EXPERIENCING AN ILCA CONFERENCE

Throughout my many years working as a lactation consultant and childbirth educator at the Western Pennsylvania Hospital, I had always hoped to attend the annual ILCA conference. This year my dreams were realized! 

In the early morning hours of July 12, 2011, I boarded an American Airlines plane to embark on my first ILCA conference in the spectacular city of San Diego. Thanks to good fortune, I was the proud and most appreciative recipient of the WPLCA conference scholarship monies which definitely helped make this dream trip a reality.

Upon my arrival in San Diego I shared the hotel shuttle bus with several other enthusiastic LCs and thus began the networking extravaganza. Since the workshops on Wednesday were full, I used the day to unwind and tour the beautiful city of San Diego, the Harbor, Old Town and Balboa Park. There I met two lactation consultants from Georgia who befriended me and allowed me to join them for the day. Little did I know that later that week we would travel together again; this time by train, up the Pacific coast line to Hollywood to conclude our whirlwind conference excursion!

The vendor show opened in grand splendor with (non-alcoholic-darn) champagne and delectable desserts. In addition to the many vendor booths was a potpourri of lactation icons to meet and talk with including: Cathy Carothers (what a delight!), Dr. Jack Newman, Kitty Franz and Dr. Jane Morton. In many ways it was like the “Lactation Hall of Fame”! 

Before the conference I recalled hearing about the traditional “parade of flags” which opens the conference. There was no way to prepare for this event which instilled in me a sense of pride as I viewed the amazing scope of this “international” organization. This year there were almost 3,000 lactation professionals in attendance.

The main conference convened in grand style as Katherine (Kat) Shealy, MPH, IBCLC, Public Health Breastfeeding Specialist for the CDC, presented an invigorating, passionate and entertaining summary of legislation which has positively impacted breastfeeding management over the past decade. Kat traced the actions beginning with the HHS Blueprint for Action on Breastfeeding in 2000 to the recent 2011 Surgeon General’s Call to Action to Support Breastfeeding as measures which should encourage and motivate breastfeeding advocates that there is “light at the end of the tunnel”. Finally we have data and thus power to persuade those in power positions about the advantages of becoming “baby friendly”. She encouraged everyone to reference the Surgeon General’s “blue book” as a very useful tool to move breastfeeding in the right direction both in hospitals and in communities. Kat breathed fresh life into a sometimes “dry” topic.

Throughout the conference there was frequent emphasis on the very real need for lactation professionals to become skilled and keep updated on the breastfeeding-related information overload available on the internet. Parents today look to the internet for information and answers to their questions. Unfortunately, there is much “opinion” rather than evidence- based fact readily available. Parents need to be guided by educated lactation professionals to identify reputable, evidence-based sources of web information and to realize that the information obtained there should not be their “end point” for information and problem solving. Like it or not, social media sites and mobile technology are here to stay and the wise lactation professional will learn about and embrace these tools if they are to survive in the future.

I was honored to represent WPLCA at the chapters meeting! The chapter representatives had the opportunity to share their local chapter’s accomplishments so I was delighted to relay the educational opportunities offered by WPLCA and our sponsorship of the Egyptian lactation consultant as a member of ILCA.

There was a wide variety of topics covered at this conference and several of the sessions I chose to attend focused on human milk feedings in the NICU environment. This was an appropriate topic choice for me since we serve a large NICU population at West Penn Hospital. Nancy Wight, MD, IBCLC, Neonatologist, presented a fascinating discussion of the many opportunities and challenges for use of human milk in the NICU. She discussed the current “quality chasm” in perinatal care which is evident in the inability to translate evidence based research into practice. This is widely observed in the inconsistent support of and use of human milk in NICUs across the country. Dr. Wight discussed the critical exposure periods for preterm infants to receive human milk and ways to change practice to improve compliance. For example, studies show that daily swabbing the mouth of a vulnerable infant with the mother’s colostrum, results in infants being advanced to and tolerating oral feedings 10 days earlier. Interestingly, Dr. Wight also discussed the problems in measuring the effects of human milk in the NICU because of inconsistent definitions of human milk feedings. The Vermont-Oxford data collection at the time of discharge, for example, records any amount of breast milk the infant received during their hospital stay. When reviewing the data, that means that for some infants, it may be exclusive breast milk and for others it could be one breast milk feeding.

Dr. Jane Morton from Stanford University spoke extensively about her impressive findings regarding milk volumes obtained by hand expression and hands-on pumping as compared to milk volumes obtained by pumping alone. Dr. Morton conducted an excellent workshop on the “headaches” in breastfeeding management of later preterm infants (aka-“The Great Pretenders”;). Her strategy to successfully provide breast milk to this group of infants is to first focus on aggressively but appropriately providing calories. The next priority should be breast milk stimulation, using pumping and hand expression. Dr. Morton has written extensively about the use of hand expression and hands-on pumping. The third priority is that lactation professionals should focus on the attachment process. This paradigm is the reverse of how we approach healthy, term infants. Discharge planning should start from day one and the lactation consultant should work with the parents to develop a comprehensive but easy to follow feeding plan to insure continued breast milk intake.

A recurrent theme in many of the presentations was that of ethical dilemmas. Jennifer Peddleston, BScPharm, IBCLC from Canada discussed at length the professional documents which guide our professional practice. She also reviewed various ethics theories and their application in our professional practice. In another session, Ms. Peddleston dissected the International Code of Marketing of Breast milk Substitutes and code violations which are challenging breastfeeding promotion and support today. On a practical level she challenged the LCs in attendance to hold their institutions accountable for practices such as providing free formula samples, failure to educate parents of the risks of formula and the failure to exclude formula feeding information from the prenatal class curriculum.

This is only a sampling of the abundance of information presented at the sessions at this year’s conference. Equally valuable and enjoyable was the time spent “networking” with colleagues from across the globe. I must admit that initially I was a little anxious attending a conference across the country and knowing no one. My concerns quickly disappeared as I began to interface and interact with many warm, wonderful colleagues. I feel blessed and fortunate to have had the opportunity to attend this conference and I am thankful for the assistance from our local chapter! Like other “first time” experiences, my trip to San Diego for my first ILCA conference will forever hold wonderful memories for me.


Sandra M. Porco, RN, BSN, LCCE, IBCLC
Manager, Maternal Child Support Services
The Western Pennsylvania Hospital