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EP06: Maternal Manifestations

Maternal pathology: expert breastfeeding support to manage comorbidities, obstetric complications and postpartum challenges for healthy perinatal outcomes

Explore common, early and unexpected maternal issues that impact breastfeeding, with an introduction to diverse maternal pathologies and technologies that help dyads continue breastfeeding successfully.

Course Learning Outcomes

  1. Critically analyse pathophysiology of early breastfeeding complications to inform evidence-based assessment, intervention, and management strategies.
  2. Critique cultural feeding practices and their physiological impact on lactation to develop culturally responsive, evidence-based breastfeeding support.
  3. Critically evaluate the impact of maternal surgical procedures on lactation physiology and breastfeeding to develop evidence-based support and management strategies.
  4. Investigate the impact of birth practices and maternal cancer on lactation to develop individualised, evidence-based clinical support strategies.
  5. Establish how lactation aids and techniques can optimise milk transfer, maintain supply, and resolve feeding complications through evidence-based interventions.

IBLCE® Detailed Content Outline

Every module maps directly to the IBLCE® Detailed Content Outline, building your knowledge progressively from foundational science through to clinical application.

This course covers the following IBLCE® DCO items. The applicable Lactation (L), Ethics (E) and Related (R) hours are shown against each heading.

A. Infant
B. Maternal
A. Infant
1. Feeding behaviours at different ages
2. Food intolerances/allergies
3. Infant anatomy and anatomical/oral challenges
4. WHO guidelines for introducing complementary foods
5. Low birth weight and very low birth weight
6. Milk banking - formal and informal
7. Normal infant behaviours
8. Nutritional requirements - including preterm
9. Preterm development, growth, and behaviours (including late preterm)
10. Skin tone, muscle tone, reflexes
11. Term development and growth
12. WHO growth charts with gestational age adjustment
13. Stooling and voiding
B. Maternal
1. Breast development and growth (typical and atypical)
2. Breast surgery
3. Composition of human milk
4. Maternal anatomical challenges
5. Maternal nutritional status
6. Nipple structure and variations
7. Nipple modifications (e.g., piercings, tattoos)
A. Physiology of Lactation
B. Endocrinology
A. Physiology of Lactation
1. Relactation
2. Infertility issues
3. Inducing lactation
4. Pregnancy and breastfeeding - tandem
5. Multiples (e.g., twins, triplets)
B. Endocrinology
1. Hormonal influence of milk production
2. Diabetes
3. Maternal hormonal disorders (e.g., pituitary, thyroid, Polycystic Ovarian Syndrome)
4. Maternal autoimmune disorders
5. Newborn hypoglycemia
1. Alcohol
2. Nicotine and tobacco
3. Cannabis
4. Medications (e.g., prescriptions, over-the-counter, diagnostic and therapeutic procedures, aids to labor and delivery)
5. Drugs of abuse
6. Contraception
7. Galactagogues
8. Gel dressings/nipple creams
9. Herbs and supplements
10. Chemotherapy/radiation therapy/radioactive scans
1. Transition to parenthood
2. Birth practices
3. Foods to eat/avoid that influence lactation
4. Employment - beginning or returning to work
5. Family lifestyle
6. Identifying support networks
7. Maternal mental health
8. Maternal psychological/cognitive issues
9. Breastfeeding dyad relationship
10. Safe sleep
11. Weaning
12. Cultural awareness
1. Effective milk transfer (including medically-indicated supplementation)
2. First hour
3. Latching (attaching)
4. Managing supply
5. Milk expression (e.g., pumping, hand expression, leakage)
6. Position of the breastfeeding dyad (hands-off)
7. Refusal of breast, bottle
8. Skin-to-skin (kangaroo care)
A. Equipment and Technology
B. Education and Communication
C. Ethical and Legal Issues
D. Research
E. Public Health and Advocacy
A. Equipment and Technology
1. Feeding devices (e.g., tubes at breast, cups, syringes, teats, paladai)
2. Handling and storage of human milk
3. Nipple devices (e.g., shields, everters)
4. Dummies (pacifiers)
5. Pumps
6. Scales (e.g., accuracy, precision, operation)
7. Communication technology (e.g., virtual visits, translation or interpretation services, websites)
B. Education and Communication
1. Active listening
2. Anticipatory guidance
3. Care plan development and sharing
4. Educating mothers and families
5. Educating professionals, peers, and students
6. Emotional support
7. Empowerment
8. Group support
C. Ethical and Legal Issues
1. Breastfeeding in public
2. Clinical competencies
3. Code of Professional Conduct (CPC)
4. Principles of confidentiality
5. WHO code - advocacy and policy
D. Research
1. Apply evidence-based practice
2. Interpret research results
3. Use research to help develop policies and protocols
4. Design research (including gaining ethical permission)
5. Participate in surveys and data collection
E. Public Health and Advocacy
1. Advocate for Baby-Friendly Hospital Initiative (BFHI)
2. Advocate for compliance with World Health Organization International Code of Marketing of Breast-milk Substitutes (WHO Code)
3. Advocate for mother / infant in healthcare system
4. Develop breastfeeding-related policies
5. Advocate to government / health ministries
6. Breastfeeding in emergency situations (e.g., natural disasters, personal emergencies)

Course Content

Welcome
Recommended Textbooks
Handbook - Maternal Manifestations
Additional Resources
Module Learning Outcomes - Physical Challenges Part I
Introduction
Painful, Traumatised Nipples
Breast Engorgement, Blocked Ducts & Milk Blebs
#1 Quiz - Breast Engorgement, Blocked Ducts & Milk Blebs
Self Directed Learning Activity - Engorgement, Nipple Pain & Mastitis
#2 Quiz - Engorgement, Nipple Pain & Mastitis
Self Directed Learning Activity - Perceived or Real Low Supply, Hypomastia, Hypergalactia
#3 Quiz - Perceived or Real Low Supply, Hypomastia, Hypergalactia
Self Directed Learning Activity - Prelacteal Feeds
#4 Quiz - Prelacteal Feeds
Self Directed Learning Activity - Lactation Techniques
#5 Quiz - Lactation Techniques
Module Learning Outcomes - Surgical Impact
Introduction
Nipple Piercing & Tattoo's
#6 Quiz - Nipple Piercing & Tattoo's
Self Directed Learning Activity - Anaesthesia and Sedation in Breastfeeding
#7 Quiz - Anaesthesia and Sedation in Breastfeeding
Self Directed Learning Activity - Breast Reduction Surgery, Augmentation Mammoplasty and Chest Masculinisation Mastectomy
#8 Quiz - Breast Reduction Surgery, Augmentation Mammoplasty and Chest Masculinisation Mastectomy
Module Learning Outcomes - Physical Challenges Part II
Introduction
Self Directed Learning Activity - More Nipple Pain
#9 Quiz - More Nipple Pain
Self Directed Learning Activity - Birth Practices
#10 Quiz - Birth Practices
Self Directed Learning Activity - Cancer and Breastfeeding
#11 Quiz - Cancer and Breastfeeding
Self Directed Learning Activity - Lactation Aids/Devices
#12 Quiz - Lactation Aids/Devices
#13 Holistic Quiz