Is Online Breastfeeding A New Thing? How The Pandemic Is Changing Everything And Nothing – By Corinne Botz And Mathilde Cohen

REPOST: https://msmagazine.com/2021/01/26/online-breastfeeding-nursing-lactation-zoom-video-call/

 

I was recently preparing to sign on to an online faculty meeting, when my two-year old began to scream, “Tétée! Tétée!”—the French for “boob” and “suckling”—thirty seconds before start time.

 

With little time to think, I hit “Join Meeting,” put him on the breast, and attempted a smile. But wait—should I turn the camera off? As a legal scholar who writes about lactation as an under-recognized and unrewarded form of gendered labor, I could not possibly turn it off. I noticed that there were 50 participants on the call. Would I come across as unprofessional? Or just French? Keep the camera on, I told myself.

 

It was a bit scary. Uncomfortable. But I’m tenured. I’m a white, cishet woman who is privileged in many ways—the type of person who ought to use her position to make lactating labor more visible.

 

A couple of minutes in, a senior colleague texted me, “Are you nursing?” I wrote back, trying to project confidence, “Of course! Online public nursing, my current research topic.”

 

If the 2000s were the decade of the “brelfie,” that is, of carefully curated breastfeeding selfies posted on social media, 2020 could be dubbed the year of “laczoom” to connote the different ways in which people expose their lactation online. Unlike brelfies, which risk censorship on Facebook or Instagram if they violate indecency and nudity policies, laczoom happens in real time, reducing the chance that it will be blocked.

 

Nevertheless, much like breastfeeding out in the world is expected to be low profile—a few state laws actually require discretion—nursing online is tolerated when not too conspicuous. A woman who kept her mic and camera on while breastfeeding during a work meeting was recently shamed on Reddit by a coworker.

 

The pandemic and its accompanying turn to online spaces for work, socializing, education, health xcare and more, exposes the contested nature of breastfeeding as an activity many view as private when it is a matter of public importance implicating the renewal and well-being of our polity, species, other species and the environment. At the same time, the crisis challenges the public-private divide itself by transforming the home into a semi-public space through video-enabled devices.

 

Lactation has become simultaneously more and less visible. In the age of social distancing, nursing in public is waning from our collective sight. At the same time, a novel form of public lactation is developing online, in particular on videoconferencing platforms, which function in many ways as the new public space.

 

Visual artist Corinne Botz and I teamed up in April to explore this question with the goal of making parents’ infant feeding labor and experiences more knowable and visible. We connected with over thirty parents and lactation professionals.

 

Botz, who previously photographed lactation rooms in the workplace, was now holding virtual photo shoots using her camera and laptop to photograph in homes across the country. Botz moved with participants around their houses, guiding them on where and how to set up their device for the photographs, listening to good-night stories, meeting family members, witnessing breakfast leftovers and toys strewn on the floors. This is photography in the time of social distancing.

 

The pandemic makes it harder for many new parents, especially the most vulnerable and marginalized, to initiate and maintain their lactation. They are isolated, have diminished access to in-person lactation counseling and may suffer from economic hardship and illness. They may also work stressful shifts as essential workers.

 

Lactation can be particularly fraught for Black and Indigenous women, whose reproductive and lactating labor has historically been exploited for white interests. The COVID-19 outbreak has amplified racial disparities in maternal health and breastfeeding rates. During the first months of the pandemic, hospital restrictions on birth and breastfeeding, such as the separation of COVID-positive or COVID-suspected parents from their newborns, disproportionately affected Black and Indigenous women, reviving the history and trauma of separating enslaved and native children from their mothers.

 

At the same time, the coronavirus has worked as a breastfeeding campaign of sorts. Camie Goldhammer, a Sisseton-Wahpeton lactation consultant and founder of the Indigenous Breastfeeding Counselor training, reports, “lots of people … really wish that they were breastfeeding” for the immunological benefits it could confer. For some parents, the pandemic has been a catalyst for producing more milk. Alarmed by reports of infant formula shortages, Black breastfeeding specialist Nichelle Clark went as far as relactating to provide her son with milk and donate the surplus through her social circle and the Facebook group she co-founded, Breastmilk Donation for Black Mothers.

