ABA Seminar: Breastfeeding: Science to Practice
Showcase Speakers
Dr Nina Berry
PhD BABEd(Hons) DipArts(Phil)

Nina Berry is an interdisciplinary health social scientist, focused on preventing infectious disease and malnutrition in infants and children. Her research centres on developing effective behaviour change interventions to improve infant and young child feeding and trust in the safety and importance of routine childhood vaccination. She is currently working on identifying the drivers of infant feeding decisions in Australia and Indonesia, improving maternal, infant and young child nutrition in Laos, and developing a communication package to support health professionals’ communication with parents about vaccination.

Her professional experiences in education, behaviour change counselling, and mother-to-mother breastfeeding support inform her approach to child health and nutrition research. She is occasionally called upon to give technical advice to the World Health Organisation and the International Board of Lactation Consultant Examiners. She worked as Infant and Young Child Feeding Consultant to Save the Children in Myanmar in 2008.

Nina is the mother of three teenagers. She has been a qualified breastfeeding counsellor and community educator since 2001 and a trainer and assessor since 2007. She takes a short shift on the National Breastfeeding Helpline once a week.

Ethics and Infant Formula. “I’m not allowed to tell you about that!”

The international Code of Marketing of Breastmilk Substitutes is designed to protect all mothers, regardless of how they feed their babies, from aggressive marketing of infant feeding products. Many health professionals are concerned to protect and promote breastfeeding lament the lack of information available for mothers who use infant formula. Mothers frequently describe encountering difficulties assessing information and education about the safe preparation, storage and use of infant formula. This presentation will describe the ethical obligations of health care workers described in the Code, and offer some practical guidance for answering common questions.
Dr Linda Martin
BA BSc(Med) MBBS(Hons) MMed(Clin Epi) FACD

Linda graduated in Medicine with first class Honours from the University of New South Wales in 2003. She undertook her dermatology training in Sydney and completed her fellowship at St John’s Institute for Diseases of the Skin in London. Linda is a Staff Specialist Paediatric Dermatologist at Sydney Children’s Hospital, visiting dermatologist at the Mater Hospital and Melanoma Institute Australia and conjoint lecturer in the School of Women & Children’s Health, UNSW. She has a special interest in dermatoses of pregnancy and lactation. 

Breastfeeding and Dermatology: Making a rash diagnosis?

To the untrained eye, many rashes look similar. This webinar will cover basic morphology and how to confidently describe cutaneous changes on the nipple and breast. A systematic approach to diagnosis of common dermatological conditions presenting in the lactating breast will be presented as well as relevant presentations in the breastfed neonate. 
Noelyn Perriman
RN, RM, IBCLC, Maternity Educator

Noelyn Perriman is a Registered Nurse/Midwife and IBCLC with over 28 years of experience in maternity care. Noelyn has worked as a Maternity Educator for over 11 years and currently works at Calvary Public Hospital Bruce, ACT. Noelyn has a strong background in all aspects of maternity care and she is passionate about ensuring women are provided with care that is evidence based. Antenatal expressing is now entrenched at Calvary and processes are in place to ensure women are educated and provided with resources to facilitate this practice. Being a practical and innovative educator she has worked tirelessly to develop tools to support antenatal expressing for all women who choose to give birth at Calvary. Lactation advice and education is one of her passions and in particular the sharing of that knowledge gained over the past 28 years. Noelyn is also a PhD student at the University of Canberra where her topic focuses on ‘Measuring Satisfaction in a Continuity Model of Care’. 

Expressing Antenatally: The Calvary Experience

It is recognized as a battle to convince women that their bodies can provide all that their babies need! In 1974 Dr James Smibert wrote, that he hoped; “the professions of midwifery and medicine would recognize the expertise of the Nursing Mothers Association and cooperate with them to achieve their goal of every mother giving her baby the best available food”. In 2010 we were still fighting that battle and were looking for new ways to persuade mothers that their bodies could provide the best food available for their newborn babies. Over the past 7 years the focus has been therefore on introducing and embedding antenatal expressing into practice at Calvary Public Hospital Bruce. The nutritional and immunological benefits of breastfeeding are universally recognized as being essential for all babies. Clinician’s play an important role in ensuring a positive breastfeeding experience for mother and baby and at Calvary, this begins with education, information and resources on expressing antenatally. 
Dr Susan Tawia
BSc, PhD, Dip Ed Dip Breastfeeding Management, Cert IV TAE

Dr. Susan Tawia holds a PhD in Reproductive Physiology, a Diploma in Breastfeeding Management and a Diploma in Education and, before joining the Australian Breastfeeding Association, worked as a research scientist and science teacher.

