Full Course Description

OB Medication Update: The Latest Pharmacological Options for Pregnancy and Birth

There have been big changes in everything from FDA medication labeling, recommendations for treating many of the major complications of pregnancy, and Covid 19 infection in pregnancy.

Jamie Otremba, MSN, RN, CNM, a practicing full scope nurse-midwife with extensive maternal child nursing experience, will break down the latest recommendations for the safest, most effective drugs to treat pregnant and laboring patients to improve outcomes, reduce risk, and improve patient satisfaction.  Watch this comprehensive one-day event….and earn up to 6.3 pharmacology CE hours!

You will take away the necessary tools to reduce complications related to Covid-19 in pregnancy. Did you know that recent Covid-19 infection is a contraindication to some drugs? Or that the thresholds and medications to treat pregnant patients with Covid-19 are different? Update your Covid-19 understanding on the vaccines, fetal and maternalnewborn transmission, when and how to treat, when to consider ventilation, and talking points for a quick and effective conversation.

But that’s not all! Jamie will also deliver the latest from evidence on over-the counter products that patients are using, hemorrhagic prevention and the best meds to treat the ‘Top 10’ pregnancy indications seen your own practice!

Program Information

Objectives

  1. Evaluate the new FDA pregnancy safety labeling information to treatment conversations with pregnant patients.
  2. Analyze evidence-based recommendations for the best medication options to treat pregnant patients, while considering gestational age and comorbidities.
  3. Analyze safety of patient’s pre-pregnancy medications in pregnancy.
  4. Develop a plan of care with pregnant patients, to pharmacologically manage pregnancy complications, considering safety, alternatives, risk, benefit.
  5. Distinguish between risks of Covid 19 infection and vaccine in pregnant women.
  6. Assess medication appropriateness for a patient with a Covid 19 infection in pregnancy.
  7. Develop a nonbiased dialogue for discussing vaccines in pregnancy.
  8. Evaluate patient’s pain control needs and apply evidence-based recommendations for narcotic alternatives.

Outline

New FDA Pregnancy Safety Labeling

  • Risk summary explained
  • Examples
Teratogenicity
  • Highest risk medications
  • Historical poor outcomes
  • Risk reduction strategies
Top 10 Pregnancy Indications & Medications to Treat
  • How to decide on safest, most effective option
  • Current preferred drugs for each diagnosis
  • Consenting the patient
  • Preexisting diagnosis
    1. Depression/anxiety preferred medications
    2. Asthma/allergies
    3. Chronic hypertension, including new BP parameters & rational for treatment Pregnancy complications
    4. Nausea/vomiting: New FDA approved medications, when you need IV treatment &what to use
    5. Gestational diabetes: oral medications vs insulin & best insulin formulations in pregnancy
    6. GI reflux: If not Zantac—what’s next?
    7. Insomnia: OTC and prescription medication compatible with pregnancy
    8. Vaginitis: Safest medication by gestational age
    9. Pain: Including opioid prescription reduction strategies
    10. Preterm labor: Prevention mediation recommendations just changed
Vaccines in Pregnancy
  • Latest info on pros, cons & safety
  • Pearls on quick but effective patient teaching/interactions
  • Flu shot
  • TDAP
  • Covid 19 vaccine
Latest Labor and Delivery Medications News
  • VTE prevention and Covid 19: Aspirin, lovenox, heparin- when, how much, how long
  • Hemorrhage prevention and Covid 19: to TXA or not to TXA
  • Treatments for pregnant women with Covid 19
    • Medications
    • Monoclonal antibodies
    • Ventilation
Over-the-Counter Products in Pregnancy
  • Overview of uses and safety
  • Essential oils: Routes, indications, evidence on effectiveness
  • Homeopathics
  • Supplements
Putting It All Together
  • Case Studies
  • Healthcare Provider/ Patient Resource List

Target Audience

Health care providers who work with childbearing aged women, pregnant women, and on labor and delivery. Appropriate for nurses, nurse practitioners, nurse midwives, family practice providers. Both inpatient and outpatient information will be addressed.

Copyright : 10/11/2022

Breastfeeding Success: Latch Secrets, Alternative Feeding Methods & Medication Safety

Over 80% of mothers say they want to breastfeed their babies – but by the time they leave the hospital almost 20% of those babies have already been given formula. Can we change that metric? Why do babies seem to refuse the breast, and what help can we offer?

Parents can feel confused, frustrated, and overwhelmed. They report that information has not been consistent amongst the nurses helping them. How can we change that? What can we do to help hit the reset button for babies who are neurologically disorganized and fighting the breast?

