lactnetter Respnding to tw posts at once. For LJ Smith who things pastel
blue is not for athletes, tell that to the quentessential Coach Smith, DEAN
Smith that is even though is is now retired that The UNC Chapel Hill Tarheel
blue is unacceptable. No I am not an Alumni- I went to another Carolina
University with a camel for an insignia.
Also hiring an anthropoloigist- GM originally went to South America to
introduce its new 1960's model car the NOVA. They thought new; in spanish No
Va means it won't go. My 1987 NOVA si' va 260,000 miles worth.
Mechell Turner
-----Original Message-----
From: Automatic digest processor <[log in to unmask]>
To: Recipients of LACTNET digests <[log in to unmask]>
Date: Monday, June 22, 1998 10:33 PM
Subject: LACTNET Digest - 22 Jun 1998 - Special issue
=========================================================================
Date: Tue, 23 Jun 1998 09:18:24 -0400
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Heidi C. Lunn M.S., I.B.C.L.C." <[log in to unmask]>
Subject: Flagly
Mime-Version: 1.0
Content-type: text/plain; charset=us-ascii
I have a question I hope that someone can help me with. I have a
mother with an infection in her uterus. The doctor prescribed flagyl.
The mother asked the DR for an alternative and he said there is none.
What are some of the possible alternatives for flagyl?
Thank you
Heidi C. Lunn, M.S., I.B.C.L.C.
WIC and Nutrition Program
=========================================================================
Date: Tue, 23 Jun 1998 10:51:43 -0400
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Dr. Tom Hale" <[log in to unmask]>
Subject: Moexipril (Univasc)
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To: Toni
Re: Univasc (Moexipril)
To echo my colleagues, moexipril is a prodrug that is metabolized to an
active ACE inhibitor. While this product may turn out to be an ideal ACE
inhibitor for Bfing moms in the future, we do not have such data now. Oral
bioavailability is low, only 13%, and its half life varies from 2-10 hours.
But why not use those we have data on, and are believed safer...such as
Captoril(Capoten), enalapril(Vasotec), or perhaps Benazepril(Lotensin).
Why all this concern, the ACE inhibitors are somewhat risky when used in
the perinatal period, especially prior to delivery. The ACE inhibitor
family can produce profound and dangerous hypotension in newborns, so we are
more cautious of their use during the prenatal, or early postnatal periods.
This is why it is given a Pregnancy Risk category of X during the last
trimester.
Regards
Tom Hale, Ph.D.
=========================================================================
Date: Tue, 23 Jun 1998 13:02:22 EDT
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Carol Brussel <[log in to unmask]>
Subject: files
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yes i did have a laugh about labeling a file "breastfeeding" - that would be
the secretary's revenge, right? labeling dozens of files with the same name.
pat, i went from windows 3.1 straight to win98 a few months ago and it is
terrific. it is very easy to put things in folders, etc. and to be able to
name files as long a name as you wish, etc.
now i sound like a bill gates apologist.
carol b.
=========================================================================
Date: Tue, 23 Jun 1998 13:57:24 EDT
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Helen M. Woodman" <[log in to unmask]>
Subject: Breastfeeding Support in Innsbruck, Austria
Comments: cc: [log in to unmask], [log in to unmask],
[log in to unmask], [log in to unmask],
[log in to unmask], [log in to unmask],
[log in to unmask], [log in to unmask]
Mime-Version: 1.0
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Does anyone have knowledge of breastfeeding supporters in Innsbruck, Austria,
who speak english? Support is needed for a UK mum who went on holiday to
Innsbruck whilst pregnant, went into early labour out there and gave birth to
a prem baby. Mum now discharged from hospital - she was in hospital for some
time because she became v ill after birth. Mum is pumping. Baby still in
NICU. The NICU is in a separate building from where mum was hospitalised.
This is mum's first baby. Boyfriend has had to come back to UK.
TIA
Helen Woodman, NCT BfC, UK.
[log in to unmask]
=========================================================================
Date: Tue, 23 Jun 1998 12:19:46 -0700
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Linda Pohl <[log in to unmask]>
Subject: Re: site of hopkins hospital
In-Reply-To: <l0313030cb1b56e053f6b@[193.78.121.206]>
MIME-Version: 1.0
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Just went one step up to the entire infant feeding category and looked at
most of the links. No one bothered to review most of the site for accuracy
it appears. At least for breastfeeding help they referred to LLL instead of
whoever wrote this stuff.
llp
check ik out:
http://www.intelihealth.com/IH/ihtIH?t=4460&p=~br,ALT|~st,3324|~r,WSALT002|~
b,*|
I think people here would like to react. They are talking about 'sore and
bruised breast' as if that's is normal.
=========================================================================
Date: Tue, 23 Jun 1998 15:33:44 EDT
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Helen M. Woodman" <[log in to unmask]>
Subject: John Hopkins University Site notification by Anneliese Bon
Mime-Version: 1.0
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This is a really tacky site - where does one begin, misinformation after
misinformation. One wishes that they had never written it, the whole thing
should be scrapped and never allowed to see light of day again - ever. Does
it not remind one of formula booklets on *helpful breastfeeding advice*? I
started to splutter on the bit that tells you to put baby's head in crook of
arm ...sigh. I felt apoplectic by the time I had finished the site.
Helen Woodman, NCT BfC, UK
=========================================================================
Date: Tue, 23 Jun 1998 16:58:15 EDT
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Alison K. Hazelbaker, MA, IBCLC" <[log in to unmask]>
Subject: Re: Mercury fillings
Mime-Version: 1.0
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After having seen the posts that suggest mercury fillings are no big deal I
would like to draw to your attention a book by HAl Huggins called Its All In
Your Head, which details exactly how much mercury is ingested from chewing on
the fillings during each and every meal and the vapor that is breathed in with
each and every respiration. There is tons of literature now that links mercury
toxicity with a whole host of degenerative diseases. What boggles my mind is
how, in early dentistry, there were warnings about the use of mercury in
fillings with a shunning of any dentist who used them (because it was cheap
filling material), an attitude that has now been replacefd with the idea that
any dentist who with good intent and in good conscience, removes mercury
fillings because of the evidence to suppport such action.
In regards to breastfeeding, the issue of removal is that the mercury is
stored in the maternal tissue and will be releaased into plasma when all of
the fillings are removed. It has someting to to with blood saturation rates.
So blood levels will increase and stay high as the maternal tissue dumps the
stored mercury into serum. This obviously increases the amount of mercury that
may get into breastmilk and is the reason mercury levels in the blood are
carefully monitored post filling removal.
Alison K. Hazelbaker
=========================================================================
Date: Tue, 23 Jun 1998 16:33:44 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "[log in to unmask]" <[log in to unmask]>
Subject: Re: Mercury fillings
In-Reply-To: <[log in to unmask]>
Mime-Version: 1.0
Content-Type: text/plain; charset="us-ascii"
Alison, thank you for your well-written post about mercury fillings. There
is so much lax attitude about such a serious health concern. I'm glad that
some of us posted about the hazards, and for a rebuttal to be that the ADA
says...well, most of us know about that kind of official position.
