Nikki,
I have often wondered the same thing. Who comes up with these
recommendations? I know there must be studies but it seems like there
is no ability to use common sense anymore. I too often, more than I
like, gear my recommendations based on the possible negative
outcome(what the home care nurses or doctors may find)rather than what
the whole picture looks like. For instance, if using a nipple shield,
milk is in and baby is gaining with good output I do not have a mom pump
and supplement. However, I am always afraid if home care nurses go out,
they will worry the mom that I did not start her pumping while on the
shield (happens often). Or if a baby comes in with no gain to a 10%
weight loss, milk is in, baby is nursing well with documented adequate
wt gain at breast per scale, and output WNL, I feel I have to be
conservative and have the mom pump and or supplement in case..... Or
the dr who finds the baby not regaining birth wt at 2 weeks but just had
a 10 oz gain in 5 days once problems were corrected and still recommends
supplementation (usually formula). It seem there is very little
critical thinking going on anymore. And I too wonder how much these
"recommendation" have gotten our moms obscessed with wt gain which
passes onto our children to effect them later in life.
Jane Helgesen, RN, IBCLC
Full time hospital lactation consultant
Burnsville, MN
-----Original Message-----
----------------------------------------------------------------------
Date: Wed, 6 Jul 2005 20:38:40 EDT
From: Nikki Lee <[log in to unmask]>
Subject: weight gain
In a message dated 7/6/2005 8:35:01 PM Eastern Daylight Time,
[log in to unmask] writes:
Is it irresponsible to think that a weight gain of 4 oz./week in the
first
5 weeks of life is acceptable and not indicative of formula
supplementation if baby is pooping/peeing well, good skin tone, growing
in length, active and generally content?
Dear Friends:
Seems like all is going well here to me. While the gain is on the
low end of the range of normal, it is still adequate in view of the
baby's total picture.
This leads me to wonder if health care providers are in part
responsible for the epidemic of obesity as a result of the insistence,
by some, that babies have to gain lots of weight. Mothers take this
seriously.
warmly,
Nikki Lee RN, MS, Mother of 2, IBCLC, CCE Maternal-Child Adjunct
Faculty Union Institute and University Film Reviews Editor, Journal of
Human Lactation www.breastfeedingalwaysbest.com
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Date: Wed, 6 Jul 2005 23:01:01 -0400
From: [log in to unmask]
Subject: Maternal Varicella
Newborn varicella can KILL, and is not completely prevented by the
VZIG. The AAP "Red Book" (the Bible on infectious disease) says keep
mother and baby apart until Mom is not infectious. She does NOT get to
kiss, touch or breath on her infant at delivery. It is not
breastfeeding that is the problem, it is ANY contact. I have had a
patient die of chickenpox at 2 weeks of age. It is not something I want
to see again.
Yes, the baby may have already been exposed, which is why you isolate
the infant (with the mother when all her lesions are closed over) for 21
days (or 28 days after VZIG) so the infant will not expose other infants
or children.
Nancy E. Wight MD, FAAP, IBCLC
Attending Neonatologist,
Children's Hospital & Health Center, and Sharp Mary Birch Hospital for
Women Medical Director, Sharp HealthCare Lactation Services
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