What is the current thinking on shingles and breastmilk? I have a mother
with shingles, and she an infant that was born at 29 weeks and mom has been
pumping. Baby was on lipids and TPN and just last weekend was going to the
breast for first time. (baby is now 33 weeks) but mom came down with
shingles, I was with the understanding that we would treat this like a
herpes lesion,.Should we save the milk, should mom breastfeed when baby
stable again? Right now baby is NPO for 7 days due to gut conditionBaby is
in very fragile condition. We had a Nec scare with her about 2 weeks ago.
Baby had a transfusion over the weekend due to anemia caused by occult blood
in the stool and also some frank bleeding noted in the stools.
Thanks
Jan Aken RN IBCLC
mailto:[log in to unmask]
=========================================================================
Date: Wed, 3 Feb 1999 01:12:49 EST
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: Shingles and breastfeeding
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Shingles is not a contraindication to breastfeeding or using the milk. Like
any herpes lesion (varicella zoster is a herpes virus) you want to minimize
any infant exposure:
cover the lesion and wash your hands. I know of no research that suggests the
virus gets into breastmilk. Shingles is a local reactivation of virus living
in nerve endings, not a systemic illness.
Nancy Wight MD, FAAP, IBCLC
=========================================================================
Date: Tue, 2 Feb 1999 23:09:23 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: [log in to unmask]
Subject: ethical issues
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sure it's infuriating, but we can't ethically advise someone to lie to their
doctor (hey, they can come up with that idea on their own), and yes, it IS the
doctor's business whether the baby is still breastfeeding. not because of this
weird belief about bf influencing the hematocrit, but because the doctor needs
to know this is normal and not something to be disrupted because of his
ignorance about the validity of a particular test. this woman should either
express her disagreement with the doctor's advice and seek to come to an
agreement as to how to handle his concerns about the hematocrit, or find a
different doctor and let the previous one know why they left his practice.
carol brussel IBCLC
=========================================================================
Date: Tue, 2 Feb 1999 23:19:58 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Tracy Kirschner, La Leche League Leader & Doctor of"
<[log in to unmask]>
Subject: Breech
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Barbara,
There is an excellent, noninvasive chiropractic technique for turning a breech
baby. It involves a specific sacral adjustment and some muscle releasing
techniques. Please let me know if you'd like the info. for a referral to a DC
trained in this procedure.
Tracy Kirschner, DC
=========================================================================
Date: Tue, 2 Feb 1999 23:40:58 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: [log in to unmask]
Subject: Re: LACTNET
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Chris:
you are a very important member and participant on lactnet... you have a
tremendous wealth of knowledge that you are absolutely briming to share with
us,,,, so, the door swings both ways....
Patricia
=========================================================================
Date: Tue, 2 Feb 1999 23:44:45 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Tracy Kirschner, La Leche League Leader & Doctor of"
<[log in to unmask]>
Subject: More on Breech Babies
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I must add a little to my previous post about breeches. I think it's great to
have all these wonderful noninvasive ways to turn breech babies but some are
determined to be born that way. It is just another way for a baby to come into
this world! I had a suprise breech baby at home with no problem what so ever.
I know several other women who have deliverd breeches vaginally. Our bodies
are built to do it! This mom may be able to find a practitioner skilled in
breech deliveries and it doesn't have to be a midwife at home. I know there
are still some MD's whom do them. Good Luck.
Tracy Kirschner, DC
=========================================================================
Date: Wed, 3 Feb 1999 00:02:51 -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: Nursing three
Comments: cc: [log in to unmask]
In-Reply-To: <[log in to unmask]>
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Barbara,
This lady has already proven she can carry to term while nursing. She did
it 11 months ago. With mom's proven track record I think it would be up to
the Dr. to prove that there might be more harm from nursing to the new baby
than benefit to the older children.
I do remember a woman in an LLL group that I attended while a Leader
Applicant (1988) that was nursing an 8 month old, a two year old and a 41/2
year old. The oldest was thin but not skinny, the second was moderately
plump and the baby was a butterball. Baby needed nothing but mom's milk
until the middle of the first year, if I recall correctly.
