Lynn, your point in some instances may be right. Burt as a non nurse IBCLC i
do question procedures, why, and wherefores.
I have a BA and Master's in Education and Psychology. I have 4 children and
all have had hospitalizations etc., and as even a parent I have made my
education work for me by buying those nursing texts and things and do read.
( well even last year attended nursing school.)
To pass the IBLCE exam, even basics like skin to skin we have to answer and
temp stabilization- we need to know. We have to know multiple stage of
growth and deveopment. I see many RN's where I work and have worked in the
past still do not understand the basics of Breastfeeding. Even in nursing
school, our 1 hr of inservice was all we got on breastfeeding. I was to say
nothing to any BF mom about any aspects- and I have the IBCLC designation,
even if the RN was wrong. Whwt really would have happened if something went
wrong and they found out I had the board designation. I assume major
lawsuit.
Mst of us Non -RN's may initially be a little timid but we learn to be
assertive. I have lost jobs to women who have an non Experienced RN who
took a 20 hr, course and she is now the expert. I no longer count, even
though I have 10 years experience dealing with nursing moms.
Forgive my spelling, etc. please.
I am tired as I have just attended 2 births in the last 40 hours as a doula.
Yes one vaginal birth - one section and I was in the OR. Both moms were
nursing in that golden 1 st hour. and I unwrapped both babies, put them
naked skin to skin and covered with blankets. Temps were stable. Latch was
great and they are still doing well.
I will get off the soap box now.
Mechell Turner, still not nursing, but M.Ed, IBCLC, CCE, Doula, Certified
Herbalist, Mom, wife, Farmer and bad housekeeper.
-----Original Message-----
From: Automatic digest processor <[log in to unmask]>
To: Recipients of LACTNET digests <[log in to unmask]>
Date: Wednesday, May 24, 2000 4:13 PM
Subject: LACTNET Digest - 24 May 2000 - Special issue (#2000-645)
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Date: Thu, 25 May 2000 08:53:34 +1000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
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From: Denise Fisher <[log in to unmask]>
Subject: Re: Better pumps at the end of our arms
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At 15:17 24/5/00 -0400, Elisheva wrote:
>whose babies
>are NPO need to "pump 10 times a day" or whatever, in the first days, before
>lactogenesis II, do we actually mean *pump*, like, with a device, because the
>suction is important here? Or is, say, Marmet technique of hand expression
>an OK substitute for this kind of nipple stim ? What are folks doing in
>countries where sick babies' mothers don't have pumps available, and does it
>work OK?
Elisheva, though I come from a country which definitely DOES have pumps
(Australia), in my experience they are not a tool we use until AFTER
lactogenesis II. Up until then it is all hand expressing. Our experience
is that we obtain milk at every expression (unlike with a pump where
previous posts suggest it can take up to 6 or so sessions to obtain
anything) and give that milk to the baby (who would otherwise have had to
have 'the other'). It's gentle and introduces pumping to a new mother who
may have to do it for many weeks in a non-threatening way.
I can't remember the name of the video, I think it may have been the
kangaroo care one (one of the originals). It shows a 'line-up' of mothers,
all of whose babies are in NICU, sitting hand expressing into basins. They
very quickly and very efficiently fill those basins without any problems.
Everyone expressing together was suggested as a very positive psychological
factor too.
So, no Elisheva, you definitely don't NEED a pump. It may make it easier
and faster for some women, but 'those tools on the end of our arms' are
just as good.
Denise
****************************************************
Denise Fisher, BN, RM, IBCLC
BreastEd Online Lactation Studies Course
http://www.breasted.com.au
mailto:[log in to unmask]
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Date: Wed, 24 May 2000 17:04:45 -0700
Reply-To: Lactation Information and Discussion
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From: Carol L'Esperance <[log in to unmask]>
Subject: Marketing of formula
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I agree with Carol B on this issue. The most powerful marketing of =
formula comes from health professionals when they are a part of the gift =
giving program for mothers and health professionals. When we accept =
gifts and give formula packs, we are the avenue for their sales and =
marketing plan. It is no different than being in a magazine =
advertisement or on TV supporting their product. We can say all we want =
that we think "breast is best" or that we support breastfeeding mothers, =
but what we do is more powerful than what we say. Formula companies =
have always said that they advertise in the hospital because they are =
not allowed to advertise to consumers. I know people don't agree with =
me, but it would be better to advertise to consumers than to have health =
professionals do their advertising. The NM Breastfeeding Task Force is =
trying to get rid of formula companies in the hospital state-wide(we =
have a few who have done this) as our project for World Breastfeeding =
Week. It has been interesting getting feedback from some of the =
hospitals. One person said that the nurses at a meeting actually were so =
upset they cried at the thought of not giving out the packs. How have we =
gotten here? By superb marketing by a commercial company! And, I think =
in a system(the health care system) where nurses (and others) are =
overworked, overstressed, underpaid, and there are few "perks" and =
"pats". In come the handsome(most were all good looking males when I =
worked in the hospial) rep who says how great they are and gives them =
something....=20
We will keep you informed!=20
Carol L'Esperance, RN, MSN, IBCLC
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Date: Wed, 24 May 2000 19:40:45 PDT
Reply-To: Lactation Information and Discussion
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From: laurie wheeler <[log in to unmask]>
Subject: Re: bili rebound
Comments: To: [log in to unmask]
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Thanks, Denny. Yes the doc considered that the bili would likely rebound
and ordered followup lab work. Today when I called the mom she was beaming
that everything was great. The baby was eating superbly and peeing and
pooping like crazy. All's well that ends well, I guess.
Laurie Wheeler, RN, MN, IBCLC
Violet Louisiana, s.e. USA
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Date: Wed, 24 May 2000 21:45:53 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Jim & Winnie Mading <[log in to unmask]>
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When our hospital finally developed a dedicated LC position, the
requirement was RN with "additional lactation training". IBCLC
wasn't specified. As I was one of the candidates, I didn't feel I
could push the issue too far at that time. I did point out the
advantages of IBCLC and the 2 of us who were eventually hired to job
share the position were both RN/IBCLCs. When we looked for our
first pool LC, administration still insisted on also having RN in
spite of our attempting to educate them on why that didn't need to
be a requirement. The ads read IBCLC preferred.
When we first had an LC intern who wanted to work with us, we again
faced some resistance as her background was as a dietitian. When
the department "survived" her 100 hours with us they were then more
receptive with the next intern. That intern eventually became a
pool LC with us when our department expanded and the current pool LC
became regualr staff LC. By that time, any ads for the position
required IBCLC.
We have now had another LC intern whose background in in Social
Work. Admittedly, the fact that her husband is one of our OBs may
have reduced resistence. We now have another non-RN intern who will
start with us soon. When the department Educator raised the
question of whether she was an RN, I pointed out the ones we have
had who weren't RN and she seemed a little taken aback, but the
program will proceed.
What's my point? Sometimes resistance won't go away all at once,
but can be eroded until it is no longer in the way. Whenever we
expand again or need to replace one of our LCs I think the position
may well be available to a non-RN, but IBCLC cnadidate. So in
addition to speaking out, it also helps to make some small inroads.
Winnie Mading hospital-based LC in WI
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Date: Wed, 24 May 2000 21:56:18 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: Jim & Winnie Mading <[log in to unmask]>
Subject: Hand expression video
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The video of the "lineup" of moms hand expressing was from either
WHO or UNICEF (I think the latter) and is at least 10, maybe 15
years old. There were several topics on one video. The one in
question was titled something like "Feeding Low Birthweight
Babies". Hope this gives you a stert in finding it.
Winnie
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Date: Wed, 24 May 2000 23:00:05 EDT
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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Subject: Re: LACTNET Digest - 24 May 2000 - Special issue (#2000-646)
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Dear Kay:
The references for Grey's Anatomy and Netter's Anatomy are in your
bibliography for my talk at Debi and Colette's conference.
Warmly,
Nikki Lee RN, MSN, Mother of 2, IBCLC, CIMI, CSTP
Elkins Park (a suburb of Philadelphia, Pennsylvania; northeastern USA)
supporter of the WHO Code and the Mother Friendly Childbirth Initiative
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Date: Wed, 24 May 2000 23:12:24 EDT
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: "Vicky M. York, Ibclc, Cpd" <[log in to unmask]>
Subject: Re: LACTNET Digest - 21 May 2000 (#2000-636)
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Jane: Regarding the baby who will not latch on, If it was just born last
night I think it is too soon to offer formula, syringe or otherwise. Would
rather sugar than milk proteins. I had a baby refuse for 7 days once and we
tried many times a day while pumping and giving it to baby via finger
feeding, syringe and bottle. Changing the method made it tolerable for the
frustrated parents. After 7 days she opened her mouth and latched on and
nursed for 3 years. So don't let her give up over this. Good luck.
Vicky York, CPD, IBCLC
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Date: Thu, 25 May 2000 06:26:04 +0200
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Esther Grunis <[log in to unmask]>
Subject: up-date on deep unilateral breast pain
Comments: To: Lactnet <[log in to unmask]>
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I spoke to the mom with the deep pain in her left breast and she is
experiencing much improvement. What seemed to help? Limiting
breastfeeding on the affected side. She feeds on that side about every
second or third feed. so I am going with the "refill" theory. Jean,
where are you? We need an anatomical-physiological explanation for this
one!!
Esther Grunis, IBCLC
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Date: Wed, 24 May 2000 22:26:03 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Barbara Wilson-Clay <[log in to unmask]>
Organization: Austin Lactation Associates
Subject: weight loss >15%
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Kay Hoover wrote a letter to the editor of JHL 1998,14(4):288 urging LCs to
be cautious about extreme weight loss in newborns. She pointed out that if
an infant has lost 15% or more of weight, the baby's electrolytes need to be
checked. Babies can be alert and active and still become dehydrated. "When
there is rapid weight loss, the baby can have an electrolyte imbalance. If
this imbalance is not corrected, the baby could have a seizure, suffer
permanent neurological damage, or even die." This last statement is ref. to
a a medical text on pediatrics.
Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.lactnews.com
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Date: Wed, 24 May 2000 23:31:41 EDT
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: [log in to unmask]
Subject: re :unilateral pain in breast
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Chris wrote:
<< Another possibility (besides yeast) of unilateral deep breast pain is that
the c4 intercostal nerve is being pinched. Physical therapists and
chiropractors are adept at adjusting for such impairments. When I have
personally experienced this, it feels as though my "rib is out of joint" >>
Chris,
I was thinking of a nerve pinch as well, but do you mean T4, as in
Thoracic, where the intercostals are innervated or that something in the
cervical region is pinched and referring somehow? The way new moms can hunch
over to see what they are doing, MY neck hurts sometimes...:)
Judy LeVan Fram, Brooklyn, NY
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Date: Thu, 25 May 2000 06:56:09 +0200
Reply-To: Lactation Information and Discussion
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From: Esther Grunis <[log in to unmask]>
Subject: "nurse-brain"
Comments: To: Lactnet <[log in to unmask]>
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In the light of the nurse/non-nurse discussion here, I have to add my 2
agarot.
This is not to be taken as "nurse bashing."
As a non-nurse IBCLC in a hospital, and in a country where the
profession will probably be handed over to the nurses as we continue to
teach them courses and allow the system to limit these courses to nurses
only, I have to say that I am very troubled.
I have coined the phrase "nurse-brain" to describe what bothers me. And
this may be a failure of the nurse training system which should be
addressed. Nurses need to translate everything into numbers and
protocols, and those of us from other disciplines do not. For example,
last week, I was working with one of my favorite nurses who is getting
her MA, and who is a terrific nurse and so open-minded loves learning
about breastfeeding. We were working with one of those huge breasted
moms,and in the course of helping her I put a rolled up towel under her
breast.
The nurse thought that was great. Within two days, every mom no matter
what, was being told to breastfeed with a towel under her breast. I
specifically explained that it was an aid for large breasted moms!!
I had a student with me, a midwife from a hospital in Jerusalem, who
has been given the project of turning her department into more
breastfeeding friendly. Her supervisor does not see the need to send
her out to a course, since she breastfed 5 babies and how much do you
need to know anyway. She said that now she understands what I mean by
"nurse brain."
The use of cabbage is another symptom. Every mom with the slightest bit
of swelling is walking around with cabbage in her bra. Where is this
coming from?
I definitely see the fact that I am not a nurse as a huge advantage,
however there is one nurse from another hospital who feels it is a
scandal that Lis Hospital has an LC who is not a nurse. To me it is a
scandal that there are nurses working in nurseries all over the country
who know nothing about breastfeeding.
I would like to hear from nurses out there why non-nurses should not be
working in the hospital setting, or any setting for that matter!!
When I approached the head nurse of our dept. about hiring another IBCLC
because I am unable to continue doing all the breastfeeding by myself
she told me two things. First that she will only hire an IBCLC who is a
RN, and in the next breath that her nurses hate helping mothers with
breastfeeding.
Esther Grunis, NN (non nurse), IBCLC who thinks that our profession
comes from the heart, not from the brain.
No insult intended to any discipline.
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Date: Wed, 24 May 2000 23:59:56 EDT
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Hi,
Anybody know the e-mail address for ICEA?
thanks,
tammy arbeter - [log in to unmask]
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Date: Thu, 25 May 2000 00:03:39 EDT
Reply-To: Lactation Information and Discussion
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From: Jennifer Tow <[log in to unmask]>
Subject: Re: Better pumps at the end of our arms
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In a message dated 5/24/0 10:54:43 PM, [log in to unmask] writes:
<< Elisheva, though I come from a country which definitely DOES have pumps
(Australia), in my experience they are not a tool we use until AFTER
lactogenesis II. Up until then it is all hand expressing. Our experience
is that we obtain milk at every expression (unlike with a pump where
previous posts suggest it can take up to 6 or so sessions to obtain
anything) and give that milk to the baby (who would otherwise have had to
have 'the other'). It's gentle and introduces pumping to a new mother who
may have to do it for many weeks in a non-threatening way.
>>
I wish it was the case here that mothers find it less threatening to learn
hand expression. It is, IMO, much easier to express colostrum with hand
expression than w/ a pump, but many mothers are extremely unwilling to do
this. Most mothers assume they will use a breastpump at some point and are
much more comfortable with a machine than with their own hands. Two weeks
ago, when I suggested a mother hand express milk, she said, "You want me to
use my hands?!". She was truly shocked and did not get over it even with good
explanation. I certainly believe all mothers should have this skill, but
clearly they do not all agree w/ me.
Jennifer Tow, IBCLC, CT, USA
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Date: Thu, 25 May 2000 00:51:48 EDT
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Sande Park <[log in to unmask]>
Subject: Re: LACTNET Digest - 24 May 2000 (#2000-647)
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I have to get in on this RN/NON RN discussion I am a certified Childbirth
educator and Lactation counselor waiting to take the Lactation Consultant
exam, certified breastfeeding educator AND have taught for 24 years, I have
had the same response from some hospitals on both titles, and ofcourse with
my knowledge and experience I get very angry about this subject I have taught
with RNs that are not certified and are terrible instructors especially To
the diverse population some of the classes are, Even they are experienced to
teach at the bedside but the complaint like I have read don't support
Breastfeeding . I had one this evening that had not even suggested to a Mom
with a sleepy baby the possibilities to get baby interested.
The real reason I need help is I have a Mom on PAXIL and the Ped said to
quite nursing and I dont have my lactation med book her, what can she take
for an antidepressant. I enjoy Lactnet very much and hope someone can help.
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Date: Wed, 24 May 2000 15:53:29 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Mary Kay Smith <[log in to unmask]>
Organization: Sinai Health System
Subject: LC/RN debate
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Some of you know that I am a NON RN, IBCLC practicing in a major metro
Chicago hospital with 3400 births/year and over 50% breastfeeding. I
think this is a good rate for an inner city, low income minority
population.When I started 2 1/2 years ago, it was 33%. I have learned a
great deal in my years in a hospital from my colleagues and from
seminars I've attended that have nothing to do with lactation. I have
also taken about 2 years of pre-nursing course work like A&P,
microbiology, psych, sociology, etc. I can recognize many problems that
some non-RN LCs who are not experienced in hospital settings may miss. I
work with our NICU quite a bit and feel very confident in my skills
regarding these very little babies. I know that we could debate this for
years and never come to agreement. But I feel that there are many very
qualified individuals (while there are also people who sat the exam and
passed and don't have a clue, just quote the literature) who can do this
job and do it well.
mary kay smith, IBCLC
romeoville IL near Chicago
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Date: Thu, 25 May 2000 01:14:16 -0700
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Phyllis Harris -Swenson IBCLC <[log in to unmask]>
Subject: Chocolate Br. Milk
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Ann Calandro,
Just read your 5/23 message. I had read the same thing re: chocolate.
It could be the added sugar in the chocolate which does cause excreation
of calcium from body. (Probably Nestles)
Try suggesting a strawberry or banana shake and/or with a dab of vanilla
if he'd like. No 'empty' calories.
Sincerely,
P.Harris-Swenson, MA, IBCLC
WIC Nutritionist & BF Coordinator
Still working on 1969 spring cleaning.
Lowell, MA USA
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Date: Mon, 22 May 2000 14:52:54 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: Mary Kay Smith <[log in to unmask]>
Organization: Sinai Health System
Subject: Pregnancy, Birth & Bfing Books
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I am looking for a good, fairly low priced book (in Spanish, no less)
that we can give our prenatal class attendees. We give out "What to
expect" in English to the English speaking classes (not my choice) but I
haven't got anything good to give to the others. Any ideas?
Mary Kay Smith, IBCLC
Romeoville IL near chicago
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Date: Thu, 25 May 2000 15:50:25 +1000
Reply-To: Lactation Information and Discussion
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From: Kay Family <[log in to unmask]>
Subject: Hand Expression Video
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Hi All,
In our hospital, we use a great video called "Hand Expressing and Cup
Feeding" to demonstrate techniques to new mum's, along with practical
supervision.
I think it may be available from Nursing Mothers here in Australia, perhaps
some other Aussies may know the details.
We also don't use pumps until the milk is in, so all mum's are taught hand
expression first.
Best wishes
Susan (Qld Australia)
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Date: Fri, 19 May 2000 09:49:12 -0500
Reply-To: Lactation Information and Discussion
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From: Mary Kay Smith <[log in to unmask]>
Organization: Sinai Health System
Subject: Please decipher this
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What is this about? the subject line doesn't give any indication. I'm
always interested in discussing pumps but I've never heard of this one.
Mary Kay Smith, IBCLC
Romeoville, IL
Date: Thu, 18 May 2000 21:03:06 EDT
From: Sande Park <[log in to unmask]>
Subject: Re: LACTNET Digest - 18 May 2000 - Special issue (#2000-626)
One item about authentically yours only endorsed one brand of pump, and
as
a
hospital based instructor I get in trouble for that.
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Date: Mon, 22 May 2000 17:37:51 -0500
Reply-To: Lactation Information and Discussion
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From: Mary Kay Smith <[log in to unmask]>
Organization: Sinai Health System
Subject: Hydrogel
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Anyone willing to share a policy using hydrogel dressings for damaged
nipples? This is something I rarely see in the hospital but am getting
my share of outpatients and ladies who delivered somewhere else.
Thanks in advance,
Mary Kay Smith, IBCLC
Romeoville IL near Chicago
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Date: Thu, 25 May 2000 13:41:56 +0800
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From: Joy Anderson <[log in to unmask]>
Subject: Re: Ten point IQ differences
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><< 10 IQ points can make a huge difference in functional abilities, especially
>at the lower end of the spectrum.
> >>
Apologies if this is a bit late - I am a bit behind. I just wanted to
add that Denise Drane (in Australia) has pointed out the *ecomonical*
effect of this as well. You have a normal 'bell' curve of IQ and for
individuals below a certain point on the horizontal axis of IQ you
need to have 'special' education provided, and employment options
when they grow up. These are much more expensive than the 'standard'
education and other facilities suitable for the 'normal' population.
So if we have an even small shift of the bell curve to the left, then
there is a dramatic increase in the number of individuals falling
below that cut-off. This can have significant effects on the costs of
government-provided education, etc. (ie our taxes).
******************************************************************
Joy Anderson B.Sc. Dip.Ed. Grad.Dip.Med.Tech. IBCLC
Nursing Mothers' Association of Australia Breastfeeding Counsellor
Perth, Western Australia. mailto:[log in to unmask]
******************************************************************
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Date: Thu, 25 May 2000 09:28:49 +0200
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From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: RN/IBCLC
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Denny asked us to slow down:
> Kirsten was simply doing the members of the list a service while also
> helping her employer. She did not ask for a debate regarding RN
> IBCLCs.
But Lactnet is meant for discussion, not for advertising. It's OK with me to
announce whatever job opportunity within our profession, but one may expect to
get a discussion started. And please be sure that the statements made about the
question wether IBCLCs in hospital settings should be RNs as well, were not
meant to flame anyone, not in person nor the professional group, but in a more
general way with the purpose to deeper understanding of what our work is and is
not about.
Gonneke van Veldhuizen, IBCLC
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Date: Thu, 25 May 2000 06:39:28 -0400
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From: Patrica Young <[log in to unmask]>
Subject: Re: "nurse-brain"
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Dear Esther, along with "nurse-brain" in the hospital you will find
"administrator-brain" and "fear of law suits brain" and many other
interesting types :-) I think Winnie's post says a lot about how we need
to work this idea of non nurse IBCLCs into the brains of hospital
administrators. They need constant reminders that other non nurse people
provide valuable services in the health care field - like PTs, OTs, RDs and
so on. They will catch on eventually if you do this nicely and
consistently! Sincerely, Pat in SNJ
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Date: Thu, 25 May 2000 06:46:05 -0400
Reply-To: Lactation Information and Discussion
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Another thing about "nurse-brain". I think what you see is the effects of
being a "beginner" at BF on the continuum of "beginner to expert". Because
BF is not the central part of a nurse's job, it's not high on her list of
priorities. Her time span as "beginner" is much longer than those who are
immersed in BF day in and day out. Brenner wrote a fascinating book about
Beginner to Expert. Can remember the title off-hand. By reading it, we
all would get a better understanding of where others are on the continuum
and maybe be less critical and more "mentoring" to those on the beginning
end of the BF knowledge spectrum.
LOL ! Did you point this discrepancy out to her?
> First that she will only hire an IBCLC who is a
> RN, and in the next breath that her nurses hate helping mothers with
> breastfeeding.
Sincerely, Pat
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Date: Thu, 25 May 2000 21:04:58 +1000
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From: Mark Brunacci <[log in to unmask]>
Subject: Unilateral breast pain
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Greetings all lactnuts.
My name is Elizabeth Brunacci, and I am a Breastfeeding Counsellor with the
Nursing Mothers Association of Australia. I have been reading and immensely
enjoying Lactnet for months, but never dreamed of posting - until now! My
reason for taking this daring step is to comment on Esther's (and indirectly
Pam's) unilateral deep breast pain stories. In my very humble opinion,
"refilling pain" is the simplest and most easily ruled-out of the
explanations. Refilling pain is often unilateral, occurring in the 'best'
milk-producing breast, varies from mild to agonizing, occurs soon after a
feed *only*, lasts no more than an hour or so, and is worse/only present
after a large feed that has 'drained' the breast. In Esther's case, with
the pain in the left breast, feeding only from the right breast at any
particular feed would eliminate the pain, and feeding only briefly from the
left before swapping to the right to finish the feed would reduce or
eliminate it. Easily tested! Also usually relatively easily managed - make
sure big feeds are shared between the 2 breasts, and limit comfort sucking
to the right breast. The onset at around one month fits with the increased
milk production by that time, and the decrease at 6 months (in Pam's case)
fits with the decline in milk production following the introduction of
solids. As to exactly *why* it occurs - I'll leave that to greater minds
than mine!
Regards,
Elizabeth Brunacci
NMAA, Sydney, Australia
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Date: Thu, 25 May 2000 06:35:16 -0500
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From: gima <[log in to unmask]>
Subject: Re: Chocolate breast milk?
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Seeing the post that Phyllis sent reminded me that I wanted to reply to
Ann's post. I read have read that chocolate has oxalic acid and that it
binds with calcium, lessening absorption. When my children were drinking
cow's milk I didn't give them chocolate milk because of this information.
Other foods have high levels of oxalic acid--rhubarb, spinach--and
therefore are not considered good sources of calcium even though they have
calcium in them. If one has an adequate intake of calcium in other foods,
the oxalic acid in one food in the diet wouldn't be a problem, for example
spinach, which is a good source of iron, but isn't eaten at every meal.
However, if a person's primary source of calcium is some form of milk and
that milk always has chocolate in it, there could be a risk of low calcium
absorption.
Pat Gima, IBCLC
Milwaukee, Wisconsin
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Date: Thu, 25 May 2000 08:06:28 EDT
Reply-To: Lactation Information and Discussion
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Dear Friends:
I have no idea how my personal post ended up on LACTNET. I apologize. The
only possible solution is that I have been battling a Trojan Horse/worm that
snuck in on a file attachment to some mail for my husband. The sneaky, nasty
thing totally messed up my email.
