CLCA Newsletter

CLCA quarterly Newsletters are posted here for your review. Event announcements, educational updates and news are welcomed for inclusion. Please submit your information to the CLCA Office at office@clca-accl.ca for consideration. 

CLCA Newsletter Issues:

CLCA Newsletter: April 2019
CLCA Newsletter: January 2019


CLCA Newsletter: October 2018

CLCA Newsletter announcement: August 2018


  • 29 Apr 2019 10:51 AM | CLCA Office (Administrator)

    Raha Afshariani , IBCLC , Ontario

    In Oman Medical Journal (2014)1, Raha Afshariani and Pooya Farhadi (2014) explained the effect of Curcumin (the active ingredient in turmeric) on mastitis in lactating mothers.

    The pain caused by inflammation of the breast tissue in case of mastitis is quite frustrating for the individual experiencing it. Thus, an important part of the treatment would be to reduce the inflammation, because if not controlled, it can influence a woman’s decision to cease breastfeeding. The main reasons cited for discontinuance of breastfeeding is because of lactation problems; in which mastitis is a significant and common complication. It can contribute to early weaning in the first three weeks. As breastfeeding is considered the most important route of feeding newborn especially in developing countries, early detection and treatment of lactation mastitis is very important. It is implicated that curcumin could potentially serve as an anti-inflammatory agent for controlling skin and soft tissue inflammations even at low doses with topical use. Although a number of studies have investigated the role of curcumin as an anti-inflammatory agent in different diseases, to our knowledge only a few number of studies have evaluated the potential of curcumin in controlling inflammation through skin topical preparations.

    In this article, Afshariani and Farhadi (2014) designed a randomized double-blind, placebo controlled clinical trial for assessing anti-inflammatory effects of curcumin in preparations for topical use comparing to placebo in patients with lactation mastitis. After considering the study criteria, the patients were randomly assigned to receive curcumin topical cream, one pump every 8 hours for 3 days (n=32) or topical moisturizer as placebo (n=31). Using an index for severity of breast inflammation, all of the patients had moderate breast inflammation before entering the study. The outcome of treatment was evaluated using the same index at 24, 48 and 72 hours of starting the treatment. After 72-hours of therapy, patients in curcumin groups had significantly lower rate of moderate (p=0.019) and mild (p=0.002) mastitis. Also, patients in curcumin group had significantly lower scores for tension (p<0.001), erythema (p<0.001) and pain (p<0.001), after 72-hours of treatment.

    This article demonstrates that topical preparation of curcumin provides favorable effects on pain, erythema and tension of the breast on those suffering from lactation mastitis within 72 hours of administration without side effects. Thus, topical preparation of curcumin could be safely administered to those suffering from lactation mastitis after excluding infectious etiologies.

    Reference

    1. Retrieved from Oman Medical Journal (2014) Vol. 29, No. 5:330-334 DOI 10.5001/omj.2014.89

  • 26 Apr 2019 10:45 AM | CLCA Office (Administrator)

    Pamela Drynan, RN, BScN, IBCLC , Ontario

    Recently, I had the pleasure of speaking with first-time mothers at an organized mommy group within our local community centre. Many of the mothers discussed challenges that they have overcome to reach beyond their initial goal of 6 months of breastfeeding, and now, eight to twelve months in, they are planning their return to the workplace and are worried about sustaining breastfeeding. Most mothers described various mixed emotions and thoughts on how to proceed within the breastfeeding relationship, unsure if they should just wean due to perceived challenges of pumping within their workplace and intimidation of approaching their employers about “extra break time to pump” or “clean places to store milk”. Some disclosed that they have been in contact with their employer who has already given her a hard time about pumping in the workplace and coordinating her schedule (ie: off-site job duties, meetings, training etc). Some plainly stated that the thought of managing breastfeeding in their workplace was just not worth the stress. I came prepared to the session with resources on pumping and storing milk, decreasing the risk of plugged ducts and mastitis, human rights within the workplace in regard to breastfeeding, and various methods of weaning. I planned how I was going to present the material and facilitate “rich discussion”. However, I was not prepared for the anxiety the women expressed and the negative thoughts they had on how they would proceed with breastfeeding within their workplace. I knew it’s our right to breastfeed for as long as we desire. But despite the policies and human rights code to protect breastfeeding families, the discrimination and disempowerment that still exists for women in the workplace was just as real as the struggles women experience at the beginning of their breastfeeding journey such as sore nipples, low milk supply, supplementation, and lack of support, just to name a few.

