23^rd Annual International Meeting Workshops

Perioperative Management of the Lactating Patient: Caring for Breastfeeding Mothers Undergoing Surgery or a Procedure Requiring Anesthesia Care 
Elizabeth Reith, MD; Kara Barnett, MD; Jennifer Simon, BSN, RN, CPAN, IBCLC

The workshop will provide up-to-date, evidence-based, comprehensive recommendations in an evolving field, addressing newer and now commonly used anesthetics for the management of the lactating patient. Beginning with a didactic presentation covering pre- intra- and post-procedure considerations for the breastfeeding mother and child, strategies for perioperative breastfeeding, breast pumping, and storage of breastmilk will also be discussed, including the common challenge of coordinating care amongst multiple healthcare disciplines and in multiple practice settings. Interactive audience questions and answers will be followed by an interactive problem-based learning discussion (PBLD). Participants will receive an annotated bibliography with up-to-date references.

Performing Physical Breast Assessment 
Katrina Mitchell, MD; Anne Eglash, MD, IBCLC, FABM; Lauren Hanley, MD, FABM; Kimberly Stone, MD

The physical breast exam is important in identifying the etiology of common complications of lactation as well as recognizing more worrisome masses. Key aspects of the comprehensive breast and regional nodal basin exam will be reviewed, and participants will perform the exam on simulation breast models. Aspects of the breast exam that are relevant to lactating women will be addressed, including identification of insufficient glandular tissue and specific findings that represent different etiologies of breast pain. A demonstration of how to perform breastmilk culture and a review the presentation of common benign and malignant masses that may occur during lactation will be included.

Implementing the use of oral glucose gel in a newborn hypoglycemia protocol 
Rana Alissa, MD

Neonatal hypoglycemia is a common problem in the newborn nursery and NICU. One institution’s success in using oral glucose gel as a first line for managing the asymptomatic newborn with hypoglycemia will be discussed. Benefits include: decreased rate of NICU admissions and transfers, increased breastfeeding rates, and decreased hospital charges. The presenter will share the institution’s hypoglycemia protocol which was based on a modification of the AAP protocol to accommodate glucose gel. The session will include a brief video on how administer glucose gel to a hypoglycemic newborn, along with breakout groups for a discussion of how to introduce glucose gel to other hospitals.

Improving Maternity Care Practices – Successful Programs from Around the World 
Julie Ware, MD, MPH, FABM; Ann Kellams, MD, FAAP, IBCLC, FABM; Elien Rouw, MD, FABM; Lori-Feldman-Winter, MD, MPH, FABM; Yvette Piovanetti, MD, FABM

The Ten Steps to Successful Breastfeeding has been shown to improve breastfeeding initiation, exclusivity, and duration worldwide, as well as decrease disparities in breastfeeding initiation. Examples of successful strategies for implementation, challenges and plans for the future, including changes inherent in the new WHO/UNICEF guidance, will be shared. Participants will receive a summary of best practices from the highlighted programs and a toolkit for implementation in their own areas. Particular emphasis will be on safety considerations while implementing the Ten Steps, the importance of engaging leadership, payors, and physicians, and the overarching importance of equity in improved maternity practices.

Hands-On Training in Lingual Frenotomy 
Susan Rothenberg, MD, IBCLC: FACOG, Bobak A. Ghaheri, MD; Earl Harley, MD

Ankyloglossia (tongue-tie) can contribute to poor latch at the breast and create significant difficulties for the breastfeeding dyad. Frenotomy, a simple, well-tolerated procedure, can be done in an office or inpatient setting with minimal equipment. Because frenotomy is rarely taught in residency programs and many communities lack easy access to the procedure, the presenter will use didactic and simulation portions to teach the indications for and technique of newborn and early infant frenotomy. The workshop will review the incidence of ankyloglossia, common symptoms, the formal evaluation of lingual frenula and will demonstrate the method using scissors with and without a grooved retractor.

Informal Breastmilk Sharing: What You Need to Know 
Natasha K. Sriraman, MD, MPH, FABM; Amy Evans, MD, FABM; Robert Lawrence, MD, FABM; Larry Noble, MD, FABM

This workshop will address the recommended guidelines of Informal Milk Sharing based on the recent publication of the ABM Statement: Informal Milk Sharing. To address the controversial topic of milk-sharing, we will have a didactic portion discussing the guidelines briefly and common questions encountered from patients and providers, and then present 3 cases where we will illustrate how to determine the safety of milk sharing in various different clinical scenarios utilizing audience participation. A question and answer session at the end will address issues not answered in the workshop.

Design Your Breastfeeding Research Study! 
Laura R. Kair, MD; Melissa J. Chen, MD, MPH; Eleanor Bimla Schwarz, MD, MS; Valerie J. Flaherman, MD, MPH

Clinical researchers will provide information and practical skills for conducting research using 4 clinical study designs: cohort, case-control, cross- sectional, and qualitative. Participants, breaking into facilitated groups based on the preferred study design for their research questions, will complete a 1-page worksheet designed to develop a 1-sentence research question. Re-convening as a whole group, the workshop leader will provide a brief overview of developing a research plan. Working again in small-groups, participants will define their study sample, outcome measures, and study documents or survey instruments, leaving the workshop with a fully-developed research question and a study outline to help answer it.

Teaching with Group Facilitation: skills to engage and inspire medical professionals 
Andrea B. Joyner, MD, IBCLC, FACOG; Erin Berry, MD, MPH, FACOG; Sarah Kellerhals, MD; Susan D. Crowe, MD, FACOG 

This interactive workshop will equip participants with teaching skills to inspire active and individualized learning about breastfeeding in a group setting. The teaching style addresses the complex needs of adult learners by engaging them in the topic more effectively and resulting in better retention. After a brief introduction to the technique of group facilitation, participants will work in smaller groups to practice their new skill set, utilizing technology (laptops, phones, tablets) to rapidly research didactic topics and present findings to fellow learners. They will learn how to adapt this model to groups of learners with varying degrees of breastfeeding knowledge.

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