 

Other women ended up with a stash of frozen milk, which they did not need because they were not leaving their houses. Britta Fithian-Zurn, a white graphic designer from Oregon recounts, “I had built up this supply thinking I would go back to the office, and it was taking over our freezer. The first donation was 200 ounces or something.”

 

Around the nation, human milk banks have been flooded with donations. Desiree Joy Frias, a queer Afro-Latina woman and community activist, had to quit breastfeeding. But she received thousands of free ounces of donor milk from families she found online. “It’s nuts. I feel like a cat burglar packing up three coolers with all that breast milk.”

 

Back in 2015, anthropologist Penny van Esterik asked, “What would happen if human milk were really treated like liquid gold? What accommodations would be made for it and for its producers?”

 

Five years later, even during a pandemic, parents who produce this valuable resource too often continue to be unseen and unrewarded. Veronica White is a Black critical care nurse in Michigan and mother of two. “Because of the pandemic and everything, we’re really short-staffed,” she notes, “so there is no way I could get away four times during my shift to pump.”

 

To maintain her lactation, she purchased a $500 high-tech wearable pump allowing her to express milk during her shifts unbeknownst to most of her patients and colleagues. She saves lives but must lactate furtively.

 

It remains to be seen whether the emergence of videoconferencing apps as our new pandemic public space will contribute to normalizing nursing in public or further consign it to the private sphere. There are similarities here with the increased availability of lactation rooms and pods in the workplace and in public or semi-public spaces. This development has been applauded as providing a welcome alternative to nursing or pumping in bathroom stalls. But what is the message sent by these facilities (or the possibility to turn off cameras and mics)? Is it, “We support you and your infant feeding choice” or, “This activity should be concealed”?

 

One lesson of the COVID-19 crisis for policy and lawmakers may be that to adequately support lactation, they should take cues from the families who had positive experiences in conditions of quarantine. These are typically the well-resourced parents not working outside the home or telecommuting and who have help from their partner and others around them. They have the opportunity to engage in practices known to support lactation such as increased time at home, rest and access to breastfeeding support. In some ways, they observe traditional postpartum customs and rituals known in some cultures as confinement—which incidentally is a term also used to denote quarantine.

 

For all new parents to experience their preferred version of postpartum confinement, here are some of the legal and policy tools which should be available: family-centered pre- and postpartum care, universal basic income, paid parental leave, paid lactation leaves and breaks, a flexible work environment, affordable housing, universal health care and equal access to high-quality, non-discriminatory and culturally appropriate care (including lactation counseling), and sliding fee child care programs.

 

The Integrity of the Remote Certified Lactation Counselor® (CLC®) Examination

The Certified Lactation Counselor® (CLC®) certification identifies a professional in lactation counseling who has demonstrated the necessary skills, knowledge, and attitudes to provide clinical breastfeeding counseling and management support to families who are thinking about breastfeeding or who have questions or problems during the course of breastfeeding/lactation. The integrity of the credential and what it represents in the lactation support provider landscape is important to families seeking professional lactation care and to the Academy of Lactation Policy and Practice (ALPP). CLCs are dedicated to the promotion, protection, and support of breastfeeding and human lactation in their work to prevent and solve breastfeeding problems. They understand that breastfeeding works best when it is the cultural norm and when the provider of lactation support and services is culturally competent.

 

The CLC® certification program is accredited by the prestigious American National Standards Institute (ANSI) and upholds the best practices that come along with such accreditation. ANSI accreditation represents a significant accomplishment and signifies a commitment to excellence. Our ANSI accreditation means that the CLC® certification program undergoes a rigorous review every year focusing on key components of the program including, sound governance and financial practices, management by professional certification staff, involvement by subject matter experts (SMEs), annual psychometric review of the certification examination, and a secure examination administration.

These accreditation standards are also of increasing importance when utilizing Live Remote Proctoring for the CLC® examination. ALPP began remote proctoring of the CLC® examination in May of 2020 in response to the COVID-19 pandemic. ALPP is proud to announce that this new mode of CLC® examination administration has been added to the ANSI-accredited CLC® certification program, meaning that all ANSI certification standards now apply to remotely proctored CLC® examinations as well as those examinations administered in-person when it is safe to resume to do so.

