Dear Hannah,

I had some problems with my E-mail program recently. I had hoped it was over
now, but it obviously is not, because I can not send my message to you to
your own E-mail address. They say, the SMTP does not reccocnize your
address, so I have to mail it by way of the lactnet. I am sorry.

The note I posted to you concerned the approach of LC's and LLL leaders in
the Netherlands. The past five years, LC's have constantly been educating
workers in the health care field. Maternity nurses, nurses in home birth
institutions, nurses that take care of children up to four years of age, so
also of breastfeeding mothers, GP's, some pediatricians etc. We have been
writing articles whenever possible and given the opportunity. Thanks to all
these activities more and more of these health care workers are getting used
to our approach of mastitis. But when you look into the books they learn
their profession from, they all still learn the wrong things, like mastitis
being the result of bacteria entering through damaged nipples or being the
result of engorgement. Which we know can be the course, but seldom is. They
advise ice compresses and antibiotics and stopping with breastfeeding in
case of an abcess. These women should be taken care of in isolation.
Preventive measures are mentioned, like preparing nipples, starting
breastfeeding with a few minutes the first days, use of nippleshields and so
on.  This book I have here, is from 1991 and still in use today. So you see
all the good things come from LC's and because we get a bigger and bigger
say concerning these matters and are consulted more and more, our vieuws are
more and more addopted. Personally I am engaged in rewriting an educational
book (schoolbook) for maternity nurses in homecare situations. I can assure
you it is a hel of a job. We think more and more publishers and writers will
come to us for assistance when day update their books.
As far as I know, no articles have been written on the subject appart from
my own in the journal for midwives. But that has Riordan and Lauwrence as
references, combined with my fifteen, no sixteen years, of experience.
Nobody is interested scientifically in the subject. I will ask around for
you. But by and large, we get all our information from sources not from the
Netherlands. The only things that are investigated here are the influence of
dioxins and PCB's on the neurological development of breastfed baby's and a
new investigations has just begun to see if putting long chain PUFA's in
formula will make formula fed baby's have the same bennefits as breastfed
baby's. We live in a country with a very large manufacturor of formula I am
afraid. Even worse, they have their main office and factury here in my town,
so I am confronted with their trucks bringing cowsmilk in everyday. If I can
come up with an article I will let you know. Hope to have been of help to you.

Siemian Berghuijs, IBCLC, the Netherlands