Annual meeting schedule of events

Hear the latest in breastfeeding medicine research and collaborate with clinicians across various medical specialties. All events and programming will take pace at the Mercure Blackburn Dunkenhalgh Hotel unless otherwise stated. View the mobile app to help stay up to date!

Attendees can receive a maximum of 26.25 continuing education credits.

Tuesday, October 15

Preconference Workshop

When: 13:00 - 17:00 GMT

Where: Scholars, Foster Building
University of Central Lancashire, Preston, PR1 2HE

Title: The Relaunched UNICEF and WHO Baby Friendly Hospital Initiative (BFHI): Practical Applications for Clinicians

Hosted by the Maternal and Infant Nutrition and Nurture Unit at the University of Central Lancashire (UCLAN), Preston, UK
Sponsored by ABM

Wednesday, October 16

Preconference Sessions: "What Every Physician Needs to to Know About Breastfeeding" Course I and Course II

20:00 - 21:00 | Meet-and-Greet 
Join the ABM board and leaders to kick off the Annual International Meeting. 

Thursday, October 17

8:00 - 8:10 | Opening Remarks

8:15 - 9:00 | Breastfeeding Research Hit Parade - 2019
Arthur Eidelman, MD FAAP FABM
Editor-in-Chief, Breastfeeding Medicine, Jerusalem, Israel
The Hit Parade session will summarize 7 recently published research studies from the English language literature. The studies were chosen because their results will have potential immediate clinical relevance or will suggest new or modification of existing public health guidelines.

9:05 - 9:50 | Breastfeeding, Bed-Sharing, & SIDS
Helen
Ball, BSc MA PhD

Durham University, Durham, UK
This talk will examine the research evidence around the issues of how and where infants sleep, and why opinions differ. The particular needs of breastfeeding mothers and infants will be explored and out latest research on how mothers manage the effects of night-time feeding and sleep disruption will be shared. The notion that infant sleep environments are 'good' or 'bad' and that parents who receive appropriate instruction will modify their infant-care habits has been fundamental to SIDS reduction campaigns. However, infant sleep location recommendations have failed to emulate the previously successful infant sleep position campaigns that dramatically reduced infant deaths. We will explore why parents bed-share, consider the perceived conflict regarding infant sleep locations, explore how to reorient discussion, and share the new guidance on SIDS and bed-sharing.

9:55 - 10:05 | Q&A with Speakers

10:10 - 10:40 | Poster Break/Networking/Exhibits

10:45 - 12:15 | Saving Tomorrow Today: An African American Breastfeeding Blueprint
Kimarie Bugg, DNP MPH IBCLC
Reaching Our Sisters Everywhere, Inc., Lithonia, Georgia, USA
Breastfeeding is well established by research as the optimal nutrition for infants. Eliminating disparities in breastfeeding initiation and duration requires that systems of oppression and privilege at systemic, institutional, and internal levels be addressed and eradiated. The fullest opportunity to breastfeed has not been afforded to African American families. Breastfeeding is considered to be an individual choice made by mothers and families however, the ability to make an informed choice has been extremely difficult due to structural barriers. The foundation of the current African American (AA) breastfeeding movement is founded on the ancestral norms of babies being nursed and nourished by breastmilk across the African continent. The ancestry of this life-sustaining first food practice has always been the tradition for growing families.
Over the past decade, increased attention has been focused on the gap in breastfeeding between African Americans and other ethnicities. The movement to increase breastfeeding (also called "first food") has been spearheaded at the grassroots level by dedicated leaders working on the ground, deeply rooted in their communities. Leaders in African American communities are passionately working to encourage, protect, promote, and support breastfeeding and to equip women with the skills needed to succeed. This crucial work mostly goes unnoticed, unrecognized, and under resourced. All who care about diversity, equity, and inclusion understand that these values enhance our strength and serve as the essence of the change we intent to catalyze. You cannot transform what you do not engage. We must continue to do the work to eliminate unfair and unjust practices that inhibit our work to increase breastfeeding initiation and duration in the African American community. Lactation support leaders set the tone for a mindset for a culture of professional accountability. Use the information gathered in this document to help you become a better practitioner to assure breastfeeding equity for all.

Supported by a grant from the W.K. Kellogg Foundation.

12:20 - 13:20 | Lunch

13:25 - 14:25 | Podium Presentations

14:30 - 15:00 | Poster Break/Networking/Exhibits

15:00 - 16:30 | Workshops

16:35 - 17:20 | Reducing SIDS Risks Whilst Promoting Breastfeeding
Peter Blair, BSc MSc PhD
University of Bristol, Bristol, UK
Although the evidence suggests that promoting breastfeeding will reduce the risk of SIDS some of the other risk-reduction advice given to parents seems counter-intuitive in terms of enabling breastfeeding. This talk will take a closer look at the epidemiological evidence (or lack of it) surrounding the promotion of dummy use, putting babies to sleep in cardboard boxes, the divergence in public health approaches to hazardous sleeping environments and the impact this may be having on international SIDS rates.  