Begin your journey towards IBCLC certification with over 5 CE hours towards the 90 Lactation Education hours needed for the exam, based on the IBLCE Core Competencies!

Program Information

Objectives

  1. Apply the BASICS of breastfeeding assessment to deepen latch.
  2. Evaluate positioning for breastfeeding couplets based on infant preference and need.
  3. Analyze the hierarchy of pharmacokinetics to evaluate the safety of medications during breastfeeding.
  4. Determine available antidepressants for use during the postpartum and their safety for breastfeeding couplets.
  5. Appraise new research suggesting the role of insulin in milk production.
  6. Investigate D-MER and proposed role of oxytocin and dopamine in its etiology and severity.
  7. Apply an understanding of states of infant consciousness to feeding rhythms.
  8. Design a care plan utilizing feeding alternatives for babies struggling with latch in the first days postpartum.

Outline

Breastfeeding Latch, Suck & Positioning

  • What is a good latch?
    • The best position is the one that works
    • Studies show families want hands-on, practical help with latch and positioning
    • Physiologic breastfeeding (also called Baby-Led) encourages babies and moms to follow their instincts
  • Steps to an effective feed
  • BASICS can help staff and families assess and improve latch 
    • B = Belly to Belly
    • A = Alignment
    • S = Space
    • I = In Close
    • C = Cheeks and Chin
    • S = Sucking and Swallowing
  • What about babies who “fight the breast”?
    • Assist with positional stability and teach the parent WHY the baby does what they do
    • Maternal and infant conditions can affect latch and positioning
  • Babies come with a history
    • The role of birth, stimulation, medications
    • Gestational age
    • Neurologic disorganization

Self-Efficacy

  • Pathways to self-efficacy
    • Performance accomplishment
    • Vicarious experiences
    • Verbal persuasion 
  • Distressed behavior
    • Babies who have been repeatedly pushed forcefully to the breast can learn it’s a place of discomfort, not comfort
    • Feed in an alternate way
    • Re-establish trust
  • Back to the breast: Make it feel safe
    • STS or not: “How do we fit together?”
    • Mother keeps calm, follows infant lead
    • Use your expertise only when needed
  • GLOW authors suggest
    • On days 2-3 share info about feeding cues and latch
    • Supports lactogenesis II and the making of milk
    • Supply will “take off like a rocket”

Alternative Feeding Methods

  • What is normal weight loss?
  • Start with hand expression 
  • Choose a safe way to get the milk into the baby – Global Media video
  • Safe use of nipple shields
  • Safe use of paced bottle feeding
  • Push the reset button
  • Teach parents about infant states of consciousness

Medication Safety

  • Considerations for availability
    • Molecular weight
    • Lipid solubility
    • Excretion of drugs including half life
    • Oral bioavailability
    • Timing in lactation
  • Translating the theory into real life
    • Hale’s Lactation Risk Categories
    • Antidepressants
    • Cannabis
    • Cigarettes
    • Alcohol
    • SARS-COV2 vaccines and therapies
    • Hormonal contraceptives
  • Resources
    • Infant Risk Center
    • PLLR labeling
    • References in print

Anatomy and Physiology Update

  • 4-18 Ductal openings (previously thought 15-20)
  • The ducts branch closer to the nipple – the lactiferous sinuses do not exist 
  • Ducts can be just below the skin surface, making them easily compressible
  • Most glandular tissue is found within 30 mm (~1.2 inches) of the nipple
  • Montgomery Glands are now called Areolar Glands
  • Lactogenesis I (Secretory Differentiation)
  • Lactogenesis II (Secretory Activation)
  • Protracted nipples
  • Inverted nipples (Grade 1 – 3)
  • Baseline prolactin levels
  • The role of insulin 
  • Is oxytocin always our friend?
  • New research on Dysphoric Milk Ejection Reflex 

Target Audience

  • Nurses
  • Nurse Practitioners
  • Clinical Nurse Specialists
  • Doulas
  • Midwives
  • Clinical Nurse Specialists
  • Lactation Consultants
  • Childbirth Educators

Copyright : 08/30/2022

Postpartum Depression & Related Disorders: Clinical Strategies to Identify and Treat Parents Who Are Suffering in Silence

It’s not a topic that comes up at play groups or over coffee. Instead, new parents suffer quietly, engulfed in shame and secrecy, afraid to dispel the ever-present myths about parenthood - “everything is perfect,” “I love being a parent,” and “this is the happiest time of my life.”

