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Overview

Training Details​

Place of Training:
Comprehensive Lactation Management Center (CLMC) associated with:

  • Kangaroo Mother Care (KMC) Unit
  • Mother and child care hospital

Target Participants:
Enthusiastic nursing staff posted in SNCU or maternity wards associated with mother and child care hospitals

Training Faculty:

  • Pediatricians with experience in lactation counseling and Human Milk Banking
  • Lactation counselors with hands-on experience in Comprehensive Lactation Management Center (CLMC)

Duration:
2 days (16 hours) of structured and hands-on training

Batch Size:
12-18 participants per batch

Training Approach:
Hands-on training with theoretical sessions, focused group discussions, case-based learning, and practical clinical exposure in CLMC settings.

2-Day Training Schedule​

Day 1: Theory and Case-Based Learning​

9:00 - 10:00 AM | Concept of "Comprehensive" Lactation Management​

  • Concept of Comprehensive Lactation Management Center (CLMC)
  • Counseling-first approach vs. milk collection center
  • Integrated care: counseling, breastfeeding establishment, and donation (CFD)

10:00 - 10:15 AM | Lactation Physiology​

  • Anatomy of human breasts
  • Lactogenesis stages (I, II, and III)
  • Hormonal regulation of milk production and ejection
  • Changes during pregnancy and postpartum

10:15 - 10:45 AM | Problems in Breastfeeding​

  • Sore nipples and nipple trauma
  • Breast engorgement
  • Mastitis and breast abscess
  • Inverted/flat nipples
  • Insufficient milk production

10:45 AM - 12:05 PM | Focused Group Discussion: Problems in Breastfeeding​

Format: 4 groups of 3-5 participants each (20 minutes per group)

Case Scenarios:

  1. Not Enough Milk

    • Presentation and assessment
    • Common causes and contributing factors
    • Management and follow-up care

  2. Sore Nipples

    • Presentation and treatment
    • Nipple shield use: indications and disadvantages
    • Prevention strategies

  3. Retracted/Inverted Nipples

    • Assessment and management
    • Breastfeeding positions for inverted nipples

  4. Engorgement

    • Causes and presentation
    • Initial and follow-up treatment
    • Prevention strategies

12:30 - 1:30 PM | Group Discussion: Breastfeeding in Special Circumstances​

Format: 4 groups (15 minutes each)

Scenarios:

  1. Cesarean Section - First 2 Days

    • Early initiation challenges
    • Positioning techniques

  2. Switching from Gavage → Paladai → Breastfeeding

    • Transition strategies
    • Non-nutritive sucking
    • Supplemental nursing systems

  3. Babies with Poor Oral Motor Tone

    • Dancer hold technique
    • Assessment and support
    • Gradual progression strategies

  4. Preterm Neonates

    • Initiation timing
    • Kangaroo Mother Care integration
    • Feeding progression

1:30 - 2:00 PM | Lunch Break​

2:00 - 3:00 PM | Counseling: GALPAC Case Scenarios​

  • GALPAC counseling framework
  • Communication skills for difficult situations
  • Cultural sensitivity

Case Scenarios:

  1. Baby Admitted in NICU After Birth

    • Counseling for expression and milk supply
    • Emotional support
    • Establishing breastfeeding post-NICU

  2. Postnatal Wards

    • Initiation of breastfeeding within 1 hour of birth
    • Exclusive breastfeeding in cesarean section
    • Addressing common concerns

  3. Insufficient Milk Complaints in Outpatient Department

    • Assessment and counseling
    • Building mother's confidence
    • Follow-up strategies

3:00 - 4:00 PM | Human Milk Banking​

  • CFD Approach (Counseling, Breastfeeding, Donation)

    • Counseling-first approach
    • Establishing exclusive breastfeeding before seeking donation
    • Donor motivation

  • Post-Donation Processing

    • Collection protocols
    • Hygiene standards

  • Pasteurization

    • Holder pasteurization (62.5°C for 30 minutes)
    • Equipment and monitoring

  • Microbiological Screening

    • Pre-pasteurization culture criteria
    • Post-pasteurization quality control

  • Storage and Transport

    • Cold chain maintenance
    • Labeling and tracking

  • Administration of Donor Human Milk

    • Recipient prioritization (preterm, low birth weight, NEC risk)
    • Thawing methods
    • Feeding protocols
    • Informed consent

Day 2: Practical Clinical Exposure​

9:00 AM - 1:00 PM | Hands-On Visit to CLMC​

Format: Participants divided into 2 groups (2 hours each group)

Group 1: Education and Support of Mothers

  • CFD approach implementation (Counseling, Breastfeeding, Donation)
  • Direct counseling with mothers in CLMC
  • Addressing common breastfeeding problems in real-time
  • Building mother's confidence
  • Recruitment of donors
  • Ethical considerations in donor recruitment
  • Supporting exclusive breastfeeding before donation

Group 2: Processing of Human Milk

  • Post-Donation Processing Workflow:

    • Collection and storage of expressed milk
    • Thawing frozen donor milk (warm water bath method)
    • Pooling milk from 3-5 donors under laminar airflow
    • Pre-pasteurization microbiological screening
    • Pasteurization process (62.5°C for 30 minutes)
    • Post-pasteurization microbiological screening
    • Final storage protocols

  • Equipment and Record Keeping:

    • Quality control documentation (HACCP)
    • Donor and recipient tracking systems

  • Reporting in CLMC:

    • Reporting format
    • What and how to report

1:00 - 1:30 PM | Logistics and Finances in CLMC​

1:30 - 2:00 PM | Lunch Break​

2:00 - 2:30 PM | National Guidelines for CLMC​

2:30 - 3:00 PM | Post-Test​

3:00 - 3:30 PM | Summary and Feedback​

  • Recap of 2-day training highlights
  • Key takeaways and action points
  • Participant feedback collection
  • Q&A session
  • Certificate distribution
  • Post-training support information

Authors​

Authors: Dr. Sheela Sharma, Dr. Ramesh Choudhary, Dr. Chetan Meena, Dr. Girija Meena

Editors: Dr. S. Sitaraman, Ms. Anne Grøvslien

Published by: Jeevan Dhara — Lactation Management Centre & Human Milk Bank, Department of Pediatrics, SMS Medical College, Jaipur