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From:
Karen Clements <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 20 Apr 2003 22:16:26 +1000
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Thank you to Barbara and Barb for the references
I haven't come across much so far but for those interested these are the
articles I found that mention vacuum extraction, although not necessarily in
relation to BF, more regarding the side effects (no wonder they have
problems have feeding!):

http://www.aafp.org/afp/20000915/1316.html
Assisted Vaginal Delivery Using the Vacuum Extractor
_______________________________________________________________
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&Dopt=r&uid=9
6112949
Subaponeurotic haemorrhage in the 1990s: a 3-year surveillance.

Ng PC, Siu YK, Lewindon PJ.

Department of Paediatrics, Prince of Wales Hospital, Chinese University of
Hong Kong, Hong Kong.

A 3-year survey of subaponeurotic haemorrhage (January 1991 to December
1993) in a tertiary referral centre in Hong Kong revealed that the incidence
of this life-threatening condition was 6.4 per 1000 ventouse-associated
deliveries, which is 60-fold more common than with other modes of
childbirth. We highlight a lesser known phenomenon of marked male
predominance (male to female ration 8:1). Three of 18 (17%) infants with
subaponeurotic haemorrhage died. Severe subaponeurotic haemorrhage with a
decrease in venous haematocrit >25% of the baseline value at birth and
requiring urgent blood transfusion in the first 12 h, in association with
significant birth asphyxia with arterial cord blood pH <7.20 and 1-min Apgar
score < or = 3 were the most important risk factors for death. A worrying
feature was the silent presentation of occult subaponeurotic haemorrhage in
two of the fatal cases. Frequent monitoring of haematocrit, early and rapid
restoration of blood volume and prompt commencement of cardiac inotropes are
the keys to the management of this condition, which should be suspected in
all ill newborn infants subjected to the ventouse applicator.
____________________________________________________________
http://www.fda.gov/cdrh/fetal598.html
FDA Public Health Advisory: Need for CAUTION When Using Vacuum Assisted
Delivery Devices
________________________________________________________________

http://content.nejm.org/cgi/reprint/341/23/1709.pdf
The New England Journal of Medicine
EFFECT OF MODE OF DELIVERY IN NULLIPAROUS WOMEN ON NEONATAL
INTRACRANIAL INJURY
DENA TOWNER, M.D.,
Vacuum Extraction
As compared with infants born by spontaneous vaginal
delivery, those delivered by vacuum extraction had
significantly higher rates of subdural or cerebral hemorrhage,
brachial plexus injury, convulsions, central
nervous system depression, and mechanical ventilation,
but the rates of intraventricular hemorrhage, subarachnoid
hemorrhage, facial-nerve injury, and feeding
difficulty did not differ significantly between the
two groups of infants (Table 2). Even though vacuum
extraction was significantly associated with major
morbidity, the absolute risk of morbidity was low. Intracranial
hemorrhage (subdural, cerebral, intraventricular,
or subarachnoid) occurred in 1 of every 860
infants delivered by vacuum extraction, as compared
with 1 of 1900 delivered spontaneously (odds ratio,
2.2; 95 percent confidence interval, 1.7 to 2.9).
____________________________________________________________
and Barbara Wilson-Clay's post re the Hall article from 1/03
http://peach.ease.lsoft.com/scripts/wa.exe?A2=ind0301A&L=lactnet&P=R5711&I=-
3

R Hall, et al:  A breast-feeding assessment score to evaluate the risk for
cessation of breast-feeding by 7 to 10 days of age, J Pediatr 2002;
141:659-64.


Regards
Karen Clements IBCLC
Melb Aust

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