Tag Archives: Education

LCinPP Talk On Bottle Feeding by Susan Howard IBCLC reviewed by Pauline McLoughlin

The LC in PP in Conference Philadelphia this year was my first international conference to attend in all things breastfeeding; the “Breastars” were in attendance! Some attending the sessions, others giving sessions … and not to forget to mention my lovely Irish colleagues who made the whole experience very worthwhile and fun. Thanks to ALCI for a bursary to attend this conference.

The programme was full and intense, and my wits needed to be on full alert to take all the information in and process it. Given that it was all things lactation I was surprised to see on the programme a session entitled “Bottle Battles, Practical Tips for the Bottle Refusing Baby”, facilitated by Susan Howard IBCLC. Bottle battles at a conference for lactation consultants!? Following an informal chat amongst my colleagues I discovered that some IBCLCs do not as a rule help with bottle feeding problems, even with EBM. In the US where the maternity leave is relatively short many breastfeeding mothers have no other option but to bottle feed EBM as they return to work and want their babies to get breastmilk. I understand that US IBCLCs are more likely to work with bottle feeding dyads. As it turns out I had a call from a mother who was bottle feeding her baby and wanted help just before I left for America. She asked me tentatively if I took appointments from mothers who bottle feed. I asked her to fill me in. She described a 4-month long journey of frustration and failure (her words). She reluctantly finished her breastfeeding journey which was a very emotional for her and started to bottle feed formula to discover to her complete frustration and upset that her problems were not resolving. I felt I could not refuse to offer her help. To be completely honest although this session resonated with me, I thought to myself there was not too much to learn here! When Susan asked her audience to raise their hand those who felt competent and confident to work with bottle refusing babies, I raised my hand without hesitation, flush with the success of my recent consultation!!! OMG when I think of it… morto!!

The session was so well put together, interactive with lots of photos and props. I learned so much that I did not know! Thank you to Susan Howard IBCLC. Anyway, I am here now to share with you all 10 points that I picked up to help with families with “Bottle refusing Babies “

If you work in primary care or on the community, you are likely to have come across babies who play with the teat, chew or chomp the teat but manage to get the milk with the help of a fast flow teat. Or I imagine you have seen babies who appear to have soaking wet Babygro from milk spillage. Or you have encountered parents who have complained to you that it takes ages to feed their baby the bottle. You may find the weight gain is normal but are these babies feeding normally from a bottle? According to Susan, weight gain however should not be the only benchmark for feeding success. In transitioning to bottle feeding a baby should be able to accept a teat into their mouth with no gagging and suck from the teat in an organised manner and with no milk spillage.

First and foremost, in helping overcome the difficulties of transitioning to the bottle Susan would say you need to manage the expectations of the parents; one consult is not necessarily going to solve the problems. She tells families I cannot “make” your baby take the bottle. What we can do as helpers is figure out why there is difficulty with transitioning to a bottle feeding or why the baby is refusing the bottle and then help with a plan.

In figuring out the whys, she looks at the breastfeeding; she observes a breastfeed and watches for leaking, clicking, flow of milk, chewing or active sucking, nibbling, slipping off the breast.

She observes the baby in the same way we all do during a breastfeeding consult, looking for asymmetry, tightness, torticollis, palate shape, cheeks, sensitive gag reflex, hypotonia and hypertonia amongst other observations. All these factors may contribute difficulty transitioning to the bottle and may require other help like bodywork.