I am sure nursing three means she will have to observe closely to be sure
baby gains and grows appropriately. She will probably need to eat well or
she would be very tired.
Linda Pohl, IBCLC
Phoenix AZ
=========================================================================
Date: Wed, 3 Feb 1999 09:11:33 +0200
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Leibovich <[log in to unmask]>
Subject: Furesemide, medical investigations
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I wanted to comment on two subjects recently discussed, even though I might
be a little late.
<<
She called her Ped to tell him she was switching to ABM. He called in a
prescription for a diuretic to dry up her milk....
The med was Furosemide.
>>
>This is crazy & dangerous. I have never heard of doing this and I certainly
>don't know any peds doing that, until now.
>
This is being done often here in Israel. I heard it recommended by many
doctors, and it seems to work. I don't know about references, but when a
mother is given one tablet, I don't think much harm could be done. I
personally don't use it.
***********************
<< They found some protein in his urine, and then a whole
bunch of investigations began, which ended with a kidney biopsy >>
>.... Afterall, he just had a
>thorough physical and they said he was fine and healthy! Excuse me, I
need to
>call my lawyer..........
We community doctors face the dilemma of how much to investigate a
complaint, or an incidental finding, all the time. I would call this "The
art of medicine". Of course you would like to make a little too many tests,
than so few that you keep missing diagnoses, but deciding what to do, whom
it should be done to, when it should be done, when you should stop - all
these make the difference between a good, experienced doctor, and someone
who knows all the options in the book.
I'm sure there are personal differences between doctors, and I find
patients choose the doctor who best fits their needs. Some like endless
tests, and only then feel secure, others want a doctor who does as few
tests as possible, explains the situation, and reasures the patient.
It has been shown that the doctors who get sued most are not the ones who
make more mistakes, but those who have a communication problem with their
patients. Doctors have made big mistakes, and not gotten sued, if the
patient felt that the doctor really did his best, and really cared about
the patient.
You can probably guess that I don't like too many tests, but I do my best
to answer a patient's medical and psychological needs.
Mira Leibovich, MD
Family Medicine Specialist
Israel
mailto:[log in to unmask]
=========================================================================
Date: Tue, 2 Feb 1999 23:28:30 -0800
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: stu and jan black <[log in to unmask]>
Subject: BF Education in school
Comments: To: [log in to unmask]
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I am looking for any ideas, programs, literature etc for a PHN I work with
who teaches reproduction in the public schools. She was very excited about
how knowledgeable some of the student were about BFing (grade 6-7).
She was wondering about what has worked for others when teaching about BFing
in school-if there have been any documented long term positive results from
teaching/presenting this as normal.
I would guess Parental acceptance to be a major roadblock?
Thankyou for all of your incredible knowledge and experience.
Janet B. RN
[log in to unmask]
=========================================================================
Date: Wed, 3 Feb 1999 06:43:41 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: newman <[log in to unmask]>
Subject: clinda, ceftizoxime
Comments: To: [log in to unmask]
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Neither of these medications is contraindicated during breastfeeding. The
ceftizoxime is poorly absorbed from the gi tract, and unlikely to cause the
baby any problems. The amount of clindamycin the baby will get is very
small as well. It is not that there is *no* risk, but the risk of
breastfeeding with some small amount of drug in the milk is less than not
breastfeeding.
The point of course here is that there are any number of other medications
which will do the trick which should be considered if there is a true
concern. But there isn't.
Jack Newman, MD, FRCPC
=========================================================================
Date: Wed, 3 Feb 1999 07:05:51 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: [log in to unmask]
Subject: Re: Curse words
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In a message dated 2/3/99 1:48:04 AM !!!First Boot!!!,
[log in to unmask] writes:
<< That is total bullshit! You are right, the doc is nuts, the simplest
solution is for her to lie to the doc re:BFing (it's none of his beeswax
anyway!) >>
Is it really necessary for posters to use such vile language? I am no saint
but I think it is inappropriate and offensive to some of us to use vulgar
language on this list.
Encouraging a patient to lie to their health care provider? That's real nice,
NOT!
None of his beeswax? Geez, I thought we wanted HCP's to be interested and
involved in BF'ing.
