On-Demand & Live Webinars with CEs and CERPS!

More Than Reflexes:

Learning, Forgetting, and Relearning Infant Breastfeeding Skills

Integrating Precepts from Breastfeeding Science and the Cognitive Sciences

with Emphasis on Kinesiology —

the Study of Human Movement, Motor Learning, and Motor Control

Following a learning experience with an artificial nipple, why do so many infants display skill decay for breastfeeding skills, particularly but not only during early learning, even while remaining neurologically intact? Similarly, why do so many bottle-fed infants display challenges in learning the oral grasp of an artificial nipple that differs from a previously learned artificial nipple in contour, length, width, and/or texture?

Please join us for this fascinating discussion on motor skill acquisition, skill decay, and reacquisition of breastfeeding skills. This groundbreaking content provides readily teachable precepts for patient/client education and much more.  

CEs 4.0 CEs approved by the West Virginia Board of Registered Professional Nurses, Provider Number 50-31004

CERPs 4.0 L-CERPs allocated by the International Board of Lactation Consultant Examiners® to begin February 20th 2024 through February 20th 2025. IBLCE Verification Number C2023300.

Upcoming Live Events:

TBA

*Payment rate for those in Tier 1 Countries: $60.00

*Payment rate for those in Tier 2 Countries: $38.00

*Payment rate for those in Tier 3 Countries: $11.00

*See below for payment listing of countries by Tiers 1 - 3.

Key Terms associative learning, procedural learning, reinforcement learning, reward-based learning, expected sensory consequences, motor learning, motor forgetting, motor control, spatial learning, learning constraints, individual constraints, task constraints, environmental constraints, feedback, sequencing, specificity of practice, task-switching, switch costs, skill decay, primacy effect, recency effect, interference, proactive interference, retroactive interference, perseverance, performance plateau, consolidation, automaticity, reaction time, movement time, response time, response inhibition, inhibition of return, pairing of associates, manual guidance, verbal guidance, visual guidance, motivation.

Course Description The presence of the primitive survival reflexes does not guarantee the oral grasp and effective suckling in all babies all the time. There is a well-known but poorly understood universal phenomenon of skill decay for infant breastfeeding skills that often follows the infant’s learning experience with an artificial nipple, and a wealth of data correlates the use of an artificial nipple with shorter duration of exclusive breastfeeding, as well as early cessation of the entire breastfeeding course. For decades, the World Health Organization (WHO) and the United Nations International Children's Emergency Fund (UNICEF) advised to avoid the use of pacifiers and artificial nipples in breastfeeding infants, as part of the Ten Steps to Successful Breastfeeding and the Baby-Friendly Hospital Initiative (BFHI).  In its most recent 2018 revision, current language in the Ten Steps advises childbearing facilities to counsel mothers on the use and risks of feeding bottles, teats, and pacifiers.

Infant breastfeeding difficulties that follow the use of an artificial nipple are often observed as a recency effect, i.e., the primitive survival reflexes are often more heavily weighted toward the more recently learned feeding method, rather than equal weighting of these reflexive feeding movements for all infant milk-feeding movements all the time. Following the use of an artificial nipple and a subsequent return to the breast, newly acquired difficulties with the oral grasp at the breast are often observed, while other infants are able to achieve and sustain the oral grasp (latch), but perseverate by displaying a shallow latching technique that is requisite for using an artificial nipple, but which is also correlated with nipple pain and visible nipple damage when feeding at the breast. These breastfeeding difficulties are particularly prevalent during early learning, prior to the achievement of robust motor memory or consolidation of motor memory for breastfeeding skills. Similar difficulties with the oral grasp and/or effective sucking can also be observed in bottle-feeding infants who are given a learning experience with a novel artificial nipple. 

