Breastfeeding Medicine

Physicians blogging about breastfeeding

The Sixth European ABM Conference in Lisbon Portugal—A Win for Organizers and Attendees Alike!

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I returned from a trip to Europe over a week ago tonight, my first stop Lisbon Portugal. I celebrated one of those “big” birthdays in Lisbon, you know, the ones that end in a “0” or a “5” with 230 of my closest friends and colleagues in Breastfeeding Medicine from 23 nations around the globe.  Honestly!!  Well, they were not all there just to celebrate my birthday, although some did stay an extra day just to celebrate the day with us!!

What began this marvelous journey was an invitation from conference organizers Elien Rouw, MD, FABM (Germany), Monica Pina MD, ABM (Portugal), and Reet Raukas MD, ABM (Estonia) to speak at the 6th European Academy of Breastfeeding Medicine Conference, held on June 17-18, 2016 in Lisbon, Portugal.  Dr. Rouw has been behind these regional international conferences from the start, and is the mastermind in organizing them, along with local physicians and other like-minded organizations at various times in the countries in which they have been held.  The success she and her co-coordinators have had is a tribute to their hard work, their desire to bring quality physician education in breastfeeding medicine and related subjects to Academy of Breastfeeding Medicine (ABM) members and other physicians and health care members outside the United States, and their tireless efforts to make these conferences affordable, with little support outside their own “blood, sweat and tears”.  This is in actuality a matter of equity and disparities in our field.  Many US physicians cannot afford to travel to Europe or Asia or Australia yet we expect our non-US colleagues to travel to the US yearly to the Annual conference, which is expensive for many of us even if we live in the US.  So do Dr. Rouw and her European colleagues accomplish their goals?  They most certainly do!!!  If one watches and grabs an airfare when they are at their lowest, even from the US this conference is very affordable, and the bonus is, no matter where you come from, you are treated to a beautiful European city, its gracious hospitality and phenomenal cuisine!

This success has built over the past 10 years. Former conferences have been organized in Germany (2007), Austria (2008), Poland (2010), Italy (2012) and Romania (2013).  The 6th Conference in Lisbon was organized in collaboration with SOS Amamentação Portugal and with support of the city council of Lisbon —the largest thus far, and buzzing with activity!!

The speakers and some attendees from outside Portugal stayed in a wonderful hotel that was noted as not far from the site of the conference. The morning of the 17th a bus was arranged to pick all of us up who were staying at the hotel an hour before the conference started to transport us the short distance to the conference venue, Auditório Polo ArturRavara ESEL, a relatively new site of the nursing school in Lisbon.  After a late arrival, we drove around for quite a while.  Turns out our (native Portuguese) bus driver was lost, because he got the wrong address!  So, we started the first day a bit late. Was this a problem?  Not at all!  Everyone rose to the occasion and soon the conference had begun in a beautiful and comfortable venue and we were all immersed in breastfeeding medicine!

I cannot praise the program, the speakers, the topics, the organizers, the attendees and the volunteers from the nursing school at the venue enough.  They came together in the perfect mix of knowledge, science, practice, learning, collegiality, global partnership, sharing, friendship and networking, across languages, practices, countries and continents!  From our Bangladeshi Muslim colleague attending despite being in the middle of Ramadan and fasting while encouraging us to eat the delicious traditional Portuguese meals provided, to a new breast surgeon (!) who just completed her training in Texas, USA attending with her 8 month old son because she received care from ABM member Pam Berens during which she learned of (and joined—way to go Pam!!) ABM and this conference and decided to attend, to the many European physicians from East and West who attended—we were able to share, learn, experience and laugh in commonality with so many from 23 different countries.

The speakers and topics were varied and interesting.  You can still find the program at Lectures and handouts were given in English regardless of native language of the speaker.  All lectures were simultaneously translated in Portuguese, so the many Portuguese attendants were able to follow the lectures quite simply.

Of course we had a number of speakers from Portugal who were absolutely fabulous!  Maria Isabel Loureiro MD, PhD addressed “Breastfeeding as a determinant for healthy habits” in which among other things synchronous versus intrusive attachment, measurable changes in the maternal brain, and responsiveness were discussed.  Monica Pina MD critically reviewed the ESPGHAN Recommendations made in 2008 and 2009 regarding breastfeeding which do not align with WHO recommendations, and yet are followed widely in Europe.  She also addressed their 2016 controversial recommendations related to introduction of gluten-containing foods to infants in the 4-6 month range.  Following her presentation was an interactive audience session: “Complementary feeding, a travel around Europe” with moderators: Monica Pina (Portugal) Reet Raukas (Estonia), and Elien Rouw, (Germany). Of course we all chimed in so it became quite global in breadth, and led to a very engaged and lively discussion!  It was fascinating throughout this conference that despite the differences in our cultures and languages, at the base of things, we all do have the same issues and problems we deal with.  When you bring physicians from 23 countries together under one roof, the synergy and the energy is amazing.