IMHO
Andrew MD
[log in to unmask]
=========================================================================
Date: Wed, 3 Feb 1999 07:18:12 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: [log in to unmask]
Subject: Re: CBC/Hgb
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In a message dated 2/3/99 1:48:04 AM !!!First Boot!!!,
[log in to unmask] writes:
<< The hemoglobin is the issue... you
don't need a CBC [complete blood count] unless you have a good reason from
history or physical exam... >> Gail
You can't tell much from just a Hgb or Hct - strictly a screening test.
A CBC will give you much more helpful information - RBC's, MCV, MCH, MCHC,
RDW, platelet count.............Anemia with a low MCV (mean corpuscular
volume) limits the anemia to one of two diagnoses: iron deficiency or some
type of thalassemia (can't diagnose by looking at patient). Anemia with a MCV
greater than 100 fl NEEDS to be explained.....spurious, reticulocytosis, liver
disease, preleukemia, sideroblastic anemia, megaloblastic anemias,
drugs..........
Andrew MD
[log in to unmask]
=========================================================================
Date: Wed, 3 Feb 1999 07:00:03 -0600
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Jeanne Mitchell <[log in to unmask]>
Subject: Universal Precautions
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Several people have asked me to post the URL's for the CDC and OSHA
standards regarding human milk.
Centers for Disease Control and Prevention
http://www.cdc.gov/ncidod/diseases/hip/universa.htm
This is a long document that defines Universal Precautions, which do not
apply to human breast milk. The paragraph about human milk is at the
bottom.
OSHA (Occupational Safety & Health Administration, US Dept. of Labor)
http://www.osha-slc.gov/OshDoc/Interp_data/I19921214.html
This is a letter clarifying that human milk is not considered a
potentially infectious material.
By the way, I have heard on 2 separate occassions that OSHA requires
expressed milk to be stored in a separate refrigerator from regular
food. I have searched their website and can find NO documentation of
this. It appears that some states and some regions define the standards
as they see fit. I want a national interpretation on this. I may make
some calls. I'll be sure to let y'all know if I find out anything.
--
Jeanne Mitchell, Austin, TX
http://www.flash.net/~xanth/home.htm
mailto:[log in to unmask]
"You can tell the quality of a person by how
they treat people they don't need." My Dad
=========================================================================
Date: Wed, 3 Feb 1999 08:09:59 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "< Lucia Jenkins R.N., I.B.C.L.C.>" <[log in to unmask]>
Subject: Re: LACTNET Digest - 26 Jan 1999 - Special issue
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VIDEOS_I am catching up on posts, so someone may have already posted about
this.I teach the bf classes at a local hosp, and after much searching, I have
come up with what I believe is the best combination- the parents in the
classes rave about the films. The first is HOW-TO, CAN-DO from Vida Films in
Cambridge, Mass. It was filmed locally, which is a big plus (many parents
have complained aboutt he foreign films- " but we live here in the US")- is
shows an LC doing a home visit, lots of latch-on close-ups, good written
"points", jazzy music, and a great section at the end on what Dads do. Even a
Dad of 2 sets of bf twins talking to dads. It is absolutely the best film I
have seen.
The touchy-feely film I show ( 15 mins) at the end of the class is made by
Texas WIC, from Childbirth Graphics. No spoken words, just mom after mom at
home latching on babies of all shapes and sizes over and over with stop
actions.
Lucia Jenkins RN, IBCLC
=========================================================================
Date: Wed, 3 Feb 1999 08:35:03 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Nikki Lee <[log in to unmask]>
Subject: tandem nursing
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Hello Everybody:
This is in response to the query about how many one can tandem nurse and
about milk supply. About 8 or 9 years ago, our Nursing Mothers' Hotline got a
telephone call from a woman nursing 4 children ranging in age from 9 down to
an infant. She called because she wanted to stop nursing the older 2. Supply
wasn't the issue at all. So I guess the potential is vast. Remember those laws
that I have heard attributed to West Virginia and to Great Britain, that one
was not permitted to wet nurse more than 6 babies per day? Warmly, Nikki Lee
=========================================================================
Date: Wed, 3 Feb 1999 08:37:55 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: G Hertz <[log in to unmask]>
Subject: Great Baby Blues Comic
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Jerry Scott & Rick Kirkman have done it again!
