Dear Ms. York,
Whenever something isn't working, the tool is blamed. I always point out
that the APNO (which is frequently prescribed or filled incorrectly,
incidentally) is only a tool. The most important thing to do is fix the
latch which we teach differently from most others. I do not recall having
seen any mothers who had no ulcers when we first saw them go on to have
ulcers only after they started the APNO. In fact, I don't remember any
ulcers on the nipple and/or areola at all. And we see dozens of women every
week with sore nipples that we start on the APNO.
So I would point out two things:
1.. Wrongly constituted "APNO", is being used a lot and I cannot speak for
those formulations. The recipe, as we use it, can be found on our websites,
www.drjacknewman.com or www.nbci.ca.
2.. Anything one puts on the skin, especially if used for a prolonged
period of time can cause irritation and contact dermatitis. The indefinite
use of APNO is inappropriate and any woman who needs it more than 2 or 3
weeks or whose symptoms return when she stops it needs a serious
re-evaluation of her situation.
I cannot understand "should not be used on the areola". I think that a
dermatologist, who probably has no experience with breastfeeding issues,
should reserve judgment. After all, s/he would see only unusual cases, not
the vast majority of mothers who actually get considerable relief with the
APNO.
Please post this message on Lactnet.
Jack Newman, MD, FRCPC
--------------------------------------------------------------------------------
From: Vicky York [mailto:[log in to unmask]]
Sent: September 8, 2009 2:44 AM
To: Jack Newman
Subject: apno causing nipple ulcer
Dr. Newman, I posted on lactnet asking about the possibility of apno causing
a nipple ulcer after awhile and got this post back. Do you think there is
any possibility?
Vicky York, IBCLC, CPD
Postpartum Care Services
Portland, OR
www.vickyyorkdoula.com
references: www.ikarma.com/user/vmyork
***********************************************
Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome
|