The only way to minimize such things is to NEVER open a file from someone
that you don't know. Even then, you may inadvertently pass along a worm.
Apparently brilliant adolescent boys develop worms and put them out into
the electronic world in the same spirit as they put up graffiti: malicious
mischief.
Warmly,
Nikki Lee RN, MSN, Mother of 2, IBCLC, CIMI, CSTP
Elkins Park (a suburb of Philadelphia, Pennsylvania; northeastern USA)
supporter of the WHO Code and the Mother Friendly Childbirth Initiative
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Date: Thu, 25 May 2000 08:12:55 EDT
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Dear Friends:
Esther's post about nurse-brain is very interesting. Taking the
specifics of one situation and applying them to all situations is a hallmark
of an early learner, a procedural knower (to use a term from Mary Belenky et
al's book "Women's Ways of Knowing"......highly recommended) . I would bet
that we all have done this when we were just getting started.
The USA is unusual in that the majority of the IBCLCs are medically
trained, and many are nurses. This slants perspective.
Warmly,
Nikki Lee RN, MSN, Mother of 2, IBCLC, CIMI, CSTP
Elkins Park (a suburb of Philadelphia, Pennsylvania; northeastern USA)
supporter of the WHO Code and the Mother Friendly Childbirth Initiative
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Date: Thu, 25 May 2000 07:10:28 -0500
Reply-To: Lactation Information and Discussion
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From: gima <[log in to unmask]>
Subject: Paxil
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>The real reason I need help is I have a Mom on PAXIL and the Ped said to
>quite nursing and I dont have my lactation med book her, what can she take
>for an antidepressant. I enjoy Lactnet very much and hope someone can help.
New Study Shows Paxil Not Found in Breast-Fed Infants of Depressed
Mothers
ATLANTA, Feb. 2 /PRNewswire/ -- A study with Paxil(R) (paroxetine HCI,
SmithKline Beecham), published this month in the American Journal of
Psychiatry, showed that breast-fed infants of mothers taking the
antidepressant had no detectable traces of the medication in their blood
and
experienced no adverse events as reported by either the parents or
pediatricians.
Paxil is a selective serotonin reuptake inhibitor (SSRI) that is used to
treat a range of mood and anxiety disorders. Paxil was recently approved
by
the U.S. Food and Drug Administration as the first and only drug
indicated to
treat social anxiety disorder. It is also indicated for depression,
panic
disorder and obsessive compulsive disorder.
"Due to the increased occurrence of mood and anxiety disorders during
child-bearing years, it is imperative that we continue to research and
make
treatment options such as Paxil available for mothers who want the
opportunity and benefit of breast-feeding their children," said lead
clinical
investigator, Zachary N. Stowe, M.D., director of Emory University School
of
Medicine's Pregnancy and Postpartum Mood Disorders Program. "This study
provides compelling data that Paxil is a viable treatment option for
mothers
who would like to continue breast-feeding."
Reassuring Data for Nursing Moms and their Infants
Results from this unique study provide the first detailed
characterization of
Paxil excretion into human breast milk as well as extensive information
on
infant exposure during breast-feeding.
Participants in the study included postpartum women treated with Paxil
(10-50
mg/day for >10 days) and their newborn infants. Blood samples were
obtained
from all mothers within 2-5 hours after the daily Paxil dose and from the
infants within 1-5 hours after nursing. The majority of the infants were
fully breast-fed with no supplemental nutrition.
The key finding was that all infant blood samples had no detectable
concentrations of the medication. Furthermore, the definition for
detection
(<2 ng/ml) was more stringent than has been reported in studies of breast
milk and other antidepressants. Although low Paxil concentrations were
found
in the breast milk (similar to or less than other antidepressants),
exposure
to the infant was minimal.
The parents involved in the study did not report any change in infant
behavior, disposition, sleep, activity, or bowel movements, and also
reported
that their pediatrician did not communicate any concerns in infant growth
or
development.
A Struggle to Balance the Need to Treat Depression and Desire to
Breast-feed
Breast milk provides a superior course of nutrients and protection
against
infection, as well as acute and chronic illnesses. The American Academy
of
Pediatrics (AAP) and the American Dietetic Association support breast
milk as
the ideal form of nutrition over formula and milk. Numerous studies have
also demonstrated that breast milk may prevent sudden infant death
syndrome,
type 1 diabetes mellitus and allergies. The AAP recommends that
breast-feeding begin at birth and continue for at least 12 months.
Equally convincing, the data on untreated depression in mothers has
demonstrated deleterious effects on infant attachment (e.g., bonding) and
development. These data reinforce the clear, unequivocal need to treat
depression when it affects mothers.
"It is important that the benefits of the medication for the depressed
mother, as well as the benefits of breast-feeding for the infant, be
considered by the practitioner and patient," said Dr. Stowe. "The data
from
this study is reassuring to both physicians and these mothers who want to
breast-feed."
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Date: Thu, 25 May 2000 09:03:08 EDT
Reply-To: Lactation Information and Discussion
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Sharon Ayers wrote that her committee was interested in integrating
information on breastfeeding into the health curriculum. Since you are new to
Lactnet you would not have seen the discussion about, "Breastfeeding: first
Step to Good Healh, An Educational Activities Package for Grade K-12." This
package was developed by the New York State Dept of Health and Dept of
Education and includes detailed examples for integrating breastfeeding into
the existing curriculum for all grades, including it as part of health,
nutrition, economics, history, etc. You will find it on the web at the New
York state Department of Health" web site:
http:www.health.state.ny.nydoh/b-feed/index.htm.
Barbara Hayes, RN, FACCE
New Rochelle,NY
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Date: Thu, 25 May 2000 09:27:45 EDT
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The FDA website ( I think it is Medwatch ) has a category for reporting defective medical equipment. I always encourage moms to report these types of pumps if they get bruised breasts or bloody milk. I had the site bookmarked on my computer at home that crashed
but I am at work now and would have to surf for it. Maybe someone else has the site.
Barbara Whitehead, IBCLC
Eastern NC ( Hot, hot hot here today! Hurricane season starts in 1 week!! And we still have people living in FEMA travel trailers from last year!)
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Date: Thu, 25 May 2000 10:07:24 -0400
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From: Jeanette Panchula <[log in to unmask]>
Subject: RN or not?
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One description of the "nurse-brain" - who uses the same "fix" for everyo=
ne
- is not really "nurse-brain" as it is "beginner brain". Please let us
remember that when people begin any new profession, they often get "hooke=
d"
on what they see working - and as they have limited experience, they have=
only seen a few things work. =
As they get more experienced, be they nurses, dieticians, La Leche League=
Leaders, peer counselors or moms (or dads) they get better at suggesting
and implementing different options.
Right now I am working with some nurses who have been scared stiff about
bilirubin by the Neonatologist at the hospital. It does not matter what
the baby does, how he acts, etc - if the baby has a yellow "tinge" he
becomes the target of poking, pinching, etc (to blanche the areas from he=
ad
to toe), and the parents see this and get frightened. Is this a
"nurse-brain" or is it simply the reaction of our lawsuit-frightened
society? =
However, there are two ways that I know of to ask "administration" to
consider IBCLCs who are not RNs which have worked:
1. IBCLCs who are not RNs don't belong to a union, so they actually can
have more flexibility many times (I have worked places where the nurses
union limits a lot of choices - even to the detriment of some of the RNs
themselves!)
2. IBCLCs can have malpractice insurance.
Jeanette Panchula, social worker, mom, La Leche League Leader, IBCLC (and=
yes, I gave in and got it) RN =
Vacaville, CA
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Date: Thu, 25 May 2000 10:19:47 EDT
Reply-To: Lactation Information and Discussion
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Can you take one more opinion? I have been IBCLC for 14 yrs. I have worked
in a large teaching hospital for 8 yrs as an LC. I graduated from nursing
school and passed my RNboards 1 year ago. I went back to school because I
felt being a nurse would expand my knowledge base. We have moms and babies
with all kinds of illnesses, syndromes, and anomalies, as well as normal
healthy moms and babies. I do not work as a nurse and have no desire to. I
am a lactation consultant and that is what I want to do. Did becoming a
nurse help me achieve my goal? Absolutely! I understand so much more now.
Does it make me a better LC? Probably but I sure didn't learn anything about
breastfeeding in school. I don't think being an RN has anything to do with
being an LC. At our hospital we know have 6 LC's and the only requirement
that we have is that they are IBCLC. That is the most important thing to us.
Good LCs don't have to be RNs.
Vicki Pena RN IBCLC
Sunny (and I really mean that) PHX
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Date: Thu, 25 May 2000 10:22:30 EDT
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I have always encouraged moms to bring back a pump that does not work well to
the store at which it was purchased. Many say that the pump is not returnable
once it is opened. If one of the smaller pumps is doing damage than that
store needs to know what they are selling.
Last week I saw a horn pump at a small drugstore. It was in very old
packaging. The pharmacist said that he does not sell many of these because
his customers want the bigger pumps. I asked why he does not take it off the
shelf! He became flustered.
Stores will take back other items if they did not work properly! I also
suggest that the mom call, write, or e-mail the company about the product.
Too many people are buying inefficient pumps and throwing them out to get a
more efficient pump. What a waste of money and resources.
I would say I talk to at least 4 moms in a 2 hour span that have bought pumps
they were unhappy about. Maybe more LC's (LLLL, nurses, etc) should promote
consumer rights.
Annette Leibovitz
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Date: Thu, 25 May 2000 09:19:37 -0500
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From: gima <[log in to unmask]>
Subject: Paint thinner
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A nursing mother is in a job where she is exposed to Citrol, paint thinner.
She wonders if her exposure is doing harm to her 5 month old baby.
Lactnet search gave me no matches, even though I have a memory of
discussion on something similar. Any advice here? Fortunately she was
advised to continue to feed her baby until something difinitive was
discovered.
Pat Gima, IBCLC
Milwaukee, Wisconsin
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Date: Thu, 25 May 2000 10:36:35 EDT
Reply-To: Lactation Information and Discussion
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From: Barbara Latterner <[log in to unmask]>
Subject: Spanish BF references
Comments: cc: [log in to unmask]
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Mary Kay,
LLL has several references available from booklets to translation of BF Pure
and Simple. All reasonably priced. In my humble opinion, the other book you
mentioned being given to English speaking moms is horrendous. I've read
snippets of it (it was hanging around the birth center where I teach and run
a support group and I got permission to "lose"it) and it is chock full of
misinformation and what I consider (as did the moms in my group) awful,
anti-baby advice. I replaced it with a copy of WAB!
Barbara Latterner
Brewster, NY (where the sun is supposed to be shining and isn't!)
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Date: Thu, 25 May 2000 12:00:10 -0400
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From: "Linda J. Smith" <[log in to unmask]>
Subject: LC/RN debate again
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Coach Smith again. This isn't an either-or choice. And I'm glad we're
discussing it AGAIN.
The world needs need good non-nurse LCs, and good RN-LCs, and good MD-LCs,
and good pharmacist-LCs, and good nurses who can manage basic breastfeeding
skills and good RDs who understand the vast differences between human milk
and other stuff, and good midwives, and so on. When all women in the world
are getting fabulous breastfeeding care, THEN perhaps these turf wars make
some sense.
In professional regulatory circles, the concept of "exclusive scopes of
practice" is diminishing, although some professions are fighting hard to
keep this control. The idea of multiple credentials in one individual is
gaining wide acceptance, and frankly, that's GREAT for the recipients of
care.
It takes a team to really help moms in all aspects of breastfeeding. We
can't all be all things to all people. We DO need to know how to
collaborate, cooperate, and refer - and "hand off" care to others on the
same page with breastfeeding. On the other hand, we DON"T need people, of
any profession, who continue to be barriers to breastfeeding and perpetuate
incorrect information or unhelpful practices.
Personally, I have far less problem with a hospital requiring an LC who
works in a NICU to also be a nurse than a hospital who allows RN's working
in a NICU to be incompetent in breastfeeding care.
Linda J. Smith, BSE, FACCE, IBCLC
Bright Future Lactation Resource Centre
Dayton, OH USA
http://www.bflrc.com
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Date: Thu, 25 May 2000 11:12:37 -0400
Reply-To: Lactation Information and Discussion
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From: Julia Scaletta <[log in to unmask]>
Subject: Schuco Breast Pump
Have a new mom that received a Schuco Breast Pump as a gift & wanted my
opinion on how well the pump worked. Since I had never even heard of the
pump, I told her & would ask the wise & experienced masters of
Breastfeeding. I did a search in Lactnet & found a little info, but no real
concrete info from people who have seen this pump in action. Can anyone give
me their opinion on this pump? It would be GREATLY appreciated.
Julia in rainy Eden, NC
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Date: Thu, 25 May 2000 18:09:39 +0200
Reply-To: Lactation Information and Discussion
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From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: Unilateral breast pain/refilling pain
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I must admit, that I did not hear of refilling pain before, in my 17 years of
experience. I wonder why? Could it be cultural? I understand that it has to do
with feeding large amounts of milk at a single feed. Would it not be easier if
that is the case to make sure that feedings are shorter after each other in
order to prevent this huge feeds and to decrease the need for the breasts to
make such large deposits.
Gonneke van Veldhuizen, IBCLC, living in Maaseik, Belgium
http://www.users.skynet.be/eurolac
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Date: Thu, 25 May 2000 17:35:01 +0100
Reply-To: Lactation Information and Discussion
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From: Magda Sachs <[log in to unmask]>
Subject: LC/RN debate
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I can hardly believe I am contributing to this topic. I am not an IBCLC
(and no plans to attempt to become one), nor an RN (or whatever the
equivilent is here in the UK) or a midwife or anything else, nor have I had
a baby in hospital special care (and, indeed, only had one baby in hospital,
as it turned out that I am highly allergic to medical childbirth), but this
remark caught my eye:
"Personally, I have far less problem with a hospital requiring an LC who
works in a NICU to also be a nurse than a hospital who allows RN's working
in a NICU to be incompetent in breastfeeding care."
This is all very well from the point of view of the hospital or
professionals, but what abuot parents? SCBU/NICU is so often such a hostile
and alien/alientating environment, maybe for parents, for the *women* who
ultimately supply the breastmilk (if you view it in that way) it makes a
difference if they have RN LCs or not. And also for women in other
situations. Has anyone ever done any work in asking women what they might
value?
Maybe they care, maybe they don't, maybe there is a variety of opinions, but
I would sure be interested in what they have to say and would feel that the
debates had acheived an extra dimension of validity if the views of women
were considered.
Magda Sachs
Breastfeeding Supporter, BfN, UK
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Date: Thu, 25 May 2000 12:43:33 -0400
Reply-To: Lactation Information and Discussion
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From: Cheryl Bean-Moody <[log in to unmask]>
Subject: Breastfeeding artist - questions re. paints/turpentine
A new client is an artist/interior decorator who uses oil-based paints and
turpentine. She did not work throughout her pregnancy and is anxious to
start painting again. She is concerned about inhaling the fumes while she
is breastfeeding, wondering if it will get into her blood stream and her
milk. We discussed wearing protective clothing and gloves to keep it off
her skin. Do you think she needs to wear a mask if she is in a well-
ventilated room? She will not stop breastfeeding. There were precautionary
warnings on the paint & turpentine containers, but they were not very
speicific.
Any tips will be helpful.
Cheryl Bean-Moody,BS,IBCLC
Waterville,Maine
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Date: Thu, 25 May 2000 12:53:43 EDT
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Re: Pregnancy, Birth & Bfing Books in Spanish
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Mary Kay -
For pregnancy, birth and bfing books try the LLL catalog:
Click on <A
HREF="http://www.lalecheleague.org/Web_store/web_store.cgi?product=Low%20Readi
ng%20Skills:%20English%20and%20Spanish&cart_id=8357858_380">Product Listing,
Low Reading Skills: English and Spanish</A> or go to
http://www.lalecheleague.org/Web_store/web_store.cgi
Also <A
HREF="http://www.lalecheleague.org/Web_store/web_store.cgi?product=Spanish%20M
aterials&cart_id=8357858_380">Product Listing, Spanish Materials</A> or go to
http://www.lalecheleague.org/Web_store/web_store.cgi?product=Spanish%20Materia
ls&cart_id=8357858_380
Cynthia D. Payne, IBCLC
In the Berkshires of western Massachusetts
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Date: Thu, 25 May 2000 13:15:35 EDT
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Multiple credentials, multiple skills
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In the discussion of whether it is necessary, beneficial, or neither for
IBCLCs to be RNs as well, it's striking to me that until Linda Smith's
as-usual-to-the-point post this afternoon, the only "other" credential
anyone's been posting about is RN.
I know this is because so many hospitals require it -- a real-world reason.
But my intuition is that even if what you NEED to be a good IBCLC is only
that, IBCLC, there are certainly many, many kinds of other knowledge can also
help you in your practice. That's why so many IBCLCs on the list have also
spoken so highly about receiving training in cranio-sacral therapy, or Wolf &
Glass's oral-motor seminars, or herbology, or etc. That's part of what we
mean, I think, when we say that IBCLC was meant to be a minimum credential.
We have a bunch of MD-IBCLCs and DO-IBCLCs on the list. Surely their two
areas of specialization -- neither necessary for the other! -- each enrich
the other.
Ditto, for more examples, the several RDs among us, and OTs. And for that
matter ditto the several anthropologists and lawyers and teachers among us!
And ditto the many, many parents.
This, btw, is my hesitation when we complain about professionals who
"practice from personal experience" instead of based on research. Definitely
research is an indispensable underpinning, and we revise our understanding of
our personal experience in the light of research findings. But having
outside experience -- in our personal lives and in their adjuncts, our other
professional training -- always enriches and informs our "research-based"
experience.
So while I *strongly* agree that IBCLC, not RN or anything else, ought to be
a minimum credential to hold yourself out as an LC, that isn't to say that
more learning -- formal or informal, medical or other -- can't enrich and
improve our practice.
Elisheva Urbas, NYC
writing "you" in this post since I am neither RN nor IBCLC and not likely to
be either anytime soon!
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Date: Thu, 25 May 2000 13:15:37 EDT
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Consumer protection & pumps
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Annette wrote,
<< Maybe more LC's (LLLL, nurses, etc) should promote consumer rights. >>
Yup. When moms go to the drugstore they are flustered and tired. But when
bf advocates go for them, or when we see bad products on the shelf, we need
to make noise about it.
On one pleasantly memorable occasion, when a store clerk tried to tell me
that it wasn't his problem if they sold bad goods and that once they were
open they wouldn't be taken back, etc., I suggested that he and I call the US
Consumer Products Safety Commission (you remember, the bad guys in the
co-sleeping study! but they do some good stuff too) right now, together,
from his telephone, and find out what sanctions they would impose on his
store for knowingly selling unsafe goods.
You bet that pump came off his shelf two times quick. "Flustered," indeed.
Elisheva Urbas, NYC
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Date: Thu, 25 May 2000 13:15:27 -0400
Reply-To: Lactation Information and Discussion
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From: The Breastfeeding Center of Maine <[log in to unmask]>
Subject: Re: pumps that do not work well
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Although the store where she purchased the pump may not take it back, I have
found that moms can get a refund by calling the customer service number on
the product information.
> I have always encouraged moms to bring back a pump that does not work well
to
> the store at which it was purchased. Many say that the pump is not
returnable
> once it is opened.
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Date: Thu, 25 May 2000 14:18:50 -0700
Reply-To: Lactation Information and Discussion
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From: Corrine Mahar-Sylvestre <[log in to unmask]>
Subject: MAM Pacifier
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I know, I know pacifiers are unnecessary and can be harmfull to the
breastfeeding relationship. That said, if a parent is hell bent on using
one, which is best/least harmfull. Archives have very little info on mam
pacifiers which I have heard are good. Also wasn't there some posts
recently about the Platex soft comfort ? You have all been so great
regarding my breast pump question and I am hoping to get lots of opinions on
this one as well. It is great to be able to offer advice to clients based
on more than my own limited-but-growing experience and most of the books and
training don't go so far as to reccommend brand names. Thanks in advance
for sharing your wisdom!
Corrine Mahar-Sylvestre
Quinte Doula Service
Postpartum Support Program of Quinte
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Date: Thu, 25 May 2000 14:34:00 EDT
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: paint thinner / Citrol
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In a message dated 05/25/2000 11:06:34 AM Central Daylight Time,
[log in to unmask] writes:
<<
A nursing mother is in a job where she is exposed to Citrol, paint thinner.
She wonders if her exposure is doing harm to her 5 month old baby.
Lactnet search gave me no matches, even though I have a memory of
discussion on something similar. Any advice here? Fortunately she was
advised to continue to feed her baby until something difinitive was
discovered.
Pat,
How about Judith Schreiber at the NYS Dept. of Health @
jss05@HEALTH.STATE.NY.US........She is an expert on chemicals and Breast Milk
, and gave me some info to share about exposures for two moms working with
two specific different chemicals ...
Judy LeVan Fram, Brooklyn, NY
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Date: Thu, 25 May 2000 15:34:15 EDT
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Re: IBCLC RN/non-RN
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Lynn, I feel I must respond to your input in this discussion and respectfully
disagree.
Please, Lynn, this is in no way meant as disrespect for you or your skill
set. As a non-RN IBCLC, whose breastfeeding skills were honed in the
community, picking up the pieces after one hospital intervention or another,
I have welcomed the addition of the IBCLC profession to the team of HCPs
available to birthing families while still in hospital.
There is a fine hospital based non-RN IBCLC right in our neck of the woods.
Anne Merewood is the LC for Boston Medical Center, the first Baby Friendly
hospital in the region. She directs a program in a facility with a
significant rate of high risk mother-baby dyads, a very busy NICU, and the
responsibility for educating a diverse staff.
She is a great believer in the power of the team approach to patient/client
care. She is also a Nursing Mothers' Counselor, and has been a real force in
the community. I admire her greatly for taking on the challenges she has, and
I am proud to have her as a member of our organization.
I am always concerned when the medicalization of what is generally a normal
physiological process, e.g., birth or breastfeeding, occurs. This does not
mean that I support acting out of ignorance in the name of keeping things
"natural". But I have to say that in the 15 years that I have worked with
mothers and babies, I have seen more damage to breastfeeding done by the
ignorance, or willful obstruction, of medical professionals (RN or MD), than
by LLLLs, NMCs or IBCLCs in the community or in hospitals.
I absolutely agree that there is no substitute for education and periodic
evaluation in any profession. I am concerned, however, that there is a great
divide emerging in our profession, that will ultimately shut out a
significant number of trained, talented and caring IBCLCs as the western
allopathic medical establishment circles its wagons to protect its position
and power.
The Gold Standard is the IBCLC, and will remain so. It is the only way to
assure the level of knowledge and clinical skill needed to protect the
breastfeeding mother-baby dyad in a very Baby Unfriendly society. I think we
all have the same goal in this, and we need to keep talking to each other.
Whew! Sorry about the length of this. I guess I felt more strongly about this
than I realized. Getting off the soapbox. Feeling a little faint from the
altitude.....
Beth Sargent, IBCLC (and proud of it)
Past (& future) Co-president, Boston Assoc. for Childbirth Education &
Nursing Mothers' Council
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Date: Thu, 25 May 2000 20:44:52 +0100
Reply-To: Lactation Information and Discussion
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From: carolyn <[log in to unmask]>
Subject: epidermolysis bullosa
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Has anyone had experience of helping a baby to feed with this problem?
It causes blisters and severe damage to the skin on contact with
anything. In its most severe form it is fatal.
The baby I am in contact with is 4 days old and the first breastfeed
caused blisters inside his mouth. Obviously he is now reluctant to take
Mums breast into his mouth even though he is hungry. Mum is very patient
with him and is determined that he will be breastfed. We have been told
that babies with this do not breastfeed, but he is managing so far.
Would be grateful for any tips from those who have been there, done
that.
Regards,
--
Carolyn Westcott RN IBCLC Southampton UK
mailto:[log in to unmask]
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Date: Thu, 25 May 2000 12:51:35 -0700
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: Re: breastmilk and cancer fighting
Comments: To: [log in to unmask]
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Tammy: You might also try Lois Arnold's bibliographies from presentations
she's done on "alternative and new uses for breastmilk." I've attended
several of these and found them fascinating. Let me know if you need me to
dig out the biblios.
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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Date: Thu, 25 May 2000 14:51:29 -0500
Reply-To: Lactation Information and Discussion
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From: Pat Thomas <[log in to unmask]>
Subject: Almond milk?
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A doctor in our area told a breastfeeding mother of a four month old that if
she needed to get away and feed the baby something besides breastmilk, she
could feed almond milk. You soak almond overnight in water, peel them and
then crush them and strain them through cheesecloth. You then add water to
the resulting mixture and feed to the baby. I had never heard of this and
thought I would run it through the expert line here.
