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Lactation Information and Discussion <[log in to unmask]>
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From:
Darillyn Starr <[log in to unmask]>
Date:
Wed, 30 Mar 2005 06:35:35 -0700
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Lactation Information and Discussion <[log in to unmask]>
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""OK this does not make sense to me.  This baby can be exposed to 100% of 
huge
maternal does during pregnancy but not to 2% of the dose via breastmilk
afterward.  THis baby went through withdrawel and absolutely should have 
been
breastfed during this period of time while infant blood levels and maternal 
milk
levels were assessed. Any medication excreted during the first week would 
have
helped soften the symptoms of withdrawel.
But now, while I agree that this mother is on huge levels of this medication
one still has to wonder if the risks of formula outweigh the risks of
breastfeeding while on this medication. ""

I am with Chris, in wondering why the baby could not have been breastfed 
from birth, having been exposed to huge doses of the drug in-utero.  It 
seems like it would have been the kindest thing for the baby, in lots of 
ways.  I remember a case, with a patient of my ex, whose baby was exposed to 
large doses of amitriptyline all through gestation.  The baby was born at 
about 30 weeks, the mother stopped taking the med at that point, and the 
baby's doctor told her to pump and dump for two months, saying that even a 
tiny bit of the med would render her milk more dangerous than formula!  
Maybe there is something I don't know, but it sounds like ignorance on the 
part of the physicians, to me!

I also wanted to comment on Kermaline's suggestion, about using a nipple 
shield, instead of a bottle nipple, for formula feeding in breastfeeding 
position.  With someone who had recently given birth, but whose baby was not 
supposed to be getting her milk, I would think the nipple shield would 
result in too much breast stimulation and end up with mom all wet (unless 
someone could think of a way to catch the milk).  Using a bottle nipple is 
easier than it might seem.  The type of bottle nipple makes a difference, 
too.  What I used, with Julia, back in 1991, was a latex, wide-base ortho 
nipple, designed to fit the Playtex Nurser.  Last time I looked, they were 
still on the market.  Many adoptive moms have used the newborn Avent nipple. 
  These apparently work, but not really as well as what I used.  One problem 
is that silicone will tear quite easily and, if great care is not taken 
while inserting the tube, a small tear can happen, making it so that it will 
not form a seal around the tube, and the baby will suck in air, along with 
formula.   Also, the standard ones do not lie flat against the breast as 
well.  However, an adoptive mom recently said that she has found that the 
nipples designed for the Avent system that uses disposable bags lie flatter 
than the others.

Back to use of a shield, I did use one as the last step of getting Julia to 
take the breast.  We had gotten to the point where, once she was fed and 
pretty much asleep, I could move the bottle nipple and she would open her 
mouth and start to take the breast, but close her mouth as soon as her 
tongue touched my nipple.  I got a latex shield, hoping that it would 
provide more of the shape of the breast, but still have the same taste as 
the bottle nipple.  I am not sure if it worked because it did that, or 
because it was a pain to use, and she had to wait for me to get it set up.  
It was alot less convenient.  What happened was that at one time she was 
getting impatient and decided to try the breast without the shield and found 
that she liked it.  Also, having the tube sticking through one of the larger 
holes in a shield was not as easy a way to get the supplementer to function 
correctly, as having the tube secured into the tight hole of a bottle 
nipple.  There are some situations where the shield would be the best 
choice, for the sake of getting some breast stimulation, at the same time.

Darillyn

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