Laurie, regarding meds in the NICU...I am the RN LC in a level 3 NICU, and we haven't had any problems with Ibuprofen use by mom, even with VLBW premies. In our area, the most common postpartum analgesics are Ibuprofen, Percocet and Vicodin. We have not had concerns about normal doses of any of these. Mary
>>> [log in to unmask] 04/30/02 09:04PM >>>
There are 8 messages totalling 233 lines in this issue.
Topics of the day:
1. NG tubes (2)
2. LACTNET Digest - 30 Apr 2002 - Special issue (#2002-494)
3. Neat reference on Engorgement
4. airport painting
5. Scent research
6. opening a can of worms..."Baby Whisperer"
7. medication talk/nicu population
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Date: Tue, 30 Apr 2002 22:39:39 EDT
From: "Mary Kay Smith, IBCLC" <[log in to unmask]>
Subject: NG tubes
I would say that this being an "invasive procedure" that it should NOT be
done by an LC in her capacity as an LC, even if she is a nurse. NG tubes
should be used by direct order from a physician and even tho I know how to do
one (because of nurse's training and spending a rotation in a NICU) it should
not be done by unlicensed health care personnel. There's a reason we need
Dr's orders to do certain things.
Mary Kay Smith, IBCLC
Romeoville IL
------------------------------
Date: Tue, 30 Apr 2002 22:47:04 -0400
From: "Catherine Watson Genna, IBCLC" <[log in to unmask]>
Subject: Re: NG tubes
But we do sometimes use ng tubes attached to syringes as homemade
nursing supplementers or fingerfeeders!
--
Catherine Watson Genna, IBCLC New York City mailto:[log in to unmask]
------------------------------
Date: Tue, 30 Apr 2002 22:48:13 EDT
From: [log in to unmask]
Subject: Re: LACTNET Digest - 30 Apr 2002 - Special issue (#2002-494)
In a message dated 4/30/02 7:27:19 PM Pacific Daylight Time,
[log in to unmask] writes:
> There is a surgical procedure that fixes this syndrome. Maybe that is a
> better choice than medication
I had this condition. Pregnancy and parenting made it worst (
stress,hormones, and age according to my MD). I nursed 3 children and tried
an assortment of meds, none of which worked. Pregnancy was the worst. I had
to be in the ER 17 tiimes with my second pregnancy, often with a heart rate
of 300+. I can now write the book on WPW. I never even thought to ask about
the safety of the meds with bfing-I just assumed my babies would be ok.
Although I never stayed with any meds very long-didn't like the side effects
and didn't like the idea of being on meds long term.(I am a very nonconpliant
patient!) I finally had an ablation done when Cody was 3 yrs old. He was
still nursing and I had to wean him because I ended up in CCU for 13 days at
that time. Weaning was the easy part-told him that mom had medicine and it
might be in the milk at which he turned up his nose and said yuck, don't want
it. My extra pathway was on the back side of my heart and they told me that's
why the meds didn't work. The ablation was done as a cath procedure--no
surgery, just a minor incision where the cath was put in and a port in my
neck for meds. I actually had 5-6 caths done at various times and was able to
watch much of it on the camera monitor. Since there are no nerves in the
blood vessels, it doesn't hurt. The worst part was being in that extremely
cold room with only a thin sheet over me! I was misdiagnosed for several
years so I would recommend she see a MD who specializes in
electrocardiophysiology. The ablation has risks but it is wonderful being
cured!!
Barb Whitehead, IBCLC
Eastern NC
------------------------------
Date: Tue, 30 Apr 2002 23:00:41 -0400
From: "Kermaline J. Cotterman" <[log in to unmask]>
Subject: Neat reference on Engorgement
Came across this recently and had not seen it discussed on LN:
Evans K, Evans R, Simmer K, Effect of the method of breastfeeding on
breast engorgement, mastitis and infantile colic, Acta Paediatr 1995;
84: 849-52.
"This exploratory study compared the effect of two methods of
breastfeeding on breast engorgement, mastitis, infantile colic and
duration of breastfeeding. An opportunity sample of subjects was assigned
either to the experimental group (prolonged emptying of one breast at
each feed) (n=150) or to the control group (both breasts equally drained
at each feed) (n=152) and both groups were followed prospectively to 6
months after delivery. The experimental group had a lower incidence of
breast engorgement in the first week (61.4% versus 74.3%; p<0.02) and
colic over the first 6 months (12% versus 23.4%; p<0.02). There was no
significant difference between the two groups in the incidence of
mastitis over 6 months and the length of breastfeeding (16.5% +/- 10.3
weeks versus 17.5 =/- 10 weeks experimental versus control group). The
majority of mothers in the experimental group (63%) felt it necessary to
offer the second breast at the end of a feed to satisfy their infant's
hunger. The "perceived insufficient milk suppy syndrome" was the main
reason given for cessation of breastfeeding in both groups. This study
provides data to advise nursing mothers about these two methods of
breastfeeding."