I've read a lot about this hazard for many years and within the last 2 have
decided to stop ingoring the evidence. My daughter and I are having our
mouths cleared of mercury, with the greatest of care and follow-up treatment.
Our posts may be the first information that many Lactnetters have heard of
in this regard and it will stick in their minds to be built upon as their
years go on.
Pat Gima
mailto:[log in to unmask]
=========================================================================
Date: Tue, 23 Jun 1998 18:11:43 -0400
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Bruce Henry <[log in to unmask]>
Subject: Breastfeeding After Chemo
MIME-Version: 1.0
Content-Transfer-Encoding: quoted-printable
Content-Type: text/plain; charset=ISO-8859-1
Hello,
It has been a while since I posted, getting caught up with life and
rediscovering how busy life with a toddler is. Since I spend so much tim=
e
on e-mail I also answer LLL e-mail questions (sent to LLLI Web Page - Hel=
p
Line) and I received a question that has me and my PL stumped. I have
looked in the Breastfeeding Answer Book and have only found references to=
moms who discover cancer during lactation, not during pregnancy. I have
received the mother's permission to post her question to Lactnet and afte=
r
the responses she gets here will probably also request information from t=
he
Center for Breastfeeding Information. Below is her question and I hope
that the 1000+ lactnuts here have some answers for her. What ever
responses I get from all of you I will forward directly to the mom.
>>> I am 32 years old and was diagnosed with Hodgkins Disease during my 4=
th
month of pregnancy. At the start of my 3rd trimester I began
chemotherapy and will have completed 3 cycles (6 bi-weekly i.v's) on July=
9th. I have several docs working with me on my situation ( a radiation
oncologist, a medical oncologist, my obgyn for the past 10 yrs, and a
special high risk pregnancy obgyn), however, none of them have given me a=
straight answer regarding breast feeding my newborn. The medical
oncologist has given me a definite "no" . I believe this response was
due to the fact that he didn't want to have to deal with the risk. My
other doctors have all hesitated and suggested I just follow the
oncologist's advice. The drug protocol that I am taking is called "ABVD"
which stands for, Adriamycin, Bleomycin, Vinblastine, & Dacarbazine. My
doc tells me that it takes approx. 2-3 days for the chemo drugs to leave
my body. =
On July 31st my obgyn has scheduled me for a cesarian section (three
weeks after my final chemo session) and I hope to begin nursing
immediately. I have a 3yr old son and breast fed him very successfully
for his first year of life and would love to be able to do the same for
this baby. =
One question I have is: When does the colostrum come in? Is it present
in my breast now? and if so, is it already contaminated? I'm willing to=
pump my breasts to dump any contaminated colostrum or milk until it's ok
to feed my baby. =
There is the possibility that I will have to begin radiation therapy
approx. a month and a half after the baby is born. Is it unsafe to
breast feed while undergoing radiation therapy? If so can I "pump and
dump" during this time?<<<<
Thank all of you for your help.
Felicia Henry
Bradley Instructor
La Leche League Leader
Oxnard, CA
=========================================================================
Date: Tue, 23 Jun 1998 23:34:27 +0000
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Heather Welford <[log in to unmask]>
Subject: that site at hopkins
MIME-Version: 1.0
Content-Type: text/enriched; charset=ISO-8859-1
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Dear Lactnet
Gosh - what a load of old tosh about breastfeeding at the Hopkins site
: 0
It's worth visiting just to see how prestigious world-famous
institutions can get something sooooooo wrong.
I have e-mailed them to let them know they need to change it
pronto...I have also suggested they get a decent writer in who knows
about breastfeeding. I have even modestly suggested myself (ahem)
while pointing out that there are many other people equally qualified.
They invite comments - lets show 'em.
Heather Welford Neil
NCT bfc
=========================================================================
Date: Tue, 23 Jun 1998 19:23:48 -0400
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Patrica Young <[log in to unmask]>
Subject: Re: What is an LC?
MIME-Version: 1.0
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I don't think any of us wants to push anyone else out. We need all the
help we can get!!! I do think you should call yourself what you are,
whether it is mom who has BF, LLLL, LC or lactation educator. As someone
else has said your personal reputation will precede you. That is, if you
truly help moms, word will get around and people will seek you out.
P.S. if athere is a person who is not certified and is calling herself an
LC, then I think ILCA needs to know the details. I don't know the
legalities, but you can't do that. Sincerely, Pat in SNJ
=========================================================================
Date: Tue, 23 Jun 1998 20:11:57 -0400
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Janet Vandenberg <[log in to unmask]>
Subject: ILCA & keeping current
MIME-Version: 1.0
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As an exam candidate for this July, I have found this discussion to
be very relevant. I did join ILCA last fall as part of my
preparation for joining the profession. I wish I could afford the
conference. It sounds like heaven. I also plan to join the local
Lactation Consultant's Association soon.
I agree that it is important that all LC be as informed as
possible. Finding ways to do this without spending large amounts of
money or doing it while one has small children is difficult. Thank
you for all the good ideas. I would like to add an idea and a
request.
One learning method that worked well for me was an online Lactation
course. Online courses are available at the university level as
well as home study modules. LLLI has some good home study modules
with more being added. Lactnews in a good source of information on
these types of educational opportunities. I even mentioned to Tom
Hale that he should give some thought to starting an online
Pharmacology & Lactation course after meeting with him at a
conference recently. I told him a number of Lactnetters would
probably jump at the chance to take such a course. While such
courses are not cheap, they do allow those of us with young children
to have access to the latest information without leaving home.
The request: Kathleen mentioned that there are a number of journals
that she reads each year. Kathleen, if you think it is appropriate
to discuss here, could you elaborate on which journals in addition
to the JHL you might recommend a LC consider reading to keep
current?
--
Janet Vandenberg, RN, BScN,
Ontario, Canada
=========================================================================
Date: Tue, 23 Jun 1998 16:00:16 -0700
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Alicia Burgett <[log in to unmask]>
Subject: Circumcision history question
MIME-Version: 1.0
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Okay, dear lactnetters, this may seem unrelated, but as we know, it comes up
with new parents all the time re circumcision, yes or no. Question is, can
anyone help with qualifying or confirming a statement that I read about 5
years ago re Hebrew ritual circumcision. It stated that originally, in
ancient times, the ritual involved only making a cut in the foreskin, not
completely removing it. This, just like other rituals throughout time, has
evolved into something totally different than intended. Now, that, in a
nutshell was what I read, claimed by a theological historian. Problem is,
it was 5 years ago, I was postpartum, it was in a magazine that is long gone
(I don't *think* it was M*th****g!), and I have no idea who the author was.
I'm not usually accused of hallucinating, but as time goes by, I'm beginning
to doubt myself! I would love to hear if anyone has ever heard this same
statement, I would think the power of it would be pretty strong if we could
just get some historical, qualified confirmation. Being that I live in a
city with one small synagogue, my local resources are limited! thanks!
