I am so glad you posted this. I too am about ready to pull my hair out with
this book. I have found several text questions that I do not agree with and
can find supporting rational for my “wrong” answer in other breast feeding
books. I am mainly using Jan Riordan’s “Breastfeeding and Human Lactation 3rd
Ed” and Barbara Wilson-Clay & Kay Hoover’s “The Breastfeeding Atlas 3rd Ed”
and have but not using as much “Breastfeeding A guide For the Medical
Professional” by Ruth and Robert Lawrence. I am at the point that I don’t
know which text to believe and follow? They all have slight variances from
each other. I am getting questions wrong in the L. Smith practice exam book,
and I don’t completely understand her rational.
In Riordan on pg 202 it suggests hypoglycemia from birth to day 1 to be under
30mg/dl and under 40mg/dl, but I get the answer wrong for the 6 hour old
with a BS of 36mg/dl that needs immediate feeding. So what is the number I
should go by?
For the questions about no traces of pain killers being found in the infant or
cord blood after the mother was given high doses before delivery. I don’t
understand why at least a trace wouldn’t be found in blood if when the
answer is because it is concentrated in the infant’s brain. My level of thinking
leads me to think there has to at least be a trace in order for it to get to the
brain to concentrate anyway?
Another questions says bf has no benefit to cardiovascular health, but I can
find in Riordan as well as several Nutritional articles that bf is now being
thought to decrease the risk of later cardiovascular disease with the thought
that higher cholesterol levels in breast milk being a contributing, protective
factor. AND I get another question wrong because according to L. Smith,
there is absolutely no cholesterol in formula; however, even though it is a
small amount, there is a small amount of cholesterol in at least cow- milk
based infant formula. Even if small, it is still there. Also, according to L. Smith,
the swallowing reflex develops at 26 weeks gestation, where B.WC, K.H, and
Riordan all say this reflex is seen first seen developing between 10-14 weeks.
I DON’T KNOW WHO TO BELIEVE or what to study anymore. I also agree, some
of the pictures are also unfair. How many of you think POISON IVY as their
first thought for a nipple rash (with no other information)? Also, why is flicking
the feet of a newborn to arouse it worse than placing a cool cloth on the
infants face? Maybe I am just thinking too much in terms of being a pediatric
nurse where this practice (cold to the face) could trigger a vagal response
which could slow the heart rate? And why is vit D supplements for a dark skin
toned bf baby, located in an area with little sunlight always the wrong answer
for treatment to prevent Rickets? How does “exposing the mothers face to at
least 20 min of sunlight daily” have any measurable effect on the infant?
Working in a pediatric clinic and reading in texts, this (Vit D supplement) is the
common and recommended practice per the AAP.
Please someone help me out here? I have had several people say “ give the
answer they want.” The thing is, I don’t know what “they” want anymore
when there are so many inconsistencies between sources. How does this
method help a person out in this career path?
Shannon Theiss, BSN,RN
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