Hi everyone. What do people use for severe engorgement when mom is allergic to sulfa (other than standard warm compresses, ice, ibuprofen, diuretic foods). Pump flanges leave imprint in breast tissue, ankles are now swollen day 5. Mom can only express 2-7 ml and is unhappy about having to supplement with ABM. Will also try reverse pressure softening. Baby also appears TT and mild labial tie as well; getting that checked out. Thank you so much.
Laura
Begin forwarded message:
> From: LACTNET automatic digest system <[log in to unmask]>
> Subject: LACTNET Digest - 18 Sep 2012 to 19 Sep 2012 (#2012-677)
> Date: September 19, 2012 11:00:21 PM CDT
> To: [log in to unmask]
> Reply-To: Lactation Information and Discussion <[log in to unmask]>
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> There are 4 messages totaling 144 lines in this issue.
>
> Topics of the day:
>
> 1. delayed bathing - infection control
> 2. Delayed bathing
> 3. reply to your Lactnet post
> 4. Biological Nurturing
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> Date: Wed, 19 Sep 2012 03:12:10 -0400
> From: Sue Pace <[log in to unmask]>
> Subject: Re: delayed bathing - infection control
>
> Here in Rotorua, New Zealand, BFHI for 6 years well babies are skin 2 skin within 5 minutes. Weighed and dressed after an hour or longer, return to skin 2 skin as first line action for any feeding issues. Bathing is carried out when parents are ready-rarely before 24 hours-preferably around 48. Parents are encouraged to bathe baby themselves using plain water-staff are available for support/guidance. Excess blood/lquor/meconium not removed with initial drying at birth may be sponged off. We don't have a nursery for well babies only a Special Care Baby Unit (level 2) so all babies are with mum aal the time. I don't wear gloves to handle a well baby-in fact I hardly ever handle a well baby nor do the rest of our Midwifery/Nursing staff. Doctors only handle/examine a baby if we have a concern. All routine baby checks are carried out by the families midwife. Infection Control have no concerns that we are aware of.
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> ------------------------------
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> Date: Wed, 19 Sep 2012 00:44:31 -0700
> From: Gwen Moody <[log in to unmask]>
> Subject: Delayed bathing
>
> Hi All,
> I am surprised that any baby is bathed before the next day except where there is an infection identified e.g. HIV, hepatitis B or C.
>
> The unit I have worked for over 28 years in a unit with a birth rate of 4000 and now > 5000 births per year as not bathed babies on the first day for at least 20 years, it could be much longer. Plus we have group bath classes so the parents can do the first bath with their baby.
>
>
> There again we even let the cord stump get wet with the baths.
>
> Gwen
>
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> ------------------------------
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> Date: Wed, 19 Sep 2012 11:45:05 -0500
> From: Rowena Tucker <[log in to unmask]>
> Subject: reply to your Lactnet post
>
> Yasmeen,
> Case #1: TT is most likely the issue even though baby is gaining well. Why not get it clipped? There are lots of reasons, not just ease of breastfeeding. Dr. Kotlow's "Aerophagia" article may be helpful.
> http://www.kiddsteeth.com/articles/aerophagia_2011.pdf
>
> Case#2: PTT clipped. Good. Did anyone check for maxillary labial frenulum tie? It is often found with tongue tie and prevents baby from getting and maintaining a good seal on the breast, therefore the breast cannot be drained well. Milk supply usually/often suffers when the body changes from endocrine to autocrine control, about 3 months postpartum, although I see from your post this is not true for the mom you are working with. Getting the lip tie "fixed" is very important! The following is a link to a presentation meant for moms but great for us and other hcp's!
> http://www.kiddsteeth.com/nursingbookmayc2011.pdf
>
> I hope this is helpful! the moms are lucky to have you for support!
> Rowena Tucker IBCLC, Texas
>
> You wrote:
>
> Date: Thu, 13 Sep 2012 22:05:46 -0700
> From: Yasmeen Effath <[log in to unmask]>
> Subject: Case 1 of no poop and Case 2 of breast swelling
>
> PTP
>
> Case 1 : A baby at 7 weeks reports gaining average of 250 gms per week but does not pass stools for over a week until mom decides to use a suppository suggested by her pediatric. So far in 7 weeks mom says baby poops on his own only 3 times and other times had used a suppository. Baby remains attached to breast for a good feed and has a good suck swallow pattern. Unlatches on his own . Baby does have a TT, pointed tongue and a bubble palate. Mother has a robust milk supply. The poop is yellow pasty consistency and not hard or watery. Baby does get very gassy after 3 days of not pooping. Baby sleeps well and has 10 good feeds and is not fussy. What are the things I may need to look at besides getting some cranio sacral work.
>
> Case 2 : Mom with 10 month old has a history of plugged ducts owing to shallow latch despite 2 revisions of PTT. This time she report her painful, tender left breast feels different. She says the breast is Swollen but no lump or hard, flu like symptoms fever, fatigue and severe nausea. Yesterday she did feel a water filled like sac in the breast that felt like pus but not feeling it anymore. I was thinking galactocele. Fever is better now but tenderness in breast remains. Do I look for something more? Does she need a ultrasound to evaluate?
>
> Thank you very much for any insights and help.
>
> Yasmin
> MA,HDSE,CLEC,LLLL,IBCLC
> www.nourishandnurture.in
> Mumbai, India
>
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> ------------------------------
>
> Date: Wed, 19 Sep 2012 20:21:14 -0400
> From: Sandy Hess <[log in to unmask]>
> Subject: Biological Nurturing
>
> I am back on LactNet after about 13 years away. I have been working in lactation off and on, more recently "on".
> Is there any consensus on bilological nurturing? Right now, the nurses on our unit are watching the video. I have used it with good success, but make certain the mother knows how to unlatch the baby if the latch is causing pain and let the baby relatch to a comfortable attachment. When I tried it with a baby who screamed every time he was touched, and who had received a few bottles, I told mom to just relax with the baby and so he could learn that mom was "safe". I noticed after a few minutes he started bobbing his head and opening his mouth wide -- and then latched. Mom was happy, baby was happy, and so was this LC. Perhaps this works as one way to get nipple confused babies back on the breast? Thoughts?
>
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> End of LACTNET Digest - 18 Sep 2012 to 19 Sep 2012 (#2012-677)
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