Cost

Students: $15
Regular: $25

Overview

Lactating parents of premature and/or ill infants in neonatal and pediatric intensive care units need support of several dimensions. Given the superior health outcomes for human milk-fed premature and ill infants, this course is designed to educate NICU/PICU teams (nurses, physicians, dietitians, health professional students) on how to encourage provision of breastmilk, support the establishment and maintenance of milk production, and troubleshoot lactation problems associated with pumping, being back to work and transitioning the infant to the breast/chest.

Objectives

• Identify health risks to premature infants who are not fed human milk.
• Identify maternal health risks of not lactating.
• Explain differences between mothers' own milk and pasteurized donor human milk.
• Identify maternal health conditions that are contraindications or that warrant special consideration during lactation.
• Explain parental barriers to providing expressed human milk, and opportunities to help.
• Describe breast anatomy and hormones of milk production and release.
• Identify maternal risk factors for insufficient milk production.
• Explain the physiologic process of secretory activation.
• Describe key factors in the establishment and maintenance of milk production.
• Describe how to counsel the parent of a premature infant on the importance of a human milk diet.
• Identify risks of delay in lactation.
• Explain the importance and technique of oral care for the preterm infant.
• Describe skin to skin and the importance for a premature dyad.
• Recognize key management strategies during engorgement.
• Explain how fresh mother's own milk is superior to older, frozen expressed milk.
• Describe how bolus and continuous feedings differ in terms of quality.
• Describe basic principles of fortifying mother's own milk.
• Explain to a parent how to perform manual expression of the breasts.
• Understand basic principles of operating breast pumps.
• Counsel parents on proper breast shield size.
• Explain key techniques of breastmilk expression and milk storage.
• Identify problems that can occur among parents who exclusively pump milk.
• Explain how the parent's milk production can be incorporated as vital sign for a NICU patient.
• Identify insufficient glandular tissue.
• Describe aspects of emotional support for the lactating parent of a NICU patient.
• Identify support strategies for a lactating NICU parent who has difficulty being present in the NICU.
• Describe paced bottle feeding.
• Describe pharmacologic properties of medications that determine their transmission into breastmilk.
• Identify unsafe medications during lactation.
• Explain how to counsel the lactating parent on the use of marijuana, tobacco, and alcohol during lactation.
• Identify evidence-based resources for medications during lactation.
• Explain strategies for establishing effective breastfeeding for term infants who are cared for in the NICU.
• Describe how breastfeeding can be incorporated in the care of a term infant who is in the NICU for low blood sugars.
• Describe support of breastfeeding when caring for an infant with hyperbilirubinemia.

Topic Outline

• Risks of a non-human milk diet for the NICU or PICU patient
• Demographics of human milk feeding in the NICU
• The basics of anatomy and physiology of lactation
• Support the establishment of successful lactation early postpartum
• Preparing and delivering expressed human milk for the NICU or PICU patient
• All about pumps- educating the lactating parent on pump use, and trouble-shooting pump-related problems
• Transitioning the human milk-fed NICU or PICU patient to the breast
• Medications during lactation
• Medical indications for supplementation for term infants in the NICU

Accreditation

This recorded activity, Basics of Breastfeeding Support for the NICU or PICU Dyad, has been reviewed and is acceptable for up to 5.5 Prescribed credit(s) by the American Academy of Family Physicians.

This nursing continuing professional development activity was approved for 5.5 Contact Hours by the Wisconsin Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. Expiration Date: May 28, 2023.

This course has been allocated 5.5 L CERPs by IBLCE Long Term Provider #CLT 117-04.

The Commission of Dietetic Registration has awarded Prior Approval of 5.5 CPEUs for this education activity.

Speakers

Stephanie Attarian MD, IBCLC
Neonatology/Breastfeeding Medicine
Assistant Professor
Dept of Pediatrics
Vanderbilt University
Nashville, Tennessee

Anne Eglash MD, IBCLC, FABM
Family Medicine/Breastfeeding Medicine
Clinical Professor
University of Wisconsin School of Medicine and Public Health
Madison, Wisconsin

Sarah Jordan-Crow MD
Neonatal/Perinatal Fellow
Rainbow Babies and Children’s Hospital
Cleveland, Ohio

Eliza Meyers MD, IBCLC
Neonatology/Breastfeeding Medicine
Assistant Professor
Yale School of Medicine
New Haven, Connecticut

Stephanie Ryan RN, IBCLC
Clinical Adjunct Faculty
Winona State University and Viterbo University
LaCrosse, Wisconsin

Liliana Simon MD, IBCLC
Pediatric Critical Care/Breastfeeding Medicine
Clinical Assistant Professor
University of Maryland
Rockville, Maryland

Conflicts of Interest

None