 

ALPP will continue to ensure that all CLC examinations are confidential, secure, valid, fair, and reliable across all modes of administration so that each newly certified CLC® and all of the families they support feel confident in their abilities, knowledge, and skills as a professional lactation care provider.

New Lactation Counselors on BCHC Team

REPOST: https://albionnewsonline.com/2021/01/12/new-lactation-counselors-on-bchc-team/#:~:text=Boone%20County%20Health%20Center%20has,Kinney%2C%20RN%2C%20as%20CLCs.

 

Boone County Health Center has announced the addition of two Certified Lactation Counselors (CLCs) to the obstetrics (OB) team.

 
Alyssa Henn, RN, and Kendra Vogel, RN, will join Deanna Kruse, RN, and Maria Kinney, RN, as CLCs.

 
“Breastfeeding is natural, but it is also a learned skill. As CLCs we have special training from a practical, evidence-based breastfeeding course with a strong focus on counseling skills to help moms and babies have the best breastfeeding experience possible,” said Obstetrics Director Maria Kinney, RN.

 
At Boone County Health Center, CLCs offer patients a free breastfeeding class to review the benefits of breastfeeding, positioning of the baby, and how to determine if the baby is getting enough milk. During the hospital stay, CLCs are available to help mothers and babies begin their breastfeeding journey.

Doctor On Call: Questions For Dr. Asbury, A Breastfeeding Pediatrician

REPOST: https://www.chattanoogan.com/2020/10/28/417489/Doctor-On-Call-Questions-For-Dr..aspx

 

How does your dual role as a pediatrician and lactation counselor help moms with breastfeeding?
One of the biggest stresses for new moms is breastfeeding. Even though it’s completely natural, it’s not always easy. I’ve seen many tearful moms in my office who were experiencing a painful latch, concerned about their milk supply or worried about a host of other breastfeeding problems. As a pediatrician who is certified in lactation counseling, I can provide some much-needed support for these moms, and it’s a great way to help my little patients get off to a healthy start.

 

What are some advantages for babies who breastfeed? 
The advantages of breastfeeding for babies go far beyond filling up a hungry belly. Breast milk is the best food for babies during the first year of life (with the addition of baby foods after six months). In addition to the perfect balance of nutrients to help a baby grow, breast milk helps reduce illnesses like ear infections, pneumonia and diarrhea, as well as lowering the impact of respiratory illnesses.

 

Breastfeeding helps decrease the incidence of asthma and eczema. The rates of obesity and type 1 diabetes are much lower in breastfed infants as compared to formula fed infants, and breastfeeding is associated with a reduced risk of sudden infant death syndrome (SIDS) and childhood leukemia.  

 

How can mothers benefit from breastfeeding? 

There are several maternal benefits of breastfeeding, and lactation plays an important role in a woman’s long-term health. Breastfeeding can help lower the lifetime risks of metabolic disease often associated with insulin resistance and high cholesterol brought on during pregnancy.

 

It can also reduce maternal obesity, lower the risk of diabetes, high blood pressure, and heart disease (including heart attacks). Breastfeeding has been shown to reduce the risk of type 2 diabetes after developing gestational diabetes during pregnancy. 

 

Breastfeeding also reduces a mother’s risk for endometrial, ovarian and breast cancers. Long-term studies have shown that the longer a woman breastfeeds the more she can reduce her breast cancer risk, particularly the most aggressive forms of the disease such as triple negative breast cancer.

 

What kind of support do you give breastfeeding moms?

I encourage my patients often, because they need to hear the effort they’re making for their own health and the long-term health of their baby is the first step for them to be successful in this endeavor. 

 

I tell my patients that breastfeeding is a labor of love because it’s not always an easy, painless journey. Infants often need to be fed every 1-3 hours for the first few weeks of life. This can create mental and physical exhaustion for the mom on top of the fluctuating hormones that occur after delivery. 

 

As a pediatrician and a lactation counselor, I can offer successful strategies for breastfeeding, address factors that have a negative impact on the mother-baby bond, and support them through difficult seasons which make lifelong impacts for both mom and baby.  

