>------------------------------
>Date:     Tue, 2 Sep 1997 08:44:42 -0400
>Reply-To: Lactation Information and Discussion <[log in to unmask]>
>Sender:   Lactation Information and Discussion <[log in to unmask]>
>From:     Automatic digest processor <[log in to unmask]>
>Subject:  LACTNET Digest - 1 Sep 1997 to 2 Sep 1997 - Special issue
>To:       Recipients of LACTNET digests <[log in to unmask]>
>
>There are 13 messages totalling 402 lines in this issue.
>
>Topics in this special issue:
>
>  1. Breast exam
>  2. Gentian Violet
>  3. Breast exams
>  4. hydrogel dressing (2)
>  5. Hydrogel dressing
>  6. LACTNET Digest - 31 Aug 1997 to 1 Sep 1997 - Special issue
>  7. PERTUSSIS
>  8. varicose veins
>  9. (Fwd) "freedom of commercial speech"
> 10. Community Support
> 11. "Bottle Mouth" (2)
>
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>
>------------------------------
>Date:    Mon, 1 Sep 1997 23:58:06 -0400
>From:    Patricia Young <[log in to unmask]>
>Subject: Re: Breast exam
>MIME-Version: 1.0
>Content-Type: text/plain; charset=ISO-8859-1
>Content-Transfer-Encoding: 7bit
>
>Dear Sarah, I've been thinking about this one all day.  Breast exam during
>pg....  I guess we need to know:
>Does she have 2? (mastectomy? birth defect?)
>Evidence of br surgery? Scars?
>normal shape? (size doesn't matter-but tubular may matter),
>does each breast have a nipple? (Had a mom who was burned as a child, one
>breast had no nipple, no outlet, worked with her on severe engorgement on
>the one side, interestingly it was less severely engorged with each
>subsequent baby)
>Accessory nipples? location?
>Inverted or pseudo inverted nipples? Flat? Respond to stimulation? (I still
>subscribe to Hoffman technique or shells)
>Breast changes during pg?
>
>OK folks, what else?????  Most of the info, if not normal/red flag can be
>noted for future use, without overtly discouraging mom.
>
>A breast exam at initial prenatal visit, along with the question, how do
>you plan to BF your baby? and HCP's endorsement of BF as preferred method,
>provides a strong message to mom  on importance of BF.  Gives an opening
>for anticipatory guidance, encourage mom to read or go to meetings or
>classes.
>
>Sincerely, Pat in SNJ
>
>------------------------------
>Date:    Tue, 2 Sep 1997 00:06:21 EDT
>From:    Becky Krumwiede <[log in to unmask]>
>Subject: Re: Gentian Violet
>
>I have always assumed that water-based gentian violet would definitely be
>preferable due to the pain/irritation anything alcohol-based would cause to
>already damaged tissue.  However, it is impossible to find anything but
>alcohol-based G.V. in my city and because of this I've been reluctant to
>recommend it.  The last time I had a mother use it she bought 1% in alcohol and
>diluted it half and half with water so she had a 1/2% solution and less
>alcohol.
>She tried it on herself first and said it didn't hurt, which surprised me.  I'm
>guessing that G.V. is equally effective in water or alcohol, but I'm curious
>whether any damage has been caused if the alcohol version is used on non-intact
>skin or mucous membrane.
>
>Becky Krumwiede, RN, IBCLC, Appleton, WI
>[log in to unmask] or [log in to unmask]
>
>------------------------------
>Date:    Tue, 2 Sep 1997 00:06:18 EDT
>From:    Becky Krumwiede <[log in to unmask]>
>Subject: Re: Breast exams
>
>I'm one who thinks breast exams DO matter, but only if you really know what
>you're looking for.  I can't TELL you how often the nurses at my hospital tell
>me a mother has "flat nipples" when they're perfectly fine.  I always show
>pictures and describe how to check for inverted or flat nipples in my prenatal
>breastfeeding classes, and offer to do nipple checks after class if a mom
>thinks
>she might have that variety.  Usually one or two women stay after class to be
>checked and most are just fine.  On the occasional true inverted nipples I have
>seen MAJOR improvement with the use of shells, sometimes only in a matter of
>weeks.  The fibrous-wrinkled-flat variety don't seem to improve as easily but
>shells do seem to help also.  I read the study from England (I think) years ago
>that said that breast shells didn't do anything, but decided to go with what I
>had seen with my own eyes rather than somebody else's experience.  Have there
>been other studies, using the shells we have available in the U.S.?
