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Date: | Fri, 23 Aug 1996 11:18:40 -0500 |
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Moshe Shulman asked for input on a 2 mos old who was previously gaining at
breast and now isn't. I have great concerns that mother and baby were not
observed breastfeeding, especially in such a serious situation. The
acceptance of breastfeeding problems not being physically assessed is
maddening and would make a good Lactnet discusssion (if it hasn't been
before). How is it you scream on E-mail? I am very curious what state this
mother's milk supply was in at the time of the visit with the nurse
practitioner.
Over the years clinically, I saw many mothers who at 6 wks - 2 mos.,
suddenly had no milk. Everything was great until then just like this
mother. The only common thread was regular pacifier use. After observing
this a good number of times, I finally felt confident to say the pacifier is
interfering with the sucking cycle of the baby. The inital milk supply is
supported by a hormonal thrust but once that wanes at about 6 wks, the
autocrine (Peter Hartmann) system takes over.
I felt greatly supported when I read the the work of Victoria, CG et al. Use
of pacifiers and breastfeeding duration Lancet 1993;341:404-6. I believe
they published a later article on the subject. I have taken to hand this
article out! A classic article is from Jack Newman in JHL 6(2), 1990 -
Breastfeeding Problems Associated with the Early Introduction of Bottles and
Racifiers.
Without a thorough assessment it is difficult to know if the pacifier is the
sole issue. I would certainly start there and work on the mother's milk supply.
Hope this helps.
Joanne Burke Snyder MA, IBCLC
Latch-On Services, a Private Practice in Indianola, Iowa
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