 

* * * 

Laura Asbury MD CLC is a pediatrician with Beacon’s Children’s Diagnostic Center who has more than 15 years experience caring for children, and has recently become a certified lactation counselor to give new moms and babies added support in their breastfeeding journey.  She earned her medical degree from the University of Tennessee School of Medicine in Memphis and completed her residency and chief residency at T.C. Thompson Children’s Hospital in Chattanooga.   

 

Dr. Laura Asbury is accepting new patients.  Call and make an appointment with her at 894-3252.

Georgia Legislative Wins For Breastfeeding Families

REPOST: United States Breasteeding Committee Newsletter 

 

The Georgia Breastfeeding Coalition published a press release titled “The 2020 Georgia Legislative session was a big win for breastfeeding families in Georgia!” The press release celebrates two state bills that were signed into law. HB 1090 updated Georgia’s workplace lactation accommodation law to state that employers “shall” provide accommodation, instead of “may” provide. The new law also specifies that break time will be paid, and extends coverage to hourly and salaried workers in private and public sectors. HB 1114 extended maternal postpartum coverage for Medicaid recipients to six months and provides new lactation care and services benefits.

 

Check out the full press release here: https://static1.squarespace.com/static/5cdb8a8741a10400019c7118/t/5f3d4e1f6ba7d21ccf9131e3/1597853215348/Press+release+LEG+update+final+2020.pdf?eType=EmailBlastContent&eId=ace35104-36bd-4805-a958-4c52e21e4526

Disciplinary Review Procedures And Updates

Following the conclusion of a complaint against a current Certified Lactation Counselor® (CLC®) in October 2020, the Academy of Lactation Policy and Practice (ALPP) would like to share our current disciplinary review procedures for the purpose of transparency. As a small, non-profit organization, we are always open to feedback from our community and to continuously improving to serve our CLCs in the best way possible.

 

When ALPP receives a complaint submitted on our Complaint Submission Form, which is publicly available on our website (https://alpp.org/pdf/CLC-Complaint-Submission-Form.pdf), the complaint is reviewed by the ALPP Director of Operations and ALPP Certification Director to ascertain if the criteria for acceptance of a complaint are met. The acceptance criteria are as follows:

 

1) Complainant must have personal knowledge of the alleged violation or misbehavior or must be in a position to supply relevant and reliable documentation.

 

2) Complainant must demonstrate by documentation and factual evidence that the complaint involves an issue or issues directly related to the certification standards and code of conduct. Matters of a personal nature or matters not related to the criteria set forth will not be considered.

 

3) The complaint will not be processed if the Academy of Lactation Policy and Practice records show the named person is no longer certified by Academy of Lactation Policy and Practice or is not a certification applicant, unless the complaint is related to such person representing him or herself as having a current certification.

 

Accepted complaints will be first processed by the ALPP Director of Operations and ALPP Certification Director for the purpose of attempting to resolve the complaint informally. If resolution by the staff is not possible, a Disciplinary Review Panel will be appointed to review and, if warranted, investigate the complainant’s statements in accordance with established policies and procedures. If the final decision of the Disciplinary Review Panel is not acceptable to the subject of the complaint, an appeals process is clearly laid out. If the decision is not acceptable to the individual who filed a complaint, we suggest that the individual file another complaint with ALPP with additional evidence in order for the complaint to be reviewed again.

 

—————————————

 

The Disciplinary Review Panel is an ad hoc panel, meaning that its members are gathered only when needed. This is because ALPP receives, on average, less than one complaint against a current certified CLC per year. The Disciplinary Review Panel has very clear and strict member requirements. Specifically, the panel shall be constituted of: at least one current ALPP Advisory Commission member, one former ALPP Advisory Commission member (when possible), and one Academy of Lactation Policy and Practice certificant not currently serving in a leadership capacity. No member shall be appointed to serve for a case in which he or she has a conflict of interest or in which the member cannot render impartial and unbiased judgment.

 

In the 21 years of our organization’s existence, these policies and procedures have evolved based on feedback from our national accreditation agency, input from our CLCs and colleagues, and the general consensus on best practices in the non-profit world. With that being said, ALPP is committed to adequately supporting and protecting the rights of all certified persons and the families served by CLCs and is currently reviewing the disciplinary procedures to ensure appropriate handling of any future complaints against CLCs who are alleged to be in violation of the CLC Code of Ethics.