Thanks,
Pat Thomas PHN IBCLC
Winona County Community Health
Winona, MN
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Date: Thu, 25 May 2000 15:19:26 -0500
Reply-To: Lactation Information and Discussion
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From: Jim & Winnie Mading <[log in to unmask]>
Subject: MedWatch
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After getting the 4th call this week (and that's fairly typical)
from a mom concerned she's getting little if anything from her
"pump" (since we're not supposed to bash products by name I'll
simply call it the turquoise and white one) I decided to start
making reports to the MedWatch site. First thing I found was that
they ask for patient information. Since I hadn't asked for
permission from the moms I stopped there. To give this info without
permission would be a serious breach of confidentiality. Has anyone
made reports on this site without including a patient name?
Incidentally, maybe something can at least be done about the
deceptive wording on the packages? When I talk to a new mom about
types of pumps and am trying to explain the difference between
constant suction and cycling battery/electric pumps, they often say
that their turquoise/white one says "auto-cycle" or"imitates baby's
rhythm". To me this is downright misleading!
I'm sure this type of pump must work for some moms (I rarely will
get a multip who says she used it with her first and it "worked
fine"), but it seems like 90-95% of the moms who call with pumping
problems are using this pump.
Winnie
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Date: Thu, 25 May 2000 16:29:24 EDT
Reply-To: Lactation Information and Discussion
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From: Chris BEtzold <[log in to unmask]>
Subject: The Lactovist's Corner
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Between the healthcare provider (HCP) who couldn't understand why a woman
would breastfeed and take an antidepressant and the controversy at my work
over whether or not the breastfeeding.com poster is acceptable because it
says "Your baby WILL be smarter". Back to that guilt thing AGAIN. And yes
that HCP was asked if he thought that an antidepressant at 5 nanograms/ml
could cause leukemia, lymphoma, obesity, diabetes, ...... and therefore I
hope was set straight about why a woman SHOULD breastfeed with or without an
antidepressant.
As far as work, After I show them the research taht shows and increase in an
IQ then I am going to ask them to show ME the research that cow's milk
formula makes babies smarter. And can they explain, why are formula
companies spending soooo much money researching the fatty acids thought to be
responsible for it and why is it mandated in Europe that formula contain
these fatty acids. And if that doesn't work I will be desperate enough to
show them the below!!!!!!
Mamma cow's are considered STUPID animals but they are smart enough to
exclusivly feed their babies' nothing but cow's milk. Think about it, cow's
don't feed their babies' goat, monkey, lamb, dog, or for that matter HUMAN
milk, do they? Truly, all mammals feed their baby's their OWN MILK~~except
humans. We are the only mammal that feeds our babies cow milk, yet we are
considered the SMARTEST mammal on Earth. Yes, we are top of the food chain.
But, imagine for a moment the effects of goat milk or even human milk on a
baby calf. You'd sure have one sick "kid" wouldn't you? Now of course if
Mamma is ill or dead some milk is better than none, however this is rare and
far between especially for humans.
So, since we human's are sooooo smart, I ask you, "What do you think the
probability is that cow's milk fed to human babies will make them SMARTER? "
Looking at the research unearthed of the last few decades, I think the anwer
is now clear. Moreover, mammals are mammals whether they are at the top or
the bottom of the food chain. Similar events creates similar results. In
other words, if human milk makes cow's sicker and stupider, then cows milk
makes human babies stupid and sicker. Human babies fed human milk are
weller and smarter~~~Given the data, how can you EVEN argue this point?
Unless of course maybe..... you were..... Uh formula fed.
OK OK maybe I will leave out the formula fed line--it is a tad bit below the
belt. BUT I will be thinking it. Christine Betzold
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Date: Thu, 25 May 2000 15:34:30 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Jim & Winnie Mading <[log in to unmask]>
Subject: Pacifiers
Comments: To: Corrine Mahar-Sylvestre <[log in to unmask]>
MIME-Version: 1.0
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I know what you mean. In spite of recommending that a mom avoid
using them especially while baby is learning, the reality is that
some will and if they do we difinitely would like to see them use
"the lesser of the evils".
The first choice when something other than a breast is going to go
in baby's mouth would be mom's (or dad's or whoever) clean finger or
even a knuckle. (I remember encouraging mine to suck on the knuckle
of my little finger whenever I needed to hold them off briefly or
just give some extra oral satisfaction.) This way at least baby
continues to feel skin in the mouth and they have human contact to
help sooth or satisfy, not just being dropped in a box (crib) with a
plug in the mouth!
My personal feeling is that the NUK is the last choice. When I
mention that to a mom and she asks why, I simply show her a drawing
of it in profile and ask if she wants hers to look like that. If a
mom's nipple has a NUK shape when baby lets go, we know right away
that we need to work on the latch.
If a parent is going to use a pacifier I tell them to look for one
that would feel the same in baby's mouth either side up, and the MAM
does fit that cirteria (or is the singular criterium?)
Winnie IBCLC
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Date: Thu, 25 May 2000 16:40:44 -0400
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: newman <[log in to unmask]>
Subject: paxil
Comments: To: [log in to unmask]
MIME-Version: 1.0
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Paxil is quite compatible with continued breastfeeding. Zoloft is also
compatible with continued breastfeeding.
Jack Newman, MD, FRCPC
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Date: Thu, 25 May 2000 17:04:38 -0400
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Pat Bull <[log in to unmask]>
Subject: BF at pool
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Message text written by Lactation Information and Discussion
>This is in Lake County, Illinois. I am
wondering if any of you know if she has any legal recourse. <
A law was passed in Illinois that it is legal to BF in public. It always=
makes me so angry when I have to think we have to legalize breastfeeding =
in
public, such a natural thing, whereby breasts and nipples can be shown an=
d
flashed just about anywhere. What next????
Pat Bull, RN, IBCLC
The Breastfeeding Connection/Medela
Naperville, IL -83 degrees and flowers planted
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Date: Thu, 25 May 2000 16:30:47 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Linda Tandy <[log in to unmask]>
Subject: Re: Dr. Jack Newman
MIME-Version: 1.0
Content-Type: text/plain; charset="iso-8859-1"
Our state annual conference just welcomed Jack Newman this week, and what a
treat! Jack, this is a very public thank you for coming to our fine state
of Iowa. We thorougly enjoyed your talk, and came away with so much. Now,
if you ever would consider coming to Iowa to practice, email me privately!
; - )
Thanks!!!
Linda J. Tandy, MSN, RN, IBCLC
Cedar Rapids, Iowa
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Date: Thu, 25 May 2000 17:11:29 -0400
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Anne Smith <[log in to unmask]>
Subject: tube/syringe feeding
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from:Anne Smith, IBCLC
The local hospital routinely sends bf moms home with a=
feeding
tube/syringe combination along with dire warnings about not=
giving
bottles. I have worked with several moms who sought help from me=
with latch on problems after attempting to use this system for
several weeks. Aside from my concern that these mothers did not=
receive adequate follow up for the problems that caused this=
feeding
system to be used in the first place (that's a whole different
issue), I am concerned about the safety of using this sort of=
"jerry
rigged" device at all. I have had success using the Hazelbaker
feeding system when needed, but it is a product designed to be
used over and over and cleaned after each use. Does anyone out=
there
have any info about the safety of using devices designed for=
single
use and then discarded for weeks after week? Bacterial or fungal=
infections transmitted, etc.? Medela has been unable to provide=
me
with any studies addressing this. I would not feel comfortable=
using
this device with my own baby, but it's just a feeling, and not=
backed
up by any empirical evidence. Are my concerns valid, or not? I
would appreciate any feedback.
-- Anne Smith, [log in to unmask] on 25/05/2000
-- Anne Smith, [log in to unmask] on 05/25/2000
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Date: Fri, 26 May 2000 08:03:48 +1000
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Denise Fisher <[log in to unmask]>
Subject: Re: Gentle suggestions for better care
Comments: cc: [log in to unmask]
Mime-Version: 1.0
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Elisheva you truly are 'the best' I've ever heard!
that was brilliant - I hope I can hold my tongue long enough for my brain
to recall your suggestions next time I'm in a similar situation (and it
won't be far away!)
Denise
****************************************************
Denise Fisher, BN, RM, IBCLC
BreastEd Online Lactation Studies Course
http://www.breasted.com.au
mailto:[log in to unmask]
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Date: Thu, 25 May 2000 17:03:40 -0400
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: The Breastfeeding Center of Maine <[log in to unmask]>
Subject: Re: Hydrogel
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I was just visited today by a sales rep from a company that sells hydrogel
dressings and she said some hospitals in the Boston area are giving these
out to all nursing moms, regardless of nipple trauma, because they feel
soothing. Maybe in that case there is no policy, or a very simple one. Are
any of you doing this?
Bettina Pearson RN,IBCLC
Portland, ME
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Date: Thu, 25 May 2000 18:23:25 -0400
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Lorri <[log in to unmask]>
Subject: Re: Pregnancy, Birth & Bfing Books
Comments: To: Mary Kay Smith <[log in to unmask]>
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Mary Kay,
If you go to the Compleat Mother Website and scroll down to the bottom of
the home page, there is an opportunity for you to select the site in
Spanish. Near the end of the second list of links on the left side of the
page you'll see Libros de la Madre, which links to a few bf, pg, and
mothering books in Spanish. Perhaps they could comment more on their choices
for you, too, in addition to the reviews on the web site. For BF, I
personally prefer Sencillo y Puro over the Spanish WAB. I don't know about
where you are, but the Spanish speaking women I've worked with pick the
thinner book every time ;o)
http://www.compleatmother.com/
Lorri Centineo
Portland, Maine
-----Original Message-----
From: Mary Kay Smith [mailto:[log in to unmask]]
Sent: Monday, May 22, 2000 3:53 PM
Subject: Pregnancy, Birth & Bfing Books
I am looking for a good, fairly low priced book (in Spanish, no less)
that we can give our prenatal class attendees. We give out "What to
expect" in English to the English speaking classes (not my choice) but I
haven't got anything good to give to the others. Any ideas?
Mary Kay Smith, IBCLC
Romeoville IL near chicago
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Date: Thu, 25 May 2000 19:06:12 -0400
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Laura Walker <[log in to unmask]>
Subject: Fw: ill mom
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We have a mom who was hospitalized on the weekend with an infection. =
She had a Csection at the beginning of the month and started having =
problems within a week of being home. Anyway, she had an incisional =
abcess drained and is on antibiotics. They thought initially , she had =
MRSA and we dealt with that. The question raised by the infection =
control nurse is this moms ability to heal quickly and how is the =
lactation process interfering with her body's ability to do that. The =
mom is now on TPN because she has been basically sick for almost a =
month. Her bowel quit working too which added to the problem. I tried =
to explain to her that lactation is a normal body function and that if =
we are concerned about her nutritional status then adjust the TPN to =
give her enough. We went round and round. She kept saying basically =
that lactation was sapping this moms energy and would delay her healing. =
I asked this nurse what she would do if this mom were so sick and =
pregnant? Any thoughts on how to handle this and or explain more =
eloquently ? =20
Laura Walker
[log in to unmask]
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Date: Thu, 25 May 2000 19:50:47 EDT
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: [log in to unmask]
Subject: Re: Fw: ill mom
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In a message dated 00-05-25 19:10:24 EDT, you write:
<< She kept saying basically that lactation was sapping this moms energy and
would delay her healing. I asked this nurse what she would do if this mom
were so sick and pregnant? Any thoughts on how to handle this and or explain
more eloquently ? >>
Perhaps asking this nurse about the impact of sudden weaning on the mother's
body; the engorgement and the emotional impact of the loss of the only part
of "normal" mothering this sick mom can probably contribute to her baby.
Does the mother get to vote on this? After all, it is her body and her
breastfeeding relationship at stake here...
Gretchen Andrews, BA, IBCLC
private practice, Redlands, So CAL, USA
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Date: Thu, 25 May 2000 16:57:08 -0700
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: "Supancheck,Kirsten L" <[log in to unmask]>
Subject: JOB POSTING
MIME-Version: 1.0
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Hi all!
Boy was I surprised to see a discussion arise out of a job posting! The last
time I posted a position couple of months ago I got one personal response.
I have appreciated your concerns and would like to clarify what I said. The
position requires an RN. It has something to with the fact that we are a
union hospital. I am exempt and my department is exempt. However because of
union rules or some kind of rules our department must remain all RN. My
manager will not budge on this. All of my group are RN case managers of such
things as ped. asthma, pre-term labor, complicated OB, dietitian (RD), chem
dependency, pediatrics, NICU patients, etc. I had an IBCLC who was not an RN
lined up and was told it was not possible. She, by the way, is working at
another hospital.
This is not the time for me to push on that issue for many reasons.
RN or not does not bother me. It does matter to me that the person knows
what /heshe is doing and is well trained and experienced and preferably has
the credential of IBCLC. Hence I am looking for someone who either has
her/his IBCLC or has lots of experience and is getting close to being able
to take the exam. Unfortunately we cannot hire a non RN at this time.
Thanks for your passionate caring about our profession as Lactation
Consultants! Someday IBCLC will be be the standard. We're in the growing
pains stage!
Kirsten
Kirsten Supancheck, RN, BSN, IBCLC
Women and Children Case Management
Kaiser Bellflower
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Date: Thu, 25 May 2000 20:10:16 EDT
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: [log in to unmask]
Subject: Hydrogel in Boston
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As one of the LC's in one Boston hospital, and a participant in the Boston
Hospital LC Consortium, I can say that we are not all giving out hydrogel
dressings to all mothers. I believe one hospital is doing a study to see if
the dressings might be used proactively. I heard one of their LC's at a talk
on nipple trauma and it appeared they would be working on this trial. But it
is not standard treatment at this point.
Lisa Enger RN BSN IBCLC
Boston, MA
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Date: Thu, 25 May 2000 17:30:14 -0700
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Chris Hafner-Eaton <[log in to unmask]>
Subject: T4 intercostal pinch
Comments: To: [log in to unmask]
Mime-version: 1.0
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Judy: Yes...you are correct, I did mean T4. I didn't even catch it when I
read it in the Digest (which is where I usually cringe after making such an
error). Thank you :) for correcting this. I'd hate to see someone try an
figure out the logistics of the C4 causing this pain (C4 pain could lead to
bad headaches, but not in the breast). It is most logical if one knows just
basic anatomy to see how this could hurt so badly.
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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Date: Thu, 25 May 2000 17:36:45 -0700
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Chris Hafner-Eaton <[log in to unmask]>
Subject: ICEA
Comments: To: [log in to unmask]
Mime-version: 1.0
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I believe the address is just: www.ICEA.org
Good luck...I just tried to link from another website (the breastfeeding
taskforce of LA--an otherwise great site) to the IBLCE site and found that
they (their webmasters) had mis-typed it in as IBCLE
-- Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
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Date: Thu, 25 May 2000 20:36:49 -0400
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: newman <[log in to unmask]>
Subject: almond milk
Comments: To: [log in to unmask]
MIME-Version: 1.0
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Oy Veh!
Jack Newman, MD, FRCPC
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Date: Thu, 25 May 2000 17:24:18 -0700
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Chris Hafner-Eaton <[log in to unmask]>
Subject: lactation intake & report forms
Mime-version: 1.0
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I have recently run out of lactation intake and report forms and found that
my supplier is no longer in business. Would anyone share (privately and/or
on LN) where they order their forms? It's been about a year since I've last
ordered (I'm a big believer in bulk--you should see me at CostCo/Price
Club).
TIA!
-- Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
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Date: Thu, 25 May 2000 18:07:05 -0700
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Chris Hafner-Eaton <[log in to unmask]>
Subject: non-RN, IBCLCs
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As a non-RN, IBCLC, who also happens to be a Certified Health Education
Specialist (and I have a PhD and MPH, in two subspecialties of public
health), I find the insistence that IBCLCs be RNs exacberating. There's a
small part of me that thinks many jobs should require a CHES certification,
but that's a whole other ball of wax. Licensing, certification, and
accreditation are supposed to provide a base standard for quality within a
field. Unfortunately, when one looks at the Health Services Research
literature for quality (in particular for certification), the evidence is
very mixed. Indeed, this is both hard to accept and to type. I, for one,
am proud of my IBCLC and CHES, and do advertise the "gold standard" for LCs
as the "IBCLC." However, in many fields certification becomes nothing more
than a means to monopolize the field by locking others out of a profession.
I don't think that is the case (yet) with lactation, but others may have a
different view. As our health care industry has become more and more
specialized (subspecialized), I think we need to be wary of this happening
with IBCLCs (such as the RN-IBCLC).
We have had clinic and hospital positions advertised in our state--that are
clearly for education and lactation--completely lock out some exceptionally
qualified candidates because they insist on an RN (yes, I take this
personally even though I'm not looking for a hospital-based job). I think
that this is another instance where we (all IBCLCs) need to do a better job
of educating what we do within health care communities and the general
public. There have been many times that I have had to describe what it is
the field of public health is about because someone assumed that I inspected
toilets or that I was automatically a nurse because they had once met a
public health nurse. Public Health suffers from the same "image" problems
partly because it is a multidisciplinary field encompassing upwards of 60
different subspecialties.
Please understand that I respect the education and training that RNs have as
distinct (in some ways, but there is considerable overlap) from my own;
certainly, the floor nurses I know have some of the hardest jobs in the
world. I also find that many RNs, especially in the litigious US, have been
trained to be somewhat hierarchical in viewing authority and unfortunately
some have adopted the territorial nature of medical licensing. This
probably colors their perception of what is "necessary" when writing these
job descriptions.
'Just my 2 dropperfuls (okay, maybe 6 dropperfuls)
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Date: Thu, 25 May 2000 21:30:53 EDT
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Shannon Victor <[log in to unmask]>
Subject: wet nurse-update
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I'd like to start by thanking the many of you who sent me some very
encouraging and positive support for this family. I wanted to share the
successes thus far.
The baby finally took to fingerfeeding from dad at the hospital using the
Hazelbaker, but only when his cousin's breastmilk was used. He was able to
bring the baby home last night at which time the "mom" spent considerable
time skin to skin with the 4 mos. old. He was finger fed through the night
but in the wee hours of the morning accepted and nursed from his stand in!!!
Since 6:30am he has already had 6 wet diapers and 1 stool. He has continued
to nurse at each feeding the rest of the day. Dad finally feels some peace,
and the baby is beginning to smile again! He actually paused in mid feed
today come off the breast and smile at the new face who was offering him his
greatest comfort and latch back on and continue nursing! :) The pediatricians
for both babies are keeping in close contact with both of the babies'
progress and both adults. At this point it seems as though encouragement is
the greatest need. The baby had lost 1lb. 2ozs. at last check but giving his
current feeding change, is expected to begin to gain back.
Mom is currently feeding the 6 wk old first and following the feed with the 4
mos. old as they seem to be on similar feeding schedules. They are both
feeding from both breasts. Any input on foremilk/ hindmilk balance for each
baby at this point? The stool the 4 mos. old gave was green which could have
possibly been from the bili count elevating, or the previously frozen
breastmilk or whatever little he did manage to take in while they were trying
to feed him in the hospital before the breastmilk was supplied.
Sincerely,
Shannon Victor, BS, CLE, WIC, LLL
mother of a 3 1/2year old, 2 year old, and 4 mos old ( the last two
currently nursing!)
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Date: Thu, 25 May 2000 19:17:12 -0500
Reply-To: Lactation Information and Discussion
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From: Nancy Klebaum <[log in to unmask]>
Subject: Invasive Hemangioma
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Hello fellow Lactnetters,
I apologize in advance as this is a query that some may perceive as not
exactly breastfeeding specific but the mom really wants any feedback she can
get.
This mom is a nutritionist, 2nd baby seemed well until 2 weeks of life when
suddenly she couldn't breathe. Eventually diagnosed with invasive
hemangioma which involved the trachea, entire side of face,nose etc. Baby
was trached and will have this for anywhere up to several years when most
regress.
Baby is now 5 months old. Mom pumps milk and baby has virtually had only
breastmilk. Mom has tried to breastfeed but apparently baby couldn't handle
the flow but would suckle on the drained breast. She is fed by Naso-Gastric
tube.
Baby is apparantly now in the second growth phase of the hemangioma and is
on high doses of prednisone.
The baby takes 120mls of EBM q3h (parents do not limit, that is just what
she seems to want) but she regurgitates copious amounts of mucosy stuff with
the feed and is gaining very poorly the past while. Baby gained only 10
grams one week, then 30 grams last week. The parents are very committed to
the breastmilk and are afraid the ped will insist on something else for
feeds. They are wondering if anyone out there has dealt with severe reflux
and what helped. Again, I hope this is not too far off the beaten track, but
I appreciate the wealth of experience and knowledge out there and knew if
anyone would be sensitive to this woman's plight it would be via this forum.
Thanks so much
Nancy Klebaum [log in to unmask]
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Date: Thu, 25 May 2000 21:07:25 -0500
Reply-To: Lactation Information and Discussion
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From: Kathy Dettwyler <[log in to unmask]>
Subject: Pregnancy, Birth and Bfing books (Spanish)
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Pam Wiggins wonderful little book "Why Should I Nurse My Baby?" is available
in Spanish.
Kathy Dettwyler
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Date: Thu, 25 May 2000 22:21:13 -0400
Reply-To: Lactation Information and Discussion
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From: Jeanette Panchula <[log in to unmask]>
Subject: PLEASE NO TURF WARS!!
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Today I had a real stressor - a mom that I had been talking to on the pho=
ne
(breastfeeding was going well, I'm helping to implement "Lact Track" whic=
h
calls moms at 2, 5, 7, 14, days and 1 and 2 months for anticipatory
guidance and to try to cover myths and prevent them from becoming
barriers), called me with a concern: Her baby's ubilical cord clamp had
been left on and it was catching on clothing (8 days old), and there was
some bleeding. =
1. It should have been removed upon discharge but it wasn't
2. She had been to the Peds office, but they said they didn't do that
3. When I asked for assistance, I was told it was not in the PHNs or the
LCs "scope of work"
EXCUSE ME???
I got the permission of a supervisor - got the cord clamp cutter and
removed it! (Yes, I checked to make sure there was no sign of infection,=
etc.)
My point - more time, effort and hard feelings were spent saying why "it'=
s
not my job" (over 2 hours) than it took me to get the cutter, go to the
home, remove it and return (25 min).
Please let's work TOGETHER and respect each other, allow for differences
and skills, and help each other grow - that's how I've seen Lactnet work
for me all this time - and I've learned so much from others who are MDs,
NICU nurses, BSN, MSN, Childbirth Ed, PhDs, RDs, Peer Counselors,
specialists in natural remedies, etc, etc. etc.
And most of all - I've learned from moms - those you write about as well =
as
those I meet. These moms really don't care what initials we have behind
our name - they just want to know we are willing and able to help them -
whether with a cord clamp or with a painful latch. =
Jeanette Panchula, BSW , LLLL, IBCLC, RN
Vacaville, CA
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Date: Thu, 25 May 2000 22:47:26 -0400
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Jeanette Panchula <[log in to unmask]>
Subject: epidermolysis bulosa
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Imagine me - IBCLC (NOT an RN)only 2 years, LLL for 12 years, new city, g=
et
a call from the largest pediatric hospital in town - we have a baby flyin=
g
in from another state with EB - =
1. What is it? was my question - and I got a large fax with all the
details.
2. Can she breastfeed? Well, in our case, the baby was literally falling=
apart - there are many grades of this disease, and this baby had the wors=
t.
He would not survive.
However, bottles or other methods of feeding are very destructive to the
baby's oral tissue - so we decided to try breastfeeding. (You had better=
believe I did NOT do a suck check!) I assisted mom in latching her baby =
on
with the least amount of strain on baby's body or mouth - we formed the
nipple and breast by using the thumb and forefinger to have more breast a=
nd
nipple to go deeply in baby's mouth so he wouldn't have to suck hard. We=
used foam padding and later lamb's wool behind the baby's head and neck s=
o
mom was not holding his skin (for this disease skin to skin may be more
damaging). =
Baby lived and breastfed longer than they all imagined he would - both th=
e
IBCLC (me) and the mom felt they had done everything they could to have
made this baby's life on earth, short as it was, the least painful and mo=
st
loving we could make it. I always made it a point to show the mom the
baby's eyes and legs, which were not deformed. He looked with such lovin=
g
eyes to his mom! He knew her well, her sound, her touch, her taste. =
However, I saw at this center other children with much less damaging case=
s
of EB, and they were doing well. Good luck and God bless. =
Jeanette Panchula, (too many messages this week - sorry) BSW, RN, IBCLC
Vacaville, CA
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Date: Thu, 25 May 2000 21:48:52 -0500
Reply-To: Lactation Information and Discussion
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From: Barbara Wilson-Clay <[log in to unmask]>
Organization: Austin Lactation Associates
Subject: conference postings
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Since posts for conferences on Lactnews are now free, be sure to post your
up-coming conf. there so people can find out what is being offered where.
