Please note: Several of the topics below will overlap, and probably should not be used in the same conference, or, at least modified so that too much is not repeated (though sometimes repetition is helpful). For example, some of the information in Breastfeeding and Guilt is contained (in greater detail) in When Breastfeeding is not contraindicated, for example. Before making final decisions about topics, please get back to me and I can inform you about such issues. I also update talks on a regular basis to reflect new studies that have been published.
What they didn’t teach you about breastfeeding in your training. Observation of video clips and discussion of what they mean. Good for grand rounds for physicians or for those who cannot make it for a full morning or day. 1 hour +. Essential for any conference. I think that every conference should start with this topic. If you want only one talk from me 60 to 75 minutes, this is it.
Norms for the Breastfeeding Baby (also called Numbers on Demand). Deals with weight gain, stools, urine output, jaundice and hypoglycemia (a topic on its own) and other issues. An essential talk, as we need to move away from imposing numbers on breastfeeding. It is divided into three parts:
i) The folly of depending on numbers (“feed every three hours”, “10% weight loss”, “20 minutes on each side”, the use and misuse of growth charts; etc.). This part alone can take a full 90 minutes.
ii) Norms for the first few days. This part takes 60 minutes.
iii) Norms after the first few days. This part takes 30 minutes.
Of course one or two parts only are possible to do. The most important is i).
Poor weight gain: approach and case studies. Why babies don’t gain. What can be done about it. 90 minutes, but as long as desired as I have many case studies. Without case studies could be done in 60 minutes.
Decreased milk supply and possible “not enough milk” after the first few months. Why do many mothers with abundant milk supplies end up after 2 or 3 months with less milk? Why would a baby who is gaining well for 2 or 3 months start not to gain well? An approach to clarifying why and how to deal with it without undermining breastfeeding. 90 minutes. An important talk, I believe, and not a well known issue. Often babies are wrongly diagnosed as having reflux or allergy to breastmilk.
Controversies in Breastfeeding. Overview of several topics. Examples, there is no such thing as “nipple confusion”, is formula almost the same as breastmilk, it’s okay to supplement formula in the first few days, premature babies cannot breastfeed until 34 weeks gestation and several others. Other controversies can also be added. A good topic for physician grand rounds if the first 4 topics only are included (50 minutes),though I prefer the video clips (topic 1). Other grand rounds topics may include Evaluation of Breastfeeding + drugs and breastfeeding or jaundice or hypoglycemia, Drugs and Breastfeeding alone. A full two days for the entire list of 18 controversies. Some controversies are relatively short (% weight loss), some are long (Formula=breastmilk?) Controversies discussed include:
- Formula=breastmilk?
- Early initiation of breastfeeding is not important?
- What does % weight loss mean?
- Breastfeeding either works or it doesn’t?
- It’s okay to supplement formula in the first few days?
- There is no such thing as nipple confusion?
- The birth control pill does not affect breastfeeding?
- Babies should be fed on a schedule?
- Premature babies all need fortifiers?
- Premature babies cannot start breastfeeding until 34 weeks gestation?
- Jaundice requires supplementation or interrupting breastfeeding?
- Hypoglycemia. We need to test all babies and need to treat with formula?
- Don’t make mothers feel guilty for not breastfeeding?
- Tongue tie does not interfere with breastfeeding?
- When a baby doesn’t gain the only thing to do is supplement with formula?
- Breastfed babies need vitamin D supplements?
- Breastmilk has no value after 6 months?
- Nipple shields are good tools?
- It’s okay to give out formula company literature and samples?
Other possibilities which are not now present in the talk could be added. Of course, controversies in one place may not be controversies in another. You may have your own, which are not included, but it is no problem to include if you wish. To discuss, even briefly, all the preceding topics, is a full day conference, so pick and choose or add and subtract as your requirements dictate. Generally, depending on the length of the topic, 1 or 2 controversies should be picked for a 50-60 minute talk. (Premature babies and fortifiers, Breastfeeding and guilt are longer than most, Breastfed babies should be fed on a schedule, shorter than most).
Breastfeeding the premature, and sick baby. 120 minutes+. Includes prematures (90 minutes for this part alone), cardiac problems, PKU. Could also include cleft palate, cystic fibrosis and others (time obviously increases). Not a topic for lay groups such La Leche League.
Breastfeeding and guilt. 90 minutes+ (depending on what other topics are in the conference, as this topic can include risks of formula feeding, which is also in the talk When Breastfeeding is not Contraindicated).
Sore nipples and sore breasts. 90 minutes
When breastfeeding is not contraindicated. 90 minutes. (Could be 60 minutes in a pinch). Is formula=breastmilk? Does it matter? Discussion of drugs and breastfeeding, infant and maternal illnesses and breastfeeding. Some of the information is also in Breastfeeding and Adult Health.
Bottle feeding mentality, breastfeeding myths. 90 minutes. How we live in a bottle feeding society and how it affects our understanding of breastfeeding. Good talk for all audiences, including non-professionals, but does not contain a lot of “hands on” information. Some, but not a lot.
Hypoglycemia and jaundice. 90 minutes. How to avoid these issues from interfering with breastfeeding.
When the baby refuses to latch on. 90 minutes. How to prevent this problem. What to do if it occurs. Plus up to three cases studies.
Breastfeed a toddler, why on earth? 75 minutes. Is there any reason to do it? Issues such as introduction of solids, sleep, the baby who won’t eat etc.
Drugs and breastfeeding. 120 minutes with “formula=breastmilk?” Good topic for physician rounds (covered slightly differently within the When Breastfeeding is not Contraindicated talk).
Baby Friendly Hospital Initiative. 90 minutes. A practical approach to Baby Friendly.
Effect of birthing practices on breastfeeding. 75 minutes. How practices during labour and birth affect breastfeeding.
Breastfeeding and adult health. 90 minutes. How being breastfed affects the baby as an adult and how breastfeeding affects the health of the mother.
Breastfeeding the adopted baby. (+ relactation). 90 minutes. Can it be done? Yes.
The WHO/Unicef Code on the marketing of breastmilk substitutes. 90 minutes. What is it? A difficult topic to make interesting.
Starting Solids. 75 minutes. Do we have to have rules for this too?
The first hours. Birthing practices + breastfeeding (or not) in the first hours + hypoglycaemia. 90 minutes
The first few days. Birthing practices + norms for the first few days (similar to the norms in the first few days in the Numbers on Demand talk) + hypoglycaemia + jaundice. Full talk 2.5-3 hours hours (can be trimmed).
Formula almost the same as breastmilk? 75 minutes. Important when formula company marketing is very successful at making us believe it is.
Drugs and breastfeeding. 120 minutes with “formula almost the same as breastmilk?” Good topic for physician rounds (covered slightly differently within the When Breastfeeding is not Contraindicated talk).
Revised December 2016