During my recent visit to Australia, I had the opportunity to meet with Associate Professor, Catherine Fetherston, at Murdoch University, South Street campus in Western Australia. We had a wonderful lunch together and discussed varying subjects about breastfeeding, mastitis, milk banking, milk sharing, and the ethics of co-sleeping in Australia. Cathy recorded last month a wonderful expert lecture called "Understanding Mastitis, Current Knowledge and New Perspectives" and we are offering it as our special this month.

I crossed the country to Melbourne where I met up with Lenore and we had a wonderful evening out with Dr. Lisa Amir and Dr. Anita Bearzatto. Our dinner conversation covered topics of last year’s ILCA conference, candida, induced lactation and tongue tie. We also discussed getting together during our next visit to Melbourne in August for the Australian Breastfeeding Association 50th anniversary Liquid Gold conference.

We would like to give a special thank you to Freddy Angel and Trinity Maas for being so accommodating during our stay in Australia.

This month we would like to share with you an interesting article by Linda J Kvist. As health care professionals working with lactating mothers we need to know how to evaluate and assess for mastitis. We need to know how to help these mothers and when to refer for treatment as about 1/3 of breastfeeding mothers will experience mastitis some time during their breastfeeding experience.

We hope you enjoy reading “Re-examination of old truths: replication of a study to measure the incidence of lactational mastitis in breastfeeding women” published online through the International Breastfeeding Journal.

Read more: Re-examination of old truths: replication of a study to measure the incidence of lactational...

Health e-Learning had the pleasure of recently exhibiting at the Human Milk Banking Association of North America (HMBANA) 2014 conference in the beautiful city of Victoria, British Colombia, Canada. Thank you to all our present and past students who passed by our booth to say hi, it was so great to meet you all. In Canada there are new Human milk banks opening including in our own city here in Montreal, so we were very excited to hear what the experts had to say about human milk banking.

The conference opened with Dr. Uwe Ewald Neonatologist from Uppsala, Sweden. Imagine a family centred neonatal intensive care unit (NICU) where infants and families remain together 24 hours a day and the parents provide much of the care for their children. Constant skin-to-skin care is a key element of this care. Integrating best practice into the NICU also includes family centred care, Kangaroo Mother Care, breastfeeding, breastmilk feeding and use of donor human milk.

Kerstin Hedberg Nyqvist, RN, PhD also from Uppsala, Sweden introduced us to Baby Friendly Hospital Initiative for neonatal intensive care (Neo-BFHI). There is a preliminary version of the document with evidence, standards and criteria for the steps and guiding principles, on the International Lactation Consultant Association (ILCA) website at http://www.ilca.org/i4a/pages/index.cfm?pageid=4214

We hope you enjoy this article by Arslanoglu et al., Donor Human Milk for Preterm Infants: Current Evidence and Research Directions.

 

Read more: Donor Human Milk

In 2013 The Journal of Human Lactation (JHL) published expert group recommendations to support the expansion of the Baby Friendly Hospital Initiative to include breastfeeding in the Neonatal Intensive Care Unit with "NICU Ten Steps" which is an adaptation of the original "Ten Steps to Successful Breastfeeding".

 

Read more: Expansion of the Baby – Friendly Hospital Initiative Ten Steps to Successful Breastfeeding into...

Special thanks to the Journal of Clinical Chiropractic Pediatrics, Dr. Valerie Lavigne and Dr. Sharon Vallone for allowing us to share this article

ABSTRACT

Objective: The objective of this report is to present the case of a neonate who presented to a chiropractor with a tongue-tie causing breastfeeding difficulties as well as evaluate the evidence for the frenotomy procedure.

Design: Case report

Clinical Features: A mother presented to the clinic for breastfeeding difficulties. Upon examination, the three-week -old neonate had clear signs of tongue-tie. The mother also had cracked and bleeding nipples associated with a poor latch caused by tongue-tie.

Intervention and outcome: After evaluation of the case, a frenotomy procedure was suggested to improve tongue function and reduce the breastfeeeding difficulties and nipple injury. Following the frenotomy, the pain decreased substantially on latch-on and during the feed. The nipples began to heal as well.

Conclusions: It is becoming more common for neonates with biomechanical dysfunctions affecting breastfeeding to present to a chiropractor. This biomechanical dysfunction along with congenital limitations should be explored to solve breastfeeding issues. This case suggests that the frenotomy procedure can help breastfeeding difficulties linked to tongue-tie. Considering the evidence published in the literature on the effectiveness of frenotomy with very few complications, it is the author’s view that patients experiencing breastfeeding difficulties caused by tongue-tie should consider the procedure.

Keywords: neonate, breastfeeding, tongue-tie, frenotomy, chiropractic

Download the full article here.

Cox SG, Breastfeeding Review 2010; 18(3); 5-7.

Abstract:

A randomised controlled trial is being considered to examine the safety or efficacy of antenatal expressing and storage of colostrum. Considering that the practice is widespread an ethical dilemma would arise  as the control group of mothers would not be educated about how to express and store their colostrum and if their infant became  hypoglycaemic artificial infant milk based on cow’s milk, with all its proven association with Type 1 diabetes, would need to be given. 

Read more: An ethical dilemma: should recommending antenatal expressing and storing of colostrum continue?

Jean Cotterman, RNC, IBCLC describes an excellent technique she developed to reduce the degree of edema surrounding the areola during breast engorgement. This technique is well accepted by Lactation Consultants and has proven to be very effective in aiding the baby to latch when mother's breasts are engorged.

Read more: Reverse Pressure Softening

Handling an issue that isn't black and white.

Use of social drugs by a minority of pregnant and breastfeeding mothers is a fact of life. Breastfeeding is the only way to feed an infant for that infant to be able to achieve optimum growth, health and mental development. Drug-using mothers need to know how their drug habit will impact on their baby and their lactation and how artificial formula will affect them and their baby. Informed decision-making, which achieves the best outcome for both baby and mother, is the goal.

Read more: Social drugs and breastfeeding

Although early research appeared to show that breastfeeding increases the risk of mother-to-child transmission of HIV, recent studies which clearly define "breastfeeding" show no additional risk of MTCT of HIV through exclusive breastfeeding over not breastfeeding at all. In addition, there is no difference in the overall mortality rate at 2 years between children of HIV+ mothers randomized to breast or bottle feeding.

Download the full article here.