I've had several people email me recently to ask me for advice on what conf.
to attend. I direct everyone to the Lactnews page, so brag about your conf.
there and save me the work.
Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.lactnews.com
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Date: Thu, 25 May 2000 23:08:54 EDT
Reply-To: Lactation Information and Discussion
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From: Jennifer Tow <[log in to unmask]>
Subject: Re: Almond milk?
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In a message dated 5/25/0 7:55:27 PM, [log in to unmask] writes:
<< A doctor in our area told a breastfeeding mother of a four month old that
if
she needed to get away and feed the baby something besides breastmilk, she
could feed almond milk. You soak almond overnight in water, peel them and
then crush them and strain them through cheesecloth. You then add water to
the resulting mixture and feed to the baby. I had never heard of this and
thought I would run it through the expert line here. >>
Pat,
I am actually a little surprised by Jack's reaction to this. (Oy, veh, I
believe. <g>). Since almonds are a fruit and not a nut, they tend to be low
allergy. The milk is mild and has a nice flavor. When they are soaked and the
skin removed, their calcium content becomes highly absorbable. This makes
them excellent for women to eat during pregnancy, BTW. I would imagine this
would be a better choice than ABM, though I must admit I never thought of it.
Most women I know of wanting to avoid ABM use goat's milk instead.
Jennifer Tow, IBCLC, CT, USA
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Date: Thu, 25 May 2000 23:27:28 EDT
Reply-To: Lactation Information and Discussion
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From: Jennifer Tow <[log in to unmask]>
Subject: Re: Pregnancy, Birth & Bfing Books
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In a message dated 5/25/0 10:56:42 PM, [log in to unmask] writes:
<< For BF, I
personally prefer Sencillo y Puro over the Spanish WAB. I don't know about
where you are, but the Spanish speaking women I've worked with pick the
thinner book every time ;o) >>
Mary Kay,
I agree that this book is preferred in Spanish--it was the one I used when I
worked in a clinic and moms loved it. But, since you are giving *that other
book* out already, I am assuming you want a pregnancy, birth and bf book, not
just bf. Birth and Life Bookstore carries several such books. I do not know
any of them, but there are descriptions in the catalogue. The phone number is
800-443-9942. I do not know if there is a website. Whatever you find, however
will have to be better than "What to Ex...", so you will then have cause to
argue for replacement. After all, everyone should receive an equal quality
education and anyone who gets *that book*, gets inferior info!
Jennifer Tow, IBCLC, CT, USA
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Date: Thu, 25 May 2000 23:51:36 -0400
Reply-To: Lactation Information and Discussion
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Sender: Lactation Information and Discussion
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From: Kermaline J Cotterman <[log in to unmask]>
Subject: Reply to up-date on deep unilateral breast pain
Comments: cc: [log in to unmask]
<Jean,
where are you? We need an anatomical-physiological explanation for this
one!!>
Lurking, mostly, Esther, and trying to fulfill some writing commitments,
slow but sure. (Taking computer WP classes this quarter)
Can't remember the total thread, but just from what you say has helped
her, my first guess would be that she may have been overproducing on that
side (e.g. baby preferring it so mother deliberately or inadvertently
letting baby nurse this side more, or first every time, etc.)
This might thereby have built up enough oversupply that some one or more
of the ducts was so dilated, and perhaps bordering on inflamed, that some
of the MER's caused the pain. (I seem to remember now that the pain came
between feedings, but MER's do often happen between feedings, as well as
during them.)
Maybe with no baby removing it as it coursed forward, the milk dilated
the duct beyond its "comfort zone" between feedings. Or overdilatation
may have resulted from a particular "kink" in that duct cause by pressure
from a cinched up bra, or upright position or some other position or
condition different than at feedings.
(BTW, I DID get to go to Chicago to the Rush conference as I hoped,
specifically to hear and actually talk with Dr. Hartmann, whose graduate
students have been doing ultrasounds during actual breastfeeding
sessions, and getting exciting pictures of just how dynamically the ducts
change momentarily during MER.)
Cutting down somewhat on the milk removal from that breast then may have
slowed production, and thereby reduced the overdistention of the affected
ducts. I am glad to hear she has not developed any plugged ducts or
mastitis, no doubt due to your skillful explanation that the frequency
and amount of milk removal must be eased off gradually.
Anybody else care to hazard a guess!
Jean (Esther's 1999 Scottsdale ILCA roomie! I talked her ear off!)
********************************************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio, (who is taking along her 16 year old grandaughter to ILCA
in Washington on the pretext of some sightseeing, and possibly some
babysitting jobs, but who is [unbeknownst to her] shamelessly immersing
her in the most concentrated breastfeeding cultural experience I have at
my disposal!)
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Date: Thu, 25 May 2000 23:19:16 -0500
Reply-To: Lactation Information and Discussion
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From: "Denny Rice, RN IBCLC, Dallas TX" <[log in to unmask]>
Organization: @Home Network Member
Subject: Re: wet nurse update
Comments: To: [log in to unmask]
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Shannon, congratulations! I'm thrilled that this poor little fella is
finally having something go right for him. :)
I do have one suggestion, one that I make to the expectant twin moms I
teach and that is: It is not necessary to feed both babies at both
breasts each feeding. It works very well to put baby A on the right
breast on MWF and baby B on the right TThS. Free for all on Sunday.
It makes trying to figure out who and which side and so on so much
easier.
Also, she might want to take advantages of one of the *good* (there are
poor ones) twin nursing pillows so that she can nurse both at the same
time. She's going to be spending a lot of time nursing and simultaneous
nursing can be a life saver. (I will be happy to recommend a couple and
help steer her away from a few others, email me privately)
As usual, its going to be tough to "get plenty of rest", but it will
likely make a significant difference in her production. It would be
terrific if she had "only" to take care of the babies for several weeks
and the regular household duties handled by someone else.
Shannon, I know that you are very proud of this family, and I hope you
are very proud of yourself as well. If we ever meet, I'll give you a
pat on the back for a job so well done. :)
--
Denny Rice, RN, IBCLC
Dallas Texas USA
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Date: Fri, 26 May 2000 01:00:27 EDT
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Book
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Thanks to everyone who has informed me of what I already know. I am looking
for a book on pregnancy and birth in Spanish that is simply written and
acceptable to those who believe in prepared and informed childbirth. I
already use several of the books you all mentioned on breastfeeding in
Spanish. I am a LLLL so know the website, etc. Pure and Simple is excellent
for my patient population but I'd like to replace the drivel on pregnancy and
birth that is there now. I did find some inexpensive booklets from the March
of Dimes that may fill the bill. Thanks again for the interesting
suggestions. Still looking for a hydrogel policy or ideas for one.
Mary Kay Smith, IBCLC
Romeoville IL near Chicago IL USA
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Date: Fri, 26 May 2000 08:57:52 +0200
Reply-To: Lactation Information and Discussion
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From: Esther Grunis <[log in to unmask]>
Subject: epidermolysis bullosa
Comments: To: Lactnet <[log in to unmask]>
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Carolyn,
I helped a baby with EB about 3 years ago. I was called into the ped ICU
to find a solution for the problem of oral blisters. Just as I got
there the geneticist arrived and grabbed a bottle and stuffed it into
the baby's mouth as all the staff looked on in horror. The poor mom was
a new immigrant from Romania, who spoke no Hebrew, and didn't understand
what was happening, but she had no intention of bottle-feeding the
baby. I do not speak Romanian but I just hugged her and explained in
sign language that the minute he left, we would fix the problem. At
that point the baby was not expected to survive.
We did notice that she managed to drink from the bottle, with less
discomfort.....mouth to breast causes more friction that mouth to
silicone. I taught the mother to use a silicone shield, in addition to
hand expression following feeds . The baby gained weight quite well
considering her situation. We used the milk from the hand expression on
some of the lesions with amazing results!!
This baby survived. The mom learned Hebrew very quickly and we remained
in touch for a long time. The breastfeeding was the least of her
problems, but it certainly helped this baby meet all the health
challenges related to EB.
It is a horrible disease and this mom will need much support along the
way. You have to be careful with positioning the baby....any contact
causes blisterous lesions immediately which then rupture resulting in
open wounds.
Here are some good websites for the mom:
http://www.debra-international.org/
http://www.leftgrlls.com/silvia/ebmommas.htm
Esther Grunis, IBCLC
mailto:[log in to unmask]
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Date: Fri, 26 May 2000 07:35:47 +0100
Reply-To: Lactation Information and Discussion
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From: Magda Sachs <[log in to unmask]>
Subject: hydrogel dressings for all
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>I was just visited today by a sales rep from a company that sells hydrogel
dressings and she said some hospitals in the Boston area are giving these
out to all nursing moms, regardless of nipple trauma, because they feel
soothing.<
Wow -- the germ of an un-researched intervention which seems intuitively
useless in terms of ehlping the bf process physically and certain to
undermine the embodied confidence women could develop in breastfeeding,
which would allow them to choose to breastfeed for as long as they and their
babies want (rather than practice brief breastfeeding as a health-based
measure). I predict this one becoming one we hear of more often.
I hpe you gave the rep a rollicking!!
Magda Sachs
Breastfeeding Supporter, BfN, UK
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Date: Fri, 26 May 2000 07:38:44 +0100
Reply-To: Lactation Information and Discussion
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From: Magda Sachs <[log in to unmask]>
Subject: hydorgel dressings for all -- the plot thickens
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>As one of the LC's in one Boston hospital, and a participant in the Boston
Hospital LC Consortium, I can say that we are not all giving out hydrogel
dressings to all mothers. I believe one hospital is doing a study to see if
the dressings might be used proactively. I heard one of their LC's at a talk
on nipple trauma and it appeared they would be working on this trial. But it
is not standard treatment at this point.<
Wow, I wonder how the rep got their information muddled? Do you think it
was a simple error, even though the error is 'in the bank's favour' (as they
used to say in Monopoly)???
Magda Sachs
Breastfeeding Supporter, BfN, UK
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Date: Fri, 26 May 2000 06:38:31 -0400
Reply-To: Lactation Information and Discussion
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From: newman <[log in to unmask]>
Subject: almond milk
Comments: To: [log in to unmask]
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Almonds may not be highly allergenic (I don't know if this is true, but I
trust you Jennifer), but almond milk, what's the point? After all this baby
is 5 months old. I don't remember how long the mother was going to be away
from her baby, but if it is more than a day or two, almond milk is not a
decent substitute for breastmilk. And if it is just a feeding or two,
expressed milk should be fine.
Jack Newman, MD, FRCPC
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Date: Fri, 26 May 2000 07:01:31 EDT
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: [log in to unmask]
Subject: almond milk
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Dear Friends:
<< A doctor in our area told a breastfeeding mother of a four month old
that
if she needed to get away and feed the baby something besides breastmilk, she
could feed almond milk. You soak almond overnight in water, peel them and
then crush them and strain them through cheesecloth. You then add water to
the resulting mixture and feed to the baby. I had never heard of this and
thought I would run it through the expert line here. >>
WHY is a doctor telling a mother that she needs to get away and feed the
baby something else? What happened to exclusive breastfeeding? Why can't she
express some milk and leave it for the baby? Why spend the energy creating a
substitute, in this case not even from the same phylum as the baby, when
there is a safe option?
Warmly
Nikki Lee RN, MSN, Mother of 2, IBCLC, CIMI, CSTP
Elkins Park (a suburb of Philadelphia, Pennsylvania; northeastern USA)
supporter of the WHO Code and the Mother Friendly Childbirth Initiative
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Date: Fri, 26 May 2000 07:50:14 EDT
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: new article on bed-sharing
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Dear Friends:
This is interesting. It is at:
http://www.babycenter.com/popup/register.jhtml?pop=y
Nikki Lee RN, MSN, Mother of 2, IBCLC, CIMI, CSTP
Elkins Park (a suburb of Philadelphia, Pennsylvania; northeastern USA)
supporter of the WHO Code and the Mother Friendly Childbirth Initiative
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Date: Fri, 26 May 2000 07:56:49 EDT
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: MedWatch Reporting
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MedWatch reporting is very careful about confidentiality. Read the section on
this. It states that the patient's identity is held in strict confidence by
the FDA and protected to the fullest extent of the law. You are not asked to
give a name, it asks for a patient identifier, age at time of event, male or
female, and weight. If you are uncertain of what the term patient identifier
means, consult with the MedWatch program. We really need to start reporting
problems with pumps in a systematic manner. Lactnet is full of complaints
about pumps but this does little in the way of protecting mothers or
improving their options. When Rep Carolyn Maloney went to improve breast
pumps for working women and checked with the FDA, there were so few
complaints that Congress essentially ignored this aspect of breastfeeding
protection. Pumps that do not work well, act like toys, hurt mothers, or make
claims they cannot deliver on need action taken! Manufacturers can easily
ignore us but it is harder to ignore the FDA and a list of complaints logged
in Washington.
Marsha Walker, RN, IBCLC
Weston, MA
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Date: Fri, 26 May 2000 08:11:19 EDT
Reply-To: Lactation Information and Discussion
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From: Kathy Rubin <[log in to unmask]>
Subject: novice to expert/RN vs nonRN
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Pat and others--
The book you are thinking of is "From Novice to Expert" by Patricia Benner.
Altho geared for nursing, I ofund myself also thinking about this book while
reading the thread on this topic. I think that it can be applied to any
profession, not just nursing.
The gist of the book is that it takes a certain amount of experience to
develop expertise in a profession. Those of you (RN, IBCLC, etc) who are just
beginning will not yet have the experience required to develop "gut feelings"
about certain situations; this only comes with seeing and working in a field
for a good while.
I recommend the book as useful reading for anyone who is just beginning or
changing roles (i.e. NICU nurse becoming IBCLC, etc!!!)
Kathy in NJ IBCLC RN C (Maternal-infant), APN C (Family Nurse Practitioner)
PhD student hoping to study labor and lactation issues
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Date: Fri, 26 May 2000 08:40:01 -0500
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From: Linda Tandy <[log in to unmask]>
Subject: Re: RN/nonRN LC
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Ok, forgive me, but I just can't be quiet any more! I have been very
interested in this discussion, and have been holding my tongue for a few
days, but just HAVE to jump in! This discussion reminds me very much of the
entry level to nursing debate in the US. (To those who are international,
bear with me). In the US a person can sit for the RN boards with three
different levels of education, 2 years (ADN), 3 years (diploma) and 4 years
(BSN). Another entry is as an LPN with 1 year of training. This is hotly
debated in nursing circles and has been since I began nursing school in
1975.
The other issue here is the comment about many RN's on OB floors knowing
less than a non-RN IBCLC. This is true, however, keep in mind that the RN
grants ENTRY into practice. Most experience in the specialities is gained
from working the floors, CEU's, reading, etc. With the limited amount of
time an RN spends in school, she cannot come out a specialist. She should
come out as a generalist, with exposure to other specialties. From there,
she gains her specialization. Yes, I believe basic breastfeeding concepts
need to be covered in nursing school, however, further learning comes after
graduation.
As a hospital based LC, I do support the theory that LC's in hospitals need
to be RN's. At least at my hospital the LC provides home visits with
physical assessments of both the mom and baby 48 hours after discharge. We
have picked up so many problems on the hv that RN assessment skills are a
must. In fact, we require the home visit RN to have at least 5 years of OB
experience before she can work in our program. This is because there are no
"seasoned" experts out in the homes with her, and she has to be able to
assess and refer. Just this last week we had a wound evisceration. We have
seen thrombophlebitis, newborn sepsis, and have found a number of heart
murmurs in newborns.
I am not saying that ALL LC's need to be RN's. What I'm saying is that each
job is individual, and requires a different skill mix. I think non RN
IBCLC's have much to offer in many settings. I have learned much from
Allison Hazelbaker and Kathleen Auerbach. I think as we debate this issue
we need to be careful not to "throw the baby out with the bathwater." There
is not only room for all of us, our profession is richer indeed with
diversity. Ok, off my soapbox!
Linda J. Tandy, MSN, RN, IBCLC
Cedar Rapids, Iowa
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Date: Fri, 26 May 2000 09:26:50 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Linda Tandy <[log in to unmask]>
Subject: Re: RN/nonRN LC
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> Ok, forgive me, but I just can't be quiet any more! I have been very
> interested in this discussion, and have been holding my tongue for a few
> days, but just HAVE to jump in! This discussion reminds me very much of
> the entry level to nursing debate in the US. (To those who are
> international, bear with me). In the US a person can sit for the RN
> boards with three different levels of education, 2 years (ADN), 3 years
> (diploma) and 4 years (BSN). Another entry is as an LPN with 1 year of
> training. This is hotly debated in nursing circles and has been since I
> began nursing school in 1975.
>
> The other issue here is the comment about many RN's on OB floors knowing
> less than a non-RN IBCLC. This is true, however, keep in mind that the RN
> grants ENTRY into practice. Most experience in the specialities is gained
> from working the floors, CEU's, reading, etc. With the limited amount of
> time an RN spends in school, she cannot come out a specialist. She should
> come out as a generalist, with exposure to other specialties. From there,
> she gains her specialization. Yes, I believe basic breastfeeding concepts
> need to be covered in nursing school, however, further learning comes
> after graduation.
>
> As a hospital based LC, I do support the theory that LC's in hospitals
> need to be RN's. At least at my hospital the LC provides home visits with
> physical assessments of both the mom and baby 48 hours after discharge.
> We have picked up so many problems on the hv that RN assessment skills are
> a must. In fact, we require the home visit RN to have at least 5 years of
> OB experience before she can work in our program. This is because there
> are no "seasoned" experts out in the homes with her, and she has to be
> able to assess and refer. Just this last week we had a wound
> evisceration. We have seen thrombophlebitis, newborn sepsis, and have
> found a number of heart murmurs in newborns.
>
> I am not saying that ALL LC's need to be RN's. What I'm saying is that
> each job is individual, and requires a different skill mix. I think non
> RN IBCLC's have much to offer in many settings. I have learned much from
> Allison Hazelbaker and Kathleen Auerbach. I think as we debate this issue
> we need to be careful not to "throw the baby out with the bathwater."
> There is not only room for all of us, our profession is richer indeed with
> diversity. Ok, off my soapbox!
>
> Linda J. Tandy, MSN, RN, IBCLC
> Cedar Rapids, Iowa
>
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Date: Fri, 26 May 2000 09:29:38 -0500
Reply-To: Lactation Information and Discussion
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From: Susan R Potts <[log in to unmask]>
Subject: For Pat
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Dear Pat,
Thanks for the chuckle. From one opinionated blabbermouth to
another! I give you lots of credit for keeping your posts short and
concise, and always helpful.
Oh how I love the field of lactation and helping young parents!!
................I can actually earn money doing this?.....Thank you, God!
Susan Potts rn ibclc
Minnesota
Packing for a canoe trip down the St. Croix river this holiday week end,
with kids and friends.
________________________________________________________________
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Date: Fri, 26 May 2000 09:44:56 -0500
Reply-To: Lactation Information and Discussion
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From: Marcia B McCoy <[log in to unmask]>
Subject: Re: LACTNET Digest - 25 May 2000 (#2000-653)
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Hi Jennifer,
I think almond milk is very nice, myself. But maybe Jack was thinking
what I was thinking - why would you recommend this rigamarole instead of
suggesting she store some expressed breastmilk?
Marcia McCoy in Minnesota
who would like to write a book called 'the Lazy Mother's Guide to Raising
a Baby' because so many suggestions to moms just make it all harder
instead of easier. (My favorite: a 4-month-old doesn't need to eat
during the night, so instead of nursing in your family bed, get up at 2
a.m. and use whatever other methods to get your baby back to sleep.)
<< A doctor in our area told a breastfeeding mother of a four month old
that
if
she needed to get away and feed the baby something besides breastmilk,
she
could feed almond milk. You soak almond overnight in water, peel them
and
then crush them and strain them through cheesecloth. You then add water
to
the resulting mixture and feed to the baby. I had never heard of this
and
thought I would run it through the expert line here. >>
Pat,
I am actually a little surprised by Jack's reaction to this. (Oy, veh, I
believe. <g>). Since almonds are a fruit and not a nut, they tend to be
low
allergy. The milk is mild and has a nice flavor. When they are soaked and
the
skin removed, their calcium content becomes highly absorbable. This makes
them excellent for women to eat during pregnancy, BTW. I would imagine
this
would be a better choice than ABM, though I must admit I never thought of
it.
Most women I know of wanting to avoid ABM use goat's milk instead.
Jennifer Tow, IBCLC, CT, USA
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Date: Fri, 26 May 2000 17:03:29 +0200
Reply-To: Lactation Information and Discussion
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From: Rachel Myr <[log in to unmask]>
Subject: epidermolysis bulosa
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Thank you, Jeanette, for a beautiful and concise post. Good job all round--
from the hospital who referred to you to mother helping her baby. There are
worse things than a short life and some parents experience the whole gamut
of attachment and loss and everything in between in the course of a dramatic
few hours, days or weeks. GREAT if everyone involved makes their experience
as rich as it can be, like here.
in admiration and gratitude for your sharing
Rachel Myr
Kristiansand, Norway
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Date: Fri, 26 May 2000 17:03:32 +0200
Reply-To: Lactation Information and Discussion
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From: Rachel Myr <[log in to unmask]>
Subject: books for expectant parents
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A book with an approach that is empowering and informative used to be
'Pregnancy, Childbirth and the Newborn' by Penny Simkin, Janet Whalley and
Ann Keppler. It was a bestseller at Birth and Life books from the time it
was first published in 1979, as an outgrowth of 'Becoming Parents', the
class manual of CEA of Seattle. On looking at my only copy, which is from
the mid-80's, I see that it would need updating on several points, but even
then the chapter on feeding had 21 pages of mostly excellent info on
breastfeeding and 2 at the very end on 'Brand X'. Knowing the authors I am
assuming that if it is still in print, it is updated, but I haven't seen a
recent copy. It is approximately the same size, shape and scope as 'What to
expect' but is in a completely different league IMNSHO.
I have no economic interest in any books (or videos) but since the 'What to
expect...' etc book has been mentioned I hope it is OK to mention this one
as well.
cheers
Rachel Myr
Kristiansand, Norway
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Date: Fri, 26 May 2000 08:19:30 -0700
Reply-To: Lactation Information and Discussion
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<[log in to unmask]>
Comments: RFC822 error: <W> Incorrect or incomplete address field found and
ignored.
From: maka laughingwolf <[log in to unmask]>
Subject: reminder
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Content-Type: text/plain; charset="Windows-1252"
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just a reminder that you can see one of my poems, "i love to nurse you!"
today (and in the archives for the next week) at
http://www.lactations.com/daily_inspiration.phtml
Maka Laughingwolf
life-after-lifepartner (12 years as of 1/6/2000!) to Mark, RN
SAHM to daystar (6/23/91) and griffin (7/11/99)
[log in to unmask] -=o=- http://www.maka.net/
-=o=-=o=-=o=-=o=-=o=-=o=-=o=-=o=-=o=-=o=-=o=-=o=-=o=-=o=-=o=-
Please take a look at my writing:
http://www.themestream.com/articles/46213.html
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Date: Fri, 26 May 2000 11:09:44 -0500
Reply-To: Lactation Information and Discussion
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From: Linda Tandy <[log in to unmask]>
Subject: Re: messages
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Sorry, I inadvertently sent my opinion twice! My lactnet doesn't seem to be
working well this am. Anyone else having problems?
Linda J. Tandy, MSN, RN, IBCLC
Cedar Rapids, Iowa
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Date: Fri, 26 May 2000 09:57:29 -0700
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: Re: CHES credential
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To all who responded to my CHES post...I'm posting this because of the high
level of interest and because I believe it is relevant to the credentialling
discussion...
CHES is granted by the NCHEC (National Commission on Health Education
Credentialling 944 Marcon Blvd. St310, Alentown PA 18103 or call
1-888-624-3248). It began in the mid 1980s (around the same time as the
IBCLC credential), when I was in my Behavioral Sciences and Health Education
MPH program at UCLA. At that point, the faculty at UCLA considered it to be
an elitist move to try to lock out professionals with long time experience,
but no advanced degrees, from the field. Unfortunately, I bought into this
fully, and didn't get grandmothered into the credential--I later had to sit
for the exam (a similar style board exam to the IBCLC). After completing my
PhD in Health Services Research and Policy Analysis also from UCLA, I took a
tenure track position at OSU (which wanted faculty to have the CHES because
one member was on the NCHEC board). So, I sat for the exam and passed.
I've since quit that job, but I'm glad I have the credential and will not it
lapse because it does carry weight in public health and in educational
fields. It appears to be relatively unheard of in lactation circles though;
time will tell.