Another breastfeeding comic to clip and save --
first frame; Wanda mentions weaning "Hammie" - Darryl mentions that Hammie
is a year old now.
second frame; discussion about eating solids and how it would be a break
for mom....
third frame; Hammie comes over, tugs on mom's shirt saying "num-num?"
Last frame shows Hammie nursing, dad looking on smiling and mom saying "On
the other hand, there's no rush..."
Yeah, Baby Blues!!!
They have a web site at www.babyblues.com where you can email them with
your comments.
If you don't have Baby Blues in your paper, you're definitely missing out -
email your local newspaper and ask for it - it's great!
[and speaking of files - I have a whole folder of Baby Blues AND I know
where it is!]
Gail
Gail S. Hertz, MD, IBCLC
Resident, Dept. of Pediatrics
PSGHS Children's Hospital
Hershey PA
[log in to unmask]
=========================================================================
Date: Wed, 3 Feb 1999 08:40:10 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Loni Denman, RN, IBCLC" <[log in to unmask]>
Subject: Hypothyroidism
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Any of you lactnuts know of any references for hypothyroidism and low milk
production? I have a client who is on oral thyroid preparation .125mg. Her
milk production is low and baby is not gaining weight adequately. We are
having to supplement at the breast right now. Her endocrinologist would like
any info we can dig up on this. TIA. Loni Denman, RN, IBCLC
=========================================================================
Date: Wed, 3 Feb 1999 08:44:28 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Kathy Parkes, RN, IBCLC" <[log in to unmask]>
Subject: Re: Curse words
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In a message dated 99-02-03 08:36:43 EST,Andrew writes:
<<
Is it really necessary for posters to use such vile language? I am no saint
but I think it is inappropriate and offensive to some of us to use vulgar
language on this list.
Encouraging a patient to lie to their health care provider? That's real
nice,
NOT!
None of his beeswax? Geez, I thought we wanted HCP's to be interested and
involved in BF'ing. >>
I must wholeheartedly agree with Andrew here. Not only are these things
inappropriate, but they are unprofessional to voice on such a large venue.
How can we (as LCs) gain respect among HCPs if this is the attitude??
Kathy Parkes, RN, IBCLC
private practice in San Antonio, TX
=========================================================================
Date: Wed, 3 Feb 1999 15:54:48 +0200
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Pamela Morrison IBCLC <[log in to unmask]>
Subject: HIV: Washington Post report on PETRA studies
Mime-Version: 1.0
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Kathy K, thanks so much for sending a copy of the Washington Post report of
the results of the PETRA studies, and for alerting us especially to the last
two sentences.
>Breast feeding increases a baby's risk of acquiring HIV from an infected
>mother by up to three-fold, depending on when the child is weaned."
What's with these people? This is a little play on words. It's true that
up until recently risk of transmission has been thought to be roughly 30%,
ie one-third in utero, one-third during delivery and one-third during
breastfeeding. That's one-third, folks, not "three-fold". However, even
this figure has recently been reviewed in the Leroy multi-centre pooled
analysis reported in the Lancet at the end of August l998, which showed that
only 49 out of 102 babies were believed to have acquired HIV through
*breastfeeding*. That's 5%, not 10% and certainly not three-fold. Why
choose to quote an earlier (larger) statistic and to omit a more recent
(smaller) one? At best this is selective reporting. At worst it's
deliberately misleading.
>A major moment of risk may occur in the first few days, when the child can
>take in more than 25,000 HIV-containing cells in the thick fluid known as
>colostrum.
This is unbelievable. Blaming infection on "HIV-containing" colostrum.
When it is *just as likely* that during delivery virus-laden maternal
secretions can infect the mucosal surfaces of the infants' eyes, mouth and
gastrointestinal tract, and the baby's skin, and gain access to the
bloodstream. Think about it. Until we have better tests, that can
*distinguish* between infection acquired during delivery and infection
acquired during the first few days/weeks of breastfeeding, then we CANNOT
say that colostrum is the culprit. Why not describe "birth" as "a major
moment of risk" instead? It interests me that the interpretation of risk is
reported to be that evil fluid colostrum, rather than labour/delivery.
