Abstract
This November, ABM will celebrate its 25th anniversary with our first-ever virtual international conference. In the “before-times,” we had planned an in-person meeting just outside Chicago in Schaumburg, Illinois; however, with the COVID-19 epidemic, we made the decision in May to move to all-virtual conference.
I know I will miss late-night conversations over cocktails with friends and colleagues from around the world—and I am also excited to connect with a global audience who can be part of our breastfeeding medicine community without packing, boarding a plane, and booking a hotel room. Key presentations will be shared live the first week in November, and all of the conference content will be available for a full year via our online platform, providing an extended opportunity to learn about the latest research and evidence-based practice in breastfeeding medicine.
The conference committee has organized an international panel of speakers. Maria Teresa Hernandez-Aguilar will present ABM's model infant feeding policy, and Marie McGrath, codirector of the Emergency Nutrition Network, will present on management of at-risk mothers and infants. Christina Smillie will give this year's Founders' Lecture. Tom Hale will provide an update on breastfeeding and medications, and Arthur Eidelman will once again present his Breastfeeding Research Hit Parade. There will be a special COVID and breastfeeding session, as well as Panels on Health Equity and Lesbian, Gay, Bisexual, Transgender and Queer or Questioning (LGBTQ) lactation, thanks to support from the Kellogg Foundation.
We are delighted that through the Kellogg Foundation funding, we are able to offer scholarships to physicians who are underrepresented minorities or who provide care for vulnerable populations. Applications are due October 9—information is available on the ABM website.
In addition to the invited speakers, the conference will feature 72 poster presentations from authors in 11 countries and five continents. The abstracts, which are published in this edition of the journal, cover the depth and breadth of breastfeeding medicine. Seven abstracts report on randomized-controlled trials, including a breastfeeding workshop within a third-year family medicine clerkship (Abstract 20), provision of a manual pump to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participants (Abstract 44), and a tailored breastfeeding counseling intervention in a primary health services in Tijuana, Mexico (Abstract 72). Two randomized trials tested the efficacy of mobile health interventions for breastfeeding support: Abstracts 53 and 54 report on the Mother's Milk Messaging™ (MMM) App, and Abstracts 59 and 60 report on the BreastFeeding Friend (BFF) app.
Seven abstracts address breast milk provision and breastfeeding in the neonatal intensive care unit (NICU). Topics include development of patient education tools for NICU families (Abstract 29), a quality improvement project to expedite initiation of pumping for mothers of NICU families (Abstract 31), hand expression training for hospital staff (Abstract 57), reducing barriers to use of donor milk in the NICU (Abstract 32), and reviewing the evidence for breastfeeding for term infants in the NICU (Abstract 47). Of note, late preterm and term infants were less likely to be breastfeeding at discharge than infants born weighing <1500 g (Abstract 56). Abstract 65 quantifies secretory activation among NICU mothers who were expressing breast milk and found that disruption of milk expression resulted in transient reversal of secretory activation, indexed by sodium to potassium ratio ≥1. This subtle change could be a point-of-care test to assess whether pumping frequency is adequate. Of note, the scope of studies extends beyond provision of human milk to NICU infants to include strategies to improve the rate of at-breast feeding at hospital discharge (Abstract 37). The authors report that introducing at-breast feeding before bottle feeding increased the likelihood that infants were feeding at breast at hospital discharge.
Donor human milk (DHM) is another major theme. Two abstracts evaluate educational programs, for pediatric residents (Abstract 22) and NICU nurses (Abstract 32), to increase knowledge of the health importance of DHM. Additional abstracts consider the effectiveness of DHM for treating hypoglycemia (Abstract 34) and the impact of implementing DHM on breastfeeding outcomes in neonatal intensive care (Abstract 58) and for well-newborns (Abstract 61). Interestingly, Abstract 58 reports that after DHM was implemented in the NICU, there was a reduction in use of mother's own milk at 7 and 28 days after birth; however, more mothers were exclusively breastfeeding at discharge (45% postintervention versus 28% preintervention). The results underscore the importance of measuring multiple clinical endpoints when evaluating the impact of a change in practice. Abstract 67 compares outcomes among infants born at <27 weeks who were fed pasteurized versus sterilized donor milk; the authors found that sterilized donor milk was associated with slower weekly head growth.
Education is another prominent theme, with multiple abstracts reporting on initiatives to increase education for medical students (Abstracts 18–21), residents (Abstract 22), and practicing physicians (Abstract 24). This work is central to the Academy of Breastfeeding Medicine's mission to unite members of the various medical specialties to protect, promote, and support breastfeeding. These abstracts present evidence for specific, actionable strategies to educate our colleagues and advance the field.
Other abstracts are putting the “M” in Breastfeeding Medicine by addressing aspects of maternal health, ranging from the mechanisms through which obesity and diabetes impact lactation (Abstracts 41, 45, 49, and 51) to an analysis of recommendations to suspend breastfeeding due to medication exposure in a large health system (Abstract 1). Taking a public health approach, Abstract 68 assesses women's awareness of the protective association between breastfeeding and breast cancer risk, finding that nearly two-thirds of women in a large U.S. sample were unaware of this link. Rare maternal conditions addressed include granulomatous mastitis (Abstracts 3 and 27) and a case report of sustaining breastfeeding for a patient undergoing brachytherapy for uveal melanoma (Abstract 5).
As we prepare for an all-virtual meeting, I regret that I will not be able to enjoy late-night ice cream with Dr. Milkas, or celebrate the newest Fellows of the Academy of Breastfeeding Medicine in Rent-the-Runway glory. However, I'm looking forward to engaging with an international network of physicians who are passionate about mothers, babies, and breastfeeding. I look forward to “seeing” you all at #ABM20.