>
>Becky Krumwiede, RN, IBCLC, Appleton, WI
>[log in to unmask] or [log in to unmask]
>
>------------------------------
>Date:    Tue, 2 Sep 1997 00:06:20 EDT
>From:    Becky Krumwiede <[log in to unmask]>
>Subject: Re: hydrogel dressing
>
>Hi Pat -- have you tried contacting an enterostomal therapist (I think that's
>what they're called)?  I have a couple of different samples sitting in my
>office
>now that I got from our hospital's therapist.  Neither are the brand the
>speaker
>mentioned at ILCA but seem to be similar.  No hideous nipples have come through
>since I got it, but I had my 15-year-old try it out on a deep cut she got on a
>camping trip and she thought it was helpful.  Not wishing for anyone to have
>nipple damage, but excited to try the hydrogel when the next nasty nipples DO
>show up.
>
>Becky Krumwiede, RN, IBCLC, Appleton, WI
>[log in to unmask] or [log in to unmask]
>
>------------------------------
>Date:    Mon, 1 Sep 1997 22:14:28 -0700
>From:    Star & Glenn Siegfried <[log in to unmask]>
>Subject: Re: Hydrogel dressing
>MIME-Version: 1.0
>Content-Type: text/plain; charset="us-ascii"
>
>Hi All,
>For those of you who read Patricia's Gima's request regarding Hydrogel, I
>thought I would fill you in.
> A woman by the name of Marcia Stewart, RN,BSN,CETN (a certified
>Enterstomal Therapist) gave a talk at this years ILCA conference about
>moist wound healing for damaged nipples. She talked about a product she has
>been using in conjunction with some LCs to aid in healing damaged nipples.
>She has found that a Hydrogel dressing used over the affected area is
>working very well to speed up the healing process. This stuff has been used
>for chronic wounds such as pressure ulcers and burns. Here is what the
>insert says: Composed of saline based, hydrophilic, biocompatible polymer.
>
>It provides a moist wound healing environment that cushions and produces a
>cooling effect--Features exceptional exudate absorption for up to seven
>days-- Has moisture vapor transmission and bacterial barrier
>characteristics--- it does not pull at the healing nipple when it is
>removed for nursing.
>
>She suggests using it in a sheet form (comes in gauze too).
>
>For info on how to get samples call: ConMed Corporation 1 800 765-8375 ext.
>2391. The gal is Sue Cornnell, Sales Rep. The dressing is called ClearSite
>Wound Care Dressing. Cat. No: 40-9220. These folks are just learning of
>this products usefulness for us in the lactation business. Marcia Stewart's
>(the gal that gave the talk) work number is (614) 225-5000, she has a nice
>instruction sheet that she made up to give to  moms.
>I plan on using it tomorrow on a bite/breast wound that is slow to heal.
>
>So much for lurking,
>Adios,
>Star Siegfried RN,BA, IBCLC Arcata, California
>
>------------------------------
>Date:    Tue, 2 Sep 1997 16:30:38 +1000
>From:    Lesley McBurney <[log in to unmask]>
>Subject: Re: LACTNET Digest - 31 Aug 1997 to 1 Sep 1997 - Special issue
>MIME-Version: 1.0
>Content-Type: text/plain; charset="us-ascii"
>
>Has there been any update on the mother in England who had water thrown over
>her by a shopkeeper when she breastfed her baby in his courtyard?  Were
>assault charges ever laid?  Just curious.
>
>
>
>Lesley McBurney
>Brisbane, Australia
>NMAA Breastfeeding Counsellor
>Publications Revision & New Publications Working Groups
>Admin Assistant, NMAA Qld Branch office
>International Conference Registrations Sub-committee
>[log in to unmask]
>
>------------------------------
>Date:    Mon, 1 Sep 1997 23:44:17 -0700
>From:    Cherie Moore <[log in to unmask]>
>Subject: PERTUSSIS
>MIME-Version: 1.0
>Content-Type: text/plain; charset=ISO-8859-1
>Content-Transfer-Encoding: 7bit
>
>I have a student whose 3 children and son have pertussis (whooping cough).
>The youngest (not yet a year) has the worst case. He is breastfeeding often
>and happy in between the severe coughs. A doctor prescribed an antibiotic.
>Any suggestions for any healthful remedies?
>
>------------------------------
>Date:    Tue, 2 Sep 1997 07:07:21 -0400
>From:    Patricia Young <[log in to unmask]>
>Subject: Re: varicose veins
>MIME-Version: 1.0
>Content-Type: text/plain; charset=ISO-8859-1
>Content-Transfer-Encoding: 7bit
>
>Dear Melissa, I think I am going to print up a form letter....