 

Thank you for your interest in our organization and how we are continually working to advance the health and well-being of families through ethical principles that guide the decisions and actions of Certified Lactation Counselors.

 

Sincerely,

The Academy of Lactation Policy and Practice

PO Box 1288

Forestdale, MA 02644

(508)-833-1500

Grant Will Support Native American Breastfeeding Initiative In Michigan

REPOST: http://geo.msu.edu/news/grant-will-support-native-american-breastfeeding-initiative-in-michigan/?eType=EmailBlastContent&eId=637a09e9-dbb5-43b7-9064-d91686bcb51f

 

Congratulations to Angie Sanchez, a Ph.D. student in the Department of Geography, Environment, and Spatial Sciences, on the award of “Native American Breastfeeding Initiative Embracing Culture,” a grant from the Michigan Health Endowment Fund ($338,406) 2020-2022. Angie and her advisor, Dr. Sue Grady, will conduct a needs assessment and implement breastfeeding programs in six Indigenous Tribal Communities in Michigan. Over 150 Indigenous community members will be trained and certified as Indigenous Breastfeeding Councilors to bring breastfeeding back as a ceremony to their communities. In addition, health care workers and other community members will be trained on how to best support breastfeeding in their communities. Breastfeeding as a traditional ceremony was lost as a result of colonialization and will, therefore, be brought back as a celebration of Indigenous Culture and Maternal, Infant, and Family Health. Most importantly, breastfeeding will help future generations of Indigenous children to thrive in Michigan and beyond. For more information, please contact Angie Sanchez at asanchez@msu.edu.

Certified Lactation Counselors in the news!

Certified Lactation Counselors: What They Do, and How They Can Help

 

Breastfeeding Challenges

 

When you are expecting a baby, there are many things you are trying to prepare for. One of those things is making the decision to breastfeed your baby; however, oftentimes new moms aren’t prepared for the challenges that may come with breastfeeding. Or, it could be your second or third baby, and while breastfeeding your first was a breeze, maybe this baby isn’t latching quite as easily. No two pregnancies or breastfeeding journeys are the same. 

 

Certified Lactation Counselors: Here To Help

 

That’s where we – certified lactation counselors – come in, and we are here to help! A certified lactation counselor is a health care professional who has completed training and passed an exam, demonstrating the skills required to provide safe, evidence-based counseling for pregnant, lactating, and breastfeeding women. 

 

What Do Counselors Do, And Who Can Benefit?

 

By assessing the needs of mother and baby, lactation counselors work with families and their health care team to solve breastfeeding problems and provide education, recommendations, and skills for successful breastfeeding. 

 

At Prevea Health, women can make an appointment with Annie Bailey, CNM, CLC, and Karen Johnson, CNM, CLC, at any time during their breastfeeding journey. Patients do not need a referral from their health care provider and appointments are normally scheduled for an hour.

 

“We’re here to help, guide, listen, and support breastfeeding mothers in achieving a successful breastfeeding experience,” Bailey says.

 

The goal of the appointment is to provide counseling, education, and assistance, which support the mother’s desires and goals for successful breastfeeding. Patients can expect to discuss the following at their appointment:

 

-What are their goals for breastfeeding?

-What issues or difficulties are they having with breastfeeding?

-Brief health history intake and discussion of birth experience for both mother and child.

 

Along with discussion of breastfeeding goals and current issues, the lactation counselor may also assess a breastfeeding session. 

 

“As certified lactation counselors, we want to make sure that breastfeeding is successful and meets the mother’s goals for successful breastfeeding,” Johnson says.

 

Original article found here: https://volumeone.org/news/2020/03/06/23479_certified_lactation_counselors_what_they_do_and

Scientists Want To Ditch Formula For Lab-Grown Breast Milk

REPOST: https://www.wired.com/story/scientists-want-to-ditch-formula-for-lab-grown-breast-milk/

 

LIKE MOST EXPECTANT mothers, Stephanie King had a firm idea of how she wanted the birth of her children to go. But when the time came to have her twins in July 2019, her plans started unraveling.

