Clinical Breastfeeding Support (online non-credit, 55 hrs)

This course is designed to help prepare learners become International Board Certified Lactation Consultants (IBCLC). Students will learn skills and content required for entry-level clinical support for infant feeding. Students will learn the fundamentals of infant positioning, latch, and suckle, assessment skills required to evaluate physical development of both the mother and the infant, milk synthesis, milk production, and milk transfer. This course will also prepare the learner to manage the feeding needs of infants across the age spectrum, from the premature infant to the toddler and older child. We will discuss complicated scenarios, to include breastfeeding with physical anomalies, infant hyperbilirubinemia, hypoglycemia, slow weight gain, failure to thrive, and many others.

Course overview:
Topic 1: Taking a Lactation History
Topic 2: Gender
Topic 3: Counseling Skills and Techniques
Topic 4: Position and Attachment
Topic 5: Communicating with Healthcare Professionals
Topic 6: Milk Transfer and Milk Supply
Topic 7: Infant Growth
Topic 8: Infant Anatomy and Physiology
Topic 9: Infant Assessment
Topic 10: Complementary Therapies
Topic 11: Devices
Topic 12: Maternal Challenges 1 (Breasts and Nipples, Physical Disabilities)
Topic 13: Maternal Challenges 2 (Viruses, PCOS, Diabetes)
Topic 14: Challenges for Parents
Topic 15: Infant Challenges 1 (Hypoglycemia & Hyperbilirubinemia)
Topic 16: Infant Challenges 2 (Preterm Infants)
Topic 17: Infant Challenges 3 (Oral Structure, GERD)
Topic 18: Communication Skills and Adult Education
Topic 19: Induced Lactation and Relactation
Topic 20: Ethics and Scope

Course materials:
• Breastfeeding Atlas, by Barbara Wilson-Clay, and Kay Hoover, 7th Edition, 2022, ISBN 096727589X, ~$80
• Breastfeeding and Human Lactation, Editors Karen Wambach, and Jan Riordan 6th Edition, 2021, ~$135
• [already required for the first course in the series, Breastfeeding and Public Health] Core Curriculum for Interdisciplinary Lactation Care, Editors Becky Spencer, Suzanne Hetzel Campbell, Kristina Chamberlain, 2nd Edition, 2023, ISBN 9781284255515, ~$100

What’s in a typical lesson?
Each topic encompasses many ways of learning: presentations, readings, participatory assignments, and quizzes.

Here’s an example of Topic 7: Infant Growth

Required Reading/Materials:
Breastfeeding and Human Lactation Reading: Chapter 8: The section on "Gestational Age Assessment"
Breastfeeding and Human Lactation Reading: Chapter 19: Child Health (section called growth and development, and the rest of the chapter if you’re interested)
Core Curriculum Reading: Chapter 22, Low Milk Production and Infant Weight; Section on Poor Growth in Breastfed Babies

Short video: “Measuring the Weight and Length of an Infant”
Short video: “How to measure growth in infants and toddlers: Height/Length”
Accurate Estimation of Energy Requirements of Young Patients: This is a heavy article, but reading the highlighted portions first will help you as you go through the rest. Please scan the pages for anything highlighted, read that, and then start at the beginning.

Lecture:
“Infant Growth”: Forty-minute recorded lecture from Dr. April Fogelman covering the following learning objectives:
1. Define LBW, VLBW, ELBW, preterm, late preterm, and term.
2. Explain the reasons why premature infants are at risk for postnatal growth restriction.
3. Predict which infants may be at increased risk for postnatal growth restriction. Calculate gestation-adjusted age for a premature infant.
4. Define catch-up growth and describe the time that should be “allowed” for infants to catch-up based on their gestational age at birth.
5. List the typical weights and lengths of a full-term infant. Define AGA, SGA, IUGR, and LGA.
6. Describe various ways by which growth is measured in infants and how to avoid measurement and plotting issues.
7. Predict the weight, length, and head circumference of an infant at various stages in his/her infancy based on birth weight, length, or head circumference.
8. Explain the importance of an appropriate growth in head circumference. Compare and contrast the CDC growth charts and the WHO growth chart.

Training Course:
Please complete this training course on the growth charts: Using the WHO Growth Charts to Assess Growth in the United States Among Children Ages Birth to 2 Years (link to external training)

Assignments:
Read the article “A Case Report of a Breastfed Infant’s Excessive Weight Gains over 14 Months” (full-text article provided)

Questions:
1. What is the growth acceleration hypothesis?
2. High breast milk protein is most highly associated with what?
3. What was the infant's eating habits from birth to 18 months of age?
4. Was there room for error in the way the breastmilk was pumped, collected, transported, and then frozen? Could this have made any difference in the results of the breastmilk results shown in table 1?
5. Since fat, protein, and energy concentrations were normal in the samples, what was the issue found in the 24 hour milk study?
6. What is the possible correlation between lean tissue accretion and infants weight gain?
7. What is the role of Ghrelin?
8. Why could the advice to wean a breastfed infant presenting with excessive weight gain be counterproductive?

Quiz:
Short quiz to check your understanding of the new terms and ideas introduced in this lesson.

Prerequisites: Breastfeeding and Public Health or equivalent*

*This course may be taken alone if you have prior coursework (e.g. other lactation trainings) or are seeking specific clinical skills for your role (e.g. physician, midwife, nurse practitioner). Please contact us to discuss if you have questions.