  1. Mother is in the best position to help their baby transition to the bottle effectively, not their mother or mother in law, child minder or friend. Mothers know their babies and babies trust their mothers.
  2. Hunger is not a great sauce. Babies who are fed and rested will be more regulated and less stressed. If the baby is hungry, they will get stressed, cry more, may have negative associations and develop in extreme cases oral aversions. Hungry babies are not motivated to learn
  3. Wake the baby’s body up: Do body warm-ups, assessing for tension in the neck and shoulders. Move arms up and down and open arms out and bring them together at the chest, talking and engaging the baby. Use lots of eye contact. Do exercises where the opposite body parts meet in the midline … e.g. arm meet the foot of the opposite side at the midline. Wake the baby’s mouth up: Oral massage, tap lips, massage TMJ, and massage palate. All exercises should be quick and playful and be led by the baby’s cues. Praise and encourage and do all of this before a teat has been taken out of the package.
  4. Encourage good baby posture for feeding, upright chest, back supported, hips flexed and positioned so that the baby can make eye contact too.
  5. Practice with empty bottle teat, and yes, no milk in the teat at LEAST AT THE START. Get permission from the baby to accept the teat into their mouth, stimulate or tap their lips with the teat, let them feel it. Touch it lick it praise them as they achieve these goals. Aim for hard palate. Sometimes mimic what you want the baby to do. Keep eye contact and let the baby hear the mother’s voice. Get the sucking skills right and then introduce milk in small amounts.Other ways to help baby suck is “Bait and switch” at the breast on to the empty teat when the baby relaxed and full. When babies are sleeping or drowsy and they “sleep suck” practice lots. Teach parents the visual cues for stress.
  6. Hold the bottle like a pencil, rest fingers on bottle collar and hand resting on chest. Support the jaw as needed. Stabilise the cheeks which helps with vacuum and support the jaw if there is chomping or jaw tremor. Practice when sucking to pull bottle teat slightly out so baby pulls it back into mouth. Discourage parents from bottle hopping or teat swapping.
  7. Success is defined by accepting the bottle into their mouth with a good seal no gagging and an organised suck with no spillage. It is not defined by taking an entire bottle.
  8. Use paced bottle feeding however Susan recommends not taking the teat out of the baby’s mouth in this instance.
  9. Tummy time improves all sucking skills by bringing the jaw and tongue forward. It encourages head/body extension. Roll into tummy time roll out of tummy time.
  10. Progress can and does stall, encourage parents to go back a step and reassure. Need to build into the consultation different stages of success, e.g. first step recognition of the teat, next cuing and opening wide then accepting teat. Following that, good lip seal, no gagging and organised suck. Parents may feel anxious to move quickly as there may be a time pressure for returning to work for example. Short 3 to 5-minute practice sessions 3 to 5 times a day. Pick times when baby is up for “play”.

Finally like all breastfeeding challenges it takes patience and practice and praise or positive feedback.


Pauline McLoughlin IBCLC September 2019

Pauline received a bursary of €200 from ALCI to attend LCinPP.


Annual International Meeting of the Academy of Breastfeeding Medicine in UK this October


The 24th Annual International Meeting presented by the Academy of Breastfeeding Medicine features world-class speakers providing cutting-edge research and clinical information on current issues in breastfeeding medicine, spanning both maternal and child health. This year’s meeting is the first to be hosted in the United Kingdom and will be held October 16-19, 2019. Physicians, registered nurses, lactation consultants and other professionals will have the opportunity to continue their professional education in a highly respected, stimulating environment, while earning continuing education credits.

ABM’s Annual Meeting is the ideal context to engage in innovative workshops, address evolving issues and connect with an international organization of clinicians devoted to the promotion, protection and support of breastfeeding.



2018 Breastfeeding and Feminism Conference – Ger Cahill IBCLC

13th Breastfeeding and Feminism Conference,  21st – 23rd March 2018 http://breastfeedingandfeminism.org/

Centre for Women’s Health and Wellness and Carolina Global Breastfeeding Institute.

Report by Ger Cahill, IBCLC, ILCA Board Member


I was given the opportunity, through my work with ILCA, and with some financial help from ALCI, to attend this conference as the dates just preceded the ILCA March Board meeting. The theme of this years conference was The Dance of Nurture in a complex World,  How biology, gender and social context shape how we nourish our children, and WOW was the whole conference as complex as the title sounded!


Ger Cahill (in yellow) with fellow ILCA board members.

This conference is a place where people from disciplines as wide ranging as Anthropology and Media can present their research as it relates to Infant feeding.


