Christina Smillie MD: Psychobiological Neuroendocrine and Neurobehavioral Basics of Breastfeeding (The ABC of Breastfeeding II.)

The Balance Association cordially invites all those interested in

Psychobiological Neuroendocrine and Neurobehavioral Basics of Breastfeeding – The ABC of Breastfeeding II. Lecture series


Place and date of lecture: Millennium Hotel Budapest, Üllői u. 94-98, 28 – 29 April 2017

Lecturer: Christina Smillie MD pediatrician, IBCLC, Stratford USA

( Click here for registration )

Detailed program:

28 April 2017, Friday

09:00-12:00 – What mothers and babies already know, how they think, and what on earth this has to do with learning to breastfeed

Mothers and infants of all ages have innate abilities that help them as they begin to breastfeed. We look a bit of the neurobehavioral and psychobiological literature that describes this remarkable ability. What we find offers lessons in both maternal and infant competence, the maternal-infant relationship, and the neuroendocrine basis for maternal and infant behavior and attachment. Illustrated with lots of video, we suggest that facilitating these remarkable behaviors may make it easier for us to support mothers and babies as they learn to breastfeed. (10:30-10:45 break)

12:00 -13:00 – lunch break

13:00-14:45 – Breastfeeding: What do hands have to do with it?

Much introductory breastfeeding teaching has involved instructing the mother where her hands should and should not be. Videos of comfortable and experienced mothers as well as pictures from great art work of centuries past give us a picture of some of the hardwired ways mothers actually use their hands, challenging some current teaching. We’ll look at how routine use of the hands on the breasts, whether nursing or pumping, can aid in the prevention and treatment of a variety of breastfeeding issues, including both rapid and slow milk production and plugged ducts, as well as help with feeding preemies, twins, etc. Here we’ll use video to look at a few of these techniques, describe the various situations where they might be useful, and suggest how to teach these techniques in an accessible and intuitive way.

14:45-15:15 – coffee break

15:15 – 17:00 – Make it easy – beyond pumps and galactogogues

The way we look at milk production actually influences what we do about it and, paradoxically, can actually interfere with a mother’s rate of milk production. What is a “milk supply” anyway? Do we have a tear supply or a saliva supply? More than a philosophical discussion, this talk looks at fundamentals of lactation physiology, reviews recent literature and draws on clinical experience to offer practical and perhaps surprising solutions for mothers in challenging circumstances.

29 April 2017, Saturday

09:00-10:40 – Slow weight gain and the vicious cycles that keep it going: Poor feeding, poor appetite, and poor production

Breastfed infants who gain weight slowly can present a challenge to both parents and providers. Their quiet, content demeanor can delay diagnosis, and their sleepy, anorectic behavior can make feeding very difficult. And there is little evidence to guide us. Lost in the confused definitions and flawed research is any solid physiologic rationale for clinical intervention: when and why should supplementation be undertaken, how much, and to what endpoint? Beginning with a review of the available literature, we’ll look at how an understanding of the pathophysiology of slow weight can bring us to a new way of looking at an old problem.

10:40-11:00 – break

11:00-14:00 – Sleeping on the job: What late preterm, jaundiced and underweight babies all have in common, and the path to effective breastfeeding

When newborns are sleepy feeders, one problem can lead to another. We’ll look at how flow-dependent feeding creates a vicious cycle that slows milk production, what to do about it, and how to prevent problems in the first place.
(12:15-13:15 lunch break)

14:00-14:30 – coffee break

14:30-17:15 – From the Perils of Block Feeding to the Magic of a Milkshake: Addressing the Challenges of Hyperlactation

The management of hyperlactation has been fraught with all sorts of rules: one sided feeding, block feeding, pumping before or after, all with the intention of ‘getting to the cream’ and/or leaving one breast full for negative feedback. We’ll look at the pathophysiology of hyperlactation, discuss some common scenarios that can lead to hyperlactation, and the mother and baby symptoms that can result. Importantly, we’ll look at the clinical and pathophysiological reasons why rule based solutions like block feeding can be counterproductive and even dangerous. And finally, will get to some right-brained, but physiologically based solutions—how mothers can use their hands to ‘homogenize’ the milk as part of an easier solution. Empirically based on our clinical experience, this talk is, nevertheless, evidence-based. (16:00-16:15 break)

17:15-17:45 Closing of program

About our lecturer:

Crsitine Smillie MD is an american pediatrician who founded in 1996 the first private medical practice in the USA devoted to the specialty of breastfeeding medicine. Board certified by both the American Board of Pediatrics in 1983 and by the International Board of Lactation Consultant Examiners in 1995, she values her continuing education from colleagues, research, and breastfeeding babies and their mothers. She’s been a member of the Academy of Breastfeeding Medicine since 1996, and an ABM Fellow since 2002. She serves as an advisor to the  La Leche League International’s Health Advisory Council. She speaks nationally and internationally about the clinical management of a wide variety of breastfeeding issues, always stressing the role of the motherbaby as a single psychoneurobiological system, and emphasizing the innate instincts underlying both maternal and infant competence

Her Clinical Research Interests: The neurobehavioral basis for maternal and infant interactions and learning, particularly learning to breastfeed, and how dyadic interactions aid infant affective development and state regulation. The pathophysiology and management of slow weight gain in breastfed infants: the vicious cycles of depressed appetite, low energy, poor feeding, and depressed milk production. Hyperlactation: causes, associated symptom complexes for mothers and infants, and management. Multiple varied topics in the clinical diagnosis and management of problems associated with breastfeeding and lactation. Much of the physiology, neurobehavior, psychobiology, and pathology we observe in our clinical practice represent topics underreported, unreported or unstudied in the medical literature.

Further information about the program:

  • The lecture’s language is English with Hungarian translation.
  • For more information in english please contact: Zsuzsanna Tanács,

( Click here for registration )