Sincerely,
Alicia Burgett, CLE,IBCLC
[log in to unmask]
=========================================================================
Date: Tue, 23 Jun 1998 19:51:44 -0400
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Kathleen Bruce <[log in to unmask]>
Subject: cardiac question *Fairly Urgent*
Mime-Version: 1.0
Content-Type: text/plain; charset="us-ascii"
I've run into a situation with a mother of a newborn. The newborn girl has
Down Syndrome and has been feeding well at the breast. At 2 weeks of age
she was diagnosed with heart problems, A-V Canal defect and a hole, and
will need open heart surgery. The baby started diuretics(lasix and
aldactone) on 6/17. The Cardiologist is allowing bf for now, but stated it
probably will be neccesary to transition to a bottle because it is easier
for the infant to feed and they can mix a suppliment to increase the
calories. When the mother answered that she had heard of studies done by
LLL that bf was easier, he replied that of course LLL is skewed in their
viewpoint, and that in his 20 years of experience he did not observe
this(of course how many mothers did he give the chance too?). The mother
does not want to use a bottle(a LLL leader) and does not believe it is best
for her baby. She would like to bf up to and right after the babies surgery.
Is there any information/studies that show bf is easier than bottlefeeding
an infant, especially babies with heart problems, that can be presented to
the Dr.? What other strategies could she use to persuade the cardiologist?
She really wants all the advantages of bf since the infant has Downs with
the problems of ear infection/speech development and mental function, not
to mention the comfort/bonding she needs at this time.
Lastly, since the cardiologist emphasis is on weight gain, what techniques
can be used to aid the baby in gaining weight and forestall
bottles/supplements? It seems that since the baby was put on the
medication she has a good day of feeding and then a poor day of
feeding(very sleepy, can barely be roused awake, then falls asleep in
seconds). This has alternated for the last 5 days. They are meeting with
the Doctor on Wednesday for a checkup(EKG and weight) and will ask the Dr.
about the effects/dosage of the medication. The dosage of medication was
calculated from the babies weight at the first visit. She was born 6 lbs 2
oz, went down to 5 lbs 14 oz and at the cardiologist visit was 6 lbs 7 oz.
After 1 1/2 days of medication, she was down to 5 lbs 11 oz from fluid
loss. Aldactone can cause drowsiness and the dosage may be adjusted to the
babies new weight.
Please email to the list and to me privately. Thanks.
Kathleen
Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet,TLC, Indep. Consultant
mailto:[log in to unmask]
LACTNET Archives http://library.ummed.edu/lsv/archives/lactnet.html
For LACTNET quilt raffle: http://together.net/~kbruce/kbblact.html
=========================================================================
Date: Tue, 23 Jun 1998 20:22:49 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Bruce Walker & Pauli Loeffler <[log in to unmask]>
Subject: ritual circumcision
Mime-Version: 1.0
Content-Type: text/plain; charset="us-ascii"
The rite of circumcision is found in Gen. 17:9-14, 23-27 when Abraham
became party to the covenant. Ishmael who was 13 at the time of the
commandment was circumcised at that time. Isaac was born later and
circumcised on the 8th day after his birth which is why we Jews perform
the circumcision on that day in a Brit Milah. This is also the time when a
Jewish male receives his Hebrew name. I am not an authority, but I don't
recall anything with regard to Jewish custom being other than full
circumcision of the foreskin. Actually, I think circumcision pretty much
means "cut around" if translated from the Latin.
=========================================================================
Date: Tue, 23 Jun 1998 21:41:34 EDT
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Carol Kelley, LLL Leader" <[log in to unmask]>
Subject: Comparing formula and BF
Comments: To: [log in to unmask]
Mime-Version: 1.0
Content-type: text/plain; charset=US-ASCII
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Carrie and all,
La Leche League encourages its Leaders to emphasize the advantages of
breastfeeding and breastmilk rather than the disadvantages of bottle feeding
and formula. We are to avoid putting down or ridiculing bottle feeding (p 91
Leader's Handbook, revised ed.) It has been the experience of LLL over the
past 40 years that mothers are more receptive to a positive presentation of
information than to a negative one.For example, bottle bashing can make moms
who've bottle-fed previous babies defensive, but a positive approach to the
many benefits of breastfeeding can empower those same moms to breastfeed a new
baby. My co-Leader is a perfect example of this. Besides a positive approach
makes us seem a bit less like the "nipple nazis". There are women, however,
who probably are more motivated to BF by horror stories of the hazards of ABM
than by the advantages of breastfeeding.
Warmly,
Carol Kelley LLLL
Taylors SC
=========================================================================
Date: Tue, 23 Jun 1998 21:56:42 -0400
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Sarah Barnett <[log in to unmask]>
Subject: Re: cardiac question *Fairly Urgent*
Comments: To: Kathleen Bruce <[log in to unmask]>
In-Reply-To: <[log in to unmask]>
Mime-Version: 1.0
Content-Type: TEXT/PLAIN; charset=US-ASCII
For increasing weight gain I would suggest Dr. Newman's breast
compression while the baby is at the breast. The other approach to this
would be expressing milk after each nursing to build the supply and then
separating the milk and cream. The baby could be fed the higher fat
portion of the EBM either by spoon, dropper or cup or with a lactation
aid at the breast.
The new Lactation Consultant Series Two from LLL starts with a pamphlet
called The Hospitalized Nursing Baby by Barbara Propper. Although it
doesn't deal with the stress of breastfeeding vs. bottlefeeding (I
remember reading this too but can't but my hand on the reference right
now) there are lots of tips in the pamphlet about the many issues that
arise when a baby is ill. I am sure that both you and the family would
find it helpful.
Hope this helps.
Sarah
Sarah Friend Barnett LLLL, IBCLC
Bronx (New York City), NY - [log in to unmask]
" You are not obliged to finish the task,
neither are you free to neglect it." R. Tarfon
=========================================================================
Date: Tue, 23 Jun 1998 20:49:50 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Jon Ahrendsen <[log in to unmask]>
Subject: Ace inhibitor question
MIME-Version: 1.0
Content-Type: text/plain; charset="us-ascii"
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Just a different comment, Doctors tend to use the newer agents first as =
they are the ones that they have samples for. There was a big paper =
done recently that was called the JNC guidelines. Then felt that =
therapy should be started with beta blockers and diuretics first and =
then use the other agents. Beta Blockers are cheaper and have a much =
longer experience with BF. The same is true with diuretics.
Jon Ahrendsen MD
=========================================================================
Date: Tue, 23 Jun 1998 21:02:19 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Jon Ahrendsen <[log in to unmask]>
Subject: Flagyl Question
MIME-Version: 1.0
Content-Type: text/plain; charset="us-ascii"
Content-Transfer-Encoding: quoted-printable
I have a
mother with an infection in her uterus. The doctor prescribed flagyl.
The mother asked the DR for an alternative and he said there is none.
What are some of the possible alternatives for flagyl?
Ask the stubborn doctor what he will do if she has an allergy to Flagyl =
(metronidizole)? There are always alternatives, doctors just don't =
like to have to think of them.
Jon Ahrendsen MD
Clarion, Iowa 50525
=========================================================================
Date: Tue, 23 Jun 1998 21:00:04 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "[log in to unmask]" <[log in to unmask]>
Subject: Re: 13 month baby with Down Syndrome
In-Reply-To: <[log in to unmask]>
Mime-Version: 1.0
Content-Type: text/plain; charset="us-ascii"
Robin, I suggest that you do a search of the archives, both Lactnet and
Lactnet95-96. There are a lot of great posts with vast experience on this
topic.