Always the same message, Don't breastfeed. Aaarrrgghh!
Pamela Morrison IBCLC, Zimbabwe
mailto:[log in to unmask]
=========================================================================
Date: Wed, 3 Feb 1999 15:54:51 +0200
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Pamela Morrison IBCLC <[log in to unmask]>
Subject: HIV: UNAIDS report on PETRA studies
Mime-Version: 1.0
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This just landed in my mailbox. Same studies, different reporting.
***************************************
Subject: [84] Early Results Released from African MTCT Trial
Author: AF-AIDS <[log in to unmask]> at INTERNET
Date: 02/02/99 11:28
Early Data from Mother-to-child HIV Transmission Study in Africa finds Shortest
Effective Regimen Ever
Geneva, 1 February 1999
UNAIDS Research Points to Important New Strategy for AIDS Prevention in
Developing Countries
Preliminary findings from the largest clinical trial ever to examine
mother-to-child transmission of HIV open the way for a new, simpler strategy for
reducing HIV infection among babies in the developing world.
According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), when an
HIV-positive mother begins an antiretroviral regimen at the time of delivery,
and she and her newborn follow a postpartum regimen for just one week, the
chances of the infant becoming infected are reduced significantly (by 37
percent). Prior to this breakthrough, the shortest regimen proven to be
effective began during the mother's 36th week of pregnancy three to four weeks
before delivery.
"Over half a million babies are infected with HIV every year, most of them in
sub-Saharan Africa where access to health care can be limited," said Dr Peter
Piot, Executive Director of UNAIDS. "Now we may be able to help women protect
their babies, even if they do not come to a hospital or clinic untilvery late in
pregnancy."
The research, presented today at the Sixth Conference on Retroviruses in
Chicago, analysed rates of mother-to-child (also called perinatal, or vertical)
transmission among 1357 out of 1792 participants in the UNAIDS PETRA
(PErinatalTRAnsmission) trial. The trial, conducted in five urban settings
inSouth Africa, Uganda and Tanzania, evaluated three regimens using zidovudine(
ZDV, or AZT) and lamivudine (3TC), as compared with placebo.
Transmission rates in all trial arms were measured at six weeks after birth.The
researchers are still analysing data from the long-term follow-up of infants
because HIV can be transmitted through breast milk and the majority of women in
the trial practised breastfeeding. However, early reports from other studies
among breastfeeding populations indicate that the preventive effects persist for
at least 6 months. The babies and mothers in PETRA will be followed for 18
months. Other early PETRA results indicate that the inclusion of a one-week
postpartum course of antiretrovirals for mother and baby is crucial. Among women
who received only an intrapartum regimen, with ZDV and 3TC taken during labour
and delivery, transmission was not at all reduced. In the longest regimen, women
started ZDV and 3TC in the 36th week of pregnancy,followed by the intra+
postpartum regimen. Among these women, there was a 50 percent reduction in
transmission. Similar findings had emerged earlier from a study among
non-breastfeeding TThai women by the Centers for Disease Control andPrevention
(CDC) and the Thai Ministry of Public Health (MOPH) in which ZDV alone was given
from the 36th week of pregnancy through delivery.
"It is vital to develop a range of prevention options for mother-to-child
transmission so that countries can cater for women living in different real-life
situations", said Dr Awa Coll-Seck, Director of Policy, Strategy and Researchfor
UNAIDS. "We hope that as more data are gathered, more public health officials
and donors will see the value of investing in mother-to-child transmission
programmes in the countries hardest-hit by the AIDS epidemic".
In the absence of preventive strategies, mother-to-child transmission rates
range from 25 to 35 percent among breastfeeding women. According to estimates,
nearly 600,000 babies are infected a year in total. One-third of them acquire
HIV through breastfeeding, a risk that is eliminated if the mother uses a
replacement method for infant feeding. But for many HIV-positive mothers in
developing countries, the risk of their infant dying if not breastfed could be
even greater than the risk of transmitting HIV infection through breastmilk.