They don’t share the dark thoughts, intense anxiety, scary intrusive thoughts, checking excessively on the baby, feelings of inadequacy, grief over lost independence, thoughts of harm to self or baby, and even delusions and hallucinations.

Perinatal Mood and Anxiety Disorders (PMADs) are real, pervasive, and can be life-threatening.

Are you missing the signs with the parents you treat?

Watch this compelling one-day seminar and gain tools to intervene during a critical period that does not offer the luxury of time. Postpartum parents are exceptionally vulnerable, as are their infants who are fully dependent on them. This seminar is a must-attend for any professional working with pregnant or postpartum parents.

Purchase today!

Program Information

Objectives

  1. Develop communication style that meets the unique needs of perinatal clients in order to improve client engagement and retention.
  2. Differentiate between “normal” perinatal experiences and clinically relevant symptoms to inform clinician's choice of treatment interventions.
  3. Modify clinical interventions and screening tools to incorporate the "holding" approach with perinatal clients.
  4. Integrate understanding of common difficulties occurring within perinatal family system for purpose of psychoeducation, collaboration with family members or partners, and improved specificity of case conceptualization.
  5. Determine self-regulation skills and interventions the clinician can use to manage vulnerability that may interfere with treatment of perinatal clients.
  6. Assess and respond effectively to special circumstances (breastfeeding, NICU, perinatal loss, adoption, depression in the partner) that impact therapeutic process and treatment planning.

Outline

The Clinical Profile of PMADs: (Perinatal Mood and Anxiety Disorders):

  • What causes postpartum mental health disorders?
  • The “perinatal masquerade” and illusion of perfection in parenthood
  • Why “perinatal” is a multi-decade stage in life
  • What makes mood disorders during this period unique
  • Breaking through guilt, shame, and silence
  • Limitations of the research and potential risks
PMAD Screening and Assessment
  • Are you asking the right questions?
  • Red flags: What to look/listen for each session
  • Evidence-based assessment tools
  • Differential diagnosis: The PMAD spectrum
    • Depression, anxiety, OCD, PTSD, psychosis
  • The Postpartum Stress Center PMAD Response Model
  • How to respond to disclosures of thoughts to harm self or baby
  • Where and how to refer to a specialist/higher level of care
Clinical Interventions for Parents Who are Symptomatic, Exhausted, and Preoccupied
  • How treatment differs for this population
  • Create a safe “holding environment”
  • Break through guilt, shame, and silence
  • Navigating scary intrusive thoughts
  • Practical interventions for busy new parents
  • The perinatal family: Identify and engage necessary supports in treatment
  • Tools for healing the perinatal intimate partnership
  • Psychotropic medications: Safe for pregnant or nursing parents?
  • Collaborative care with other providers
  • Videos: Beyond the Fear & Voices of Recovery
  • Exercises: Token assessment and case examples
The Nuanced Experience of the Perinatal Clinician
  • Managing countertransference
  • Ethical decision making: Breaking the rules and self-disclosure
  • Collaboration and collegial support
Special Considerations
  • Feeding issues: Breastfeeding and/or bottle
  • Infertility/Assisted reproductive technologies
  • Trauma
  • NICU
  • Perinatal grief and loss
  • When PMADs are left untreated or present later in parenthood
  • Multicultural factors

Target Audience

  • Social Workers
  • Counselors
  • Psychologists
  • Marriage and Family Therapists
  • Psychiatrists
  • Pediatricians
  • Gynecologists
  • Nurses
  • Nurse Practitioners
  • Midwives and Doulas
  • Lactation Consultants
  • Other professionals who work with perinatal parents

Copyright : 11/14/2022

Not Your Mother’s Postpartum Book

“But no one told me to expect this …”

So many new moms find themselves saying this phrase in the first hours, days, and weeks postpartum – sometimes even for years! That’s where Instagram’s wildly popular @mamapsychologists come in. In Not Your Mother’s Postpartum Book, Chelsea and Caitlin share what to really expect postpartum – and it’s not just the baby blues.

This refreshingly candid resource fills a notable void by providing real, honest, and raw insights into motherhood. With their nonjudgmental yet humorous tone, Caitlin and Chelsea provide a deep dive into all things #momlife, including:

  • Birth trauma & perinatal mood disorders
  • Baby feeding & sleep
  • The mental load of motherhood
  • Body image struggles
  • Mom guilt & burnout
  • NICU life
  • Intimacy & romance postpartum
  • Pregnancy complications & loss
  • The balancing act of returning to work
  • And more …

Mom life feels hard because it is hard. There is hope, and this book is here to provide it.