There was so much new research I was spinning – there were 2/3 concurrent sessions on each of the 3 days, we had to choose one piece to attend from a choice of 7/8 at each of these sessions.  So a lot of researchers and research pieces being discussed and disseminated.  The research all took place within a feminist context so was mostly qualitative, though there were some quantitative pieces.  There were also film showings and an exhibition of photos all related to breastfeeding so a whole lot to absorb and assimilate.


The keynote speaker Penny Van Estrik set the tone on the 1st day with her piece entitled “the Dance of Nurture” where she explored how a framing of dancing and breastfeeding within a nurturing role can help us to see breastfeeding as the foundation of solid relationships in life.  She explained that just as dance can be a metaphor for interactedness and relatedness, with its stress on rhythms and cycles, that can be an expression and emotion.  Then so can breastfeeding be a metaphor for nurturing.  Nurturing is carework, but it is often not measured and there is no economic structure put on it or breastfeeding.  She very much put breastfeeding and nurturing as cyclical and evolutionary practices which we have been watching being eroded but we don’t understand or even know what we are losing.   She talked about mothers now not being connected to their babies as they spend time on their iPhones being connected with the outside world, but perhaps missing some of their babies cues.  Penny has taught Nutritional and Feminist anthropology at York University, Toronto and has a long history of advocacy work in breastfeeding and child health.  Her latest book the Dance of Nurture explores further the issues explored in her talk.  My copy is already ordered, amongst some of her other writings and books.


The rest of the conference confronted privilege, explored queer theory, indigenous knowledge and a feminist approach to technology and reproductive justice.  Reproductive justice was particularly interesting to me in view of our upcoming 8th amendment and it’s accompanying debates.   The talk looked at Reproductive rights and social justice through an intersectional lens, the things that jumped out at me was that individual service delivery is both a human right and a legal right but has been based on both colonial and masculine hegemonies at a global level.  It was shocking to learn, how some women in the justice system in the U.S. give birth in shackles (87 reported cases recently) and this is because of statutes that still exist from colonial times.  This was actually a most disturbing talk and colleagues from Pakistan and Malaysia (also ILCA board Members) were as disturbed as I was and could entirely relate to the ‘colonial’ aspects of the talk, which, though U.S. focused, certainly had echoes for each of us in our own country contexts.


The next panel took us to a completely different place, Water and Weather Insecurity – perhaps you can begin to understand the reeling – this was global in focus – water insecurity exists all over the world and has far reaching consequences, in terms of infant health and the practices surrounding it.  The researchers talked about family’s spending money on water, which would otherwise be spent on food, mothers spending a long time looking for water, which they would otherwise spend feeding their babies and thus other longer issues such as growth, and social disadvantage can stem from this.


The disaster that happened in Puerto Rico in the wake of hurricane Maria and the continuing struggles that this one time 1st world nation is now experiencing was shocking.   This was presented by a resident, an IBCLC, who has been living through it and who gathered the statistics and the stories.  40% of homes still have no running water or electricity and 40% of the road intersections still have no traffic lights, These people are feeling completely let down by their own local government and the federal government in America.  The bright spot in this was the growth of women-led support groups,  regardless of feeding method.  With little access to milk powder as so many shops are closed, the milk sharing that has been taking place and the support they are giving to one another is what has been keeping most of the residents going as they face into the next hurricane season which is fast approaching.


There was then a talk on the issues facing Haitian refuges who have been moving up through the United Stated over many years and who, because of the political situation have now immigrated, en masse, into Canada.  An issue I have never even heard of at all, the Canadian system has been overwhelmed, and doesn’t have the capacity to deal with the issues, but is also unwilling in many cases to engage with those on the ground who could help, especially when it comes to birth and feeding issues.  A very harrowing case study was outlined which made me think of the refugees who have entered our own country and I wondered do any of the advocates for breastfeeding in Ireland, have any idea about who is supporting these women from Syria and elsewhere around birth or breastfeeding?  Definitely an area that needs some research!