Patricia Gima, IBCLC
Milwaukee
mailto:[log in to unmask]
=========================================================================
Date: Tue, 23 Jun 1998 22:33:18 -0400
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Digest Katie Allison Granju <[log in to unmask]>
Subject: breastfeeding compared to bottle-feeding
MIME-Version: 1.0
Content-Type: text/plain; charset=us-ascii
Content-Transfer-Encoding: 7bit
> Subject:
> Comparing formula and BF
> Date:
> Tue, 23 Jun 1998 21:41:34 EDT
> From:
> "Carol Kelley, LLL Leader" <[log in to unmask]>
>
>
> Carrie and all,
>
> La Leche League encourages its Leaders to emphasize the advantages of
> breastfeeding and breastmilk rather than the disadvantages of bottle feeding
> and formula. We are to avoid putting down or ridiculing bottle feeding (p 91
> Leader's Handbook, revised ed.) It has been the experience of LLL over the
> past 40 years that mothers are more receptive to a positive presentation of
> information than to a negative one.For example, bottle bashing can make moms
> who've bottle-fed previous babies defensive, but a positive approach to the
> many benefits of breastfeeding can empower those same moms to breastfeed a new
> baby. My co-Leader is a perfect example of this. Besides a positive approach
> makes us seem a bit less like the "nipple nazis". There are women, however,
> who probably are more motivated to BF by horror stories of the hazards of ABM
> than by the advantages of breastfeeding.
>
I wonder, though, whether it's less than honest to talk about the
"advantages" of breastfeeding, when in fact, the real issue is the risk
of artificial feeding. Breastfeeding helps keep babies well, but infant
formula can make them sick. This is a reality that breastfeeding
counselors and advocates are going to have to figure out a way to impart
to women.
Katie Allison Granju
Knoxville, TN
=========================================================================
Date: Tue, 23 Jun 1998 22:13:06 -0400
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Nancy Holtzman <[log in to unmask]>
Subject: Cardiac Question
Comments: cc: Kathleen Bruce <[log in to unmask]>
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Hmm, Kathy, I happen to have this handy dandy tidbit in my files... this
sounds like what you are looking for...
Title
Oxygen saturations during breast and bottle feedings in infants with
congenital heart disease.
Author
Marino BL; O'Brien P; LoRe H
Address
Children's Hospital, Boston, MA 02115, USA.
Source
J Pediatr Nurs, 1995 Dec, 10:6, 360-4
Abstract
Bottle feeding is commonly advised for infants with congenital heart
disease (CHD) based on the belief that breast feeding is too difficult
for them. However, studies of preterm infants have shown that
greater cardiorespiratory effort occurs during bottle feeding than
during breast feeding. The purpose of this study is to determine if
there is a relationship between feeding method (breast vs. bottle) and
oxygen saturations (SaO2) in infants with CHD. In a correlational
design, pulse oximetry measured SaO2 during one breast and one
bottle feeding in each of 7 infants with CHD. SaO2 during breast
feeding is significantly different from SaO2 during bottle feeding (F =
59.72, p < .0001). SaO2 during breast feeding is higher on average
and less variable (M = 96.3%, SD = 2.2) than SaO2 during bottle
feedings (M = 92.5%, SD = 6.9), indicating that there is less
cardiorespiratory stress with breast feeding. None of the infants
desaturated (SaO2 < 90%) during breast feedings, whereas four
infants desaturated during bottle feedings.
Language of Publication
English
Nancy Holtzman RN BSN
Great Beginnings New Mothers Groups
Boston MA
617.323.9977
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[log in to unmask]
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Date: Tue, 23 Jun 1998 21:30:21 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "[log in to unmask]" <[log in to unmask]>
Subject: Re: LC ed ideas
In-Reply-To: <[log in to unmask]>
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>I am really impressed with activities of various chapters to underwrite BF
>ed . Let's hear some more!
>I realize our chapter is well enough off to do some of these and I intend
>to bring it up at next mtg. Sincerely, Pat in SNJ
I agree, Pat. I am excited about exploring what our Wis. Assn. can do. I
hope to get some ideas here as well as at the conference. Keep those ideas
coming. What do others do that keeps their Assn. energized and LCs nourished?
Patricia Gima, IBCLC
Milwaukee
mailto:[log in to unmask]
=========================================================================
Date: Wed, 24 Jun 1998 12:04:31 +0930
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Ellen McIntyre <[log in to unmask]>
Subject: baby care room awards
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Does anyone know of any organisation that awards baby care room awards?
Here in Australia, the Baby Care Room symbol is awarded by NMAA to a
facility with:
1. a convenient, quiet place to feed in privacy
2. comfortable seating (armchair style is preferable)
3. cleanliness
4. somewhere safe and clean to change nappies
5. hot and cold water and hand drying facilities
6. waste disposal facilities
7. a smoke free zone
8.preferably access for fathers who need to care for infants without
interfering with the privacy of breastfeeding women.
Thanking you in anticipation
Ellen McIntyre, South Australia
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Date: Tue, 23 Jun 1998 23:05:15 EDT
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Sandy Hankin <[log in to unmask]>
Subject: Intro/ Tooth enamel and caffeine
My name is Sandy Hankin and I'm new to Lactnet. I've been a LLLL for
around 7 years and have 3 children. I have a question about a study I
heard about linking caffeine consumption in lactating mothers to tooth
enamel defects. I know that the study was done on rats and looked at the
molars, specifically. From what I have heard about the study, it
hypothesized that the inadequate enamel development was related to poor
calcium absorption in the infant due to maternal caffeine consumption.
Has anyone heard of this study? Does anyone know whether a link was
found? TIA
Sandy Hankin
Austin, Texas
_____________________________________________________________________
You don't need to buy Internet access to use free Internet e-mail.
Get completely free e-mail from Juno at http://www.juno.com
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Date: Tue, 23 Jun 1998 23:25:19 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: millie <[log in to unmask]>
Organization: www.peapods.com
Subject: circumcision
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My understanding is the ancient Jewish circumcision was in fact much
different than modern circumcision. The ancient circumcision rite was
called milah. It basically involved stretching the foreskin forward and
cutting off the "tag" of skin that protrudes beyond the foreskin--a very
small amount of skin. It did not involve forcibly retracting the
foreskin or breaking the frenulum.
Modern circumcision (periah) didn't start until after the time of
Christ, and included everything we associate with circumcision
--stripping back the inner lining, removing the entire foreskin and
frenulum.
There is some speculation that the more radical periah was introduced
because milah was too easy to disguise/undo (by elongating the remaining
foreskin.) Rabbis in the church felt that milah did not effectively
bind men to "the seal of the covenant."
Most of this information is from a book entitled "Say No to
Circumcision" by Thomas J. Ritter and George C. Denniston (both M.D.s).
The book (with references) is available from an organization called
NOCIRC, but I can't find their address/phone.
Hope this helps.