We adults have much in common with our former infant selves in that learning is most effective when practice is specific to the task. Motor learning is a complex process, and task-switching between tasks that are similar yet different is a time-consuming process requiring enough rehearsal time to learn how to discern and differentiate which movements are effective and ineffective for correctly performing a specific task, as well as the time-consuming demands for the repetition of practice in building robust motor memory. After learning a similar but different task and subsequently returning to the original task, switch costs are often observed, and these switch costs are measurable in regard to decreased speed of movement as well as decreased accuracy in performing the task, prior to the needed rehearsal for once again improving the level of skill. Task-switching and switch costs have been studied for decades by comparing measurements in reaction time to stimuli; movement time for the achievement of a movement or a series of sequenced movements for completing a task or skill; response time; and inhibition of return, the delay in responding to a previously cued (orienting) stimulus. 

Examples abound for switch costs that often follow task-switching. At approximately six months of age, the older baby begins to learn to drink from a sippee-cup, but weeks to months are required for basic skill acquisition in sippee-cup drinking. During this early skill acquisition, the baby will not display any ease in switching to a similar but different sippee-cup, and a novel sippee-cup is often refused by infants in favor of the originally learned sippee-cup. Older babies and toddlers begin to learn how to use a spoon and fork, and during early practice sessions, often display spoon-like movements when using the fork, and fork-like movements when using the spoon. 

Across the lifespan, whether the individual is a novice or an elite performer, the greater the difficulty of the task, the greater the need for practice that is specific to the task. Therefore, the professional musician will never prepare for a job audition on the clarinet by rehearsing with an oboe, as there is a world of difference in the oral grasp of the clarinet mouthpiece and the oral grasp of the oboe reed. The professional baseball player will never rehearse for the World Series by practicing the manual grasp with a softball or a non-regulation sized baseball, and the pro golfer will not suddenly change the style of her clubs just prior to competition. After a lifetime of skill acquisition, we adults intuitively know these things, yet in non-Baby Friendly settings and elsewhere, extraordinary task-switching abilities are often expected of the newborn who is just beginning to learn the earliest of motor skills.

Toward greater understanding of the acquisition of infant breastfeeding skills, this intensive webinar also discusses clinical interventions for infant feeding difficulties that often follow the use of an artificial nipple. Research opportunities are discussed in regard to the acquisition, decay, and re-acquisition of infant breastfeeding skills, utilizing the measurement parameters of reaction time, movement time, response time, and inhibition of return.

Presenter Debra Swank is a graduate of Davis & Elkins College, and began her healthcare career as a registered nurse serving infants, children, and young adults with genetic and other chronic health issues. Since 1995, Ms. Swank has provided care in lactation and infant feeding in both rural and large urban settings to over 15,000 infants and their families from many walks of life. In addition to her professional interests in sensory-perceptual-motor learning for the acquisition of infant feeding skills, Ms. Swank’s professional interests also include the science of human milk and Tronick's Mutual Regulation Model (MRM).

Pricing

Tier 1 Countries $60.00: Andorra, Aruba, Australia, Austria, Bahamas, Bahrain, Belgium, Bermuda, Brunei Darussalam, Canada, Cayman Islands, Chile, Croatia, Curacao, Cyprus, Czech Republic, Denmark, Estonia, Falkland Islands, Finland, France, Germany, Gibraltar, Greece, Greenland, Guadeloupe, Guam, Hong Kong, Hungary, Iceland, Ireland, Israel, Italy, Japan, Kazakhstan, Kuwait, Latvia, Liechtenstein, Lithuania, Luxembourg, Macau, Malaysia, Malta, Martinique, Monaco, Netherlands, New Caledonia, New Zealand, Norway, Oman, Panama, Poland, Portugal, Puerto Rico, Qatar, Reunion, Romania, Russian Federation, San Marino, Saudi Arabia, Seychelles, Singapore, Slovakia, Slovenia, South Korea, Spain, St. Kitts and Nevis, St. Maarten, Sweden, Switzerland, Taiwan, Trinidad and Tobago, Turkey, United Arab Emirates, United Kingdom, United States, Virgin Islands (British), Virgin Islands (US).