The panel talked about the need for pictorial info-graphics and information packs, about building informal and community capacity in place of and to counter white savior syndrome, structural and gender violence and institutional racism, intended or otherwise.


We need groundwork to happen before the emergencies, thinking about our own emergencies over the last year or so I wondered do the emergency feeding issues of our dairy industry come before those of our vulnerable infants, is Infant feeding even represented on our Emergency Task Force?


So as you can see a lot to take on board, and this was only Day 1.  Talks over the next few days encompassed many areas, Conflicts of Interest, Transgender breastfeeding, the impact of Intersectionality on breastfeeding, Post Natal Depression, Pumping and the commodification of breastfeeding tools, Milk Sharing and looking at how people feel about this.  Implicit Bias and Clinical Breastfeeding care, Improving workplace breastfeeding support, Body autonomy/Nursing aversion and agitation and why consent in all its forms matters to these women, Addiction, breastfeeding beyond the first year, lack of physician training in breastfeeding and human lactation – just to give a flavor of the talks and panels I managed to get to!


The milk sharing talk explored the themes around the stories that women who share human milk tell, both the receivers and the givers.  Milk sharing being a part of carework makes for it being a deeply emotional and intersubjective ritual for both parties.


One piece I would like to see replicated here in Ireland was a qualitative piece about the experiences of the NICU parent’s perspective on the care received in order to facilitate their return home.


The very last panel on the last day was also a highlight for me.  It’s was about Social media and had very interesting titles


  • “Discursive formation of white feminism, privilege and visibility with the #free the nipple campaign to change social media nudity policies”
  • “Breastfeeding and media – exploring 200 years of conflicting discourses.”
  • “Patching the Gaps – how online support shapes breastfeeding practices in Poland”


Three pieces of great research, grounded in women’s experiences, and a great way to finish an amazing conference.  So this is a special call to those who do research to send in their abstracts to this conference and help to make this a truly global conference.  They tried really hard to make it global, but apparently they just don’t get enough submissions from other countries, though among their non U.S. entries this year were submission from Malaysia, Thailand, England, Ethiopia, Nigeria, Poland, Sweden, South Africa and Brazil.


The range of topics covered in this conference, law to gender, race, ethnicity, to workplace issues, to mental health and to policy and its implementation, this conference showed that the sky is the limit when it comes to choosing a research topic that relates to infant feeding and human lactation.


To have met so any amazing women from different backgrounds and to discuss breastfeeding for 3 days and to hear so much research presented was a real privilege and I really hope that others will attend and report on this conference from Ireland in the future and also take some of the ideas presented here and bring them to our context.


ALCI All Ireland Conference 2017

The Association of Lactation Consultants of Ireland is delighted to announce that its’ Annual All Ireland Conference will take place this year on Friday 29th and Saturday 30th September at the beautiful Radisson Blu Hotel and Spa in Limerick.  The date, as usual, coincides with National Breastfeeding Week and this years’ keynote speaker is renowned international speaker and author Lisa Marasco, IBCLC. Booking is available here and the timetable is here.


Lisa has been working with breastfeeding mothers for over 30 years and has been an IBCLC since 1993. She holds a Master’s degree in Human Development with specialisation in Lactation and was designated a Fellow of ILCA in 2009. Her thesis on Polycystic Ovarian Syndrome and Breastfeeding was the first to investigate infertility-related causes of low milk production. Lisa is a co-author of The Breastfeeding Mother’s Guide to Making More Milk, a contributing author to The Core Curriculum for Lactation Consultants, and a new Cochrane Collaborative author. She lives in Santa Maria, California, and works as an IBCLC for the Santa Barbara County Public Health Department, while she continues to research, write and speak. In addition, Lisa is an Associate Area Professional Liaison La Leche league of California/Nevada, and serves on the Breastfeeding Coalition of Santa Barbara County. Topics that Lisa will be speaking on at the ALCI conference include hormonal imbalances and milk supply, the Cochrane review on galactagoges, ‘The Milk Making Factory’, and how to know when things are heading south.