It is a similar set of requirements in terms of requiring BOTH education and
experience in the field (a relatively huge number if I recall). There is a
stagered education vs experience provision to not penalize those who have
"worked their way up" but without Master's level or above degrees. The
exam is MUCH broader than the IBCLC exam in that one needs to know about
general theory and practice of public health education in the community,
schools, one-on-one, mass media, etc. However, once certified, it would be
easy for an IBCLC to maintain. They require 75 hours of continuing ed over a
5 year period--much of which can overlap with the IBCLC. In fact, I have an
easier time meeting my IBCLC credits and having them count as CHES, than the
other way around. This is because almost all IBCLC CERPS are health
education related, but not all CHES CEs are lactation related. Does that
make sense? That is not to say it is difficult to fulfill the 75--there are
many opportunities by mail, at conferences, etc. At the annual Am Public
Health Association conference alone, I rack up 25-30 hours of CHES, but many
folks do it solely by mail.
I do not sit on their board, so I'm not trying to plug this for that reason.
I do think there is a valid overlap and practice enrichement with both
credentials. I am seeing more and more IBCLCs with MPH or MN degrees and I
think these folks could very easily turn around and become CHES certified.
Those with years of experience might look into it because of their
experience trade-off provision (not very common in certification programs).
I hope this helps and is clear.
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
----------
>From: [log in to unmask]
>To: [log in to unmask]
>Subject: CHES credential
>Date: Fri, May 26, 2000, 5:36 AM
>
> Hi Chris--
>
> I always enjoy your posts on LactNet!!
>
> What is a Certified Health Education Specialist?? Is it a masters credential
> or a certificate? What schools/programs provide this type of credential.
>
> My friend and I are both RN/BSNs who became certified first as childbirth
> educators then as IBCLCs. We both went on for MS, mine in Nursing and hers in
> Education. Both of us want to **TEACH**!! (whether patients, or nursing/med
> students) I also hold a Post Master's Certificate in Nursing Ed.
>
> If you have time, I would be very interested in info on the CHES credential.
>
> Thanks,
>
> Kathy in NJ IBCLC RN C (Maternal-infant), APN C (Family Nurse Practitioner)
> PhD student hoping to study labor and lactation issues
>
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Date: Fri, 26 May 2000 13:49:40 -0400
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
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From: Dressler/DeMarco <[log in to unmask]>
Organization: WTSTB, LLL, VLCA, and HOME
Subject: bfdg curriculum website correction
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For the person looking for the school breastfeeding curriculum
information--
The web site for the NY State DOH curriculum was incorrectly given. It
is
http://www.health.state.ny.us/nysdoh/b_feed/index.htm
Diane
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Date: Fri, 26 May 2000 10:45:40 -0700
Reply-To: Lactation Information and Discussion
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From: Shannon Hill RNC <[log in to unmask]>
Subject: Breastfeeding Multiples/Spanish Handouts?
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Hello,
I am a hopsital based RNC/LC in training planning to sit for the IBCLC exam in
July!
I am putting together a packet of info to be handed out to moms pregnant with or
who have just delivered twins or more.
I have been having trouble finding a nice breastfeeding multiples handout or
booklet in Spanish. Is there anyone who might be able to direct me to where I
might find something useful for the spanish version of the packets? I have tried
the archives but have been unsuccessful.
Thanks in Advance,
Shannon Hill RNC
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Date: Fri, 26 May 2000 11:40:51 -0700
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: Chris Hafner-Eaton <[log in to unmask]>
Subject: The Lactation Consultant software
Mime-version: 1.0
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Has anyone purchased and/or used the MIS system called The Lactation
Consultant by Info Nation Systems? I stumbled across this software and am
curious as to all of your experiences with this. It seems logical to use a
computerized system of documentation since I'm online so much. Any thoughts
as to the practicality of it? How does this method hold up for legal
documentation and reimbursement? TIA!
-- Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
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Date: Fri, 26 May 2000 15:00:57 EDT
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: [log in to unmask]
Subject: RNs and IBCLC
Comments: To: [log in to unmask]
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Linda, what I think I hear you saying is that IBCLC's don't need to be RNs,
and RNs don't need to be IBCLCs; but that there are some particular jobs that
are best done by a person with both sets of qualifications.
Makes sense to me.
I recently gave two different names of LCs to a mother whose problems
required a higher level of technical bf expertise than I could provide. I
told her that although both are smart, knowledgeable, and excellent
technically, the one who is a parent and long-time LLLL would probably suit
THIS MOM's needs better if she were available, because THIS JOB needed good
hand-holding and sympathy skills in addition to fundamental lactation
knowledge.
think that's the same as what Linda is saying about the home-visiting LCs in
her program -- they need LC expertise per se, plus they will do a better job
in their particular circumstances if they also have something else (in my
case mom-knowledge, in her case nursing knowledge) as well.
The nice thing about having different kinds of LCs, with different
supplementary backgrounds, is that it gives us a range of this sort of
combinations to choose from in the different contexts in which this normal,
part-of-life activity of bf falls.
Elisheva Urbas, NYC
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Date: Fri, 26 May 2000 14:20:40 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Linda Tandy <[log in to unmask]>
Subject: Re: RNs and IBCLC
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Elisheva, you have summarized it exactly! Thanks!
Linda J. Tandy, MSN, RN, IBCLC
Cedar Rapids, Iowa
-----Original Message-----
From: [log in to unmask] [mailto:[log in to unmask]]
Sent: Friday, May 26, 2000 2:01 PM
To: [log in to unmask]
Subject: RNs and IBCLC
Linda, what I think I hear you saying is that IBCLC's don't need to be RNs,
and RNs don't need to be IBCLCs; but that there are some particular jobs
that
are best done by a person with both sets of qualifications.
Makes sense to me.
I recently gave two different names of LCs to a mother whose problems
required a higher level of technical bf expertise than I could provide. I
told her that although both are smart, knowledgeable, and excellent
technically, the one who is a parent and long-time LLLL would probably suit
THIS MOM's needs better if she were available, because THIS JOB needed good
hand-holding and sympathy skills in addition to fundamental lactation
knowledge.
think that's the same as what Linda is saying about the home-visiting LCs in
her program -- they need LC expertise per se, plus they will do a better job
in their particular circumstances if they also have something else (in my
case mom-knowledge, in her case nursing knowledge) as well.
The nice thing about having different kinds of LCs, with different
supplementary backgrounds, is that it gives us a range of this sort of
combinations to choose from in the different contexts in which this normal,
part-of-life activity of bf falls.
Elisheva Urbas, NYC
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Date: Fri, 26 May 2000 17:30:03 EDT
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Jennifer Hornsby-Smith <[log in to unmask]>
Subject: almond milk
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My name is jennifer Hornsby-Smith, I'm new to lactnet and a LLL Leader
working toward taking the IBCLE in a couple of years. Regarding the use of
almond milk as a sustitute for mother's milk while the mother is away - why
not use EBM or better yet, take the baby with her and nurse as usual. If the
mother visits her local health food store and check out the aseptic boxes of
almond milk where I'm sure she will find the statement "Not to be used as
infant formula."
By the way can anyone offer reccomendations as to value of a lactation course
prior to taking THE TEST? Although I've Bf 3 kids and been a leader for 3
years, I feel that I need more info. THanks!
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Date: Fri, 26 May 2000 18:10:07 EDT
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: the rigamarole of expressing breast milk
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Marcia wrote:
<< why would you recommend this rigamarole instead of
suggesting she store some expressed breastmilk? >>
Honestly, we know there are some moms who for whatever reason, will not nurse
exclusively, feel they must have the freedom to leave their infants in
someone else's care - some of them may hate pumps for their mechanical
nature, may have histories of sexual abuse and do not touch their own
breasts. We never really know what goes on in a mother's head about the
reasons she finds some options feasible and others not, but I guess the best
we can do is make sure she has the info she needs to make the best choices
she can. Some will express, some will choose AIM, some would rather spend
time making homemade stand-ins for their milk, and we know that in the face
of whatever family and cultural pressures they are feel they are under by
breastfeeding, some will even wean. We see them all over time - our own
Breastfeeding Moms Bell Curve...
Judy LeVan Fram, Brooklyn, NY
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Date: Fri, 26 May 2000 18:19:26 -0400
Reply-To: Lactation Information and Discussion
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From: The Breastfeeding Center of Maine <[log in to unmask]>
Subject: Re: The Lactation Consultant software
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Chris,
I too have had interest in this program so I hope your responses will be
posted to the group, or that you will share them with me if not.
Thanks,
Bettina Pearson RN, IBCLC
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Date: Fri, 26 May 2000 19:39:50 EDT
Reply-To: Lactation Information and Discussion
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From: "Valerie W. McClain, IBCLC" <[log in to unmask]>
Subject: Re: The Lactovist's Corner
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"....And can they explain, why are formula companies spending soooo much
money researching the fatty acids thought to beresponsible for it..."
Crude oil is expensive. Valerie W. McClain, IBCLC
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Date: Fri, 26 May 2000 13:20:28 -0400
Reply-To: Lactation Information and Discussion
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From: Norma Ritter <[log in to unmask]>
Subject: Re: taking back pumps
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> I have always encouraged moms to bring back a pump that does not work
well
to the store at which it was purchased. Many say that the pump is not
returnable once it is opened.
Yes, breast pumps are a *personal care * item, but it IS supposed to
work. I tell moms to take it back and say *This does not work*, and they
always get a refund. No problem. My hope is that eventually the stores
will get the message that if so many ppl are bringing back a particular
pump. it is more trouble that it is worth to have it in stock.
Norma Ritter, IBCLC
private practice in Big Flats, NY
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Date: Fri, 26 May 2000 20:03:31 -0400
Reply-To: Lactation Information and Discussion
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From: Pat Bull <[log in to unmask]>
Subject: Dr. Miriam Labbok
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Hello Netters,
"Someone asked about references for the economic impact of breastfeeding:=
Dr. Miriam Labbok presented a wonderful talk on the Economic Benefits of
Breastfeeding a couple of years ago. "
She spoke at ILCA 1995 Conf. The topic was "Models for Cost Savings
Associated with Breastfeeding". The audiotape is #F520 ordering from Fir=
st
Tape,Inc. (708) 386-0660. =
Pat Bull, RN, IBCLC
The Breastfeeding Connection/Medela
Naperville, IL
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Date: Fri, 26 May 2000 20:12:49 EDT
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Pampers breastfeeding study
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Pampers has a research study on how long to breastfeed.
Put your vote in!!!
<A HREF="http://pampers.ad.yahoo.com">http://pampers.ad.yahoo.com</A>
Annette Leibovitz, IBCLC
Buffalo Grove, IL
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Date: Fri, 26 May 2000 22:08:52 -0400
Reply-To: Lactation Information and Discussion
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From: Jeanette Panchula <[log in to unmask]>
Subject: pregnancy book in Spanish
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I was informed by an LLL in Puerto Rico that "What to expect when you're
expecting" is already available in Spanish there at Sam's. Those
interested should probably contact the publisher.
Jeanette Panchula
Vacaville, CA
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Date: Fri, 26 May 2000 22:21:38 EDT
Reply-To: Lactation Information and Discussion
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From: "Laura Hart, RN, BSN, IBCLC" <[log in to unmask]>
Subject: Re: "nurse brain"
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In a message dated 5/25/00 12:16:20 AM Eastern Daylight Time,
[log in to unmask] writes:
<< Her supervisor does not see the need to send
her out to a course, since she breastfed 5 babies and how much do you
need to know anyway. She said that now she understands what I mean by
"nurse brain." >>
Esther,
You know how we say that most cases diagnosed as breastfeeding jaundice are
actually LACK of breastfeeding jaundice. Well, it is not necessarily nurse
brain, but "LACK of breastfeeding knowledge in nurses' brains." I am a nurse,
so maybe I am a little defensive. I also used to lack breastfeeding knowledge
and actually had misinformation about breastfeeding when I started my nursing
career. But I did learn and it was those of you who did not have
misinformation that knew enough about breastfeeding to teach us. I am very
grateful that I had June & Debby to help me learn about breastfeeding. They
were the only IBCLC's in the area for years and neither are nurses. They
helped lots of us in Central Florida learn about lactation issues.
I work in a hospital with lots of nurses and moms. You can tell those nurses
and moms who have done their homework and really have a knowledge of
breastfeeding. I often find some of the moms know more about breastfeeding
than some of the nurses. Unfortunately some of these nurses don't want to
know any more about breastfeeding and even use their own personal experiences
to teach our new moms about breastfeeding. Things like, "I used a nipple
shield and I did fine" or "Someone told me to sleep all night and that was
the best thing that could have happened to me." Right now we seem to have
lots of moms & nurses who think that feeding baby in the nursery & sleeping
through the night is good. What is it that Dr. Jack says? "ARRGGHHH!" They
must have "nurse brain" !!!!!!
Laura Hart
Winter Park, Florida
Do what you can, with what you have, where you are.
-- Theodore Roosevelt
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Date: Fri, 26 May 2000 22:38:21 -0400
Reply-To: Lactation Information and Discussion
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From: Pat Bull <[log in to unmask]>
Subject: almond milk
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Hello Netters,
" A doctor in our area told a breastfeeding mother of a four month old
that if she needed to get away and feed the baby something besides
breastmilk, she
could feed almond milk. You soak almond overnight in water, peel them an=
d
then crush them and strain them through cheesecloth. "
When I coordinated the Chicago Milk Bank, I had moms feeding all sorts of=
things to their babies. When you have a baby allergic to everything but
breastmilk, the moms and Drs. become very creative. I do remember some D=
rs
recommending almond milk. This, I think, because it was natural and one =
of
the least allergenic. I did have some moms feeding this to their babys a=
nd
did OK. Breastmilk is still the best and always will be. =
Pat Bull, RN, IBCLC
The Breastfeeding Connection/Medela
Naperville, IL
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Date: Fri, 26 May 2000 23:45:43 -0300
Reply-To: Lactation Information and Discussion
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Sender: Lactation Information and Discussion
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From: barbara montague <[log in to unmask]>
Subject: Update on Vomiting 5 wk.old baby and REPOSTING OF: Are there
glutens & wheat proteins in cow's milk? transferred into human
milk when nursing mom drinks cow's milk ?
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Hello again lactnetters;
Thought I had better say THANK YOU to everyone for all your ideas and
suggestions to my post on May 10th, 2000 about this poor vomiting baby who
was placed on soy formula and had stopped all vomiting------this mother
would absolutely not reconsider resuming breastfeeding after having 3 days
of no vomiting on the soy formula. I continued to follow her up to be sure
that this precious baby was still tolerating the soy formula, and that the
mother possibly might reconsider nursing. The father had some say in this
situation as well---he definitely did not want this baby back to the breast
after all that they went through for about 2 weeks [of vomiting]. I fully
understand and respect their decision, and the mother continued to consult
with me for assistance with her abrupt weaning---and luckily enough that
went smoothly and uneventful. So ends another sad chapter of my lactation
challenges; but I thank you all again as this has been an unfortunate but
learning experience for all of us I'm sure. And I hope the next time if
this happens again that the mother/father involved will consult with me [ or
some other KNOWLEDGEABLE PERSON IN LACTATION ] first before the doctor gets
is opportunity to introduce the ABM---soy or otherwise !
ALSO
Here's my other question that I posted earlier in May 2000, but
unfortunately I did not get any responses :
My chiropractor, who is very supportive of breastfeeding and sees alot of
possible "celiac" patients in her practice, would like some info ( and
references if possible) on the question " Does cow's milk contain glutens
and wheat proteins, as they are primarily grain fed ? " and " Are these
glutens and wheat proteins transferred into human milk when the nursing
mother drinks cow's milk ? " Both she and her husband are chiropractors and
do alot of dietary counselling in their hollistic practice.
Many thanks for this rather 'different' question that does tie-in
breastfeeding.
Sincerely,
Barbara Montague RN IBCLC
[ Private Practice ]
Saint John, NB CANADA
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Date: Fri, 26 May 2000 21:13:31 -0700
Reply-To: Lactation Information and Discussion
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: teething, soreness consensus
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In my attempt to cordially work through the difference of opinion regarding
the treatment of an "older baby" causing sore nipples because of teething, I
have opened another can of worms. To help settle this, maybe to create some
basis for consensus, I'm asking all of you what you have tried in similar
situations. To refresh your memories...a mom of a 9 month old teething baby
called me because she was having difficulty with getting a sustained good
latch and he was slipping down the nipple causing soreness. The mom had
been told by another IBCLC that she needed a nipple shield. Mom was
dismayed about this advice and came to see me. It was obvious that this
baby was very uncomfortable and restless, plus chomping on everything in
sight. I watched them nurse, suggesting "the usual". The usual included
readjusting the latch; having mom get him to mimic open mouth and tongue
out; tapping on the breast to have him gulp more into his mouth; tugging on
the outter edge of the areola; nursing with football hold with chin to
chest; nursing in sling; nursing while asleep; putting pressure on the chin;
using cold wash cloths, frozen bannana chunks, and massage on gums; massage
to face and body; etc. She had been using Hylands Homeopathic teething
pills, but "unsuccessfully", which actually might have been due to the fact
that she wasn't giving them frequently enough. (BTW, I see this all the
time where moms think 2-3 hour dosing is correct when in fact they need to
give small doses every 15 minutes for an hour and then every 2-3 hours).
Even with Tylenol, baby showed symptoms of gum engorgement after 2-3 minutes
of nursing. I suggested we try NSP teething drops (liquid in a veg.
glycerine base). The response was dramatic. After two, maybe three doses
10 minutes apart, the child relaxed and lay calmly while nursing.
SOOOO, what DO all of you do in these cases. Am I living on another planet?
Please, I'm quite serious and I need a reality check. TIA.
-- Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
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Date: Sat, 27 May 2000 00:38:49 EDT
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Re: Pampers breastfeeding study
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Looks like the Lactnet and LLL folks have found this poll - just voted and
checked it - 40% of 1055 polled, voted for 2+ years to breastfeed their
child. In my dreams!
Gretchen Andrews, BA, IBCLC
private practice, So Cal, USA
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Date: Sat, 27 May 2000 01:05:30 EDT
Reply-To: Lactation Information and Discussion
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<[log in to unmask]>
From: [log in to unmask]
Subject: Re: teething, soreness consensus
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In a message dated 00-05-27 00:41:17 EDT, you write:
Breastmilk popsicles are very effective to reduce the swelling as well as
deaden the pain sensations for the teething tot - plus it gets some nutrition
into a little one who may not want to L/O well and suck properly.
Gretchen Andrews, BA, IBCLC
private practice, So CAL, USA
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Date: Sat, 27 May 2000 03:11:47 EDT
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Mom with Hypothyroidism
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Hi Lactnetters,
It has been a while since I posted and I have the following question:
I have a mom who has hypotryroidism. Her baby will be 8 weeks on Friday.
Her thyroxine dosage was increased to 0.2 mg about 6 weeks ago because she
did have a decrease in milk supply and was feeling very tired. She had been
pumping with the Elite until two weeks ago when she switched to the PY (got
for $100!). She has been taking Fenugreek 2 caps 3x/day ( I offered her the
suggestions mentioned earlier). She continues to be concerned about her
supply and I am to the point where I really do not know what to do. This was
her schedule of feedings in the last 2 days for your review (sorry, but I
also don't know how much information to provide when I need to ask for advice
from this wonderful group!):
2AM - R (15mnts.), L (5) baby fell asleep
3AM - PUMPED (15)
5AM - R(8), L(15), R(15) b asleep
7AM - R(5), L(15)
9AM - 2.5 formula supplementation via bottle after nursing R(10), L(10)
10AM - L(5)
10:30 - baby crying
11AM - R(10)L(20)R(10) asleep
3PM - 2.5 Expressed breastmilk after nursing, R(10), L(20) R(5)
5PM - R(5)
6:30PM - R(10-15),L(15),R(5),L(10)
8:30PM - L(20), R(20) asleep
9:30-1AM BABY SLEPT
This day baby seemed content with the exception of that one morning cry.
************
4:25AM 2.5 Formula supplementation after nursing- R(10)
6:15AM - R(10), L(15), R(5), L(10)
9:30AM - 2.5 Formula via bottle after nursing - R(10),L(10),R(5), L(15)
12NOON - R(20), L(20), R(10)
1:30PM - R(10), L(10)
3:30PM - 2.5 Formula via bottle after nursing - R(8), L(10)
5:45PM - R(20) asleep
6:30PM - R(30), L(30) Baby started acting fussy
7:30PM - 2 Formula via bottle
8:00PM - R(30), L(15) asleep
9:00PM - 2.5 Formula
Sorry about all of this. I llet the mother borrow my pump over the weekend
so that her mind was satisfied that the she was indeed producing milk. On
average the baby liked nursing for nourishment during the morning and at
night with approximately 2.5 oz per feeding. Baby did have times when he
only got .3 oz and was fussy by Sunday evening so mother was worried that
baby did not get enough. On Saturday baby came to breast with 14.8 oz as per
weight checks and was supplemented with 2 oz. He weighs 10 lbs so needs 24.0
oz/day which means he was under by about 7.2 oz. (This little information
tells me that mother may not be producing all the baby needs). By Sunday he
had 10 oz by noon and may have been hungry by later when I saw the mom again,
but she immediately wanted to give him a bottle because of his crying yet
when I convinced her to offer him her breast. He nursed on both sides and
seemed happy and content.
My feeling is that mother really is not following my instructions and she may
be too quick to offer him a bottle and does not pump consistently to increase
her supply. Do you have any suggestions for me?
TIA,
Yvonne Bannister
Baby's BestFeeding
Hollister, CA
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Date: Sat, 27 May 2000 03:15:27 EDT
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: [log in to unmask]
Subject: Constipation?
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Hello again,
Here is another question (can you tell I am getting busy!)
I have a mother who has a 6 week old little girl who is a little
concerned about a possible constipation with this little one. The baby had a
good regular bowel movement on 5/14 then had spots on the diaper and was very
fussy. She was really worried. I did mention the change in some babies
around 4 -6 weeks. She was still worried because her baby seemed to really
be in pain. The on 5/19 her baby did a "greenish toddler looking poop" and
was then happy with yellow ones thereafter. With this green poop baby was
not happy until it came out and she believes this was also causing her to be
so fussy earlier in the week. Is there anything that I can tell mom in this
situation?
TIA,
Yvonne C. Bannister
Baby's BestFeeding
Hollister, CA
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Date: Sat, 27 May 2000 03:17:05 EDT
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: [log in to unmask]
Subject: Herbals and BF, any danger?
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Hello AGAIN!
I needs lots of help on this one! Sorry I caught you in the middle on a nic=
e=20
long weekend, this one has me really concerned!
Baby born at home on 5/20 at 2pm in the middle of a heat wave here in=20
Hollister, CA with temperatures of 100. Second baby, first is 8 years old.=20=
=20
Birth weight 9 lb 1 oz. Nursing well on 5/20 at 4pm. No problems reported o=
n=20
Sunday 5/21, mom says nursing is going well. Mom suspects baby may have a=20
fever, but due to the temperature outside and inside was not sure. Monday I=
=20
talk to mom. Baby has temperature of 101.7. Midwife has no concern. I hav=
e=20
concern due to the temperature both outside and inside and wonder about over=
=20
dressing the baby. Mother calls her Herbalist who has a doctorate in=20
Naturopathy and is a master herbalist.
The herbalists recommends that she give the baby a saline enema, she says sh=
e=20
used approximately =BD oz. Baby had 3 diaper fulls of tarry brown bowel=20
movements. Fever diminished. Mother continued to worry about the baby=20
because she had tested positive for Strep B two weeks prior to delivery for=20
which she was treated with Comfrey (1 oz) and Transfer Factor Plus (1 capsul=
e=20
3x/day). Mother did not retest prior to delivery. At the hospital baby was=
=20
found dehydrated and was treated with IV antibiotics and was submitted to th=
e=20
hospital for observation due to the fever and possible Strep B. (Mother did=20
not mention enema). Mother refused to admit the baby. She took him home.=20
Continues to breastfeed baby and begins treatment for baby of 12 drops of=20
Echinecea and 10 drops of V-DC for the baby and Comfrey 2 =BD dropper fulls=20=
for=20
herself since Comfrey goes through the breastmilk which will also take care=20
of the baby.=20
I saw mother again on Wednesday. Breastfeeding was going well. Baby looked=
=20
good. Mother could not nurse on R due to pain. I lent her a pump so that=20
she could give that side a break and continue to nurse on L. Mother felt=20
good and was doing well. Mother gets a call from Dr. in ER, baby has tested=20
positive for Staph. Need to readmit baby to hospital. Mother tells him she=20
will take him to another hospital. Dr. is not happy and tell her she will=20
call the cops. In the meantime she calls her midwife and her pediatrician=20
(for this baby). Midwife tells her not to worry, cops will probably not be=20
called. Pediatrician tells her to take the baby to another hospital for=20
another opinion. Cops show up, do not report because they see no reason to.=
=20
I get there and hear the story. Nursing is going well although mother canno=
t=20
use her R due to pain. Mother does not want to take baby to hospital due to=
=20
fear of having to readmit and possible use of antibiotics. After my=20
suggestion, mother decides to take baby to pediatrician the next day.