17:25 - 18:10 | Confident Conversations; Empowering Parents to Make Choices to Prevent their Baby from Sudden Unexpected Death in Infancy
Christine McIntosh, BSc,MBChB,Dip.O&G,Dip.Paed.FRNZCGP,Doc.Cand.
The University of Auckland, Auckland, New Zealand
Sudden Unexpected Death in Infancy (SUDI) is the sudden death of a baby who was thought to be healthy in the 24 hours prior to death. SUDI remains as a leading cause of post neonatal death in many countries and indigenous and marginalised population groups are the most affected. Experts agree that most SUDI deaths could be prevented, however ssuccessful SUDI prevention programmes require system wide, consistent SUDI prevention advice and programmes tailored for higher risk groups.
The Safe Sleep Calculator is a SUDI risk assessment web-based tool that considers 15 SUDI risk factors and provides individualised recommendations on risk reduction. It enables clinicians to provide objective individualised advice for families on infant care behaviours to reduce SUDI risk. The experiences of implementing the Safe Sleep Calculator in a primary care setting and, in a district health board area in New Zealand, will be described.

18:15 - 18:25 | Q&A with Speakers

18:30 | Awards Banquet

Friday, October 18

8:00 - 8:45 | Management of At Risk Mothers and Infants under Six Months (MAMI)
Marie McGrath
Emergency Nutrition Network, Oxford, UK
The presentation will share experiences and research regarding an international collaborative initiative on the management of at risk mothers and infants under six months (MAMI) in humanitarian contexts and in settings where malnutrition is prevalent. The aim is to share how breastfeeding support for at risk infants is at the heart of interventions that looks to integrate within existing health-system centered care packages and services, the challenges of the operational contexts, programme innovations, and key research planned.

8:50 - 9:35 | Ending Sponsorship of Paediatricians by BMS Companies - Case Study of RCPCH
Tony
Waterston

Newcastle Upon Tyne, UK
I shall summarise the problems created by sponsorship of paediatric associations by the manufacturers of Breastmilk Substitutes, using findings from the literature. I shall then present the experience of the Royal College of Paediatrics and Child Health (RCPCH) in the UK, over the last 20 years since efforts were first made by the membership to end the sponsorship by several formula manufacturers including Nestle and Danone. Following a number of motions passed at the AGM over successive years, members voted in 2017 to end sponsorship. Following this the leadership carried out a consultation of the whole membership which led to the policy of sponsorship being re-affirmed. In 2019, following a change in leadership and the publication of two critical papers in prominent medical journals, the policy was changed to end all sponsorship by BMS manufacturers. The essential ingredients of this successful advocacy were lobbying by members over a long period of years; the publication of critical data in medical journals; and the election of officers sympathetic to a change of policy.

9:40 - 9:50 | Q&A with Speakers

9:55 - 10:25 | Poster Break/Networking/Exhibits

10:30 - 11:15 | Influencing a Paradigm Shift in the Unicef UK Baby Friendly Initiative (BFI)
Fiona Dykes, PhD MA RM ADM FHEA

University of Central Lancashire, Preston, UK
In this presentation, Fiona Dykes describes a program of research that has significantly contributed to a paradigm shift in the Unicef UK Baby Friendly Initiative (BFI). In 2013, Unicef UK BFI published a revised set of evidence-based standards for all maternity and children's services placing a particular emphasis on mother-infant relationship building rather than the previous specific emphasis on breastfeeding (Unicef UK 2013).

11:20 - 12:05 | Resurgence and Role of Human Milk Banking
Natalie Shenker, BM BCh (Oxon) PhD (Imp)
Hearts Milk Bank, Hertfordshire, UK
Evolution has created human milk as a way to protect the baby postnatally, patterning the immune system and microbiome, and providing diverse developmental cues for each organ system to develop normally. Milk also provides nutrition. When screened donated human milk (DHM) is available, mothers facing the most stressful circumstances of having an ill premature baby tend to have high chances of establishing breastfeeding. If donor milk is used appropriately as a bridge to lactation, they are less likely to perceive that their bodies have failed. The work of the Hearts Milk Bank over 2 years have laid the foundation for a UK-centred drive to upscale milk bank capacity, facilitate research to determine the optimal use of donor milk, and support a shift in perception about the role of human milk, underpinned by the latest science.

