Dear Wise Ones,

I'll try posting again on this topic, I'm not sure my other one was
received, at least no replies to date. Would like to do a research study on
nipple shields and infant growth during the first month of life. As we
reintroduce them into our practice, I am seeking to validate our current
practice which is to have mothers pump hindmilk 3-4 x daily and offer about
4 ounces per day total on average in additon to nursing. In addition we
recommend weekly weights until truly thriving.  As with all things, we reun
the gamet of response to this from having slow weight gain in the beginning
to apparently creating an overabundance in other mothers.

My question is to the ethics of assigning mothers to a "pump" or "no pump"
group and getting passed by an IRB, since earlier research determined then
to be implicated in low weight gain. The last good scientific study I can
find is the Auerbach one from 1990 or so that had mothers pump using a
shield and it made a definite difference (less)in the quantity pumped. To my
knowledge, no one has published good data re: weigh gain in infants using
them. I think Barbara Wilson Clay (can't remember the reference) had a good
article on how they facilitate good outcomes for some mothers,

We obviously would use term babies, avoid PIH, thyroid, IDDM moms and would
check for anatomical variatons, and use those who have babies to the breast
within the first 12 hours of birth, to minimize variables. In addition we
would note reason the shield was given.

My questions are this:

1. Anyone have an "established protocol" for nipple shield use at hospital
discharge that they feel comfortable in sharing? both in how they manage
followup and how the outcomes have been?

2. Does anyone think this project has potential, or perhaps I should I think
of just anectdotally reportting our sucess with them and how we educate our
moms re: the need for close f/u how we are able to provde it? We are
fortunate to live in smallcity with a fairly central location in the county
and moms really do come back for the "free weight checks" .

3. Anyone know of any literature I'm missing that is not just anectdotal? I
didn't turn up too much at library.

Thanks to everyone for all the wonderful sharing that occurs on this list
and a special thanks to the listmothers for being so dedicated!

LuAnn Smith RN, IBCLC
York, PA

_________________________________________________________________
Send and receive Hotmail on your mobile device: http://mobile.msn.com

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html