Pediatrician fines no problem with the baby, but will not continue with her=20
services to mother due to mothers desire to use herbs for treatment. I see=20
baby again today. Baby has now weighs 8 lb which means he has lot more than=
=20
10% of birth weight. I leave strict instructions that mother needs to feed=20
baby every 1 hour, keep him skin-to-skin, nurse him every 2 hours at night=20
and should not go more than 2 hours without nursing. The Echinecia and V-DC=
=20
should be given to the baby after breastfeeding or with breastmilk. Mother=20
is to supplement baby after nursing with pumped breastmilk. I will weigh th=
e=20
baby tomorrow morning.
Have I missed anything? Michell what do you thing about the herbs and do yo=
u=20
have any suggestions and/or recommendations for this mother or for me as the=
=20
LC?
Thanks,
Yvonne
Baby's BestFeeding
Hollister, CA
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Date: Sat, 27 May 2000 10:08:36 +0200
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: almond milk
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I've kept quit for some time, but feel I've got to add my pinch of salt here.
The use of almond milk for infants is widely recommended in antroposofic
circles. It is there seen as a good substitute for human milk for it's
''intrinsic'' qualities, which they see as close to human milk. From a
allopathic nutritional point of view almond milk is far from adequate in fully
nourishing a human infant for it's lack of several vital elements.
I do agree with someone (a new lactnetter: welcome) suggesting taking the baby
when mom goes out. I think it would be good to point out to mothers that in many
cases it is very well possible to take the baby whereever mom goes, especially
an infant. It's convenient and good for mothers and babies health.
In the case a mom has to leave the baby in someone elses care (and I do know
that that exists, I'm not that alienated from the real world :-) ), let's
please be sure she gives the baby an adequate human milk substitute, which
almond milk certainly is not, nor are cowsmilk or milk-water preparations.
Gonneke van Veldhuizen, IBCLC, living in Maaseik, Belgium
http://www.users.skynet.be/eurolac
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Date: Sat, 27 May 2000 10:32:01 +0200
Reply-To: Lactation Information and Discussion
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From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: teething, soreness consensus
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Geesh, Chris, you list an inches-long list of solutions and still want us to add
MORE.... :-))
But I do have a question. Could you give some generic names of the medications
you name? The only tincture or homeopathic dilution I know for theeting is
chamomilla and it usually works fine. The allopathic medications I hesitate to
use, while it is not always clear what's in it and they might contain
painkillers, tranquilizers, etc.
Chamomilla globules (C30 or up) as a baseline treatment (frequent start up every
15 minutes in the first hour, use 3 globules in 30ml plain water, shake firmly
ten times before each treatment, give half a teaspoon of this solution, make new
solution every day, rest of day every 2-3 hours, 2 globules in mouth once a day
rest of the week; same sequence again if needed), chamomilla tincture on the
gums prior to feeding, good positioning, carefull re-positioning and have the
baby chew on hard and cold things are the things I recommend moms with teething
babies. Mom may drink chamomilla tea to support treatment 1 cup a day.
Gonneke van Veldhuizen, IBCLC, living in Maaseik, Belgium
http://www.users.skynet.be/eurolac
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Date: Sat, 27 May 2000 18:49:18 +1000
Reply-To: Lactation Information and Discussion
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From: Kay Family <[log in to unmask]>
Subject: Pregnancy Info in USA please
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As an Aussie midwife and IBCLC, I need to learn a bit about the 'usual'
things that happen when a woman is pregnant and labouring in USA.
Our lovely exchange student (From MN) is pregnant (I think that will make me
a grandma) and has asked me to go for the delivery, but unfortunately, the
budget prohibits this.
She is already asking my opinions on many things. I know how we do things
here, but would like to understand how things are done over in USA.
As I have many questions, I would appreciate having some midwives from USA
email me privately.
Would be also interested in hearing about good websites and books for her.
Thanks so much
Susan in Qld Australia, where it is finally cooling down into winter!!
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Date: Sat, 27 May 2000 06:29:41 EDT
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: gluten in breastmilk
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The question of whether there is gluten (in the form of wheat, rye, barley
and/or oat protein) and casein (from cow's milk) in breastmilk is currently a
hot topic on the other list of which I am a regular reader---the Gluten Free
Casein Free Diet (GFCF). GFCF diets are becoming increasingly popular as a
treatment for children with autism and autism spectrum disorders. It appears
that with some children on the spectrum, casein and gluten act as opiates on
the brain, which intensifies autistic behaviors and learning problems. The
diet also ties in with the belief that the children's guts were damaged (are
permeable), much like those of celiac disease sufferers.
While I was suspicious, I've tried it on my boys (both of whom are autistic),
and I have to say there are significant improvements. I am becoming a
believer.
This of course leads to all sorts of breastfeeding related questions,
including Barbara Montague's about celiac disease. It is my presumption that
yes, cow's milk does contain gluten if they are eating these grains as feed.
Do I have the research to back it up? No. But think about how dairy
proteins (casein) can transfer into mother's milk and cause problems in
sensitive babies. Wheat gluten/protein and cow's milk proteins are very
similar. It would make sense that they would transfer in similar ways. If a
celiac can't have any gluten at all, then cow's milk from grain-fed animals
is off the list.
Now here's another question. In addition to eliminating all casein and
gluten, part of the GFCF diet therapy to repair the gut for some people
includes supplementation with glutamine, zinc, vitamin B6 and other nutrients
and amino acids found in breast milk. It would make sense to me that by
relactating a woman could provide these, and more benefits, to a child on
this therapy, provided of course, she herself was gluten and casein free.
What do you all think of this?
And while I'm jamming up the digest, one more question. Ruth Lawrence says
"physiochemical differences exist between human and cow caseins. Casein has
a species specific amino acid composition." (p. 117 of her book), but some
peds are telling mothers to discontinue breastfeeding because "casein is
casein". Based on Lawrence, I disagree with this. Am I right?
As you probably can tell, besides breastfeeding, autism (causes, treatments
and a cure) is my other life crusade.
Barbara Ash, MA, IBCLC
Canberra, Australia
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Date: Sat, 27 May 2000 08:03:17 EDT
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: antroposofic
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Gonneke,
<< The use of almond milk for infants is widely recommended in antroposofic
circles. >>
This was not in the AOL dictionary, what does it mean, in case someone else
doesn't know either, I ask here...
Judy LeVan Fram, Brooklyn, NY
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Date: Sat, 27 May 2000 08:42:18 -0400
Reply-To: Lactation Information and Discussion
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Sender: Lactation Information and Discussion
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From: Sharon Knorr <[log in to unmask]>
Subject: Re: Mom with Hypothyroidism
Comments: cc: [log in to unmask]
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Dear Yvonne,
A few comments and questions. This mom is already nursing about 10x a day,=
so I wonder how often you expect her to pump in addition to this? Is=
there any problem with the baby's latch/suck which would decrease his=
effectiveness at the breast? There seems to be a lot of weighing going=
on. How is the baby doing? He sounds pretty normal with some evening=
fussiness - not unheard of in any newborn. How is the overall weight gain=
and development? Why does this mom think that she has a problem to begin=
with? Has her pumping become less efficient with the new pump - perhaps=
she has a pump problem rather than a supply problem.
If baby's weight gain has been very poor (< 3-8 oz/week on average), then=
you may really have a situation here. Thyroid levels may need to be=
tested again, now that her dose has been adjusted. She may need to try a=
different galactagogue or add something like goat's rue, blessed thistle,=
fennel. If mom is experiencing low milk supply in the evenings, suggest=
she make a real effort to relax and put her feet up in the late afternoon=
with a light snack and a drink. Is the baby latching and sucking=
correctly? If baby is sucking well and frequently, then pumping will not=
help much, if at all.
This sounds like a confidence problem with the mom as much as anything.=
What kind of support is she getting in the home? Does she have contact=
with LLL or some other support group? She may be convinced that she will=
have problems because of the thyroid. Or it may be that the baby that is=
contributing, but you are focusing on the mom side of the production=
problem.
Sorry if this seems a bit disjointed. More of my just before bedtime=
musings - just can't seem to resist a little Lactnet before retiring.
Warmly,
Sharon Knorr, BSMT, ASCP, IBCLC
Newark, NY (near Rochester on Lake Ontario)
mailto:[log in to unmask]
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Date: Sat, 27 May 2000 09:05:37 -0400
Reply-To: Lactation Information and Discussion
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From: Sharon Knorr <[log in to unmask]>
Subject: Re: Herbals and BF, any danger?
Comments: cc: [log in to unmask]
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Dear Yvonne,
Throughout this history you keep saying that breastfeeding is going well.=
And yet the baby is getting dehydrated and losing weight and mom is=
unable to nurse on one side due to extreme pain and I am assuming some=
kind of nipple trauma. This does not sound to me like breastfeeding is=
going well. What kind of assessment are you doing? How are the pees and=
poops (without an enema)? What does baby's latch and suck look/feel like?=
Possible newborn sepsis is nothing to fool around with, which is probably=
why the ped is so hesitant to stay in. Giving a 2 day old an enema for=
fever???
Lot's of issues here. Do you have other IBCLCs close by to consult with?=
Get very nervous with those who absolutely will not treat allopathically.=
Be careful.
Warmly,
Sharon Knorr, BSMT, ASCP, IBCLC
Newark, NY (near Rochester on Lake Ontario)
mailto:[log in to unmask]
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Date: Sat, 27 May 2000 14:53:30 +0200
Reply-To: Lactation Information and Discussion
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From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: antroposofic
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Antroposophy is the term used for the thinking concept which was induced by
Rudolph Steiner, who also initiated The Waldorf School
Gonneke
----- Oorspronkelijk bericht -----
Van: <[log in to unmask]>
Aan: <[log in to unmask]>
Verzonden: zaterdag 27 mei 2000 14:03
Onderwerp: antroposofic
> Gonneke,
> << The use of almond milk for infants is widely recommended in antroposofic
> circles. >>
> This was not in the AOL dictionary, what does it mean, in case someone else
> doesn't know either, I ask here...
> Judy LeVan Fram, Brooklyn, NY
>
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>
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Date: Sat, 27 May 2000 14:56:02 +0200
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: Constipation?
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With this green poop baby was
> not happy until it came out and she believes this was also causing her to be
> so fussy earlier in the week. Is there anything that I can tell mom in this
> situation?
Yvonne, maybe this was an allergic reaction of the baby to something the mom had
eaten? Dairy comes to mind or an other kind of protein the mom does not eat
regularly.
Gonneke van Veldhuizen, IBCLC, Maaseik, Belgium
http://www.users.skynet.be/eurolac
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Date: Sat, 27 May 2000 08:18:27 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Becky <[log in to unmask]>
Subject: update on "complicated case"
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The dad called me a couple of days later. Mom was in tears, baby fighting
latching, both baby and mom very frustrated, baby still biting when he did
latch, mom very sore. Suggested they take an "emotional break" for a
couple of days: Mom just pump to allow nipples to heal (also using
hydrogel), and dad to fingerfeed baby. Saw them back yesterday. Dad said
he understood why mom was so sore, because baby had clamped down on his
finger a couple of good times! Anyway, mom's nipples looked and felt
nearly healed, and dad reported that baby had stopped biting. So we
attempted latch, and with some gentle chin pressure and coaxing baby to
open wide by syringe feeding a little first, we got baby on. Comfortably,
for the first time! And baby drank! Mom happy, dad happy, baby happy, MD
happy! Suggested continuing working with baby on opening wider, etc., when
he's NOT so hungry. Will followup with them after to long weekend. You
just never know what will work for some babies.
Becky Saenz, MD, IBCLC
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Date: Sat, 27 May 2000 15:48:53 +0200
Reply-To: Lactation Information and Discussion
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From: The Curries <[log in to unmask]>
Subject: Lactose intolerance
Hi All,
I am off on a Saturday and have just heard that our Paed has told a
mother that her baby has "lactose intolerance" and must go onto AL...
The baby is 2 days old and the mother thought it had "colic". I know that
all newborns fuss when they are passing a stool. Mothers are told that
their newborns are cramping by other staff. What do you all think of
this? I don't agree.
Sincerely,
Barbie Currie RN RM - White River, Mpumalanga, South Africa.
Having the most wonderful winter day here - warm and hazy.
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Date: Sat, 27 May 2000 09:59:38 -0400
Reply-To: Lactation Information and Discussion
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From: Patty Spanjer <[log in to unmask]>
Subject: almond milk
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> I do remember some Drs
>recommending almond milk. This, I think, because it was natural and one of
>the least allergenic.
Having a child allergic to tree nuts, I am having trouble with this
statement. Tree nuts cause a lot of allergic problems. Can someone
explain to me why almonds would be safe for a baby.
Patty Spanjer, IBCLC
Dalton, GA
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Date: Sat, 27 May 2000 09:51:47 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Barbara Wilson-Clay <[log in to unmask]>
Organization: Austin Lactation Associates
Subject: nipple shields-alternate uses
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I have encountered uses for silicone nipple shields that sometimes
capitalize on their potential to create a barrier between the breast and
the baby. This is not typically a desireable thing to do, of course, but in
certain situations, can assist. I have not personally used them for
teething problems because a baby with teeth could probably still hurt the
mother through them as the silicone shields are thin. However, I can see
that it might be worth a thought if all else has failed. I recommend the
Hylands teething preps, having had good success with them personally, but
have no knowledge of the other herbal remedies suggested, and would hesitate
to venture into territory about which I know little. Being an herbalist is
a skill some LCs have been trained in and as such may augment their LC
practice, but it is not within the scope of our practice per se.
Consequently, an LC who lacks such skills might well look to what she has at
hand for a solution. My motto in such situations is: There is more than one
way to be right.
The mother in Chris Hafner-Eaton's situation did what she had every right
to do, which was seek another opinion, and it sounds as if she was very
satisfied by the help Chris provided. Going beyond that specific situation
to the broader discussion of shields, I've found that propaganda that brands
them as unequivicably evil can make it difficult for parents to trust the LC
who occasionally recommends them, even if she has a reasonable clinical
rationale for doing so. And I think that it also inhibits the discussion on
how to use tools when there is such a risk of being criticized if you admit
to trying a new technique. I received hate mail for publishing research
about shields, so I am sensitive to this.
Yesterday I saw a 3 month old baby girl with birth wt.of 6lb5 oz . She had
surgery at 2 weeks for a prolapsed umbilical problem, with good recovery and
normal results on bloodwork evaluations that have been done monthly to try
to discover why she she is growing so poorly. She has not had a swallowing
study, which I am going to recommend if my intervention doesn't work. Her
current weight is 8lb 15 oz. Baby typically goes to breast for about 5 min.
and then pulls off and refuses to nurse any more. She either pulls away
crying or shuts down and goes to sleep. She refuses bottles, finger feeding,
spoon feeding. Her facial tone, reflexes and movement seem normal, as does
her oral anatomy. She is not spitting up. She is responsive, well-attached
to her mother (who is a 2nd time exper. nurser who bfed 1st child 7 mo.)
The baby interacted well with me, making eye contact and smiling. Seems
healthy as per pedi's assessment, just very thin with a clinical dx of
Failure to Thrive.
Watching mom nurse, I was struck by her letdown. She has not been pumping,
and is concerned about low milk supply, yet her left breast sprayed streams
of milk that projected a foot away from her body! Baby pulled off, went
back on briefly, but pulled off a min. later. Breast was still spraying.
Went on; pulled off again. Breast still spraying. Baby fed for approx 3
min. then refused to go back to breast. Test weight indicated she took in
44 ml. At breast, I observed normal nutritive sucking with 16
suck-swallow-breathe bursts prior to a pause, but the baby preferred to
maintain a weak lip seal so that she could spill milk to protect herself.
For many weeks postpartum mom soaked towels across her abdomen to catch
spill from her breasts. Mother reports enough nasal stuffiness that she
uses saline nose rinses every other day to evacuate accumulated debris, so
I'm assuming baby aspirates enough during feeding to require this. Mother
states that what I observed is the typical pattern of a feeding. She feeds
8x/24hrs at a minimum. She normally would have put baby to the other breast
as soon as baby would accept it, for another short feed.
Mom has been well supported by other capable LCs and worked closely with a
very bfg friendly pediatrician. Dr. wanted me to evaluate the situation,
set up an SNS, or find another way to deliver supplemental calories.
However, in my opinion, an enhanced milk flow rate is precisely the opposite
of what this baby needs. She had a terrible time with the bottle (the only
one in the house had a fast flow rate), and wouldn't accept spoon feeding.
She is very wary and aversive of liquid, and tremendously defensive of her
oral space when fluids are involved. She loves to suck on her pacifier,
which I can see is the only safe sucking experience available to her. I
really hate to take this baby away from the breast, which she still accepts,
tho tentatively and briefly -- for just long enough to stay hydrated.
So here is the nipple shield part. I put a nipple shield on the mother to
act as a physical barrier between the spray and the baby, and the baby
relaxed, and willingly consented to nurse again. Weights confirmed she
consumed an additional 35 ml from the breast. This is still a bit shy of
what I would have liked for a feed, but I am going to give this plan a few
days to see whether her acceptance of the breast continues with a physical
barrier in place. If we can get her to nurse longer and better with a $6.00
piece of plastic that protects her from drowning, maybe we can get something
other than foremilk into her. I hope to help restore her trust in the
feeding process, and improve her growth. I am of the opinion this baby's
situation very closely parallels the Woolridge and Fisher article about
over-supply sometimes resulting in FTT at the 3 month mark.
I offer this brief case study as a plea to consider that tools are just
tools, and that often LCs are doing the best they can to try to think
outside the box in their efforts to help a mom.
Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.lactnews.com
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Date: Sat, 27 May 2000 10:55:30 -0400
Reply-To: Lactation Information and Discussion
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From: PrMechell Roberts Turner <[log in to unmask]>
Subject: Hypothyroidism/non compliance
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Yvonne, I agree, mom sounds too eager to bottle feed. I this a possibility
that there is pressure form some where to bottlefeed. I would definitely
investigate the latch and transfer. Maybe give the mom option to supplement
at breast. for many moms it is frustrating to breastfeed, then bottle feed
then pump.
for them it is not just physically frustrating but emotionally.
As far as the herbs go, I find that moms with thyroid problems actually do
really well on dandelion ( 400-600mg caps) 2 or 3 3 times daily. The
dandelion seems to normalize function and helps to with liver function. It
also will help boost milk supply.
hope this helps.
Mechell turner.
-----Original Message-----
From: Automatic digest processor <[log in to unmask]>
To: Recipients of LACTNET digests <[log in to unmask]>
Date: Saturday, May 27, 2000 4:51 AM
Subject: LACTNET Digest - 26 May 2000 to 27 May 2000 - Special issue
(#2000-657)
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Date: Sat, 27 May 2000 17:09:11 +0200
Reply-To: Lactation Information and Discussion
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From: Rachel Myr <[log in to unmask]>
Subject: antroposofic
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Anthroposophers is the word used to refer to followers of Rudolf Steiner.
In N. America the schools which we know as Steiner Schools in Europe, are
called Waldorf schools.
Does this help?
Rachel
Kristiansand
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Date: Sat, 27 May 2000 10:07:08 -0500
Reply-To: Lactation Information and Discussion
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From: Kathy Dettwyler <[log in to unmask]>
Subject: Casein is NOT casein
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Someone wrote:
>Casein has a species specific amino acid composition." (p. 117 of her
book), but some
>peds are telling mothers to discontinue breastfeeding because "casein is
casein". >Based on Lawrence, I disagree with this. Am I right?
You are right, pediatricians are wrong (and it's scary to think that
pediatricians really believe "casein is casein"). That's like saying "milk
is milk" or "blood is blood." Wouldn't want that doctor in charge of giving
me a blood transfusion!
Proteins vary from species to species depending on the amount of time since
the last common ancestor, plus different forces of natural selection and
gene flow and genetic drift operating on the different species once they
have diverged. Hemoglobin is an excellent example. Human and chimpanzee
hemoglobin is almost identical, but not quite, gorillas more different from
humans still, monkeys even more different -- by the time you get to a
comparison of say, horse and mouse and human hemoglobin, they are quite
different -- yet they are still all hemoglobin.
Within human hemoglobin, each molecule is made of two different types of
hemoglobin, alpha and beta, and each functioing protein contains 2 alpha
strands and 2 beta strands. In people who have a *single amino acid
substitution* in the beta protein -- you find sickle-cell anemia.
All proteins are like this, varying to differing degrees from person to
person, and certainly from species to species. Cows are not at all closely
related to humans, and their casein proteins are not identical.
Children sensitive to cows' milk casein *may or may not* be ALSO sensitive
to human milk casein.
Kathy Dettwyler
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Date: Sat, 27 May 2000 11:36:04 -0400
Reply-To: Lactation Information and Discussion
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From: Susan Keith-Hergert <[log in to unmask]>
Subject: pain between feedings, one side only
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Jean Cotterman ventured this guess about the client with unilateral breast pain:
"This might thereby have built up enough oversupply that some one or more
of the ducts was so dilated, and perhaps bordering on inflamed, that some
of the MER's caused the pain. (I seem to remember now that the pain came
between feedings, but MER's do often happen between feedings, as well as
during them."
**************************************************************
Having experienced this myself, I concur that it is a likely cause.
Yes,refilling or MER between feeds can be painful if the ducts are already
overfull (I am speaking first hand here) and I don't believe for one minute that
it always means there is yeast in on board. I have had many women describe
refilling pain to me. The fact that this one particular mom experienced it only
on one side means, most likely, that there was only overfullness, and hence
ductal stretching, on that side. Could be, as Jean says, that the mom has
overstimulated this side. Could also be that this is just one of those normal
variations in production.
Just MHO,
Susan
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Date: Sat, 27 May 2000 11:38:23 EDT
Reply-To: Lactation Information and Discussion
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From: Carol Brussel <[log in to unmask]>
Subject: cow's milk contents
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a friend of ours recently became the VP of marketing for horizon dairy (they
produce only organic dairy products here in the us). they have two people i
can talk to about questions such as do wheat proteins and gluten enter the
cow's milk from their diet. i have a bunch of other questions to ask. i am
very curious to know what they know about cow lactation. obviously much more
is known about cows than humans! but it will have to wait until next week, as
i am off to albuquerque to a wedding. so many people were invited, that if
you are reading this, you may well have been the only person on the planet
who WASN'T invited.
carol brussel IBCLC
any other ideas for questions to ask, email me
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Date: Sat, 27 May 2000 11:45:44 -0400
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From: Susan Keith-Hergert <[log in to unmask]>
Subject: hemangioma and reflux, Nancy's question
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"They are wondering if anyone out there has dealt with severe reflux
and what helped."
Nancy, I think you said this baby is five months old, right? I have worked with
a lot of refluxers and, a common way of helping them keep their food down is to
add rice cereal to it. I don't see why this couldn't be added to the
breastmilk...at five months the babe is probably ready for it anyway. Would mom
be opposed to that? It is the thickening of the bbreastmilk that helps it stay
down and, it would add a few calories without introducing the more allergenic
cow's milk formulas.
Susan Keith-Hergert RN, MS, CPN, IBCLC
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Date: Sat, 27 May 2000 12:03:58 -0400
Reply-To: Lactation Information and Discussion
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From: newman <[log in to unmask]>
Subject: gluten
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Actually there are some studies which have documented the passage of gliadin
(the protein of gluten) into breastmilk.
Troncone R, Scarcella A, Donatiello A, Cannatar P, Tarabuso A, Auricchio S.
Passage of gliadin into human breastmilk. Acta Paediatr Scand 1987;76:453-6
There are other studies which mention allergen avoidance and mention gluten
in the title, but I've forgotten what they say (the mind whithers with age
and constant pounding against brick walls).
Jack Newman, MD, FRCPC
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Date: Sat, 27 May 2000 12:07:57 -0400
Reply-To: Lactation Information and Discussion
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From: newman <[log in to unmask]>
Subject: colic in a 2 day old?
Comments: To: [log in to unmask]
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Oh this is rich. Over to formula at two days because of colic. More likely
the baby just wanted to be on the breast and cried when he was off it, and
when the baby gets more milk at the breast, the colic will disappear, eh?
Of course, the baby getting more milk if he does go over to formula will
quiet right down. Quod erat demonstrandum. The physician will be
sooooooooo proud of his brilliant diagnosis.
Jack Newman, MD, FRCPC
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Date: Sat, 27 May 2000 13:10:41 EDT
Reply-To: Lactation Information and Discussion
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From: Barbara Latterner <[log in to unmask]>
Subject: relactation
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First of all, thanks to all who responded to my request for suggestions to
help mom who's relactating due to her baby's allergies! An update: baby
took the breast this am with SNS, after minimal fussing, according to mom.
Took both breasts, approx. 2 ozs from SNS each, total 4 ozs. Later took only
one breast with SNS, then refused to relatch; mom plans to try again.