Other speakers at the conference will include Nicola O’Byrne IBCLC, Margaret Murphy IBCLC, UMHL Clinical Skills Facilitator Cliodhna O’Sullivan and Coombe Hospital IBCLCs Mary Toole and Meena Purushothaman. Friday afternoon will be taken up with valuable workshops; Lisa Marasco IBCLC will facilitate a workshop on lesser known ideas for increasing milk supply, Sue Jameson IBCLC will present a workshop on Private Practice and Avoiding the Pitfalls and Caoimhe Whelan IBCLC will shed light on becoming an IBCLC from a non-medical background.


Handouts, lunch and refreshments are included in the registration fee and delegates will be entitled to a 15% discount on treatments at the hotel spa. The prices are €160 for ALCI members (for both days) or €120 (for one day) and €210 for non-members (for both days) and €170 for non-members (for one day). Full-time undergraduate students, in relevant professions, may register for a fee of €40 per day. 6.25 L CERPs and 4.25 E CERPs have been awarded. NMBI CMUs have been applied for.


As part of the conference, two Annual Scholarships will be awarded to help first-time IBLCE candidates. Here is the ALCI Scholarship Application. Conference participants are invited to submit research and practice posters for display, discussion, and awards.  Here is the ALCI Poster Application 2017.


With 8 plenary presentations, 3 workshops and a few surprise ‘nuggets’ over the 2 days, plus research posters, networking, new product information, craft stalls (artist Marta O’Leary, Seoidin Jewellery, Bia Beauty Skincare products and Hancock Glass Breast Bowls) and much more, the ALCI Annual Conference is the premier event for health workers and volunteers involved in assisting breastfeeding families in Ireland.


Booking is available here and the timetable is here.

ALCI Conference Hailed A Great Success

The recent Annual Conference of the Association of Lactation Consultants in Ireland was opened  by Frances Fitzgerald, T.D., and Minister for Children & Youth Affairs, pictured here with  (from left to right) ALCI President Margaret Murphy IBCLC, Keynote Speaker Barbara Wilson Clay, IBCLC, Minister Frances Fitzgerald and ALCI Vice President Meabh Anne McNamara IBCLC.

ALCI Conference Hailed A Great Success

In her opening address Minister Fitzgerald thanked the International Board Certified Lactation Consultants (IBCLCs) community for the work they do in supporting breastfeeding in Ireland. She highlighted the valuable contribution Lactation Consultants make to the health of the nation’s children. She cited in particular the emerging evidence from the Growing Up in Ireland Survey and the benefits of breastfeeding in combating childhood obesity. She encouraged IBCLCs (as strategic, key stakeholders) to become involved in government policy development, particularly in formulating the Early Childhood Strategy.


With 10 plenary presentations and 3 workshops, over 2 days, plus research posters, networking, new product information and much more, the ALCI Annual Conference proved to be the premier event for health workers involved in assisting and promoting breastfeeding in Ireland.


See Barbara Wilson Clay and ALCI President Margaret Murphy speaking on Ireland AM 3rd Oct 2013.

 Twitter: #2013ALCI

Register before Friday Sept 20th to SAVE €20 at the Annual ALCI Conference

Creating Realistic Breastfeeding Expectations”

Annual Conference of the Association of Lactation Consultants in Ireland.

Friday 4th and Saturday 5th October 2013 in the Green Isle Hotel, Clondalkin, Dublin 22.




Workshops are filling fast – register NOW to get your first choices


Special rate B& B in the hotel with triple rooms for an even better deal.


Conference is about networking too. After the sessions on Friday enjoy a chat in the special interest groups:


CMS-Lactation, IBCLCs in Private Practice, Primary Care, Paediatric, Education and others, or spend some time in the leisure centre.


Sign up for adinnertable to continue networking .