 

Stanley, the first twin, was nearly born in the car park. “He came so fast that I didn’t even get to have gas and air,” says King, who lives in Herefordshire in the UK. Soon after, the heartbeat of her second twin—Sophia—dropped so dramatically that the doctors sent King for an emergency caesarean section. Both babies were fine, but King wasn’t. She hemorrhaged severely, losing 5 liters of blood. As if that wasn’t enough, she then developed an antibiotic-resistant infection in her womb, which later spread to her blood and turned septic. Pneumonia followed, and then her chest cavity filled with pus, requiring two further surgeries.

 

It would be eight long weeks before King returned home. On strong antibiotics and hormone replacement therapy, she couldn’t safely breastfeed her twins. “It was almost more traumatic than what I had been through in the hospital,” says King, whose older son self-weaned at the age of 3. “Because I had breastfed my son for so long, I knew the nutritional benefits breast milk provides.”
 

According to the World Health Organization, breast milk is an important source of nutrients and energy for infants, protecting against gastrointestinal infections, and helping to reduce obesity risk while improving IQ later on in life, among other benefits. For mothers like King—unable to breastfeed yet still wanting to provide their babies human milk—the options are limited. Milk banks aren’t available in every country or city, and marketplaces on Facebook, Craigslist, and other online platforms are poorly regulated.

 

Fengru Lin is trying to find a way around the problem. In January 2019, Lin founded TurtleTree Labs, a Singapore-based startup that is attempting to grow human breast milk in a laboratory. The company starts with stem cells taken from donor breast milk, multiplies them before putting them into a growth fluid within a hollow fiber bioreactor—“imagine a giant steel cup with hundreds and thousands of little perforated straws,” says Lin. There, the cells differentiate into mammary ones and start producing milk. The entire process takes three weeks, says Lin, and the mammary cells can lactate for roughly 200 days.

 

It’s a technique that can theoretically be used to obtain milk from any mammal, as long as stem cells are available. TurtleTree has already successfully produced full-composition cow’s milk from stem cells in freshly expressed cow’s milk. It now plans to do the same for human milk. “We’re not trying to replace breastfeeding, which is something we’re fully behind,” says Lin, who was first drawn to the idea of making milk from cells because of a passion for cheesemaking. 

More than 80 percent of new mothers in the US and UK start out breastfeeding, but only half and a third, respectively, still do so exclusively at six months. Globally, this figure is 37 percent. The reasons vary: Some struggle to produce sufficient amounts, while others have to return to work where pumping and storing milk isn’t convenient. Many also find expressing milk physically painful, experiencing mastitis, chafed nipples, and other excruciating effects. Then there are mothers on medications or undergoing treatments that make it unsafe for them to breastfeed. And sometimes, babies may be premature or too weak to suckle. “The fact is, mothers rely on infant formula,” says Lin. “That’s where we want to be the next best thing.”

 

While formula has come a long way, especially in the past two decades, it still lacks many nutrients found in breast milk. And that’s largely because most infant formulas are based on cow, rather than human, milk. “The two contain mostly the same type of molecules but in different proportions,” says Alan Kelly, a food scientist at University College Cork in Ireland. “And the difference in those levels is very physiologically significant.”

 

The mineral levels in cow’s milk are much higher and so is its protein content (3.5 versus 1 percent), while the carbohydrates levels are significantly lower (roughly 4.5 versus 7 percent), he says. Crucially, there are a group of complex carbohydrates that are unique to human milk. “It’s now known that oligosaccharides play a huge role in the development of an infant, for example protecting against infections,” says Kelly. Infant formula can be tweaked to adjust for some of these differences, but it can’t fully replicate the real thing.

 

And because formula uses cow’s milk as a starting material, the environmental cost of producing it is also substantial. It takes an estimated 4,700 liters of water to make just 1 kilogram of milk powder. Formula also frequently contains palm oil, which has a large carbon footprint.

 

Lab-grown breast milk holds the potential to alleviate some of these problems. “Some of it has to do with a renewed interest in sustainability, while the rest is because we now have a much deeper understanding of the different types of cellular agriculture,” says Michelle Egger, cofounder of the North Carolina-based startup BioMilq, which is also looking to produce breast milk in the lab.

 

“To everyone else, it sounds like pigs flying,” she says. “But for us, it’s just applying science in a way that can help more women.”