Cautioned her re forcing baby to take but first congratulated her for this
big success! She is seeing another Ped, BF friendly and knowledgeable, and
has baby on Nutramagen and Alimentum, though giving Nut. as baby doesn't like
tast of other but says Ped suggested mixing to cover taste of one baby
refuses(she hasn't done this yet. She is pumping every 2 hrs with double
elec. and sl increase in drops obtained, they now go down to bottom of
container; she feels MER, as well. Reglan use is being tapered after two
weeks 30 mg/day; also taking hops, m. milk tea (not my sugg) and due to her
environmental allergies afraid to try capsules of fenugreek(I sugg not to)
nor bl thistle (I sugg she try).
Ped states, according to mom, that he is reluctant to use banked milk as
supplement because tho screening done, Hep B and C can come up false neg if
mom just contracted within less than month of when she donates. My
question-is this accurate? I couln't find info re this in texts on
lactation. I'd like to know so I can talk with him after the holiday. He
told mom he'd consider human banked milk as last resort if formula causes
prob and mom still in process of relactating.
Appreciate your input. Any other resources where I could look? Thanks!
Barbara Latterner
Brewster, NY
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Date: Sat, 27 May 2000 13:31:56 EDT
Reply-To: Lactation Information and Discussion
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From: Barbara Latterner <[log in to unmask]>
Subject: Re: LACTNET Digest - 27 May 2000 - Special issue (#2000-658)
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re Barbara Wilson-Clay's post on nipple shield use. Thank you, Barbara! I
used nipple shield with relactating mom because baby had not been on breast
in over 2 mos, she had flat nipples and SNS was on breast underneath the
shield (have done this before with good results). This did work and baby
took several min of feeding this way where he wouldn't go near breast without
the shield. I just wanted mom to experience baby at breast again, thought it
might work and help to speed relactation process by having baby at breast,
even with a shield. As it turned out, mom didn't like shield and so didn't
use it again. I use shield's rarely, but find if baby won't/can't latch any
other way, at least it keeps baby at breast with a pos experience of getting
food from breast (also, have not had difficulty weaning from shield as always
working with mom until baby on bare breast).
I feel it's important to try techniques, tools, whatever it takes and
communicate to moms one's willingness to do so and go the extra mile with
them as this increases their confidence in "can do" attitude and that it can
just be a case of perseverence. Hope I'm making sense; just felt I wanted to
respond to Barbara's post in agreement and respect for her approach.
Barbara Latterner
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Date: Sat, 27 May 2000 14:39:18 EDT
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: different paths/same goal
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Barbara writes:
<< I offer this brief case study as a plea to consider that tools are just
tools, and that often LCs are doing the best they can to try to think
outside the box in their efforts to help a mom. >>
One thing that struck me immediately about this situation, is that whoever
suggested the shield to the mom with the nursing baby, did the one thing we
all try to do, she solved the problem! The problem with the solution was that
is was not acceptable to the MOM. I wonder if the mom told the first LC this,
actually. Here is where our profession gets trickier than any other I can
think of - there are, as has been mentioned, often several ways to get to a
breastfeeding goal, and sometimes it comes down to solving with what is in
our personal arsenal, as well as what our professional skills are. Some moms
and some LCs are not aware of homeopathics and so they are not "available" as
solutions. Maybe there would be later problems from the shield as solution,
maybe not. After all homeopathics are an intervention too, but are more
acceptable as intervention than shields for a variety of reasons, some of
them scientifically- based, and some cause we just might feel that way... I
guess because I have so little experience, I often ask myself "under what
cirsumstances would I have suggested the same?" and see what I can learn from
that. I really appreciate this forum for its case-specific scenarios as well
as its potential to move out into wider philsophical discussions.
Thanks, publicly, to all who participate,
Judy LeVan Fram, Brooklyn, NY
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Date: Sat, 27 May 2000 13:52:38 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Barbara Wilson-Clay <[log in to unmask]>
Organization: Austin Lactation Associates
Subject: baby with FTT
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More on the baby with FTT and the mother with the overactive letdown. The
baby has been willing to stay at the breast much longer for feedings with
the shield. She resists less when put to breast, and there is some reason
to be encouraged about that. However, the amount of time spent in
non-nutritive sucking still exceeds the time spent nutritively sucking, and
the diaper vols are still low after 24 hours of this plan. I read up on the
possible adverse sequelae of surgery for Meckels diverticulum (the umbilical
prolapse baby had surgery for on Day 10 pp). Bowel blockage is a
possibility. I have requested a swallowing study to rule out damage from
intubation during surgery, since baby gained back to birth weight by Day 10
and growth probs are subsequent to surgery. I am sure the pedi has already
considered the possibility that a bowel blockage may be the underlying
issue, but I will make sure my report highlights that the supply is not the
problem -- baby is unwilling to feed and is deliberately liminting intake.
Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.lactnews.com
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Date: Sat, 27 May 2000 16:01:27 -0400
Reply-To: Lactation Information and Discussion
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From: Stephen Curless <[log in to unmask]>
Subject: complicated case:dehydrated/herbs
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Yvonne:
I am very concerned that several issues are not being addressed. Nursing
is not going well when nipples are very sore, weight loss is below 10%,
newborn sepsis is being ignored, and enemas are given to tiny newborn in
this way. Newborn sepsis is indeed a very serious issue not to ignore.
Mom needs to work with a pediatrician and IBCLC to correct the latch
problem. Where are the wet & poops? dehydration must be addressed
asap. Helen Curless,RN,IBCLC
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Date: Sat, 27 May 2000 16:02:23 EDT
Reply-To: Lactation Information and Discussion
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From: Jennifer Cox <[log in to unmask]>
Subject: Re: Almond "Milk"
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My only experience with this was more than 5 years ago, when I was practicing
in Chicago. I had a young patient (can't remember exactly, but certainly less
than 6 months), who had lost over a pound in-between well child visits. Mom
was feeding him a bottle of what looked to me like expressed breast milk, but
it turned out that she had been exclusively feeding him "almond milk"-made as
described in previous posts, but with some seaweed added, for at least
several weeks. The baby had severe electrolyte disturbances (Sodium was
around 120), and an awful eczematous rash. Nutritionally this concoction is
not adequate for exclusive feedings! I don't know about occasional use, but
as previously noted, Mom has other, better options.
Jennifer Cox
pediatrician in sunny Salt Lake
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Date: Sat, 27 May 2000 13:18:40 -0700
Reply-To: Lactation Information and Discussion
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: FW: breast milk popsicles
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----------
From: "Chris Hafner-Eaton" <[log in to unmask]>
To: [log in to unmask]
Subject: breast milk popsicles
Date: Sat, May 27, 2000, 1:18 PM
Yes, Gretchen...I did suggest these. She tried it. My problem is actually
not the mom/baby (we've solved their issues). It is the other IBCLC who
thinks my methods are ridiculous. Her one and only suggestion was to use
the shield. Thanks for your thought and input though.
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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Date: Sat, 27 May 2000 13:24:26 -0700
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: Chris Hafner-Eaton <[log in to unmask]>
Subject: constipation/green stool
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Yvonne: I have several thoughts on this...I'm not sure I'd call this
constipation per se. It could be a maternal diet of cow-milk protein
allergy manefesting as infrequent stools and green (where they stringy and
foul smelling also?) Another possibility is a foremilk-hindmilk imbalance.
Is the baby nursing sufficiently long enough on a side to reap the benefits
of post let down milk? Green stools can be the result of excess lactose
from too much foremilk. I would also query the mom to find out if she's
giving anything such as iron supplements or lactose based homeopathics (this
is because the lactose is derived from cow milk and in sensitive babies it
will trigger allergy).
There are babies who stool very infrequently when they are going through a
growth spurt; although the green stools somewhat rule this out.
I hope this helps.
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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Date: Sat, 27 May 2000 13:33:03 -0700
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: Chris Hafner-Eaton <[log in to unmask]>
Subject: herbs in young babies
Comments: To: [log in to unmask]
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Yvonne: You didn't direct this to me, so I'm not sure if you want my
opinion, but I'm going to give it anyway (sorry if you don't want it). I am
VERY leary of giving herbs to babies under 6 months (YES, this really is
Chris H-E writing) because I consider them to be foods and I don't recommend
foods for babies under 6 mo either. I do employ herbs liberally in older
babies and adults, but I always start out with very small test doses (this
is an essential recommendation to anyone who wants to use herbs), AND I make
sure that I know the herbs are from a reliable source (no pesticides,
fungicides, herbicides; guaranteed potency, dosage, and dated for
freshness--not all herbs are created equally and the gov't does not regulate
these aspects). Now, there is an alternative which IS completely safe...try
homeopathics. I have had great success using homeopathic preparations in
very young babies and even in premies. Here in Oregon, there have been
numerous cases of allergic reactions to herbs with young babies, not to
mention the possibility of delayed reactions.
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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Date: Sat, 27 May 2000 13:41:02 -0700
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: Chris Hafner-Eaton <[log in to unmask]>
Subject: teething preparations
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The NSP (Nature's Sunshine Products) teething preparation contains:
Chamomilla 3x, Natrum phosphoricum 3x, Calcarea Carbonica 6x, Kali
Phosphoricum 6x, Staphysagria 6x, Kali Sulphuricum 12x, and other
ingredients in a vegetable glycerine base. The Hylands tablets have
chamomilla, belladonna (please no one panic, remember these are in in
homeopathic titrations), and several other things but I don't have a bottle
here.
I'd still take your long list. The mom and baby are doing fine. It's the
other IBCLC that I need this for. Thanks again.
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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Date: Sat, 27 May 2000 16:42:08 EDT
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Cheryl Parrott <[log in to unmask]>
Subject: febrile baby in CA
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Here is my 'nurse brain' screaming loudly over my lactation part. This child
needs to be treated. So many early warning signs, wt loss, fever early on,
+strep in mom, possible, if not probable +cultures in baby. Even wth
breastfeeding and herbs this little ones immune system just isn't up to par
and needs to be treated. I would strongly encourage mom to treat, even as
outpatient. Good luck, it sounds as if things might get worse before better.
Carefully...
Cheryl Parrott RN, BSN, aspiring IBCLC
Kokomo, IN
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Date: Sat, 27 May 2000 13:53:42 -0700
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Chris Hafner-Eaton <[log in to unmask]>
Subject: lactose intolerance
Comments: To: [log in to unmask]
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Barbara: Lactose intolerance is EXCEPTIONALLY rare in newborns (think about
it, it would literally have meant death to our species if this was common).
It is entirely possible though that the baby is allergic to cow-milk protein
(see my prevoius post about the baby with green stools). Solution would be
to remove all cow-milk related products from the mom's diet. But before
going to even this extreme (and to do this right, it really is extreme), I
have other suggestions. How about teaching the mom (and the staff) infant
massage. The I Love You pattern on the abdomen works very well. I've
had enormous success with this with colicky babies. The use of
simethicone-based products (Phazyme or Mylicon in the US) works very well
for excessive gas and it is not absorbed across the intestinal membrane.
Homeopathic colic drops are useful (there are a variety of both simple and
compound formulas available here--let me know if you need actual
constituents). Even something as simple as skin to skin contact and baby
wearing can reduce the symptoms of colic. Any doctor who jumps to formula
this fast is sacrificing breastfeeding unnecessarily without fully exploring
the options available. 'Stepping down from that BIG soap box.
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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Date: Sat, 27 May 2000 13:58:50 -0700
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Chris Hafner-Eaton <[log in to unmask]>
Subject: thanks for input
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Barbara: Thank you for that detailed and thoughtful reply to my question
about the consensus on older babies and teething. I absolutely agree that
there's more than one way to be right. The other IBCLC was accusing me of
not practicing "the standard of care" because I DIDN'T suggest a sheild! At
this point, I'm just trying to gather a variety of ways that LNers approach
this particular problem. The mother and baby are doing fine with the
suggestions I made. This is very much an academic discussion. BTW, I'd
love to see the article that inspired hate mail (I promise not to add to the
mail).
-- Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
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Date: Sat, 27 May 2000 17:49:06 EDT
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: [log in to unmask]
Subject: resource
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Dear Friends:
People on LACTNET often ask about books or videos or software. Please
remember that the Journal of Human Lactation carries reviews of all the
latest materials in various media. So check out JHL for reviews of books,
videos, or software. And soon, websites may be reviewed!
Warmly,
Nikki Lee RN, MSN, Mother of 2, IBCLC, CIMI, CSTP
Elkins Park (a suburb of Philadelphia, Pennsylvania; northeastern USA)
supporter of the WHO Code and the Mother Friendly Childbirth Initiative
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Date: Sat, 27 May 2000 17:55:45 EDT
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: [log in to unmask]
Subject: Re: LACTNET Digest - 26 May 2000 (#2000-656)
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Dear Friends:
I just checked this poll and saw that 45% of respondents are planning to
breastfeed two years or more! It is at:
http://polls.yahoo.com/public/archives/26709218/p-pa-38
How many of us have taken this poll? I put down two years or more, even
though I am done with childbearing.
Warmly,
Nikki Lee RN, MSN, Mother of 2, IBCLC, CIMI, CSTP
Elkins Park (a suburb of Philadelphia, Pennsylvania; northeastern USA)
supporter of the WHO Code and the Mother Friendly Childbirth Initiative
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Date: Sat, 27 May 2000 18:14:12 EDT
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: [log in to unmask]
Subject: Re: reflux
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Susan:
there is absolutely nothing in the literature to substantiate thickening of
feeds. there is absorbtion of nutrients although there is the apearance of
the majority of the feed being returned. I would only add those foods that
were approriate and that the baby is willing to eat at this time. these
children are often very sensitive eaters.
Patricia
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Date: Sat, 27 May 2000 15:57:08 PDT
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: laurie wheeler <[log in to unmask]>
Subject: lactose intol in 2 day old
Comments: To: [log in to unmask]
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My first thought is that the baby is fussy, crying, and having problems
stooling due to lack of milk. I think the bf needs to be evaluated so that
the baby is assured of getting the milk out. I don't agree with the lactose
intolerant thing, but the formula marketers are getting to lots of people.
Laurie Wheeler, RN, MN, IBCLC
Violet Louisiana, s.e. USA
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Date: Sat, 27 May 2000 19:29:44 -0400
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Jeanette Panchula <[log in to unmask]>
Subject: professional disagreement vs. disrespect
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Barbara said:
I've found that propaganda that brands
them as unequivicably evil can make it difficult for parents to trust the=
LC
who occasionally recommends them, even if she has a reasonable clinical
rationale for doing so. And I think that it also inhibits the discussion=
on
how to use tools when there is such a risk of being criticized if you adm=
it
to trying a new technique.
This same attitude is important to re-consider whenever we are discussing=
another professional's choices of recommendations about a lot of things..=
.
As we were not there during the visit, we don't know why the previous
professionals chose this course of action. It is amazing how different a=
mom/baby will behave from one day to another (in fact, from one hour to
another). =
I have been in to see moms in hospital, seen a few others, come back, and=
found totally different behaviors in baby (no tongue thrusting to LOTS of=
tongue thrusting, arching baby to relaxed baby, etc...) and mother. =
I have had Public Health Nurses call me from mom's home and describe one
thing - then we visit the next day and things are different. I choose NO=
T
to BLAME the PHN, but to agree with her that things are different - and
that NOW we may want to try... thus and so...
Having been in a job where I saw moms other LCs had seen previously, we
agreed to follow whatever course the first LC chose UNLESS we saw it was
obviously not working - then we would NOT criticize the previous LC
(thereby making the mom feel she's stuck between two professionals who
can't make up their minds, so how can she know who is right), but to say:=
well, why don't we try this now... it seems this other course has done as=
much as it can, and now we need to try this step. =
I don't consider this being "untruthful" - we have no idea what the first=
LC or professional saw. We only can go forward from this place in time. =
=
Of course I am not speaking about hiding unethical or dangerous behavior.=
=
I am speaking about the multiple choices that different professionals may=
choose, any of which may be appropriate based on his/her experience and
what they saw at the time...
Jeanette Panchula, BSW, LLLL, RN, IBCLC
Vacaville, CA
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Date: Sat, 27 May 2000 19:41:10 -0700
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Ann Calandro <[log in to unmask]>
Subject: Antidepressant, Zelexa
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I just searched the archives for information on Zelexa, or Zitalopram. =
Couldn't find it there or in the latest Hale.
It is a new antidepressant. Mom of a one month old was prescribed this =
for postpartal depression, and wants more information before starting =
it. Did talk to her about Paxil and Zoloft, but MD gave her a bunch of =
free samples of this one, and she wants to know more. Anybody know =
anything about this one?
Ann Calandro, RNC, IBCLC
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Date: Sat, 27 May 2000 19:30:51 EDT
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Kathy Boggs <[log in to unmask]>
Subject: Dehydrated, possibly septic infant
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This is my first post, so let me introduce myself. I am an RN, IBCLC working
in the lactation center of a large teaching hospital south of San Francisco.
I have many years of experience working as a NICU nurse and have had a
special interest in breastfeeding issues of premies. The lactation
consultants in our hospital cover post partum, NICU, Intermediate Intensive
Care Nursery and mothers and babies who have been readmitted to either adult
floors or to the children's hospital. We have an outpatient practice as
well. In regards to this infant whose mother has a history of Group B strep
and has tested positive for Staph, it is imperative that s/he recieve medical
care immediately. Infants who are septic may show only soft signs such as
poor feeding and lethargy. A temperature in a newborn always warrents a
further workup. This baby is showing signs of being sick. I have had the
unfortunate experience in the NICU of seeing babies die of overwhelming
sepsis and it can happen quickly. I would use all of your powers of
persuasion to convince this mother to get the baby to the hospital and if
this doesn't work a call to CPS (Child Protection Services) may be warranted.
I understand the difficult situation you are in but this baby needs medical
care. Perhaps a call to the pediatrician who can access CPS and make them
understand the importance of quick action would be helpful. Sorry my first
post is so long.
Kathy Boggs, RN,BSN, IBCLC
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Date: Sat, 27 May 2000 18:59:07 CDT
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Sharon Samuels <[log in to unmask]>
Subject: Re: Antidepressant, Zelexa
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Ann--
The anti-depressant med is spelled Celexia, not Zelexa.
Sharon Samuels
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Date: Sat, 27 May 2000 21:30:34 -0300
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Ron and Amanda Surbey <[log in to unmask]>
Subject: Re: Pregnancy Info in USA please
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I can talk to you about this -- I'm not a midwife or LC, but I have had a
child in an American hospital and can describe the wide range of options
available.
Although I don't care for it, the book "What to Expect When You Are
Expecting" is considered by many to be the birth Bible. I think it is an
accurate description of what many American women expect and ask for. I
prefer the books by Dr. Sears (The Pregnancy Book, The Birth Book) as
well-balanced discussions of what one can have to choose from.
In general, any type of birth experience is possible in the US. One must do
one's homework, research what is in one's community, make decisions based on
budget and one's health history, etc. Personally, my birth was in a
hospital, but it was a very pleasant surprise. In the US one can usually
decline (by signing forms) any procedure. A polite "No thank you" will often
eliminate interventions. But one must know what to expect and be prepared to
make these decisions.
A birth plan, albeit a brief one, is a good place to initiate a discussion
with one's healthcare provider. It is really important to ascertain the
HCP's c-section rate, induction rate, episiotomy rate. How to they define
and handle late babies. AND, it is never too late to change providers.
NEVER.
Hope this helps.
Best regards,
Amanda Surbey
Buenos Aires, Argentina
[log in to unmask]
A vivir que son dos dias.
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Date: Sat, 27 May 2000 21:24:21 EDT
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Judi Hall <[log in to unmask]>
Subject: Re: fenugreek during pregnancy
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I was on the phone with a woman expecting her third child. She has not been
successful with her first two. Of course there could be insufficient
glandular tissue, but there are plenty of things that could have contributed
to low milk supply. She had no help with the latch and thinks the babies
were never on well as her nipples were cracked and bleeding. She asked for
help ahead of time and I outlined the help we could give. She asked if there
were anything she could do before the baby came and I thought I would check
with the experts on lactnet as well as the "Guru," Dr. Newman. Would
fenugreek be of any help/harm before the baby is born? Is there anything
else you all would recommend?
Judi Hall,
(dare I say RNC) IBCLC
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Date: Sat, 27 May 2000 18:27:48 -0700
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: criticising other IBCLCs
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Jeannette: I have to clarify that I didn't criticise the first IBCLC. This
mom came to me because she was unhappy with only being given one option (the
shield) which SHE considered unacceptable. I never said "Boo" about the
shield or the other LC, and in fact I said it (the shield) was and would
remain an option should she change her mind. This mom wanted nothing to do
with the shield or the other LC after I presented what SHE considered to be
a more palettable option (the long list I posted yesterday including
massage, baby-wearing and homeopathic teething drops). My follow-up with
the other LC is what prompted me to post regarding the "consensus" for
managing teething 9 month olds who are sliding down the nipple and getting
furiously frustrated with engorged gums. My biggest problem with the shield
in this case is that it only treats a symptom and not the underlying
problem. This baby needed some relief from what was obviously horrible
pain. The mom did not want to use Ibuprophen, but had tried Tylenol
(unsuccessful). The first LC was the one who was "shocked" (her words) that
I didn't "insist" she try a shield. BTW, I have never insisted that a
patient do anything, so we clearly have a gap in practice styles. Thanks
for your input.
Warmly,
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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Date: Sat, 27 May 2000 21:47:43 EDT
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: [log in to unmask]
Subject: nipple sheild/ standard of care
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Chris wrote:
<< The other IBCLC was accusing me of
not practicing "the standard of care" because I DIDN'T suggest a sheild! At
this point, I'm just trying to gather a variety of ways that LNers approach
this particular problem. The mother and baby are doing fine with the
suggestions I made. This is very much an academic discussion. BTW, I'd
love to see the article that inspired hate mail (I promise not to add to the
mail). >>
Egads, Chris, where is there any standard of care that would suggest that a
nipple shield is the only way to help a mom and baby nurse through teething?!
Sheesh...
As for the hate mail, we all saw those nipple shield pieces that Barbara
wrote in JHL Im sure - it just seemed to us they were thoughtfully-written
articles, and not anything to inspire hate mail....sheesh again...and I like
how Jeanette summed things up as :
"Having been in a job where I saw moms other LCs had seen previously, we
agreed to follow whatever course the first LC chose UNLESS we saw it was
obviously not working - then we would NOT criticize the previous LC
(thereby making the mom feel she's stuck between two professionals who
can't make up their minds, so how can she know who is right), but to say :
well, why don't we try this now... it seems this other course has done as
much as it can, and now we need to try this step. "
Bravo!
Judy LeVan Fram, Brooklyn, NY
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Date: Sat, 27 May 2000 22:05:00 -0400
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: "J. Rachael Hamlet" <[log in to unmask]>
Subject: Celexa (was: "Antidepressant, Zelexa")
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The name of the drug is "Celexa", generic name "citalopram" and
there are some notes about it on Dr. Hale's website, as well as a
full review in the 1999 edition of Hale's. To read the website notes,
go to: <http://neonatal.ttuhsc.edu/lact/> and click on "Medications
and Breastfeeding Forums". You can register or enter as a guest,
then search on "Celexa".
Rachael Hamlet
On 27 May 2000, at 19:41, Ann Calandro wrote:
> I just searched the archives for information on Zelexa, or Zitalopram. Couldn't find it there or in the latest Hale.
> It is a new antidepressant. Mom of a one month old was prescribed this for postpartal depression, and wants more information before starting it. Did talk to her about Paxil and Zoloft, but MD gave her a bunch of free samples of this one, and she wants to know more. Anybody know anything about
this one?
>
> Ann Calandro, RNC, IBCLC
>
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Date: Sat, 27 May 2000 22:40:48 -0400
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: Jeanette Panchula <[log in to unmask]>
Subject: criticising other IBCLCs
Comments: To: Chris Hafner-Eaton <[log in to unmask]>
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I did not mean you had - I am just "hearing" a lot of ciriticism of what
LCs have chosen to do when they post a problem..
such as "why didn't you" or "the usual treatment is"
This was not a post directed at you at all. Sorry if the timing made it
seem that way!
Jeanette Panchula
Vacaville, CA
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Date: Sat, 27 May 2000 23:48:00 EDT
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Jennifer Tow <[log in to unmask]>
Subject: Re: almond milk
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In a message dated 5/26/00 6:40:33 AM, [log in to unmask] writes:
<< but almond milk, what's the point? After all this baby
is 5 months old. I don't remember how long the mother was going to be away
from her baby, but if it is more than a day or two, almond milk is not a
decent substitute for breastmilk. And if it is just a feeding or two,
expressed milk should be fine. >>
Jack,
I absolutely agree w/ you. I just assumed we would all agree that the mother
would do best to take the baby with her and the next best choice is EBM. From
the post, I also gathered this was not an extended separation. So, I
responded based on the possibility that the mother did not choose to express
her milk (although it would be a whole lot quicker than making almond
milk!---oh vey!).
