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CONTRIBUTORS FEATURED STORIES THIS MONTH Cindy Wagner MS, RD, IBCLC Education Consultant NEWS YOU CAN USE Medela, LLC

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CONTRIBUTORS FEATURED STORIES THIS MONTH Cindy Wagner MS, RD, IBCLC Education Consultant NEWS YOU CAN USE Medela, LLC March 2018 The Human Milk Insights newsletter presents the latest breastfeeding topics and clinical practice solutions, addresses coding issues challenging the lactation community, features a lactation service, as well as announces upcoming webinars and conferences. CONTRIBUTORS FEATURED STORIES THIS MONTH Cindy Wagner MS, RD, IBCLC Education Consultant NEWS YOU CAN USE Medela, LLC. Tuscaloosa, AL. Value of Human Milk . Human Milk and Informal Milk Sharing Maria Lennon, MSN, CNM, IBCLC . Human Milk and Influenza Nurse-Midwife, Perinatal Education . Human Milk and Breastfeeding Consultant Support Sedona, AZ. Human Milk in the Hospital Irene M. Zoppi RN, MSN, IBCLC . Human Milk in the NICU Clinical Education Specialist . Human Milk After Discharge Medela, LLC. McHenry, IL. HUMAN MILK EDUCATION . Human Milk Webinar TOOLS YOU CAN USE . Educating Mothers (and others) About the Flu: Resources at Your Fingertips CLINICAL PEARLS IN LACTATION . Breastfeeding and the Flu SPOTLIGHT ON PRACTICE . Diane T. Asbill RN, BSN, IBCLC NEWS YOU CAN USE The Centers for Disease Control and VALUE OF HUMAN MILK Prevention have published an updated webpage on breastfeeding and influenza. The Importance of Infants’ Exposure to The webpage includes guidance on what to Micro-Organisms do if breastfeeding infants or mothers https://www.nytimes.com/2018/02/05/well/liv contract influenza, and addresses methods e/infant-microbiome-cesarean-childbirth- for preventing transmission of influenza to breastfeeding.html infants. A mother's breast milk contains The article discusses the microorganisms antibodies and other immunological factors that reside inside the human body, and the that can help protect her infant from flu and benefits of early exposure to reduce risks of is the recommended source of nutrition for health problems from asthma to cancer. the infant, even while the mother is ill. When Research is now pointing to the “organisms an infant has flu, the mother should be encountered during birth and the first encouraged to continue breastfeeding or months of life” as some of the most feeding expressed breast milk to her infant. influential on those that inhabit the body later in life. Babies born vaginally and breastfed for the first 6 months of life HUMAN MILK AND BREASTFEEDING showed better patterns of bacteria SUPPPORT development and fewer health problems. Breastfeeding Support Infographic from CDC HUMAN MILK AND INFORMAL https://www.cdc.gov/breastfeeding/pdf/brea HUMAN MILK SHARING stfeeding-cdcs-work.pdf The Centers for Disease Control and ABM Position Statement on Informal Prevention have released an infographic Breast Milk Sharing for the Term Healthy highlighting their continued work to support Infant and promote breastfeeding in hospitals, http://online.liebertpub.com/doi/full/10.1089/ worksites, and communities. The bfm.2017.29064.nks infographic highlights the benefits of The ABM Position Statement on Informal breastfeeding for infants and mothers, how Breast Milk Sharing for the Term Healthy CDC is increasing breastfeeding support for Infant, published in ABM’s journal, mothers across the nation, and the impact Breastfeeding Medicine discusses of these efforts on breastfeeding rates. strategies to maximize the safety of community-based breast milk sharing, including 1) medical screening of the donor HUMAN MILK IN THE HOSPITAL and 2) safe milk handling practices. The statement includes detailed guidance In-Hospital Lactation Assistance: The for healthcare providers to talk with their Opportunity to Get It Right patients about informal milk sharing. Irene Murphy Zoppi, RN, MSN, IBCLC http://blog.neonatalperspectives.com/2018/0 2/01/in-hospital-lactation-assistance-the- HUMAN MILK AND INFLUENZA opportunity-to-get-it-right/ Irene Zoppi discusses the challenges CDC Updated Guidance on breastfeeding mothers face and how Breastfeeding and Influenza facilities can address these with in-hospital https://www.cdc.gov/breastfeeding/disease/i lactation assistance nfluenza.htm Proactive Nipple Pain Care: Prevent http://online.liebertpub.com/doi/pdf/10.1089/ Premature Breastfeeding Cessation bfm.2017.0224#utm_source=ETOC&utm_m Diana Chisholm Estep, RN, BSN, IBCLC, edium=email&utm_campaign=bfm RLC This article discusses nursing mother’s use http://blog.neonatalperspectives.com/2018/0 of topical drugs, including antibacterials, 2/20/proactive-nipple-pain-care-prevent- antifungals, insecticides and anti- premature-breastfeeding-cessation/ inflammatory drugs. Diana Estep outlines the importance of proactive nipple pain care and its Storage of Unfed and Leftover Mothers' relationship to premature breastfeeding Own Milk cessation. http://online.liebertpub.com/doi/abs/10.1089 /bfm.2016.0168#utm_source=ETOC&utm_ medium=email&utm_campaign=bfm HUMAN MILK IN THE NICU While this study provides evidence that human milk might be safe at longer storage 4 Signs a Premature Infant is Ready to times, storage