 

While both Biomilq and TurtleTree Labs—who have each raised more than $3.5 million in funding—hope to eventually produce human milk sans breasts, there are some key differences. For one, Biomilq is working directly with mammary epithelial cells rather than stem cells. It’s also aiming to sell milk directly to consumers, whereas TurtleTree plans to license its technology to large formula companies.

 

Any milk made in a lab won’t be able to replicate the immune benefits that breastfeeding gives to infants. Human breast milk contains high amounts of antibodies produced in the blood that are then passed on to the baby, giving them some protection against diseases. “Breast milk is an extraordinarily complex biofluid,” says Natalie Shenker, a breast milk researcher at Imperial College London. Not only does it have hundreds of proteins and more than 200 oligosaccharides, it also comprises a multitude of hormones, fats, and beneficial bacteria, which are made elsewhere in the body and transported into mammary cells.

 

These components—which cannot be replicated in the lab—are crucial for renal, cell membrane, and immune system development, says Shenker. Plus they help keep fluid and electrolyte levels consistent, among other functions.

 

In addition, breast milk is a dynamic substance that responds to a baby’s changing needs. “Saliva can flow backwards into the milk duct and be a way of signaling to the mother,” says fellow breast milk researcher Maryanne Perrin at the University of North Carolina Greensboro. “And some studies show that antimicrobial proteins go up with an infant illness.”

 

Shenker adds: Human milk “is tailored based on the mother’s and baby’s genetics, the environment they live in, the geography, season, and even temperature of the day—that’s how responsive human milk is.”

 

Biological differences aside, a number of hurdles remain before lab-grown milk becomes a reality. For one, firms must find a way to keep the most costly aspects of production—the nutrients and lactation media—low in order for the milk to be affordable. Scaling up also comes with technical difficulties. TurtleTree Labs is currently optimizing their lactation process in a 5-liter bioreactor, which they hope to scale up linearly to industrial-size ones of 1,000 and 50,000 liters next year. (Biomilq declined to share the size of its reactors.)

 

Figuring out how to preserve the final product will also be key, says Kelly. Pasteurization, freezing, or dehydrating it into a powder might change some of the milk’s components and “undo some of its advantages.”

 

Safety testing is another big hurdle that the companies will have to overcome. “This is not just you and me going to the supermarket and buying food for ourselves,” says Perrin. “Infants are considered a vulnerable population.” It’s ethically tricky to conduct clinical trials when such young infants are involved. And because lab-grown breast milk is uncharted waters, regulatory authorities will have to figure out how to classify it and even create a formal breastmilk standard (which doesn’t currently exist).

 

“I think the research going into making breast milk in the lab is a wonderful prospect,” says King, who was forced to rely on formula to feed her twins in the early weeks but is now breastfeeding them exclusively. “Had I been offered donor milk initially, or if this lab-grown breast milk was in full swing, then that is what I would have gone for first.”

 

This story originally appeared on https://www.wired.co.uk/article/lab-grown-breast-milk-turtletree-labs

Online Certified Lactation Counselor (CLC) Examination

As of May, 2020, the Certified Lactation Counselor (CLC) Exam is now available online to all candidates looking to take the exam for the first time or looking to retake the portion of the exam they did not successfully pass. Per ALPP policies and procedures, all test candidates have up to one year to retake their exam and can retake the exam a total of three times within that year.

 

To be eligible for the CLC exam, a candidate must complete one of the three certification pathways described here: https://alpp.org/certifications/certifications-clc.

 

The online CLC exam is remotely proctored by a live proctor who is trained by an outsourced organization. The online exam is available Monday-Friday from 9am-5pm EST. To learn more about the online exam, please refer to the Frequently Asked Questions document here: https://alpp.org/pdf/FAQs_for_Online_CLC_Examination.pdf.

 

If you need to sign up to retake the exam and you wish to do so online, you may complete the appropriate retake form, found here: https://alpp.org/forms/forms-clc, for the pathway that you are a part of. 

 

The global pandemic is an ever-changing situation and ALPP is working diligently to make sure that all staff members, ALPP proctors, and test takers remain safe and healthy. As a result, all in-person examinations have been canceled through 2020. For a list of locations that we hope will be able to take place in 2021, please click here: https://alpp.org/index.php/test-locations/test-locations-clc. This list is subject to change if it is unsafe to host in-person examinations when the time comes.