Upskill in Naturopathic Early Life and Perinatal Health

Module 1 – Breastfeeding Contemporary Context and Milk Supply Concerns

Learn about the many elements that influence breastfeeding success by following the story – of the common clinical presentation of perceived low milk supply that illustrates how these features (below) play out in clinical practice. This session covers:

• Functions of breastfeeding for mother and child.
• Health implications for mothers and infants when breastfeeding is sub-optimal. 
• How breasts work – physiology of breastfeeding from establishment to galactopoiesis (maintenance of milk supply). 
• Perceived and true low milk supply.
• How to assess infant intake. 
• Supplementation considerations and risks – risk hierarchy from: mothers own milk, donor milk, formula and “home-made-formula”. 
• Historical, cultural, and societal factors that undermine breastfeeding.  
• Seen and unseen barriers to breastfeeding and the role of the natural medicine practitioner can play helping to dismantle these. 

Module 3: Herbal Medicine, Drugs, Pollutants and Breastfeeding

This session explores the transfer of non-nutritional substances through breastmilk including botanical medicines, drugs, alcohol, and medications. Pragmatic risk:benefit assessment around medications and drugs are outlined. The potential for environmental contaminants to be in breastmilk and formula is explored including nutritionally-focused risk reduction strategies.

Module 6: Naturopathic Approaches to Common Breastfeeding Challenges and Presentations (Mastitis spectrum; More on low supply; Nipple and breast pain unpacked)

This session focuses on the naturopathic approaches that can help address commonly-encountered breastfeeding challenges. A deeper look at the various potential causes of true low milk supply underpins individualised herbal support strategies and the nuances of using herbal galactagogues. We delve into Mastitis – a common clinical presentation which can exist in various forms along a spectrum. Mastitis is commonly driven by milk stasis, amongst other drivers, but the breastmilk microbiome may modulate resilience and susceptibility. Other breastfeeding-related presentations are explored such as breast refusal, tandem feeding, differentials for nipple pain, and D-MER (dysphoric milk ejection reflex).

Module 8: Discussions on Infant Microbiome Assessment and Infant Microbiome Case Studies

Dawn will share several different infant microbiome stories, many with a  similar history of microbiome-disturbing events, yet the stool microbiome results for these infants follow different patterns over time. The demonstrated resilience of the breastfed infant’s ecosystem (with follow-up testing) guides Dawn away from intervening in two of these cases, while in the third case, Dawn explains the clinical reasoning and shared decision-making process that brought her to intervene. 

Case exercise given to unpack during live Q&A

Module 10 – Colic, Reflux, and Unsettled Infants Unpacked

Frequently parents seek support for their unsettled infant and often they are labelled as having reflux or colic. This session unpacks these diagnostic labels in the context of normal infant physiology and explores the many explanations for unsettled behaviour in infants including which more serious presentations to rule out. A range of gentle treatments are explored with a focus of treating through the breastfeeding parent where possible.

Module 10 – Colic, Reflux, and Unsettled Infants Unpacked

Frequently parents seek support for their unsettled infant and often they are labelled as having reflux or colic. This session unpacks these diagnostic labels in the context of normal infant physiology and explores the many explanations for unsettled behaviour in infants including which more serious presentations to rule out. A range of gentle treatments are explored with a focus of treating through the breastfeeding parent where possible.

Module 12 – Allergic proctocolitis and other allergy-mediated gastrointestinal presentations

There are a range of gastrointestinal allergy presentations that can occur in infants – with allergic proctocolitis probably being one of the more common of these in the breastfed infant. Typically, the infant is thriving in this situation, but is presenting with frank blood in their stools, sometimes accompanied by mucous, which can be quite alarming for parents and practitioners. The nuances around managing this, with a combination of ruling out other causes, watch and wait, immune modulating treatments through the mother, and judicious maternal-diet manipulation are explored.  This session will also cover naturopathic approaches to Food Protein Induced Enterocolitis Syndrome (FPIES), Eosinophilic Oesophagitis (EoE), and other gastrointestinal allergy presentations. 

Module 15 – Naturopathic Support for Preterm Infants

Module 16 – Constipation in Infancy

Preterm birth affects up to 10% of infants and, hence, as practitioners we will find ourselves working with the parents of pre-term infants. Supporting families to access practical support to help them establish milk supply, supply mothers’ own milk, access donor milk (if needed) and establish breastfeeding, clearly saves lives and promotes long-term health outcomes for infants and their families. Parents of preterm infants navigate many interventions, including direct nutritional supplementation to their infant and often protein fortification of their expressed breastmilk. While many of these infants do require iron supplementation directly, due to being born with insufficient stores, there may be scope for mothers to discuss maternal supplementation of some nutrients over direct supplementation, when there is a clear evidence base that supports breastmilk transfer. Each situation is different, and careful consideration and collaboration with the health team is important. Additionally, sometimes there is capacity to delay iron supplementation and utilise a different form with less microbiome-disrupting consequences (in consultation with the health team of course). Maintaining a focus on safety and not compromising health outcomes is important while these strategies are considered. Consideration of microbiome recovery is another avenue to explore in this population and many parents will seek our support in this. 

With the commencement of solids, most infants will experience slow transit time and hard stools. Prevention and prompt management of this presentation is important to prevent protracted and persistent stool holding and constipation-related issues persisting into childhood and beyond. Typically, this can be managed with dietary manipulation and pacing/slowing down the volume of solids. Sometimes this is not enough, and intervention with lactulose (or other prebiotics used at laxative doses) needs to be implemented and maintained until a regular soft and easy stooling pattern is established durably. During this session, we will clearly outline an approach to prevent and treat infantile constipation.

Case exercises given to unpack during live Q&A