guidelines should not be Breastfeed revised until more research is performed. Jenny Murray, BSN, RN More research is needed regarding leftover http://blog.neonatalperspectives.com/2018/0 human milk storage with a greater number 2/06/4-signs-a-premature-infant-is-ready-to- of participants, determination of the quality breastfeed/ of human milk, and the storage of human Jenny Murray outlines four signs that a milk in a real-life setting. premature infant is ready to breastfeed. Neonatal Gastrointestinal Tube Use and HUMAN MILK EDUCATION Management Sandra Sundquist Beauman, MSN, RNC- Human Milk Webinar NIC Connecting the Dots Between Increasing http://blog.neonatalperspectives.com/2018/0 Lactation Risk Factors and Suboptimal 2/12/neonatal-gastrointestinal-tube-use- Breastfeeding Outcomes: A Proactive and-management/ Approach to Clinical Practice Sandy Beauman provides an overview of the use and maganement of gastrointestinal Jean Rhodes, PhD, CNM, IBCLC tubes with the NICU infant. This webinar was conducted in February Do We Need Better NICU Acronyms? and will be soon available as a recorded Jae Kim, MD, PhD webinar. More information to follow. http://blog.neonatalperspectives.com/2018/0 2/16/do-we-need-better-nicu-acronyms/ 1.0 Nursing Contact Hours Dr. Jae Kim addresses the confusing 1.0 Dietitian CPE Credits nomenclature of neonatal conditions. HUMAN MILK AFTER DISCHARGE Topical Drugs in Nursing Mothers Philip O. Anderson TOOLS YOU CAN USE Educating Mothers (and Others) About This webinar may be over before you the Flu: Resources at Your Fingertips receive this issue of Human Milk Insights, but here’s an opportunity being presented The influenza virus season of 2017-2018 by the American College of Obstetricians continues to be intense and widespread, and Gynecologists and the American and has affected many people in the United College of Nurse Midwives to educate States. This year, the flu has been yourself about the issue of maternal especially severe in children and as of this immunization. If you miss the live writing, 97 children have died. Practicing presentation, they plan to record it for health care professionals have to keep up convenient viewing. with changing information and recommendations regarding this year’s Free webinar: Maternal Immunization: strain. Understanding Safety and Efficacy The mothers and families you work with Please join ACNM and ACOG for an definitely need specific information on what upcoming free webinar, Maternal it is, how to avoid getting it, what the Immunization: Understanding Safety and symptoms are, how to keep from spreading Efficacy and Making a Strong it and how dangerous this flu strain can be. Recommendation, on Thursday, March 1, at They also need reassurance that 5-6 p.m. Eastern Time, 2-3 p.m. Pacific breastfeeding or feeding their babies their Time. The webinar is jointly hosted by the own milk is the best thing they can do. ACNM, ACOG, ASTHO and CDC. Read Many expectant mothers and fathers more. express concern about receiving the flu Another very important aspect of influenza vaccine while pregnant, however it is that all need to know, are the danger signs considered to be safe and is the most of when it’s time to go to the Emergency effective defense against getting the virus. Room. Most of the time, flu can be cared And it’s not too late to get a flu shot even for in the home setting, but if the following now. Pregnant women, babies and young occur, it’s essential to seek care children are some of the most vulnerable to emergently. getting the flu and developing serious complications. Bring up the subject when If you have the emergency warning signs of talking with patients and give them some flu sickness, you should go to the written information, so they can make a fully emergency room. These include: informed decision about vaccination. In children: Here’s a list of six things parents need to Fast breathing or trouble breathing Bluish skin color know about this flu season: Not drinking enough fluids Not waking up or not interacting https://blogs.cdc.gov/publichealthmatters/20 Being so irritable that the child does 18/02/flu-season/ not want to be held Flu-like symptoms improve but then return with fever and worse cough Fever with a rash In addition to the signs above, get medical help right away for any infant who has any of these signs: Being unable to eat Has trouble breathing Has no tears when crying Significantly fewer wet diapers than normal In adults: Difficulty breathing or shortness of breath Pain or pressure in the chest or abdomen Sudden dizziness Confusion Severe or persistent vomiting Flu-like symptoms that improve but then return with fever and worse cough Resources for Professionals and Parents: CDC’s Guidelines for Breastfeeding Mothers:https://www.cdc.gov/breastfeeding /disease/influenza.htm Here’s a toolkit for Prenatal Care Providers, Responding to Influenza: https://www.cdc.gov/breastfeeding/disease/i nfluenza.htm Six Things You Need to Know About This Flu Season: https://blogs.cdc.gov/publichealthmatters/20 18/02/flu-season/ CLINICAL PEARLS IN LACTATION This column is for lactation practitioners to share clinical challenges and successes, observations and pearls with colleagues.
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