Then attend the free Friday social evening: Comedienne Rose Henderson (pictured here on the right) on mothers and breastfeeding plus Fit to Bust talent, silly games and plenty of time to meet new colleagues and catch up with old friends.


With 10 plenary presentations and 3 workshops over 2 days plus research posters, networking, new product information and much more, the ALCI Annual Conference is the premier event for health workers involved in assisting breastfeeding in Ireland.


Register NOW and don’t miss out
Click here for a Booking Form, and further information is available from info@alcireland.ie or text 089 441 6497

“Creating Realistic Breastfeeding Expectations”

Annual Conference of the Association of Lactation Consultants in Ireland


Friday 4th and Saturday 5th October 2013


Green Isle Hotel, Clondalkin, Dublin 22


The use of appropriate language for promoting and supporting breastfeeding and creating realistic breastfeeding expectations for both parents and health workers are the focus for the upcoming Annual ALCI Conference. 


With 10 plenary presentations and 3 workshops, over 2 days, plus research posters, networking, new product information and much more, the ALCI Annual Conference is the premier event for health workers involved in assisting breastfeeding in Ireland.


– The Conference will be opened by Ms Frances Fitzgerald, Minister for Children & Youth Affairs.


– Barbara Wilson Clay, IBCLC, world renowned presenter, will speak on Guilt and Infant Feeding Choices; How Language Affects Expectations; Assessing Lactation Acuity: big problem or little problem?; Why is the Baby Sleepy?; and Why No Milk?


– Siobhan Hourigan, National Breastfeeding Coordinator and Mary O’Connor, IBCLC, will discuss Community breastfeeding initiatives for change and the introduction of a pilot community support programme in Kerry.


– Aileen Doyle, IBCLC and Mary O’Rourke will present findings from their recent research studies on practice related issues with breastfeeding in Ireland.


– Workshops on Saturday 5th October include topics such as the private IBCLC interacting with other health service providers (Nicola O Byrne, IBCLC); ending free formula in hospital (Dr. Genevieve Becker, IBCLC); choosing and using breast pumps (Ger Cahill, IBCLC); and assessing a feed/taking a history (facilitator to be confirmed), and Mary Mahon, IBCLC will facilitate a workshop on achieving and sustaining change in practice.


Conference participants are invited to submit research and practice posters for display, discussion and publication in the conference abstract book and awards.


The conference is approved for 12.25 (L & E) IBLCE CERPs and 5.5 Nursing and Midwifery Board of Ireland (An Bord Altranais agus Cnáimhseachais) CEUs (Category 1, Course Groupings 4 and 9). INDI CPD Approval has been sought.


Handouts, lunch and refreshments are included in the registration fee.


Early Bird rate (before Friday September 13th 2013) is €100 for members (for both days) or €60 (for one day) and €140 and €100 for non-members. There is a discount rate available for full-time students in relevant professions.

Keynote Speaker for ALCI Conference 2013 – Linda Smith

Keynote Speaker for ALCI Conference 2013 – Linda SmithLinda Smith MPH, FACCE, IBCLC, FILCA, is confirmed as the Keynote Speaker for the 2013 ALCI Conference. Linda is a lactation consultant, childbirth educator, author, and internationally-known consultant on breastfeeding and birthing issues. Linda is ILCA’s liaison to the World Health Organisation’s Baby Friendly Hospital Initiative and consultant to INFACT Canada/IBFAN North America. As a former La Leche League Leader and Lamaze-certified Childbirth Educator, she provided education and support to diverse families over 35 years. Linda was a founder of IBLCE, founder and past board member of ILCA, and is a delegate to the United States Breastfeeding Committee from the American Breastfeeding Institute. She owns the Bright Future Lactation Resource Center, whose mission is “Supporting the People who Support Breastfeeding” with lactation education programs, consulting services, and educational resources.


This theme of this two day ALCI Conference is ‘Creating Realistic Breastfeeding Expectations’ and it will take place in the Green Isle Hotel, Clondalkin on October 4th and 5th 2013.


Further detail will be available here.