Millie Adelsheim
http://www.peapods.com
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Date: Wed, 24 Jun 1998 00:32:19 EDT
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Carol Kelley, LLL Leader" <[log in to unmask]>
Subject: cardiac problems and BF
Comments: To: [log in to unmask]
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Kathleen and all,
Studies by Paula Meier and Gene Cranston Anderson,and by B Marino, et al have
demonstrated that feeding at the breast is less stressful to compromised
infants than is bottle-feeding. Marino studied 7 infants with congenital heart
disease and found that the oxygen saturation during breastfeeding was higher
and varied less than during bottle-feeding. None of the infants desaturated
(SaO2<90%) during breastfeeding, but four of the infants desaturated during
bottle feeds. Marino and collegues at Children's Hospital in Boston concluded
that cardiorespiratory was less during breastfeeding.
Dr Ruth Lawrence suggests that the baby with a heart defect be fed on one
breast per feed to increase the intake of hindmilk and to reduce the stress of
switching to the other side. (Meier has found that position change is
stressful to the infant.) The BAB also suggests feeding expressed hindmilk to
increase calorie intake. Some babies with cardiac problems may need extra
calories, but not extra volume, in order to gain weight since their energy
expenditures are greater than that of healthy babies. The hindmilk may be
given by supplementer at the breast, finger-feeding, cup, spoon or dropper to
avoid the bottle.
Hope this helps,
Warmly,
Carol Kelley LLLL
References:
Lawrence, Ruth A. Breastfeeding: A Guide for the Medical Profession. Mosby
1994 4th ed. p 431-432, 464
Mohrbacher, Nancy and Julie Stock. The Breastfeeding Answer Book. La Leche
League International 1997, revised edition p296-297
Marino BL, et al. Oxygen saturations during breast and bottle feedings in
infants with congential heart disease. J Pediatr Nurs 1995; 10(6):360-364
Meier P. Bottle-and breast-feeding: effects on transcutaneous oxygen pressure
and temperature in pretrem infants. Nurs Res 1988; 37:38
Meier P, Anderson GC. Responses of small preterm infants to breast- and
bottle-feeding. Matern Child Nurs J 1987; 12(2):97-105
=========================================================================
Date: Tue, 23 Jun 1998 21:32:33 -0700
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Stephanie Barth <[log in to unmask]>
Subject: Re: cardiac issues
Comments: cc: [log in to unmask]
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>From The Breastfeeding Answer Book, page 296:
"Although ist was once thought that breastfeeding takes more energy than
bottlefeeding, research on premature babies (Meier 1988) and babies with
congential heart disease (Marino 1995) indicates that the oposite is
true: bottle-feeding is more physically stressful than breastfeeding.
Differences between the composition of human mik and formula may also
affect the amount of energy expended. One study of healthy thow-day-old
babies found that the breastfed newborns had more energy-efficient heart
rhtythms, lower heart reates, and expended less energy thatn the
artificially fed babies, even though the breastfed babies spent less
time sleeping than their bottle-fed counterparts (Zeskind 1992)."
Citations: Marino, B. et al. Oxygen saturations during bresast and
bottle feedings in infants with congential heart diesease. J Pediatr
Nurs 1995; 10(6):360-64.
Meier, P. Bottle and breast feeding: effects on transutaneous oxygen
pressure and temperature in small preterm infants. Nurs Res 1988;
37:36-41.
Zeskind, P. et al. Rhythmic organization of heart rate in breast-fed and
bottle-fed newborn infants. Early Dev Parent 1992; 1(2):79-87.
=========================================================================
Date: Wed, 24 Jun 1998 02:09:55 EDT
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Carol Brussel <[log in to unmask]>
Subject: cardiac case
Comments: To: [log in to unmask]
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dear kathleen,
the mother should tell the doctor that if he knows of some other way to give
her child the extra IQ points and health protection, to please speak up and
share that info with us. . . meanwhile, wouldn't it be best if on the days
that the baby didn't nurse well, she could try an SNS with some of her milk
pumped and mixed to be "high test" (mix skimmed fat to make milk richer). i
guess i am tired, i can't remember the actual word for doing this. i do
believe the milk bank here locally has done this, perhaps others have as well,
and maybe there is something written about it. i will attempt to find out
tomorrow. perhaps someone has experience doing this?
meanwhile, perhaps someone knows the particulars of the study showing
breastfeeding is easier, but it was not "just" a LLL study, although why not?
oh wait, here it is, or at least one study along these lines - "suck-breathe
patterning during bottle and breastfeeding for preterm infants," paula meier.
this is directed towards encouraging breastfeeding in preterm infants, because
it presents less physiological instability than bottle feeding; i would think
the results mentioned here would validate the mother's desire to breastfeed as
opposed to bottlefeeding, especially since her child has these health
problems.
i guess this is the place to throw in sacrificing bf on the altar of
ignorance, etc.
carol b.
=========================================================================
Date: Wed, 24 Jun 1998 02:13:58 EDT
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Sherry Caruso <[log in to unmask]>
Subject: Breastfeeding after Chemo
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I was just reading Lactnet ...doing some research for a mother that has been
referred to me when I came across your post to Lactnet. I had just finished
doing a "search" of the archives and reading the current posts when I thought
I had hit upon my subject with your note. Well it must really be a small
world with the Lactnet group! Seems like we are working with the same
mother...Hodgkins Disease, last chemo is on 7/9, c/s scheduled 7/31 and poss.
radiation following the birth. I have been trying to educate myself more
about this before I speak to her, we have been playing phone tag for the past
day or two so I hope to speak to her tomarrow. It is quite likely that she
will be delivering at the hospital where I work and I've been talking to our
Clinical Nurse Specialist in reference to this case. I've been wondering
about some of the same questions that you have posed to the group and am
hoping that her doctors will be open to working with this mother....as I'm
sure I will be in contact with them soon!!!! Any info from the group will be
greatly appreciated.
Oh I know that I should introduce myself to the group as I have been lurking
in the background for several months and learning lots from all the wonderful
people on Lactnet (yes Jay I've finally surfaced). I am a hospital based LC
(overworked and covering four hospitals in our system) in Sacramento and I've
been working with breastfeeding mothers, and in parent education for the past
12yrs or so. I am also one of the few LC's in our area that is not an RN and
yes it is true that I don't think it ever occured to our hospital when my job
just kind of evolved into what it is today.
Thanks again,
Sherry Murga Caruso, CCE, IBCLC
Sacramento, CA
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Date: Tue, 23 Jun 1998 23:33:01 -0800
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Venus <[log in to unmask]>
Subject: Re: Continued post partum bleeding
Comments: To: Leibovich <[log in to unmask]>
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Mira,
Has this mum had an ultrasound to determine if there is any retained
placenta? Has her uterus shrunk to pre-pregnant size, or is it
still enlarged? (If the latter, what about oxytocin to help contract
the uterus?)
Jennifer Landels, BA, CE
Vancouver BC
=========================================================================
Date: Tue, 1 Jan 1980 00:15:32 +0100
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: =?iso-8859-1?Q?Fran=E7oise_Railhet?= <[log in to unmask]>
Subject: bottle
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Dear Lactnetters
We have here in France an article which sing the praises to a "special new
angled bottle", much better than a normal bottle for feeding a baby.