On Saturday Susana Rocha, MD, also from Portugal, addressed “Breastfeeding and Neurological Disease in Babies”.  As a pediatric neurologist and lactation specialist, she took us on a very complete journey from the development of fetal oral motor development, CNS pathways involved, CNS conditions associated with depressed, weak or uncoordinated sucking, evaluation and management with breastfeeding support.  The Baby-Friendly Hospital Initiative in Portugal was presented by Ana Jorge, MD, in which we learned that 14/39 hospitals in Portugal are currently designated as Baby-Friendly (35.9%), and national breastfeeding rates in hospital exceed 98%!  Also from Portugal, Matilde Campos, MD, an anesthesiologist, gave a wonderful discussion of “Pain Control, Anesthesia and Breastfeeding”, which followed our recommendations in the ABM protocols of like names exactly!  We may need to sign Dr. Campos up for the next revision!!

Speakers were from a number of other countries as well.  “Chemicals and Breastfeeding” was presented by Adriano Cattaneo, MD from Italy.  Adriano is a learned man in so many different areas of Breastfeeding Medicine and he demonstrated his breadth yet again by his understanding of this topic area.  This was a wonderful discussion of the various categories of chemical contaminants, their effects, why formulas are not safer, why human milk is used to measure these substances and thus is often a “scapegoat” (my word), and why human milk and breastfeeding should be supported.  Heavy information.

My long-time German friend and colleague who often helps us on reviewing protocols, Skadi Springer, MD, addressed “Tongue Tie – Harmless Anomaly or Breastfeeding Obstacle?”  It is the same issue in Germany, Europe, the US and for many of the attendees.  The pendulum has swung in many of our opinions from under-diagnosis to over-diagnosis and treatment—while others believe it is being adequately treated, or still not treated enough—so lively discussion ensued!  And talking of lively discussions—how about Jim McKenna PhD on the “Physiology of Mother-Infant-Sleep” or as he now calls it “Breastsleeping”.  The audience was thrilled to hear Jim speak and provide his rationale for the new terminology in addition to addressing this hot topic by truly one of its world’s experts.  Another hot topic, “Microbioma, Bacteria and Breastfeeding” was presented by Dr. Esther Jiménez Quintana from Spain.  The nuts and bolts of “Maternal Infection and Breastfeeding” was extremely well received given by speaker Robert Lawrence MD of the US, while an in-depth look at “Mastitis” was covered by Linda Kvist of Sweden.  And I provided too much information on the complexities of “Diabetes, Obesity and Breastfeeding”.

All of this was fit into two very civil days, along with poster presentations and a “poster walk”, an award given for best poster, questions and answers, and time for networking over delicious Portuguese sandwiches and baked delights with European coffee and teas at breaks.  We were kept on absolute time by Monica Pina, who did fabulous job, and allowed for the question and answer periods.  Back to the food—the dinner the night before for speakers and the banquet the night in-between for conference attendees—all local Portuguese cuisine and absolutely “spot on”!

So—pronounced “Zo” by my German and Swiss friends, I hope you have gotten a bit of the excitement we all felt who attended this conference.  Those of us who attended are looking eagerly forward to the 7th European ABM Conference.  Elien needs a bit of recovery time, but I have it on good advice that she is already thinking about the possibilities for 2018.  Maybe cities/countries such as Rotterdam, Prague, Croatia, and others come to mind.  Interested?  I am.  Just keep your eyes and ears open.  Tie flies, especially once you pass those “big” birthdays.  2018 will be here before you know it.  With the state of the world, and my own country, I can’t think of anything better to decrease violence and increase stability than oxytocin at the global level!

Kathleen Marinelli MD, IBCLC, FABM is a neonatologist, a previous Board member of the Academy of Breastfeeding Medicine, and previous Chair of the United States Breastfeeding Committee.

Posts on this blog reflect the opinions of individual ABM members, not the organization as a whole.

Written by kmarinellimd

July 28, 2016 at 6:44 am

One Response

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  1. There seems to be a new influx of information telling women that breast may not be best after all. It’s certainly disheartening to hear, as breast feeding can be quite challenging as it is, within the first few months, when it seems that all baby wants to do is be latched at the breast and sometimes fussier than formula feds too.
    I wonder if formula companies have financed this new research that is flooding in.

    I breast fed both my kids for 23 months each. It is damn difficult, no freedom away from the baby, lack of desire of bedroom fun due to the change in hormone levels…but if it is all for nothing then wow…what a shame.

    Ofcourse, I cant be sure, but my kids do seem slightly different to other children and im not sure if its the health aspect that stands out to me.
    It seems to be a psychological difference that i observe most. My girls are very confident and adjusted, they handle change very easy in their stride, they seem to exibit less anxious behaviours than other children. They seem more self soothed and independant from mum. Obviously i cant be sure because this is just an observation. I also note that at 8 amd 5 years old neither have had a round of antibiotics yet and have the most amazing skin.
    But both were extremely fussy high maintenance babies who were always wanting me as their human pacifier, wouldnt allow anyone else to comfort them except mum and the breast. Not even just mum alone without the boob out.
    I think of we were to be 100% honest, breast feeding is damned hard, dont kid yourselves mums, and be aware Drs. But to know that it definately has benefits makes it all worth it

    Deniz Ekrem

    July 29, 2016 at 6:40 pm

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