    Multiple research efforts have demonstrated that hospital practices impact breastfeeding. The Baby-Friendly Hospital Initiative (BFHI), that is built around the World Health Organization (WHO) and United Nations International Children’s Emergency Fund’s (UNICEF) 10 Step’s to Successful Breastfeeding, advocates that there is strong evidence to demonstrate a dose-response relationship between the number of steps the hospital adopts and breastfeeding outcomes. In Rouse & Ferrarello’s 3 quality project, results indicated that only one third of the families were still breastfeeding at 3 weeks postpartum (2019) 4. In Canada, data reports that nearly 25% of the families at one month postpartum have stopped breastfeeding 1. Across the nation as well as internationally, policy makers and leaders continue to advocate for improved breastfeeding outcomes. Ladores et al 2 discuss in their article, Breastfeeding Women in Academia: Pursuing Tenure Track versus “Mommy” Track, how imperative it is for health care professionals to ensure that we target improving the transition for women back into the workplace while sustaining breastfeeding (2019) 4. This article was helpful for me in conceptualizing the difficulties women face as they return to work. Ladores et al 2 indicate specific applications for practice as follows: 1) Improved and standardized family leave policies, 2) Improved workplace infrastructure, 3) Flexibility in work schedule and structure, 4) Equal opportunity to advance on the tenure track, 5) Establishment of onsite daycares, 6) Supportive policies clearly communicated and enforced, and 7) Change in attitude and culture (2019) 4. Some things to consider for moms pumping in the work place include mothers who have difficulty with mechanically expressing milk due to supply or nipple pain, but also environmental challenges such as lack of private rooms that have a locked door, electrical outlet, comfortable chair, table, and running water, as well as adequate break time to complete pumping session (typical session requires up to 30 minutes). Many employers require employees to attend lengthy meetings or days long conferences, all of which can propose challenges physically for a woman maintaining breastfeeding plus host a variety of stigmas within the workplace. Each place of employment is unique as is every family, however a standardized, collaborated effort to ensure that equal social justice and health outcomes are achieved for all families are an important aspect of advocacy for Lactation Consultants across the globe. Ledores et al 2 also indicate that although the article specifies women in academia, they report that these recommendations can be applied to all women in all work settings (2019) 4.

    I am grateful that Clinical Lactation journal supports the growth and development of the practicing Lactation Consultant to ensure that we can continue to support families at all stages of the breastfeeding journey. Share your journey of professional growth as you read the Clinical Lactation journal on our social media: Facebook, Instagram, Twitter. Log in to the CLCA Members portal here to access the latest Clinical Lactation Journal issue


    References:

    1. Government of Canada: Chapter 6: Breastfeeding: Retrieved on April 23, 2019.

    2. Ladores et al: Clinical Lactation, 2019, 10(1).

    3. Rouse & Ferrarello: Clinical Lactation, 2019, 10(1).

    4. Clinical Lactation Journal (2019) 


  • 31 Jan 2019 9:41 AM | CLCA Office (Administrator)

    Bethany Heintz, RPN, IBCLC, Ontario

    Happy New Year!!

    With deep gratitude, I welcome back all of our returning CLCA members and offer a very special welcome to our new members who have joined us in 2019.  We are thrilled you're here!

    We've kicked off the new year with a bang here at CLCA.  Thanks to you, we are welcoming two new board members to the CLCA team this year - Jandy Beresford, our new Chapters Director and Raha Afshariani, our new Education Director.  Both new Directors currently join us from Ontario, Canada and have already jumped in with both feet at our January board meeting.  I'm excited to witness how their support and enthusiasm for CLCA and our mission will contribute to shaping the future of our organization.

    CLCA continues to grow. I am thrilled to see our membership numbers swelling again this year.  This touches my heart as I've watched this organization emerging stronger from its new birth over the last 4 years and my smile has only grown wider.  CLCA takes its commitment to its members seriously and with more members, the organization can do more for you!

    Our 2019 conference planning committee is well on their way to bringing you an incredible lineup of speakers, exhibitors, experiences, networking opportunities and hands on workshops you don't want to miss.  With the energy and enthusiasm of this committee, we are seeing the Richmond, BC conference shaping up to be an incredible event packed with opportunities for all attendees.

    CLCA wants to celebrate you!  In each newsletter, we are opening the doors for you to tell us about the amazing, life changing work you do.  I invite you to drop us a quick email and tell us about a moment in your own practice, a testimony about a colleague or a highlight story you want to share.  We want to feature YOUR story in the next newsletter!  

    May your 2019 be overflowing with peace, abundance and joy, 

    Bethany Heintz 

  • 28 Jan 2019 6:04 PM | CLCA Office (Administrator)

    Pamela Drynan, RN, BScN, IBCLC , Ontario

    In the recent Clinical Lactation journal, Marsha Walker discusses how social media posts and campaigns have declared exclusive breastfeeding as dangerous and have caused attention deficit disorder, hypoglycemia, hyperbilirubinemia, hypernatremia, dehydration, brain damage, and even death. Although poor breastfeeding outcomes do occur, there are so many ways health care professionals can help these breastfeeding families achieve more healthy outcomes with appropriate breastfeeding management. Walker describes in the article strategies that can improve the clinicians professional practice as an opportunity to help families achieve exclusive breastfeeding safely.