Sponsorised by the manufacturer. The problem is that their use a Ruth
Lawrence's article for the justification of this bottle. They give as a
reference : "The clinician's role in teaching proper infant feeding
techniques ; J Pediatrics 1995 ; 126-6 (s112-17), and the impression given
is not at all the same as the article from Lawrence.
I don't know if Ruth Lawrence is on Lactnet (perhaps someone know how to
join her), but we would like if she is aware that one of her article is used
to publicize a bottle. I can send her the copy of the article if she want.
Biberon spécial nourrisson : un progrès dans l'alimentation infantile. J
Valleteau de Mouliac (pediatre) et JJ Delas (pharmacien). Medecine et
Enfance, avril 1998, 234-35.
Kindly
Francoise Railhet
LLL France Medical Associates Program
[log in to unmask]
=========================================================================
Date: Wed, 24 Jun 1998 14:28:31 +0300
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Barry & Yael Wyshogrod <[log in to unmask]>
Subject: cardiac question
Comments: cc: [log in to unmask]
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It would be quite simple to perform pulse oxymetry during a feeding to
determine the degree of oxygen desaturation while breastfeeding. In
babies, the oxymeter probe is often taped to the toe, and this baby is
probably monitored continuously or frequently anyway.
Monitoring throughout a breastfeed would enable to doctor, as well as
the mother, to really see what is going on before deciding that the
mother should not breastfeed.
I would suggest this, as well as the reference from Journal of
Pediatrics.
Yael Wyshogrod
Rehovot, Israel
=========================================================================
Date: Wed, 24 Jun 1998 07:38:48 -0400
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Cindy <[log in to unmask]>
Organization: http://www.erols.com/cindyrn/
Subject: Re: Flagly
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Heidi
I beleive that it is now ok to breastfeed while taking Flagyl, did you
look it up in Hales book and search the archives?
Cindy
--
^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^
Cindy Curtis , RN, IBCLC ~ Virginia , USA
ICQ # 412812 mailto:[log in to unmask]
Benefits of Breastfeeding Home Page http://www.erols.com/cindyrn
=========================================================================
Date: Wed, 24 Jun 1998 07:46:24 -0400
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Cindy <[log in to unmask]>
Organization: http://www.erols.com/cindyrn/
Subject: Tom Hales Book
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The 1998 -1999 Medications and Mothers Milk Book is due out anytime now.
If you dont have it and you work with breastfeeding mothers you NEED it
, if everyone on LActnet had it , it would save a ton of posts about is
this or that medication ok. It is truly an invaluable book. Here is the
ordering information :
Dr Hales Web Page http://neonatal.ttuhsc.edu/lact/index.html
Ordering Information
Medications and Mothers’ Milk
1998-1999 ed.
752 pages
By
Thomas W. Hale, Ph.D.
Pharmasoft Medical Publishing
21 Tascocita Circle
Amarillo, Tx 79124
Call.... 806-358-8138
Sales... 800-378-1317
FAX... 806-356-9480
Multiple Copies
1 to 9...............19.95
10 to 19...........18.95
20 to 100.........17.95
Australia:
Capers Bookstore
Jan Cornfoot
Spring Hill Quarter
454 Upper Edward Street
Spring Hill QLD 4004 Australia
Canada:
Parentbooks
01 Harbord St.
Toronto Ontario, Canada M5S1H6
--
^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^*^
Cindy Curtis , RN, IBCLC ~ Virginia , USA
ICQ # 412812 mailto:[log in to unmask]
Benefits of Breastfeeding Home Page http://www.erols.com/cindyrn
=========================================================================
Date: Wed, 24 Jun 1998 08:11:36 EDT
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Patrician Drazin IBCLC <[log in to unmask]>
Subject: Re: FLAGY:
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Jon:
Flagyl comes in a number of different forms.... T. Hale speaks of an
intravaginal gel, an ob in my area uses a insert.
P
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Date: Wed, 24 Jun 1998 09:02:23 EDT
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Debi Page Ferrarello, RN, IBCLC" <[log in to unmask]>
Subject: cardiac baby
Comments: To: [log in to unmask]
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Dear Kathleen-
Dr. Paula Meier has done research, as has Matthews, that demonstrate that
bottle-feeding babies experience more apnea (they stop breathing temporarily)
and bradycardia (slow heart beat) that breastfeeding babies.
However, one issue with low muscle tone Down syndrome babies, and with
infants with cardiac problems, is that they expend much energy in feeding and
tire easily. It is a challenge to provide the needed calories and nutrients
in a way that will not compromise the baby's cardiorespiratory status.
I had a client whose baby was born with a hypoplastic left ventricle
(essentially was missing the left side of the heart). She had 3 surgeries
over 1-1/2 years for repair. Her surgeons strongly advised breastfeeding as
research done at Boston Children's hospital demonstrated significantly
improved outcome in breastfed babies.
Mom used a digital electronic scale to determine how much the baby took
at breast, and chose to complement expressed milk with human milk fortifier
after breastfeeding when necessary. At first, a feeding tube was used.
Eventually, a bottle was used, butthat was much later. Another option is to
use a feeding tube device with the widest tubing, to deliver additional milk
at breast. Breast compression to increase milk flow and fat content also
helps a lot. (BTW, the insurance co. picked up the cost of the scale as
documentation showed that it was medically necessary durable medical equipment
for this baby).
Best wishes and prayers to this baby and family, and to you who are
giving them much needed help and support!
-Debi Page Ferrarello, RN, IBCLC
Abington, PA
=========================================================================
Date: Wed, 24 Jun 1998 09:22:47 -0400
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: GJLanc <[log in to unmask]>
Subject: nocirc
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NOCIRC (National Organization of Circumcision Information Resource
Centers)
PO Box 2512
San Anselmo CA 94979-2512 USA
(415)488-9883
Fax (415)488-9660
web site http://www.nocirc.org/
Julie Lancaster RN
[log in to unmask]
=========================================================================
Date: Wed, 24 Jun 1998 09:54:58 -0400
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Linda J. Smith" <[log in to unmask]>
Subject: what affiliate groups do
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Hi All,
Our state ILCA affiliate, OLCA (Ohio Lactation Consultant Association) has
been offering 2-3 hours of continuing education at every meeting for at
least 9 years. We invite local LCs who have in-depth experience on a topic;
professionals in other fields; BF-friendly doctors in our communities; panel
discussions of common problems where we debate pros and cons of various
remedies; etc. The regular meetings are held 4-6 times a year on a
Saturday: a 2-hour business meeting in the morning, then a break for lunch
and the education in the afternoon from 1-3 pm. Our members get free CERPS;
non-members pay a nominal fee. We tape-record all the education sessions and
usually have a copy of the accompanying handouts in the lending library. I
think that this consistent commitment to high-quality education over the
years has been the #1 factor in developing a strong, well-informed
association and membership. Much of the credit should go to Alison
Hazelbaker, OLCA president from 1990-1992, for the organization's commitment
to continuing education. At $25 a year, membership is a true bargain.
By the way, Ohio is a sorta square-shaped state. We've found that meeting in
the center city (Columbus) has generally worked better than moving the
meetings around to the corners of the state. A central location means
nobody has to drive more than 3 hours to the meeting, and most are within a
2-hour drive.