Furthermore, in places where women may be ostracized and even endangered should
their HIV-positive status become known, women may choose not to use replacement
feeding for fear of being identified as HIV-positive. Hence the need to find
prevention methods that are effective for breastfed infants. "As final results
come in from this and other mother-to-child transmission studies, public health
officials will have more choices available, especially as more information about
the dynamics of transmission through breastfeeding emerges", said Dr Joseph
Saba, a clinical research specialist at UNAIDS who manages the PETRA trial.
Glaxo Wellcome announced last year that it would substantially lower the pricing
of AZT for the prevention of mother-to-child transmission based on the CDC Thai
trial regimen. In view of the early PETRA results, Glaxo Wellcome has pledged
similar public sector preferential pricing for 3TC and Combivir (the fixed-dose
combination of AZT and 3TC) in an effort to support this regimen as another
option in establishing effective mother-to-child public health programmes in
developing countries.
The PETRA study is part of an international research effort coordinated by the
UNAIDS Informal Working Group on Prevention of Mother-to-Child Transmission of
HIV, with membership of all research institutions involved in mother-to-child
transmission trials including the CDC, the National Institutes of Health (NIH),
and the French Agence Nationale de Recherche sur le Sida (ANRS). The working
group has sought to identify the most promising drug regimens for testing and to
coordinate trial designs to eliminate duplication of effort and compare results.
The following institutions conducted the PETRA trials: In South Africa, the
Baragwanath Hospital, University of Witwatersrand, Johannesburg, and King Edward
Hospital, University of Natal, Durban; in Tanzania, Muhimbili University and
General Hospital, Dar-es-Salaam; and in Uganda, Mulago Hospital, Makerere
University, Kampala, and Nsambya Hospital, Kampala. Data management and analysis
was conducted by the National AIDS Therapy Evaluation Centre in Amsterdam. The
PETRA study has received financial support from Australian AID (Australia),
Istituto Superiore di Sanita (Italy), Het AIDS Fonds (Netherlands) and the
Swedish Agency for Research Cooperation with Developing Countries(Sweden).
For more information, please contact Anne Winter, UNAIDS, Geneva,
(+4122)791.4577, Lisa Jacobs, UNAIDS, Geneva, (+41 22) 791.3387 or Karen
O'Malley at the Retroviruses Conference in Chicago, (+1 312) 329.7281. You may
also visit the UNAIDS Home Page on the Internet for more information about the
programme(http://www.unaids.org).
**********************************
Pamela Morrison IBCLC, Zimbabwe
mailto:[log in to unmask]
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Date: Wed, 3 Feb 1999 08:59:48 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: "Presutti, Lenard" <[log in to unmask]>
Subject: Re: Shingles and breastfeeding
Comments: To: "Nancy E. Wight MD, FAAP, IBCLC" <[log in to unmask]>
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The most recent information I have read is that there is no
contraindication to breastfeeding with active Herpes Zoster unless the
lesions are on the breast itself as Herpes Zoster is spread by contact
and not by aerosol spread as is Chicken Pox.
Len Presutti, DO
Dept. of Fam Med.
Ohio Univ. COM
Athens OH 45701
>----------
>From: Nancy E. Wight MD, FAAP, IBCLC[SMTP:[log in to unmask]]
>Sent: Wednesday, February 03, 1999 1:12 AM
>Subject: Re: Shingles and breastfeeding
>
>Shingles is not a contraindication to breastfeeding or using the milk. Like
>any herpes lesion (varicella zoster is a herpes virus) you want to minimize
>any infant exposure:
>cover the lesion and wash your hands. I know of no research that suggests
>the
>virus gets into breastmilk. Shingles is a local reactivation of virus living
>in nerve endings, not a systemic illness.
>Nancy Wight MD, FAAP, IBCLC
>
>
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Date: Wed, 3 Feb 1999 09:00:25 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: G Hertz <[log in to unmask]>
Subject: Re: CBC/Hgb
Comments: To: [log in to unmask]
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> << The hemoglobin is the issue... you
> don't need a CBC [complete blood count] unless you have a good reason
from
> history or physical exam... >> Gail
You can't tell much from just a Hgb or Hct - strictly a screening test.