    One implication for practice that Walker discusses is normal infant crying vs inconsolable crying, highlighting that inconsolable crying can be a sign that milk transfer is poor and then suggests how clinicians can assess the breastfeeding dyad for adequate milk transfer and support the family to reach their breastfeeding goals. Walker lists the commonalities among mother-reported narratives on social media in this article. Those statements really resonate with common complaints lactation consultants hear from the families they support, and it also highlights that as clinicians, we have a role in debunking the inaccurate representation of exclusive breastfeeding from social media by providing early and comprehensive clinical lactation support. Walker provides research-based information on a variety of topics such as understanding and knowing the signs of milk production and removal, insufficient milk vs delayed lactogenesis II, supplement volumes, hypoglycemia, discharge plans for families to ensure adequate breastfeeding support, and implications for our practice as lactation consultants. This article includes practical resources that Marsha Walker developed on the following topics: “Guidelines for Breastfeeding Your Newborn”, “My Hospital Discharge Checklist”, “Breastfeeding Problems Can Happen”. She also connects her article to the other featured article regarding neonatal weight loss by Watson Genna & Notarangelo (2018) that is in the current Clinical Lactation journal.

    To read the featured article visit the Members  Portal here and log on to the Clinical Lactation journal to add to your knowledge and skill library today!

    Walker, Marsha, Clinical Lactation, 2018, 9(4), http://dx.doi.org/10.1891/2158-0782.9.4.171


  • 28 Jan 2019 6:01 PM | CLCA Office (Administrator)

    Newborn Weight Loss

    Pamela Drynan, RN, BScN, IBCLC , Ontario

    In the current Clinical Lactation journal, found in the Members Portal here, Catherine Watson Genna and Micaela Notarangelo (2018) explain the details of differentiating between normal infant weight loss from weight loss related to breastfeeding failure. Many clinical professionals who work with newborns often experience a heightened sense of worry when they see a baby approaching 10% weight loss. The article describes the details of strategies that protect infants from hypernatremic dehydration, birth interventions and hospital routines that impact breastfeeding opportunities and weight changes in newborns, what normal versus problematic weight loss may look like, identifying babies at risk (of excessive weight loss or breastfeeding failure), factors that contribute to the risks, symptoms of low milk intake, and recommendations for practice (Watson Genna & Notarangelo, 2018).

    Many professionals have demonstrated through research that it is vital for most breastfeeding dyads to have an early assessment by an IBCLC within the first 24 hours to help with breastfeeding management. Watson Genna & Notarangelo (2018) are among those professionals that state early intervention within the first 24 hours is vital when an infant is experiencing higher than expected weight loss within the first 24 hours to ensure infant safety and to preserve breastfeeding. As an IBCLC, we can carefully assess the breastfeeding situation, help prevent hypernatremic dehydration, as well as prevent unnecessary supplementation that can impair the infant’s microbiome (Watson Genna & Notarangelo, 2018).

    This article can provide you with up to date strategies to help you clinically manage prevention of hypernatremic dehydration as well as treatment strategies. This article adds to the body of knowledge of infants adapting to extrauterine life and is essential for lactation consultants to gain further knowledge and skill for supporting families during a vulnerable time. You can access the article via the Members Portal here.

    Clinical Lactation, 2018, 9(4), http://dx.doi.org/10.1891/2158-0782.9.4.183 

  • 17 Oct 2018 4:43 PM | CLCA Office (Administrator)

    Pamela Drynan, RN, BScN, IBCLC , Ontario

    By now you most likely have learned about the microbiome of the human gut and how human milk influences the development of the microbiome. But have you heard about the microbiome of the breasts themselves? Marsha Walker, RN, IBCLC, RLC discusses the connection between the microbiome, treatment during pregnancy and labour and delivery, and the risk of developing mastitis in the most recent Clinical Lactation journal in the article “Mammory Dysbiosis: An Unwelcome Visitor During Lactation” She also describes the research of how probiotics have shown some positive effects on treatment of mastitis. The article provides some education on the nature of the bacteria of the breast and the influence of the breast microbiome while also providing education on the specific microorganisms that induce acute and subacute mastitis. Breast have their own community of bacteria that work together to protect breast tissue, however, there are many variables that can disrupt that protection and increase breastfeeding parents risks of mastitis. Marsha Walker brought to life how the community of microorganisms are an important area of knowledge that Lactation Consultants should have a greater understanding of in order to provide optimal clinical support to the families they service.

    Access the online Clinical Lactation journal to read the full article here


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