I like that last sentence. Advising mothers of both ways and letting them
decide from their infant's cues. No hard and fast rules and "You musts"
pontificated by the staff. And good info to feed back to the
grandmothers, aunts, etc. who frequently pontificate this same point to
new mothers.
Maybe this would be good for staff education, so the staff could give
some evidence based guidance instead of blithely telling the mother "Well
they used to say . . . . . but now they're saying . . . . . . . . so it
doesn't seem to matter much which way you do it, just do what you want
to do."
Despite our lack of control over pitocin inductions, IV's, & epidurals,
we might be able to reduce the incidence and severity of engorgement
somewhat simply because of this variable, which uses the influence of
the nursing/LC staff.
Maybe a little more emphasis on reducing chances of severe engorgement by
using what ended up seeming to be the "First breast first" principle,
might be worth a try.
The mother is still in charge, and always has the second breast to offer
if she thinks the baby needs it.
Jean
******************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA
------------------------------
Date: Tue, 30 Apr 2002 23:19:37 -0400
From: Karen J Samford <[log in to unmask]>
Subject: airport painting
The name of the painting and artist AND the airport escape me, but if
this hasn't been mentioned, there is a picture of the painting in this
month's Mothering magazine. I haven't checked yet but it's quite
possible that there might be a picture on the website for mothering as well.
I hope everyone gets to see it!
It's a beautiful painting and to be honest I might not have even seen
the b'fing baby in the painting. I of course don't find it offensive at
all!!
Karen
------------------------------
Date: Tue, 30 Apr 2002 22:30:39 -0500
From: Barbara Wilson-Clay <[log in to unmask]>
Subject: Scent research
Sometimes I just get real cheered up by interesting research. Thank you
Kathleen Pasakarnis for sharing about Julie Mennella's new project. I'm
sure that much of what we do is driven not by how we think, but by how we
feel, and how we behave is often driven by powerful senses we don't even
acknowledge. How wonderful to have these mysteries revealed. I love the
scent of breastfed babies.
Barbara Wilson-Clay BSEd, IBCLC
Austin Lactation Associates
http://www.lactnews.com
------------------------------
Date: Tue, 30 Apr 2002 23:21:41 -0400
From: The Bentleys <[log in to unmask]>
Subject: Re: opening a can of worms..."Baby Whisperer"
There are two articles available from LLLI's LEAVEN which are online, for
Leaders consulting with mothers using the Babywise program - you might find
them helpful (I don't know if they are password protected or not).
Counseling Challenges: Helping Mothers Handle Conflicting Information
from LEAVEN, Vol. 34 No. 2, April - May 1998, pp. 19-20
See also "Background Information for Leaders" from the April-May 1998 issue
of LEAVEN.
www.lalecheleague.org/ (search LEAVEN)
Michelle Bentley LLL
----- Original Message -----
From: "Charity Pitcher-Cooper" <[log in to unmask]>
Subject: opening a can of worms..."Baby Whisperer"
> Pedschat tonight has inspired me to research building an informational
> website about the book, Secrets of the Baby Whisperer. This is just in
the
> idea/planing stage, so I need ideas and stories about pro's (if there are
> any) and con's of breastfeeding "the Baby Whisperer way" as well as tips
> for educating parents who have read Baby Whisperer.
------------------------------
Date: Wed, 1 May 2002 03:55:02 +0000
From: laurie wheeler <[log in to unmask]>
Subject: medication talk/nicu population
hi
i will be talking to neonatal nurse practitioners in nicu settings about bf
and use of meds. i am interested in hearing especially from the pharmacology
gurus on the list, other nnps, neonatologists, and nicu nurses about what
particular issues give the most trouble re bf and meds in that setting. for
example, it is pretty straightforward to say it is ok to bf on ibuprofen for
the healthy term infant. but what would be the special considerations for
the LBW and VLBW infant (small premies), for example any ductus closure
issues. any other special considerations you think i should address for the
very small or sick baby. thanks.
Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA
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------------------------------
End of LACTNET Digest - 30 Apr 2002 (#2002-495)
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