> A CBC will give you much more helpful information - RBC's, MCV, MCH,
MCHC,
> RDW, platelet count............. Andrew
I don't do CBCs on patients just because they are breastfeeding...
and still feel that a fingerstick hgb is an adequate test to "screen" for
anemia.
If there is a reason from the physical exam, then a CBC is a good tool to
"evaluate" anemia as you have mentioned.
All I hear, though, is that these two are breastfeeding. Not that any
indication to evaluate is present.
Gail
Gail S. Hertz, MD, IBCLC
Resident, Dept. of Pediatrics
PSGHS Children's Hospital
Hershey PA
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Date: Wed, 3 Feb 1999 09:33:13 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Gail Macklin <[log in to unmask]>
Subject: Re: LACTNET Digest - 2 Feb 1999 to 3 Feb 1999 - Special issue
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Janet,
I worked for 2 years in a 5th and 6th grade where I developed the "puberty"
program. In addition, I did a 50 minute presentation on breastfeeding. I
remember one of the teachers saying...you want the boys to come to? I
replied...well, yes, one day they will be the dads!
I began my presentation with a T/F test. Kids love to see how much they know.
I called it "Test your breastfeeding IQ". I gave them a little time to
complete the test and then we reviewed it out loud as a class. The kids were
amazed at some of the answers and of course a few want to share some stories
along the way. I ended it with a little breastmilk experiment I read about
here on Lactnet which is very visual and very scientific that teachers and
kids both enjoy.
I did get one call from and irate parent who's child was not breastfed and
didn't understand why we would be teaching this in school. When I called back,
I spoke to her husband. By the end of our conversation he was agreeing with
me, and I never heard back from her. Incidentally, she works for a formula
company.
If you are interested in any of my materials e-mail me privately and I will
send them out.
Gail Macklin RN BSN IBCLC
The Breastfeeding Center-Buffalo Grove, IL
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Date: Wed, 3 Feb 1999 08:50:03 -0500
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Diane Wiessinger <[log in to unmask]>
Subject: birth expectations
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>One thing you mentioned in your post especially caught my attention. You said
>"mom wants a perfect birth". Some counselling here about birth expectations
>may be the best thing for her and her baby right now. That's a pretty tall
>order and one that, in my experience, can set a woman up for deep feelings of
>failure...
Our Lamaze instructor had had her second child 10 months earlier. It was a
planned home birth. Her first labor had been fast, this one was even
faster: baby was born hastily on the bathroom floor as Dad slid a Chux
under her. She never even pushed. She had envisioned laboring on the bed,
surrounded by loving friends, and the loss of her dream made it hard for
her to talk about the birth even 10 months later. Home birth? Fast? No
pushing? And she was *unhappy* about it???? We all have our dreams...
Diane Wiessinger, MS, IBCLC Ithaca, NY
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Date: Wed, 3 Feb 1999 09:50:00 EST
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Colette Acker <[log in to unmask]>
Subject: Re: Nursing three
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Barbara,
I recall a breastfeeding hotline call where a mother was nursing all five of
her children and wanted assistance with weaning. She was exhausted. Remember
the old supply and demand, the more you nurse, the more milk you will make.
Tell mom to nurse newborn first, and keep close eye on wet and poopy diapers
to ensure baby is getting enough. Her concern will not be with milk supply,
it will be with the time constraints of nursing 3 children. As for the
doctor's concern with premature labor; this mother has nursed while pregnant
before without a problem, why should it be one now.
Best wishes to this mom!
Colette Acker
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Date: Wed, 3 Feb 1999 06:56:43 -0800
Reply-To: Lactation Information and Discussion <[log in to unmask]>
Sender: Lactation Information and Discussion <[log in to unmask]>
From: Judi Hammett <[log in to unmask]>
Subject: Re: Nursing three
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I don't know how common it is to nurse three at a time, but you can tell
this mother that it has definitely been done before. I know of several
mothers (on the internet, not in real life) who have done so.
Judi
LLLL