In 2008, Susan was appointed a Scientific Information Officer with ABA, and in that role she provided up-to-date scientific information to breastfeeding mothers, ABA counsellors and community educators, health professionals and other stakeholders. Susan also writes review articles for ABA’s peer-reviewed journal, Breastfeeding Review. 

In 2013, Susan was appointed the ABA Manager of Breastfeeding Information and Research and while continuing to write articles and ensuring that ABA provides evidence-based information, she has also been identifying research opportunities within ABA and promoting research collaborations between ABA and university-based researchers.

Research and Ethics: How to identify high-quality evidence to inform breastfeeding practices and policies

As health professionals, you are ethically obliged to ensure any recommendations you make or any information you provide is evidence based. This depends on you being able to distinguish whether the information published in a research paper is of high quality, or not, when searching for the best evidence to inform your practice or change policies. So, how can you discern which research is well designed and provides high-quality evidence?

An understanding of the types of research that are conducted, and where they fall in a hierarchy of evidence, will allow you to identify the highest quality research studies and to then determine the applicability of such evidence to your practice and policies. The different types of research studies and where they fall in a hierarchy of evidence will be reviewed. The types of research studies considered particularly appropriate and, most importantly, ethical for infant feeding and breastfeeding research will be highlighted.

Probiotics have been proposed as: 1) prevention for atopic diseases including eczema and food allergies in young children, 2) prevention or treatment of colic in infants and 3) treatment for mastitis in breastfeeding mothers. What does the evidence say so far? An evaluation of the evidence for probiotic use in pregnant and breastfeeding women, infants and young children will be used to show how a critical review of the evidence is conducted and how conclusions on the strength and quality of the evidence are drawn.
Elizabeth Williams OAM

Elizabeth (Liz) Williams OAM is a paediatric physiotherapist and researcher who received recognition for service to paediatric physiotherapy and to the rural community of Victoria. Her career has been as a physiotherapy lecturer in paediatrics at the University of Melbourne and as a clinical paediatric physiotherapist at both the Royal Children’s Hospital and in the community. In 2014 she received an NHMRC Australian Postgraduate Scholarship to study the effect of the successful ‘back to sleep’ program to reduce Sudden Infant Death Syndrome (SIDS) on motor development in infants aged 0-4 months to try to understand why current plagiocephaly prevention programs were not working.

Plagiocephaly and Infant Motor Development between 0-4 months: A new look at the effects of the ‘Back to Sleep’ Program

The successful Sudden Infant Death Syndrome (SIDS) recommendation is that infants sleep in supine. This is known as the ‘Back to Sleep’ program. An unexpected outcome has been an increased number with deformational plagiocephaly. This research has investigated the effect of the ‘Back to Sleep’ program on early motor development focusing on the development of head control 0-4 months. It has been viewed as largely a cosmetic condition but there is debate over the effect of plagiocephaly on development. A reason for concern is a longitudinal study of children with deformational plagiocephaly which shows children aged 3 years continued to receive lower developmental scores in language and cognitive development and adaptive behavior than unaffected controls. The study did not imply plagiocephaly causes the differences but suggested it may be an indicator of risk factors. The cause is not clear with a recent systematic review concluding the aetiology is ‘fragmentary and heterogeneous’.

Tummy time and counter positioning are common prevention strategies and recently controlled plagiocephaly prevention studies have been published that focus on advice in the maternity ward. However, a survey of Maternal Child Care Nurses in Victoria indicates there is still a gap in educational materials for prevention of plagiocephaly in the community. An educational fact sheet on infant head control development has been developed in collaboration with the University of Melbourne and The Royal Children’s Hospital (RCH) and was informed by results of studies of normative infants and patients attending RCH Deformational Plagiocephaly Clinic and an expert focus group.