Linda J. Smith, BSE, FACCE, IBCLC
Bright Future Lactation Resource Centre
Dayton, OH USA
http://www.bflrc.com
=========================================================================
Date: Wed, 24 Jun 1998 10:16:02 EDT
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Elisheva S. Urbas" <[log in to unmask]>
Subject: Re: Circumcision -- off topic
Comments: cc: [log in to unmask]
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The Hebrew Bible's description of circumcision are pretty clearly about
removal, not just incision, of foreskins. The hebrew word < 'arel> means
"covered and obscured by the foreskin" and is used, both in the bible and
later, metaphorically (an uncircumcised heart, uncircumcised speech, etc) as
well as literally. See, if you're interested, the incident in Exodus, end of
chapter four, where Moses wife Zipporah circumsizes their son with a flint and
physically throws the foreskin on the ground in front of Moses -- sure sounds
like complete removal to me.
That's internal philological evidence that goes back to the time those bible
passages were written, apparently about 1200 before the common era, or about
3200 years back from the present.
As far as the suggestion from the Ritter/Deniston book that "milah," by which
they refer to removing just the end of the foreskin, is much earlier and
"periah," or total removal, is later, that sounds possible to me, but
certainly even in this presently-used form circumcision is described in detail
in the talmud (tractate shabbat), in passages written within a couple hundred
years, one way or another, of the year zero.
So even if the ritual evolved -- as presumably it did; all rituals do -- it
reached its present form a very, very long time ago.
So I'm guessing that Alicia's original source was speculative rather than
authoritative. There may be people who would like to think ritual
circumcision is all just a misunderstanding but, love it or hate it, I don't
think there's any good evidence to support this particular view of it.
Elisheva S. Urbas
NYC
Elisheva
Elisheva S. Urbas
NYC
=========================================================================
Date: Wed, 24 Jun 1998 10:16:03 EDT
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Elisheva S. Urbas" <[log in to unmask]>
Subject: Question on theory and practice of hindmilk increase
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Hello wise ones, can you please help me out of a confusion in my bf-theory
education? I seem to have learned two things that seem to be contradictory,
but I suspect I am just missing third, explanatory fact that will clarify all.
On the one hand I was taught that the foremilk is present in the breast before
the baby begins to feed, and that the continued suction causes the breast
actually to produce the hindmilk as the feed continues.
On the other hand I have heard from many of you that breast compression
increases the calories that a baby is getting during the feeding.
I used to believe that this was because it stimulated the breasts to better
let down, or drain out, hindmilk that was already in the breasts, high and
back in the milk sinuses. But this seems would suggest that the hindmilk was
in fact already in the breast at that time, and seems inconsistent with the
idea that the hindmilk is actually produced while the baby in nursing.
So then does breast compression somehow send a signal to the breasts to
produce a higher proportion of hindmilk than they are stimulated to do by
suckling alone? And if so, is anything known of the mechanism through which
this works?
Any clarification from those with better lactational anatomy than mine will be
much appreciated.
Elisheva
Elisheva S. Urbas
NYC
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Date: Wed, 24 Jun 1998 10:20:30 -0400
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: The Fishers <[log in to unmask]>
Subject: terconazole
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I had a call from a mom today. She used terconazole once yesterday morning.
By evening her 19 month old breastfed son was vomiting violently and
contiuously, she also has some nausea and gastric upset. Dad does not.
After looking in Hale's '98 edition (yeah!!!) I learned that an adult
concern was flu-like symptoms. Her rconcerns are whether to continue
breastfeeding and how long it may take for her son to recover. He "looks
grey" and is very lethergic, vomitting every 20-35 minutes. Any thoughts or
info?
She is continuing to breastfeed at the moment since we don't KNOW that this
is a drug reaction and he might otherwise become seriously dehydrated, also
according to the timetable in Hale's book her levels should be down by now.
Victoria
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Date: Wed, 24 Jun 1998 10:34:59 EDT
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Barbara Hayes, RN, FACCE" <[log in to unmask]>
Subject: LC in new york
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Carol wrote looking for an LC in the prot chester or greenwich area. There
are many LCs in this area, close to NYC. If you give me a snail mail address,
I will send you the Breastfeeding Resource directory which our group
publishes, listing IBCLCs in the tri-county area you describe. It is such fun
to see a posting looking for help in an area which is right next door!.
Barbara Hayes
mailto:[log in to unmask]
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Date: Wed, 24 Jun 1998 10:39:17 EDT
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Barbara Hayes, RN, FACCE" <[log in to unmask]>
Subject: Hollister pump
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My daughter, Kathy, is a nurse and an enterostomal therapist, specializing in
wound care. With that backgound, she recently joined the Hollister company and
is rapidly learning about breastfeeding! She tells me that the company has
just introduced a electric& battery operated pump, called"Purely Yours". for
more information, contact your Ameda-Hollister rep(yes they will continue to
use the Ameda name, at least for a while) or contact Hollister at
1-800-323-4060.
Barbara Hayes
mailto:[log in to unmask]
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Date: Wed, 24 Jun 1998 11:35:02 EDT
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Nancy E. Wight MD, FAAP, IBCLC" <[log in to unmask]>
Subject: Re: Flagyl
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Flagyl is used to treat anaerobic perinatal infections and trichomonas. It is
classified as "use with caution" by the AAP because of possible teraogenic
effects in rats. I use full dose flagyl IV in 500gm infants when we suspect
NEC (rare because we use lots of BM) without problems. I have a hard time
believing that 2% of Mom's dose will cause a problem for my premies, let alone
a full term, healthy infant!
Nancy Wight MD
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Date: Wed, 24 Jun 1998 09:02:57 -0700
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Johnson, Martha (PHMG)" <[log in to unmask]>
Subject: Re: cardiac question *Fairly Urgent*
Comments: To: Kathleen Bruce <[log in to unmask]>
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Dear Kathleen,
Check Marsha Walker's JHL [9(2) 1993] artcle "A Fresh Look at the Risks of
Artificial Infant Feeding". On the second page, there is a section with the
heading "Cardiorespiratory Disturbances During Bottle-feeding", with at
least 5 refs. That's all I can come up with right now. Good luck!
----------Martha Johnson RN IBCLC, Eugene, Oregon
> ----------
> From: Kathleen Bruce[SMTP:[log in to unmask]]
> Sent: Tuesday, June 23, 1998 4:51 PM
> Subject: cardiac question *Fairly Urgent*
>
> I've run into a situation with a mother of a newborn. The newborn girl
> has
> Down Syndrome and has been feeding well at the breast. At 2 weeks of age
> she was diagnosed with heart problems, A-V Canal defect and a hole, and
> will need open heart surgery. The baby started diuretics(lasix and
> aldactone) on 6/17. The Cardiologist is allowing bf for now, but stated
> it
> probably will be neccesary to transition to a bottle because it is easier
> for the infant to feed and they can mix a suppliment to increase the
> calories. When the mother answered that she had heard of studies done by
> LLL that bf was easier, he replied that of course LLL is skewed in their
> viewpoint, and that in his 20 years of experience he did not observe
> this(of course how many mothers did he give the chance too?). The mother
> does not want to use a bottle(a LLL leader) and does not believe it is
> best
> for her baby. She would like to bf up to and right after the babies
> surgery.
