and federal levels. She served as a vice president of the International Lactation Consultant Association (ILCA) from 1990-1994 and in 1999 as president of ILCA.

She is a previous board member of the US Lactation Consultant Association, Baby Friendly USA, and the Massachusetts Breastfeeding Coalition. She serves as USLCA’s representative to the USDA’s Breastfeeding Promotion Consortium, NABA REAL’s representative to the US Breastfeeding Committee, Associate Editor of Clinical Lactation, and a board member of the Massachusetts Lactation Consultant Association. Marsha is an international speaker, and an author of numerous publications including ones on the hazards of infant formula use, Code issues in the US, and Breastfeeding Management for the Clinician: Using the Evidence, 4th edition.

Lecturer: Marsha Walker. 2 month student enrollment period.

1 L-CERP, 1 CH/CPD

The late preterm infant is defined as being born between 34 0/7 to 36 6/7 weeks gestation, while the early term infant is born between 37 0/7 - 38 6/7 weeks gestation. The advantages of breastmilk feeding for premature infants are even greater than those for term infants; however, a large body of literature in the past 15 years documents the increased risk of morbidity, mortality and long term sequalae of the late preterm infant often related to feeding problems, especially when there is inadequate support of breastfeeding. Early term infants can demonstrate some of these same characteristics, so deserve to be discussed and often managed similarly.

Dr Kathleen Marinelli is an Associate Professor of Pediatrics at the University of Connecticut School of Medicine, and a neonatologist and director of lactation Support Services at Connecticut Children's Medical Center, CT, USA. Her research interests focus on breastfeeding and the use of human milk in the neonatal intensive care unit, cup-feeding, donor milk and donor milk-banking, and the education of medical professionals.

Lecturer: Dr. Kathleen Marinelli. 2 month student enrollment period.

1 L-CERP, 1 CH/CPD

Pump-dependent mothers of preterm infants commonly experience insufficient production. In this lecture Dr Morton presents compelling research demonstrating the combination of two milk removal techniques: hand expression of colostrum, and hands-on pumping of mature milk, that increased mean daily milk volume to nearly 1L and maintained production at that level for at least 8 weeks despite pumping less frequently. This lecture is complete within itself, however CE38: Baby-Friendly Bedside Care for Low and High Risk Infants is supported by the application of these techniques.

Dr Jane Morton was the Director of the Breastfeeding Medicine Program at Stanford University, executive board member of the American Academy of Pediatrics’ Section on Breastfeeding and Fellow of the Academy of Breastfeeding Medicine. Her particular interest is preventing breastfeeding problems by training new mothers, their partners and their providers simple, doable but critical steps from the first day, no matter what the challenges may be.

Lecturer: Dr. Jane Morton. 2 month student enrollment period.

1 L-CERP, 1 CH/CPD

In this lecture Dr Morton discusses the most important actions to be implemented in the first few days following birthing that will guarantee successful, continued breastfeeding. She looks at how to apply these principles to the healthy, term baby, then how to adapt them to the special needs of the infant at risk of morbidity and re-admission to hospital. Finally, to achieve this goal, Dr Morton outlines a 5-point "Share the Care" plan that provides a proactive plan of care that will reduce the perennial staff problems of insufficient time, insufficient knowledge and skills, and lack of individual accountability that pervades many hospitals. This lecture is complete within itself, however CE37: Game-changing Research about Breast-milk Expression provides the background knowledge you will need for success.

Lecturer: Dr. Jane Morton. 2 month student enrollment period.

1 L-CERP, 1 CH/CPD

This lecture presents the differences between kangaroo and skin-to-skin care practices at birth and what is meant by evidence. The exhaustive evidence that is available for two Baby-friendly Steps: step 4 on skin-to-skin and step 7 on mother-infant togetherness, is explained.

Lecturer: Louise Dumas. 2 month student enrollment period.

1 L-CERP, 1 CH/CPD

In this presentation, participants will realize the importance of the documented risks of non-breastfeeding for both mother and baby. They will discover how to inform pregnant women and mothers on those risks. Participants will also recognize that most of the women’s difficulties with breastfeeding are often due to the non-respect of bases and criteria of Baby-Friendly Initiative (WHO/UNICEF). Dr Dumas will prompt participants’ reflection on their own practice by explaining the bases of Baby-Friendly Initiative (WHO/UNICEF) and how certain aspects of the Code (WHO/UNICEF) influence practices and services.

Lecturer: Louise Dumas. 2 month student enrollment period.