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Going to The Heart of Lactation Practice November 3, 2016, 15th Annual Conference CONFERENCE 8:30-09:45 OPENING SESSION 8:30 AM – 09:45 AM Alexander Valley Room I&II Mother’s Speak Out: Top Five Traits of a Great LC Presenter: Lisa Marasco What makes for a great LC? Find out what real mothers had to say about what was most important and impressive to them! Great insights for improving effectiveness and clinical outcomes. CONFERENCE 09:45 – 11:00 PRESENTATIONS 09:45 AM - 11:00 AM Alexander Valley Room I&II Getting a Better Grip on Prolactin Presenter: Lisa Marasco Prolactin is considered to be a key hormone for lactation, yet our knoweldge has been surprisingly sparse. It is necessary for pubertal and pregnancy mammary development as well as milk synthesis. While prolactin level does not correlate directly to milk production, lactation fails without it. This talk will take a closer look at current research and what we do and do not yet understand about prolactin. We will then examine specific cases and discuss the process of elimination, as well as possible strategies for affected mothers. 09:45 AM - 11:00 AM Facilitating State Control in Non-Latching Infants Dry Creek Room Going to The Heart of Lactation Practice Presenter: Catherine Watson Genna Maintaining neurobehavioral organization in dyads that are struggling with latching difficulties is a challenge for lactation professionals. Maternal interpretations of infant behavior and signs of frustration can affect her motivation to breastfeed and available psychosocial resources. This presentation explores how lactation consultants can scaffold maternal functioning by providing support, interpreting and framing normal infant behaviors, and modeling and teaching ways to scaffold the infant’s organization to improve the dyad’s ability to work through breastfeeding difficulties. CONFERENCE 11:15-12:30 PRESENTATIONS 11:15 AM – 12:30 PM Alexander Valley Room I&II Breastfeeding on the Insulin Dysregulation Spectrum Presenter: Lisa Marasco Insulin is part of the Lactogenic Complex and Lactogenesis 2 cannot start without it. Until recently, however, we did not understand its role well. Emerging research is starting to shed light on specific roles for insulin in both pregnancy breast development as well as milk synthesis. Discover the how and why diabetes and insulin resistance can cause lactation problems, and what treatments may be helpful for affected mothers. 11:15 AM – 12:30 PM Dry Creek Room Breastfeeding Babies with Torticollis Presenter: Catherine Watson Genna Many infants with unilateral breast refusal and asymmetrical tongue movements have a tight neck muscle from their intrauterine position. This presentation Going to The Heart of Lactation Practice discusses torticollis and related craniofacial asymmetries and the effect on breastfeeding, as well as creative ways to position babies at the breast and support normal feeding. CONFERENCE 1:30-3:00 PRESENTATIONS 1:30-3:00 PM Alexander Valley Room L&II Why Can’t That Baby Latch? How Tongue and Lip Mobility Restriction Can Affect Breastfeeding Presenter: Lisa Marasco Successful lactation depends in part on a baby’s ability to latch and draw milk from the breast in an effective and efficient manner. When baby isn’t able to do his job, everyone suffers. Tongue and lip mobility restriction can both overtly and subtly impact baby’s suck, yet this problem is rarely picked up by most health care providers. Anterior tongue-tie is easiest to identify, but restrictions involving the posterior tongue or the lip can be equally devastating and yet are almost unknown. This talks covers the role of the tongue and lips in sucking and red flags for tongue mobility restriction. Each variation of problem is illustrated by multiple photos and video clips, and optional cases describe presentation, treatment and outcome. 1:30 PM – 3:00 PM Dry Creek Room How Milk is Made: Implications for LC Practice Presenter: Catherine Watson Genna The control of milk synthesis depends on a complex interaction of autocrine and endocrine factors. The contributions of these two systems are continually being clarified by research. This presentation explains the two systems, their interactions, and what this means for the advice we give to mothers. Should an engorged mother pump? How do we best help a mother increase milk supply? How do we control oversupply without increasing the risk of mastitis? The scientific background is clearly delineated in understandable language, and these quandaries discussed. Going to The Heart of Lactation Practice CONFERENCE 3:30-5:00 PRESENTATION 3:30 PM-5:00 PM Alexander Valley Room L&II What About Next Time? Planning for the Next Baby Presenter: Lisa Marasco When a mother has struggled with chronic low milk production, sooner or later she begins to wonder about the next baby. Will this happen to me again? Is there anything I can do to increase my chance of more success the next time around? Should I even try breastfeeding again? Research suggests that mothers often do better with subsequent babies, but not all mothers wish to wait passively on the roll of the dice. For those who desire to be proactive, there often are concrete clues that can help paint a prognosis and lend guidance to future plans. This session will look at various scenarios of low milk supply and analyze potential variables that might be influenced in the future. Specific cases with varying outcomes will be presented, along with discussion on counseling challenges and helping mothers find emotional balance in the process. 3:30 PM-5:00PM Dry Creek Room Red Flags of Breastfeeding Presenter: Catherine Watson Genna Some conditions require further scrutiny and referral to a health care professional. This presentation uses clinical photographs to illustrate signs of insufficient milk intake, cardiac and respiratory problems, and tongue-tie in infants; as well as signs of breast cancer or risk factors for insufficient milk production in mothers.