>
> Is there any information/studies that show bf is easier than bottlefeeding
> an infant, especially babies with heart problems, that can be presented to
> the Dr.? What other strategies could she use to persuade the
> cardiologist?
> She really wants all the advantages of bf since the infant has Downs with
> the problems of ear infection/speech development and mental function, not
> to mention the comfort/bonding she needs at this time.
>
> Lastly, since the cardiologist emphasis is on weight gain, what techniques
> can be used to aid the baby in gaining weight and forestall
> bottles/supplements? It seems that since the baby was put on the
> medication she has a good day of feeding and then a poor day of
> feeding(very sleepy, can barely be roused awake, then falls asleep in
> seconds). This has alternated for the last 5 days. They are meeting with
> the Doctor on Wednesday for a checkup(EKG and weight) and will ask the Dr.
> about the effects/dosage of the medication. The dosage of medication was
> calculated from the babies weight at the first visit. She was born 6 lbs
> 2
> oz, went down to 5 lbs 14 oz and at the cardiologist visit was 6 lbs 7 oz.
> After 1 1/2 days of medication, she was down to 5 lbs 11 oz from fluid
> loss. Aldactone can cause drowsiness and the dosage may be adjusted to
> the
> babies new weight.
>
> Please email to the list and to me privately. Thanks.
>
> Kathleen
>
>
>
> Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet,TLC, Indep. Consultant
> mailto:[log in to unmask]
> LACTNET Archives http://library.ummed.edu/lsv/archives/lactnet.html
> For LACTNET quilt raffle: http://together.net/~kbruce/kbblact.html
>
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Date: Wed, 24 Jun 1998 12:00:09 EDT
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Susan Manore, IBCLC, LLL" <[log in to unmask]>
Subject: Brief intro and calling oneself an LC if not certified
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Hi. I've been lurking for a while so I'll briefly introduce myself. My name
is Susan. I'm an IBCLC, LLL Leader, and mother to 4 children (all were
breastfed). Brief enough?
Pat wrote that if someone is saying they are an LC and are not certified they
should be reported to ILCA. She said she wasn't sure of the legalities but
that they couldn't do that. I wish that were the case. While I agree that we
should call ourselves what we are, anyone can hang out a shingle and call
themselves an LC. They may have loads of breastfeeding knowledge or zip.
There are no legal restraints on this yet.
I don't mean to open a can of worms here, but having the initials (IBCLC)
doesn't assure me that this person is well trained to handle breastfeeding
difficulties well. I've met too many people who have taken classes or
workshops for training, who were able to pass the exam. They went on to do
more damage than good. I feel that if you step into the situation you stay
with it until the difficulty is resolved. If it's beyond your level of
expertise then you refer them to someone who can help. I'm sorry to say I
don't see that happen often enough. Moms are sent home no better off than
when they started. Some are worse off because they are given incorrect
information or told to 'just keep trying and your baby will get the hang of
it'. I'm afraid this attitude does more damage to the image of an LC than
someone who isn't certified. I'll step off this soapbox. Now I remember why
I'm afraid of heights ;)
Sue
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Date: Wed, 24 Jun 1998 11:45:39 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Katherine A. Dettwyler" <[log in to unmask]>
Subject: Baby with Down Syndrome
Comments: To: [log in to unmask]
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>I've run into a situation with a mother of a newborn. The newborn girl has
>Down Syndrome and has been feeding well at the breast. At 2 weeks of age
>she was diagnosed with heart problems, A-V Canal defect and a hole, and
>will need open heart surgery. The baby started diuretics(lasix and
>aldactone) on 6/17. The Cardiologist is allowing bf for now, but stated it
>probably will be neccesary to transition to a bottle because it is easier
>for the infant to feed and they can mix a suppliment to increase the
>calories.
It is probably easier for the baby with Down Syndrome to feed from a bottle.
Whether easier is better is debatable. It's also easier for the child to be
put in a wheelchair rather than be encouraged to learn to walk. It's also
easier for the child to be allowed to remain mute than to teach it to talk.
It is easier to allow the child to never learn to read than to insist that
he try, and keep on trying. Hard work has its rewards. Breastfeeding may
be hard work for the baby, this will be rewarded with proper muscle
development in the face, including the mouth and tongue, which will help
greatly with pronunciation later when she is learning to speak. HOWEVER,
you don't want it to be so difficult for the baby that she becomes exhausted
and falls asleep at the breast before getting enough to eat (which is what
happened with Peter). If the breastfeeding is closely monitored, there is
no reason why the baby shouldn't start each feeding at the breast. The baby
should be offered the breast several times an hour, as she probably won't be
able to sustain effective sucking for long periods of time. Careful before
and after weighing with a Medela scale can help determine how effective the
baby is at removing milk. The mother should also be encouraged to pump with
a good quality pump after each feeding and give any hind milk she gets to
the baby with a cup or spoon (no need for a bottle). That should alleviate
the doctors fears that the baby needs caloric supplementation.
When the mother answered that she had heard of studies done by
>LLL that bf was easier, he replied that of course LLL is skewed in their
>viewpoint, and that in his 20 years of experience he did not observe
>this(of course how many mothers did he give the chance too?).
I believe the studies show less "stress" for the breastfeeding baby, as in
high heart and respiratory rate. Bottle-feeding is "easier" in the sense
that it takes less muscular effort. So "easier" is an ambiguous term.
She would like to bf up to and right after the babies surgery.
It's her baby -- she can do what she wants.
> She really wants all the advantages of bf since the infant has Downs with
>the problems of ear infection/speech development and mental function, not
>to mention the comfort/bonding she needs at this time.
It is even more important for babies with Down Syndrome to have breast milk
than for other babies, as Down Syndrome carries with it cognitive deficits
and immune deficiencies. If you add the cognitive deficits and immune
deficiencies of formula on top of that, you are looking at significant
impairment for the baby that is not necessary.
>
>Lastly, since the cardiologist emphasis is on weight gain,
Make sure the cardiologist is aware that children with Down Syndrome grow
more slowly than other children, regardless of heart defects, regardless of
intake. They just grow slowly. There are special growth charts for Down
Syndrome children, from the late 1980s, I believe. First author is
Christine Cronk. The doctor needs to be using these, so that he isn't
over-zealous in trying to get the baby to reach "normal kid" growth levels
-- it ain't gonna happen, no matter what they do.
and then a poor day of
>feeding(very sleepy, can barely be roused awake, then falls asleep in
>seconds).
Many children with Down Syndrome, in the newborn period, sleep for extended
periods of time and difficult to rouse -- again, whether or not they have a
heart defect. Peter did not have any kind of heart defect, yet at 3 weeks
of age, when we brought him home from the NICU, he was still sleeping 23
hours out of every 24. He didn't really "wake up" until he was about 4
months old. He would have episodes of bradychardia (slow heart beat) where
he would turn as white as a sheet, and NOTHING would wake him from these
episodes -- we just had to wait them out. They were apparently harmless.
Hope this helps. Feel free to share with the doctor. Remember that a
cardiologist is focusing on the heart issues, and may know little or nothing
about the other aspects of Down Syndrome that impact on sleep/wake issues,
growth, etc.