Tier 2 Countries $38.00: Albania, Algeria, American Samoa, Anguilla, Antigua and Barbuda, Argentina, Armenia, Azerbaijan, Barbados, Belarus, Belize, Bhutan, Bolivia, Bosnia and Herzegovina, Botswana, Brazil, Bulgaria, Cape Verde, China, Colombia, Cook Islands, Costa Rica, Dominica, Dominican Republic, Ecuador, Egypt, El Salvador, Equatorial Guinea, Fiji, French Polynesia, Gabon, Georgia, Grenada, Guatemala, Guyana, Indonesia, Iraq, Jamaica, Jordan, Kosovo, Laos, Lebanon, Libya, Maldives, Mauritius, Mexico, Moldova, Mongolia, Montenegro, Montserrat, Morocco, Namibia, North Macedonia, Northern Mariana Islands, Palau, Paraguay, Peru, Philippines, Serbia, South Africa, Sri Lanka, St. Lucia, St. Martin, St. Vincent and the Grenadines, Suriname, eSwatini, Thailand, Tunisia, Turkmenistan, Ukraine, Uruguay, Uzbekistan, Venezuela, Viet Nam.

Tier 3 Countries $11.00: Afghanistan, Angola, Bangladesh, Benin, Burkina Faso, Burundi, Cambodia, Cameroon, Central African Republic, Chad, Comoros, Cote D’Ivoire, Democratic Republic of the Congo, Djibouti, Eritrea, Ethiopia, Federated States of Micronesia, Gambia, Ghana, Guinea, Guinea-Bissau, Haiti, Honduras, India, Kenya, Kiribati, Kyrgyzstan, Lesotho, Liberia, Madagascar, Malawi, Mali, Marshall Islands, Mauritania, Mozambique, Myanmar (Burma), Nepal, Nicaragua, Niger, Nigeria, North Korea, Pakistan, Palestine, Papua New Guinea, Republic of the Congo, Rwanda, Samoa, Senegal, Sierra Leone, Solomon Islands, Somalia, South Sudan, Sudan, Syria, Tajikistan, Timor-Leste, Togo, Tonga, Tuvalu, Uganda, United Republic of Tanzania, Vanuatu, Western Sahara, Yemen, Zambia, Zimbabwe.

Upcoming Webinars

Developmental Science and Breastfeeding Skill Acquisition addresses learning, forgetting, and relearning in the context of the developmental progression of task-switching abilities (cognitive flexibility) from infancy to adulthood, with emphasis on the earliest of skills to be learned.  A historical overview of early research on sucking in puppies and rat pups is presented, including seminal work by Dr. Walter C. Stanley (1922 - 2015) and by Dr. William P. Smotherman (1946 - 2008). Groundbreaking work by Dr. Carolyn Rovee-Collier (1942 - 2014), the founder of infant long-term memory research in humans, is a centerpiece of this discussion.  Rovee-Collier's master's thesis was on sucking in puppies.  

Looking on the Inside:  Neural Analogs of Learning and Forgetting discusses how the brain changes as we learn, forget, and adapt.  A historical overview on cognitive neuroscience is given, and precepts from breastfeeding science and associative learning are integrated, with emphasis on excitatory and inhibitory processes.  Across the lifespan, sleep is critical for the consolidation of memory - the strengthening of memory toward a robust state.  As new memory traces are first encoded, there is a fragility of the new memory, but over time - with the repetition of practice followed by rest and sleep - new memories become more robust, and this robust state is termed consolidation.  Following the use of an artificial nipple, the infant's reflexive breastfeeding movements are often subsequently inhibited at the breast, particularly during early learning.  Inhibition is a dynamic area of study in the cognitive sciences, including the inhibition of reflexes, when reflexive behavior is altered during the learning process.