12:10 - 12:20 | Q&A with Speakers

12:25 - 13:55 | Lunch

14:00 - 15:00 | Business Meeting and Town Hall 

15:15 - 16:45 | Workshops

Saturday, October 19

8:00 - 8:45 | Founders' Lecture: Insights into the Biomechanics of Breastfeeding: What Can Engineering-Based Studies Tell Us About the Process?
Michael Woolridge, BSc DPhil
Great Ormond Street and Institute of Child Health, University College of London, London, UK
Understanding how a baby extracts milk from the breast is essential to practising sound, effective breastfeeding management. This is necessary to optimise milk transfer from mother to baby, in turn, allowing one to maximise the transfer of calorie rich nutrients (predominantly breast milk fat). 
For several centuries, received wisdom was that babies extract milk from the breast by a combination of baseline suction, compression and relaxation of the baby’s jaws against the breast, and rhythmical application of waves of pressure applied to the underside of the breast/nipple held within the baby’s mouth by the tongue. Based on this premise the core principles of WHO/UNICEF training were established, focusing on optimising the ‘positioning’ and ‘attachment’ of the baby at the breast, in order to maximise the effectiveness of milk transfer.
In the past decade, this received wisdom was challenged by the use both of modern ultrasound equipment and engineering-based modelling of breast anatomy (specifically the milk duct system) and the baby’s sucking action. A key novel claim was made that the baby can generate localised, ‘added’ suction with its tongue to enhance milk transfer; this has since been confirmed, although the evidence is that this novel mechanism remains secondary to the core process of peristaltic expression by the tongue. In contrast, the engineering-based studies have proved contradictory, providing new insights yet posing fresh challenges. To date, however, they have not produced a definitive view, nor have they altered the core underpinnings of best breastfeeding practice and management.
In the field of Medicine, it is recognised that the validity of Randomised Controlled Trials (RCTs) should be evaluated by a set of quality control standards, and the Critical Appraisal Skills (CASP) framework is a way of achieving this. No such quality standards or guidelines exist for evaluating engineering-based models of a physiological process. So, in order to address the veracity of the conclusions drawn, I have sought to evaluate the assumptions made in these models; whether or not they are valid; and whether specific elements are missing from current models which might affect their outcome.
Certain physical assumptions, made during the modelling process, are known to be incorrect, but have been made in order to simplify the modelling process (i.e. the ducts are rigid). Further ways in which the modelling process departs from known physiology include the view that negative suction pressure is the exclusive force in these models, without any contribution being made by the progressive peristaltic pressure exerted by the baby’s tongue. The models also make the core assumption that the milk duct system remains patent throughout a feed, thereby ignoring the occlusive impact of the baby’s jaw closure with each suck. The inclusion of any one of these natural processes would radically alter the conclusions from modelling, thereby disproving the claim that ‘suction alone can explain milk extraction’ while giving greater credence to the suggestion that ‘suction alone may not fully explain milk extraction’.
One feature consistently missing from such analyses is the clinical implications arising from them, and what they add to our understanding in terms of how to help mothers and babies breastfeed more effectively. To this end, the pivotal role played by peristaltic tongue movements, essential to effective breastfeeding, will be identified and elaborated, so providing evidence as to why the core management principles of ‘Positioning’ and ‘Attachment’ remain central to breastfeeding success.

8:50 - 9:35 | Antibiotics and the Breastfeeding Diad
Monica Pina, MD
IMDJC, Lisbon, Portugal
Dr. Pina will talk about the importance of a correct use of antibiotics to avoid resistances in both mother and baby. She will address the current knowledge of the effect of antibiotics in normal microbiome and possible implications in health, and will summarise indications for antibiotic prescription in some common conditions of the lactating woman.

9:40 - 9:50 | Q&A with Previous Speakers

9:55 - 10:25 | Poster Break/Networking/Exhibits

10:30 - 11:30 | Podium Presentations

11:35 - 12:30 | Breastfeeding and Perinatal Mood Disorders: Circuits and Circumstances

Maria Enrica Bettinelli, MD IBCLC
University of Milan, Milan, Italy
Breastfeeding, attachment, and perinatal mental disorders share the same neruobiological circuits and neurosciences have shown there are connections acting both in a protective and negative sense. Relational experiences in the early years of life put the basis for future physical and mental health. Avoiding early toxic stress is essential in preventing mental problems later. Maternal depression, and in general perinatal mental disorders of parental figures, especially of the mother, have a well-documented negative effect on infants and children, altering the mechanism of responsive interaction. Depressed mothers do not engage with their children and fail to respond to their signals. Children find this situation stressful, and there may be permanent effects arising from being raised by chronically depressed parents.
According to recent studies, breastfeeding helps reduce early toxic stress, as well as allowing optimal nutrition. The responsive interaction mode is the basis of the relationship established with breastfeeding. So breastfeeding has a significant impact on the mental health of children and adolescents. The way mothers respond to their children's needs is the key to understanding these long-term effects. When mothers respond consistently to the signals of their children, they lay the foundations for the resilience of their children. By understanding that the success of breastfeeding is linked to perinatal maternal mental health, we can create awareness when counseling the breastfeeding mother.

12:30 | Adjourn