Well, I can't believe I'm the first to post about this Massachusetts
conference that just ended today... we had two great days here in Boston
despite an unexpected snow and ice storm today...
Yesterday a talk by Dr. Tom Hale and Marsha Walker, and today was Dr. Jack
Newman's. Tom turned out to be a Friendly Texan Guy who made pharmacology
interesting and understandable. (And, yes, he signed copies of his book!)
Key points of the morning were: determining relative safety of drugs by
determining the oral bioavalability, the protein binding (if it's highly
bound to protein, it cannot enter into the milk), the plasma level (if it's
not concentrated in plasma, it will not enter the milk in large amounts),
and avoiding nursing during the peak effects of the medication (often 1-3
hours after intake), and selecting meds with the shortest half-lifes, as
almost all a drug is gone after 5 half-lives. I sat next to a fellow
lactnut who whispered to me: "This is all great information, and I see now
that it's in the front of his book- we'd better all re-read that!"  (You
know who you are :)
 Dr. Tom's afternoon talk focussed on Labor and Delivery anesthesia and
analgesics... Did y'all know that Demerol has the highest transfer into a
fetus at about 2-3 hours after administration, so a baby born 3 hours after
it was given to the mom for labor pain relief, may have days of effects on
the baby before they can metabolise it. Also, Stadol may cause floppy,
"out-of-it" behaviours in a baby that make him not able to latch and suck.
 Marsha Walker spoke about the importance of teaching moms a newborn's
natural feeding cues (mouth movements, hand-to-mouth, REM, body movements,
sounds) while still in hospital, since so many moms think that "demand
feeding" means "wait until baby demands to be fed <cries>" or try to feed
on a q3h schedule when babies are in deep sleep, and that is how moms and
babies get into trouble at home.
 Today, Dr.Jack spoke, and he was also a fun lecturer, which amusing slides
and joking asides that I'm sure you can imagine.  He discussed the
composition of breastmilk vs ABM ("about the only thing they have in common
is water" I think is a direct quote) also (this is a good one!) "I used to
say 'Lactose is only found in Mammalian milk'...then I realised "what other
kind of milk is there?!"   He talked about the importance of evaluating the
latch and milk transfer (listen for the suck...pause...swallow).
  We had a Lactnet Lunch both days with Tom and Jack joining us for lunch,
and there were at least twenty-five Lactnetters about.  If we don't get
another hundred subscr*bers this week I'd be surprised, considering how
many times it was mentioned by the speakers.  It was obvious that if you
weren't "on Lactnet", you were missing out!  BTW, I spent time with the
lovely Cindy Anderson from N.Dakota who has been sending us all those
well-informed nursing students!
 Well, that's a summary, sorry it was long, but a very nice two days.  I
know conferences can't be announced on the list, but certainly if you've
recently attended a meeting or talk that would be of interest to others,
the list would enjoy a summary.
Nancy Holtzman RN BSN MOM (mom of the happy slingbaby with the hair)
Great Beginnings New Mothers Groups
Boston MA
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