Jennifer Tow, IBCLC, CT, USA
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Date: Sat, 27 May 2000 23:57:08 EDT
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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Subject: Re: criticising other IBCLCs
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If we don't support one another and learn from each other we won't have to
worry about the future of our profession - we'll succumb to internal
injuries. LC's as a group are only as strong as our weakest link, so we need
to mentor one another, share what works and communicate with as many others
in our field as we can - just like we do here in this wonder forum of
Lactnet. Unfortunately, many of the people who could use this daily infusion
of wisdom and sharing are not a part of this group. We still need to be
respectful and mutually supportive.
This is especially difficult to do if one is dealing with a really
bone-headed move by someone who doesn't seem to know what they are doing!
But if we say anything to discredit the other person we weaken the overall
perception of our profession and everybody in it. It is very difficult to
try to bridge those gaps by reaching out and talking to another practitioner
and encounter their hostility and refusal to dialog. Sometimes it takes more
than one pass to create enough rapport to begin to dialog and sometimes it
just doesn't work. But we really need to make a concerted effort to be
mutally supportive and not fight amongst ourselves.
The comment that there are many paths to the same end is very true. Each of
us looks at the problems moms and babies present to us through the lens of
our own experience, training, personality and current state of mind. We
ourselves might use a totally different approach to the same exact problem if
the mothers or babies personalities were different. The positive support
that has been expressed on this thread has been wonderful! The growing pains
that our profession is experiencing are mandatory to continue that growth. A
case of no pain, no gain?
Wonder what the OT's and PT's had to go through in the beginnings of their
fields' struggle for autonomy and recognition? Maybe we could learn
something about what works (and doesn't work) by looking them.
At any rate, mutual respect and cooperation are the best strengths we can
offer one another. This didn't start off as a soap box stand...
My 2ccs seems to have gotten larger than intended.
Humbly,
Gretchen Andrews, BA, IBCLC
private practice, Redlands, So CA, USA
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Date: Sun, 28 May 2000 00:04:07 EDT
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Jennifer Tow <[log in to unmask]>
Subject: Re: almond milk
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In a message dated 5/27/00 10:02:52 AM, [log in to unmask] writes:
<< Having a child allergic to tree nuts, I am having trouble with this
statement. Tree nuts cause a lot of allergic problems. Can someone
explain to me why almonds would be safe for a baby. >>
Almonds are a fruit, not a nut. More people are allergic to cow's milk and
soy than to nuts. They are not safe for babies, but are recommended routinely.
Jennifer Tow, IBCLC, CT, USA
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Date: Sun, 28 May 2000 03:45:21 EDT
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Sarah A Osgood <[log in to unmask]>
Subject: Re: Human Milk Bank Testing
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Barbara -
I am not sure about false negatives with Hep testing, but I do know that the
milk banks screen their moms repeatedly and also pasturize their milk. I
would consider this a much safer risk than those associated with formula!
Sarah Osgood, slowly learning with all my eavesdropping...
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Date: Sun, 28 May 2000 10:59:51 +0200
Reply-To: Lactation Information and Discussion
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From: Gonneke van Veldhuizen-Staas <[log in to unmask]>
Subject: Re: fenugreek during pregnancy
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> Judi Hall asked: Would
> fenugreek be of any help/harm before the baby is born? Is there anything
> else you all would recommend?
I think I'd encourage this mom to visit a mother support group (like LLL) during
pregnancy as well as give her factual information about good lactation
management. Then see her asap after delivery and follow up in the first days. I
wouldn't start on galactogogues before other factors have been ruled out.
Visiting a MSG would be very beneficial for this mom, so she'll see
breastfeeding practiced and get emotional support.
Gonneke van Veldhuizen, IBCLC, living in Maaseik, Belgium
http://www.users.skynet.be/eurolac
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Date: Sun, 28 May 2000 06:29:07 EDT
Reply-To: Lactation Information and Discussion
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From: Diane DiCarlo <[log in to unmask]>
Subject: Any new info on Effexor?
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Hello all,
I'm working with a mom who is succesfully breastfeeding her seven month old,
but is suffering debilitating PPD and not responding to Zoloft. She also has
a four year old child, after whose birth she experienced PPD, and she was
helped then only by Effexor. She's like to begin taking it again, but her
doctors are advising her to wean in order to do so.
I've checked the archives, my copy of Hale, and made a few phone calls, but
the info on Effexor seems to be pretty scanty. Tho Tom Hale posted some
useful studies a while ago, I've been unable to locate much information on
the drug, and was hoping that one of you might know of some additional
information that could help this mom make a decision she can be comfortable
with.
The mom wants very much to continue breastfeeding, but she also feels that
her current state of depression and anxiety is interfereing with her ability
to function. After fighting the depression off for seven months in an effort
to continue breastfeeding her daughter and getting no relief from Zoloft,
she's at the end of her rope. We've discussed the unknown and apparently
undemonstrated risks of Effexor vs. the known and proven risks of formula,
but the info on Effexor is so scanty as to make an informed decision
difficult.
Any information or experiences would be welcome. Thanks!
Diane DiCarlo
LLLL
Brooklyn, NY
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Date: Sun, 28 May 2000 08:25:45 -0400
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: newman <[log in to unmask]>
Subject: citalopram
Comments: To: [log in to unmask]
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This drug is actually in Hale. The information suggests it would be an
acceptable drug but not as good as sertraline (Zoloft) or paroxetine
(Paxil).
Having free samples to give to a patient is *not* a good reason for using a
particular drug. If she stays on this drug, she will likely pay more in the
long run, because the newer the drug, generally the more expensive it is
(not always, but generally). So forget the free samples and get a drug
which we are more comfortable with.
Jack Newman, MD, FRCPC
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Date: Sun, 28 May 2000 09:16:42 -0400
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Susan Hergert <[log in to unmask]>
Subject: thickening with rice cereal for a five month old, tube fed,
seriously ill baby.
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Pat,
I think you need to look at the case study to which I was responding.
This is a baby with internal hemangiomas who is trached and being fed
with a G-tube (or NGT). He is five months old and now he has developed
such severe reflux that he is not gaining. Let's not be rediculous
about applying "rules" to
everyone. This is not a normal baby. My point was that, were he able to
eat, he may well be able to take Rice Cereal...and it is less allergenic
than the other options available. I figured I might get lambasted for
this. LOL. Hey, this might be one of those cases where being a pediatric
nurse as well as an
IBCLC might come in handy.
Susan
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Date: Sun, 28 May 2000 22:29:00 +0800
Reply-To: Lactation Information and Discussion
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From: Kirsten Blacker <[log in to unmask]>
Subject: teething
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OK, I'll be brave and post again!
This is purely personal experience
When my first son was teething at 5mo and started biting, I made icecubes of
EBM and gave them to him in a clean handkerchief to suck on. He liked the
taste better than plain ice cubes, and it did the same trick of soothing the
gums before a feed.
Boy,the feeling of those icey gums on my nipples tho!
Kirsten Blacker
RN RM
Mum to two BF boys
Australia
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Date: Sun, 28 May 2000 10:33:11 EDT
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Brain preparation instead of nipple preparation
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Judi says that an expectant 3rd-time mother << asked if there
were anything she could do before the baby came >>
YES! She can learn.
She can learn a lot about bf, both her side (how breasts work) and her babies
side. (
how babies' suckling works). She can get a really good book (maybe
Bestfeeding?) or some good, not-dated handouts with helpful pictures, to try
to understand what better latch would look like. She can try to figure out
as best she can what problems she may have had the last time -- poor latch
only from poor technique? What's her kids' oral anatomy look like? What was
her feeding pattern like? And she can learn what support is available to
her -- not only professional support, like you, though its great she has you,
but also who will do her laundry? When and where does LLL meet in her
neighborhood? etc etc etc.
All obvious, I know, but so often we are asked for "technical" solution,
even in advance, when fixing the head may be as important or more so than
fixing the anatomy.
Elisheva Urbas, NYC
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Date: Sun, 28 May 2000 10:47:55 EDT
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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From: Jennifer Tow <[log in to unmask]>
Subject: Re: Herbals and BF, any danger?
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In a message dated 5/27/00 3:17:51 AM, [log in to unmask] writes:
<< Mother refused to admit the baby. She took him home.
Continues to breastfeed baby and begins treatment for baby of 12 drops of
Echinecea and 10 drops of V-DC for the baby and Comfrey 2 dropper fulls for
herself since Comfrey goes through the breastmilk which will also take care
of the baby. >>
Yvonne,
I have to say I agree w/ Chris on this one. Speaking as someone who has used
allopathic drugs in only *one case* for all of my children in 11 years, I am
not comfortable w/ giving herbs to newborns, either. When I have treated my
young babies herbally, it has been through my own milk, and even then very
carefully and rarely. However, like Chris, I have used homeopathy from the
earliest weeks w/ my babies, if needed. I would recommend she try a homeopath
vs an herbalist, esp if she can find an MD. BTW, I do not any naturopath who
would be so unconcerned about this baby (have you had permission to speak to
this naturopath directly to express your concern?)
<Yvonne wrote:
<I saw mother again on Wednesday. Breastfeeding was going well. Baby looked
good. Mother could not nurse on R due to pain. I lent her a pump so that
she could give that side a break and continue to nurse on L. Mother felt
good and was doing well.>>
<<I see baby again today. Baby has now weighs 8 lb which means he has lot
more than 10% of birth weight. I leave strict instructions that mother needs
to feed
baby every 1 hour, keep him skin-to-skin, nurse him every 2 hours at night
and should not go more than 2 hours without nursing. >>
Sharon responded:
<<Throughout this history you keep saying that breastfeeding isgoing well.
And yet the baby is getting dehydrated and losing weight and mom is unable to
nurse on one side due to extreme pain and I am assuming some kind of nipple
trauma. This does not sound to me like breastfeeding is going well>>
I have the same thoughts--it does not sound like bf has ever been going well
with this baby. When bf is going well, the baby does not lose so much weight,
mom does not have to wean baby from one side, etc. Have you considered a
supplementer w/ EBM at the breast?
<< Mother gets a call from Dr. in ER, baby has tested
positive for Staph. Need to readmit baby to hospital. Mother tells him she
will take him to another hospital. Dr. is not happy and tell her she will
call the cops. In the meantime she calls her midwife and her pediatrician
(for this baby). Midwife tells her not to worry, cops will probably not be
called. Pediatrician tells her to take the baby to another hospital for
another opinion. Cops show up, do not report because they see no reason to.
I get there and hear the story. Nursing is going well although mother cannot
use her R due to pain. Mother does not want to take baby to hospital due to
fear of having to readmit and possible use of antibiotics. After my
suggestion, mother decides to take baby to pediatrician the next day.>>
<snip>
Pediatrician fines no problem with the baby, but will not continue with her
services to mother due to mothers desire to use herbs for treatment. The
Echinecia and V-DC should be given to the baby after breastfeeding or with
breastmilk. Mother is to supplement baby after nursing with pumped
breastmilk. I will weigh the baby tomorrow morning. >>
.
Carol wrote:
<<Here is my 'nurse brain' screaming loudly over my lactation part. This
child
needs to be treated. So many early warning signs, wt loss, fever early on,
+strep in mom, possible, if not probable +cultures in baby. Even wth
breastfeeding and herbs this little ones immune system just isn't up to par
and needs to be treated. I would strongly encourage mom to treat, even as
outpatient. Good luck, it sounds as if things might get worse before
better.>>
Kathy wrote:
<<In regards to this infant whose mother has a history of Group B strep
and has tested positive for Staph, it is imperative that s/he recieve medical
care immediately. Infants who are septic may show only soft signs such as
poor feeding and lethargy. A temperature in a newborn always warrents a
further workup. This baby is showing signs of being sick. I have had the
unfortunate experience in the NICU of seeing babies die of overwhelming
sepsis and it can happen quickly. I would use all of your powers of
persuasion to convince this mother to get the baby to the hospital and if
this doesn't work a call to CPS (Child Protection Services) may be warranted.
I understand the difficult situation you are in but this baby needs medical
care. Perhaps a call to the pediatrician who can access CPS and make them
understand the importance of quick action would be helpful. Sorry my first
post is so long.>>
As much as I agree that this baby needs further intervention, it is hard to
say what that should be, as it sounds like he needs to be nursing better as a
baseline. More breastmilk just might be the solution. My biggest concern is
that everyone is always so ready to call some outside force when a parent
refuses "the standard of care". I am not surprised this mother is afraid to
go back to the hospital as she has had the police called on her once already.
Remember that both her naturopath *and* ped said there was nothing wrong w/
the baby, so she is not avoiding medical care. B/c I work extensively w/ the
homebirth community and other families who choose holistic care for their
children, I often see families make extra effort to avoid allopathic
intervention. IMO, the problem is not the choices these families make, but
the attitudes of others who find them unacceptable. Perhaps if the ped had
been willing to respect the mother's choices and work *with* the naturopath,
this baby would be in better shape. The same for the ER doc who had to have
it all his way or no way. If they had offered to treat the baby as an
outpatient, perhaps this baby would be getting better care right now. This
mother is afraid of having her baby under the control of those who have
clearly conveyed that they are antagonistic towards her. I would be afraid of
that, too! I would suggest you try to take a larger role in helping her to
find a provider more willing to work with her, rather than against her, for
the sake of this baby.
Speaking as a mother who has had to make life-or-death choices for my own
son, I can tell you that it can be extremely unnerving, no matter how strong
you may be otherwise, to find a way though the extremely controlling and
manipulative world that allopathic medicine *can* be. I was lucky to be
working in the hospital at the time, so had huge advocates in pediatrics.
This mother needs an advocate, too.
Jennifer Tow, IBCLC, CT, USA
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Date: Sun, 28 May 2000 12:13:16 EDT
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I want to thank the people that have responded in regards to that baby in
CA--- when I read the first post-- my jaw hit the floor, I stuggled with it
at church and with my family at dinner. I began to wonder when this childs
"breastfeeding" story would hit the newspapers. ?1. Why is this mother so
biased against receiving medical care for her infant. 2. 1 lb. weight loss is
not normal and therefore breastfeeding is not normal-- even if infant appears
to be on the breast, they frequently do not have the energy to breastfeed
"well" ( how would you feel if you lost 10% or more weight in a week?) 3.
The staph/strep thing has me very concerned, over the years I have seen
several infants die from beta strep,( one recently was a 6wk old fullly
breastfed infant) its not pretty. 4. The infants temperatures described are
not normal no matter how hot it is. 5. I hope this mother gets help soon for
her infant because I am concerned that the only herbs she will be dealing
with are the ones on her infants grave. 6. If this mother continues to try to
avoid treating the infant and you continue to work with her
breastfeeding---is your liability insurance paid?
Karen Querna, RN, BSN, IBCLC
Spokane WA
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Date: Sun, 28 May 2000 12:18:06 -0400
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
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From: Kerri Frischknecht <[log in to unmask]>
Subject: Abrupt weaning
This is my first posting so I shall introduce myself. My name is Kerri
Frischknecht. I am a RN,RM,IBCLC(1999) and the most of my experience has
been with premature and sick babies,(over 25yrs) I work in a Womens
Hospital in Switzerland. I am originally from Melbourne, Australia.
One of my peers has asked me if I could find out what the usual drug is
that is used for mothers to wean abruptly in the USA? I have already
exhausted other resources, without any luck. As far as I know Bromocriptine
is not used in the USA for this purpose, due to the very adverse
circulatory complications. What about Cabergoline, is this used? I would be
very grateful for some help here. Please e-mail me privately if necessary.
Keep up the great work out there! I am truly addicted to Lactnet. Best
wishes to you all. Kerri Frischknecht.
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Date: Sun, 28 May 2000 11:48:12 -0500
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
<[log in to unmask]>
From: Jim & Winnie Mading <[log in to unmask]>
Subject: Professional "disagreements"
Comments: To: Jeanette Panchula <[log in to unmask]>
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Jeanette:
Thanks for your very well expressed post. Having had word get back
to me with what a mom reports I have said and seeing how much that
differs from what I actually said (or at least thought I had said) I
have learned to take a mom's or HCP's report of what someone else
said with a grain of NaCl!
One of my favorite expressions is,"What you think you heard me say
may not be the same as what I think I said." This is one reason
communicating via more than one sense is so helpful. When I make
this point in presentations to professionals I like to use the Neil
cartoon where a mom is standing by the table bare chested with a
rolling pin in her hand and the dad is saying "I don't think that's
what the book meant by 'rolling your nipples'."
No matter how similar situations may appear, one is never in the
same situation, in the same place, at the same time, with the same
recources available, in the same frame of mind, etc. etc. etc.
Both in our working with moms and with other HCPs, we need to give
the benefit of the doubt and approach different suggestions not as
right or wrong, but as just that-different. Lactation is certainly
NOT an exact science. We are constantly learning (one of the main
reasons personal experience alone isn't adequate). Whenever someone
says something like "but that's not how I learned it" or "but I
(we)'ve always done it..." my response is that while it is true
that breastfeeding doesn't change, our understanding of it and how
to help if work most effectively does change.
Enough rambling-time to see if the race is on.
Winnie RNC, IBCLC, etc.etc.
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Date: Sun, 28 May 2000 13:28:44 EDT
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
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<[log in to unmask]>
From: [log in to unmask]
Subject: Re: baby with reflux
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Susan:
this childs history not withstanding, the fact remains that there is
noting to substantiate thickening to keep foods down and if you are going to
start foods then do so with something of nutritious value.
"this might be one of those cases where being a pediatric nurse as well as an
IBCLC might come in handy.".... Susan I do not see what this has to do with
anything.
Patricia
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Date: Sun, 28 May 2000 13:30:23 -0400
Reply-To: Lactation Information and Discussion
<[log in to unmask]>
Sender: Lactation Information and Discussion
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From: Becky Flora <[log in to unmask]>
Subject: Fenugreek during pregnancy
Fenugreek is considered contraindicated during pregnancy due to the risk of
uterine contractions. I would favor sitting down with this mother and getting
a full history of her past breastfeeding experiences; ie. time of initial
feeding, frequency of feedings, early use of hormonal birth control, history
of thyroid dysfunction, were there any changes in her breasts during the
pregnancies (enlargement, increased sensation, darkening of the areola,
etc.), did the babies have any oral abnormalities/sucking problems, were the
babies hard to wake for feedings, early supplementation, labor medications
and interventions, sore nipples, extreme engorgement, etc. Then devise a plan
with her to make it more likely that she'll be successful this time. Go over
the basics of getting off on the right foot. Most moms who follow those do
fine. Even when a problem arises, if the mother seeks the right kind of help
early enough she most likely can work through it and preserve breastfeeding.
Having a plan should make her feel more confident and empowered to be able to
do something preventive and positive. I also like to get moms involved in a
mother-to-mother breastfeeding support group during their pregnancies so that
they'll have a support system already in place before the baby arrives.
Becky Flora, BSed, IBCLC
Kingsport, TN
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Date: Sun, 28 May 2000 14:08:39 EDT
Reply-To: Lactation Information and Discussion
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fenugreek is contraindicated for pregnancy... please check the archives as
I am sure that has been covered in the past. if not I will pull the reference
from commission e.
Patricia
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Date: Sun, 28 May 2000 14:14:25 -0400
Reply-To: Lactation Information and Discussion
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From: newman <[log in to unmask]>
Subject: effexor
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Yes, but why this drug? Why not something else. These SSRI antidepressants
are essentially all the same. There are individual differences in response
to them, but that does not mean that if she didn't respond to this one she
won't respond to another. I mean, with her last baby did she try Paxil?
What about tricyclics?
If I were in her place, and there were no other choice, I would take the
effexor, keep breastfeeding and keep an eye on the child. The doctors could
even do studies on breastmilk levels and baby's levels.
Jack Newman, MD, FRCPC
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Date: Sun, 28 May 2000 15:04:55 -0500
Reply-To: Lactation Information and Discussion
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From: Steve & Gerry Welch <[log in to unmask]>
Organization: Bad Mojo Productions
Subject: Re: Abrupt weaning
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I'm not aware we use anything.
Kerri Frischknecht wrote:One of my peers has asked me if I could find out what
the usual drug is
> that is used for mothers to wean abruptly in the USA?
--
________________________________________
| Another ugly, gray Impala blocking |
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| Steve & Gerry Welch |
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Date: Sun, 28 May 2000 14:11:52 -0700
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: Effexor
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Diane: Living in Oregon where we have rainy winters, there seems to be an
abundance of SAD, treated with Prozac, Effexor, Paxil, etc. I have had many
a mom on Effexor without OBVIOUS negative effects. In fact, these moms seem
to do quite well and have continued bf for long periods. The literature is
somewhat vague and scanty, but I thought I'd give you some (actually, now
that I count, it's over 20 cases that I know of in my practice) of moms who
have used Effexor.
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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Date: Sun, 28 May 2000 14:22:13 -0700
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From: Chris Hafner-Eaton <[log in to unmask]>
Subject: gassy baby now gaining
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Update: I posted two weeks ago or so about a baby who was full of gas and
losing weight initially/failing to gain even a measly 1/4oz/day at 3
weeks...Well, I just saw a very delighted smiling mom at church who burst
out THANK YOU. (Don't you just love those?) Well, the simethicone, plus
homeopathy and infant massage, really did the trick with this baby. She
gained a pound in 9 days and the ped was ecstatic with the progress. (This
was the doc who said to supplement with formula in a regular bottle after
each nursing). Unfortunately, the mom never told the doc what she did other
than that bf was now going well. I encouraged her to detail their
experience at their next visit. Hope you are all having a great weekend.
Holiday weekends are always busy for me (it's Memorial Day in the US).
warmly,
-- Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
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Date: Sun, 28 May 2000 17:32:19 EDT
Reply-To: Lactation Information and Discussion
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From: [log in to unmask]
Subject: Depressed mom
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Diane writes:
<< The mom wants very much to continue breastfeeding, but she also feels that
her current state of depression and anxiety is interfereing with her ability
to function. After fighting the depression off for seven months in an effort
to continue breastfeeding her daughter and getting no relief from Zoloft,
she's at the end of her rope. >>
While I've recently beat my drum on this topic, it seems to demand repeated
percussion:
After 7 months, I'm not so sure that we are looking at PPD. My DSM IV is at
my office, but I believe that the parameters are narrower than that.
Whether it is or is not PPD, one also needs to look at the stressors and
other issues in this mother's life. As attractive as we have made it become,
taking a pill will not resolve those things. And though a significant amount
of depression is, in fact biochemical, it is a mistake to assume that all
etiology will be found in the brain/hormones, etc. The fact that she isn't
responding to Zoloft makes me suspicious. Further, no matter what the
problem is, the hormonal chaos of weaning and loss of this exquisite intimate
experience with her baby may precipitate a larger crisis.
The vast majority of the women who come to me to address their "PPD" issues
have no such diagnosis. With exploration, we determine that most of the
things bothering her have been there for a while, or are totally unrelated to
her birth or supposed maladjustment to baby's arrival, or even to her
hormones. Methinks we may be in danger of overdiagnosing.........
Regardless, this woman could use the services of a good therapist.
Nancy Williams, MA, MFT, IBCLC
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Date: Sun, 28 May 2000 19:11:34 -0500
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Date: Sun, 28 May 2000 21:37:07 -0400
Reply-To: Lactation Information and Discussion
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From: Jeanette Panchula <[log in to unmask]>
Subject: Postpartum depression
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I am not a psychiatrist, and my degree in Social Work is not adequate to
deal with this subject in a professional way, however, I would also like =
to
add my somments on the diagnosis of PPD. =
It seems to have become a "catchall phrase" for anyone who has children a=
nd
is overwhelmed. The other day I was at a mom's home. She was dealing
with:
* Living in a mobile home with her husband and three children plus a
newborn
* Her recently widowed sister and two children have moved in during the
last months of her pregnancy
* They are undocumented, so there her husband's employment is erratic and=
they are not eligible for any financial aid.
* The entire family has limited groceries, and the food is mostly given t=
o
the children and the working husband.
* She delivered a baby who was very tiny and would not latch on well.
* You see very little facial expression. =
Is SHE suffering from PPD or "overwhelmed"?
Another mom -
* Trying to break a drug habit
* Living in a motel which requires she move every 29 days so that she is
not considered a "renter"
* No cooking facilities other than an illegal microwave. (not allowed by
the motel).
* Baby has been transferred to a hospital that requires her to spend $15
and 2 hours in public transportation each way.
* Nurses at the NICU criticise her that she doesn't "visit often enough"
and is not pumping enough.
* You see her crying a lot.
Is this PPD?
Those are the families I visit with the Public Health Nurses. I worry
that when these moms are referred, the "easy" option is PPD and medicatio=
n.
What is really needed? Well - you can make your own decisions...
Jeanette Panchula, BSW, LLLL, IBCLC, RN
Vacaville, CA
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