To Dr. Karp:
Dear Dr. Karp,
I have been following this thread with great interest and am wondering where
the evidence is for this quote of yours:
"In other words, THBOB is a tool to help improve breastfeeding success
rates. As you all know, many women struggle with nursing because of stress
and fatigue associated with prolonged infant crying. Crying can lead to
difficulty latching on, decreased lactogenesis and let down, loss of
confidence, onerous diets, false perception of child illness, loss of
support of father and family, increased depression, etc. ALL of these stack
the deck against nursing success!"
If indeed crying leads to decreased lactogenesis how would the 5 s's
increase it? I am wondering for those of us that work in hospitals where
baby swaddling is routinely done for hours old infants, how many of us find
that we need to unwrap the baby just to stimulate baby to wake up and find
the nipple? Lactogenesis by its very name, whether it is lactogenesis I or
II, is significant of the beginning of lactation. How would the 5s's be
appropriate in the very beginning of lactation?
You may say that this is all covered in your book which I haven't read, I
only skimmed through it once while killing time in Barnes & Noble (perhaps
like many of our moms) but then why would you bring up crying decreasing
lactogenesis as proof that your method works? Yes I gleaned from my skimming
the idea of the 4th trimester, it's an interesting theory. I can't however,
imagine that the 5 s's would be recommended before galactopeisis is firmly
established.
I think it is really a shame that your editor took out information about
baby wearing. In that chapter was there crucial information about the
relevance of skin to skin contact with oxytocin production taken out as
well?
Recently, I saw a mom in the hospital who was reading "Babywise" by the
bedside on the recommendation of a friend. She asked me what I thought of
this specific advice given by that book: her infant had been at the breast
most of the night doing her job to bring on lactogenesis II while mom was
reading about the importance of disciplining her infant to feed at very
specific times and cry it out if baby wanted to feed more than that.
Naturally I told her that I didn't agree with Ezzo's methods, particularly
in the first few days of life.
Of course your method is very different from Ezzo's, but are you sure that
parents understand the appropriate time for use of your techniques? I am not
sure of it, particularly if you are advocating use of the 5 s's during any
part of lactogenesis.
I got a call from our Peds team the next day before I went to see that mom,
baby had dropped 11% of birth weight, and was going home that day, and how
were we going to supplement? The last thing I would recommend in a case like
that is swaddling. Dr. Karp, this is TYPICAL. I'm sure you know that, but do
you really emphasize it in your book enough so that parents (and
pediatricians and nurses for that matter) get it? There is nothing more
destructive in my opinion to production of oxytocin of mom in the first few
days of life than swaddling her baby.
By the way, we had a happy ending with that mom, we got her an electric pump
from WIC and the parents supplemented a few times with a cup and a syringe.
Baby had gained weight at her pediatric appointment the following week and
continued to exclusively breastfeed.
Sincerely,
Barbara Holmes RD, IBCLC
Lactation Coordinator,
Bellevue Hospital
NY, NY
And:
Barbara Holmes RD, IBCLC
The Breast of Both Worlds
-Nurturing Your Baby
-Nurturing Yourself
Brooklyn, NY
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