>We were all beginners once upon a time (a LONG time ago).  Experience and
>expertise comes with doing, just like anything else we humans learn!
>Please don't be intimidated by us!
>
>Do you homework, read, read, read....that's what we do.
>Listen, listen, listen, adsorb like a sponge...that's what we do.
>Brainstorm...that's what colleagues are for...that's what we do.
>Don't over or under estimate your abilities.  Know when to ask for
>help...that's what we do.
>Be flexible...go for what works, not rules...that's what we do.
>
>Welcome to Lactnet!
>
>Sincerely, Pat in SNJ, USA
>
>------------------------------
>Date:    Tue, 2 Sep 1997 13:28:34 -2
>From:    Lynn Moony <[log in to unmask]>
>Subject: (Fwd) "freedom of commercial speech"
>MIME-Version: 1.0
>Content-Type: text/plain; charset=US-ASCII
>Content-Transfer-Encoding: 7BIT
>
>Along the lines of the discussion re. the College of Midwives
>decision....
>
>"Ja-well, no-fine!" - this is a common expression used here which I
>can't really translate.  I came back last night from spending a
>couple of days at the IBFAN Africa office and my mom pointed out an
>article in this weekend's newspaper under "Media & Marketing".
>
>I don't know how much I can type out for you without infringing
>(should this have an "e" somewhere?) copyright.  Could someone please
>give me an idea?  Basically, various companies here have got together
>and formed a "freedom of commercial speech trust" to lobby for carte
>blanche on advertising.  They indicate that the companies will
>regulate themselves and that government decrees are not necessary.
>
>This latest article is specifically calling for the promotion of
>breastmilk substitutes so that moms can be made aware of the dangers
>of breastfeeding and HIV.  They say that the moms need to have the
>products advertised enabling them to make an informed choice.
>(Do you recognise any of "our" jargon?)
>
>I'm pretty low on energy right now to do anything about this.  Your
>comments would be appreciated though, so that I can at least share
>your thoughts/ideas with colleagues at a meeting that is coming up
>soon.
>
>Regards, Lynn.
>
>P.S.  There is such a sense of loss, both in Swaziland and here in
>S.A., re. the tragic death of the "people's princess", Diana.
>Perhaps because she was in this part of the world so recently and
>people feel so strongly about the landmine and AIDS issues.
>--------------------------------------------------
>Lynn Moony
>Johannesburg, South Africa
>[log in to unmask]
>
>------------------------------
>Date:    Tue, 2 Sep 1997 13:28:34 -2
>From:    Lynn Moony <[log in to unmask]>
>Subject: Community Support
>MIME-Version: 1.0
>Content-Type: text/plain; charset=US-ASCII
>Content-Transfer-Encoding: 7BIT
>
>Hullo, I'm just back from a heavy "brainstorming" weekend re.
>Community Support and how we can facilitate implementation of Step
>Ten.  Wellstart have developed a "trilogy" of manuals which are
>great.  Unfortunately, they are rather overwhelming and not
>appropriate for our needs generally around Africa.   There are a few
>places in S.A., at least, where we have the expertise to use them as
>is.
>
>So, *help* again please!  If anyone has any outlines of
>manuals/materials targeting community workers which you would be
>willing to share, they would be greatly appreciated.  Even if it is
>just to help us get a sense of direction.  We need to work on
>something which could be adapted for various levels of literacy and
>differing degrees of knowledge/expertise on breastfeeding.  I'd
>appreciate hearing from anyone who has ideas on this topic.  Thanks,
>Lynn.
>
>P.S.  I do have a WIC manual (thanks, Jewell!) which gives us some
>pointers.
>--------------------------------------------------
>Lynn Moony
>Johannesburg, South Africa
>[log in to unmask]
>
>------------------------------
>Date:    Tue, 2 Sep 1997 07:53:29 -0400
>From:    Diane DiCarlo <[log in to unmask]>
>Subject: Re: "Bottle Mouth"
>
>In a message dated 97-08-28 00:11:47 EDT, you write:
>
><< What are your thoughts on this?  From my reading I have gathered that
>night
> nursing really plays no part in BBM bc the milk (if any) goes right down the
> throat and does not pool in the babys mouth.
> Comments? >>
>
>I'm having the same problem with my 20 month-old daughter, Emma. Bottle mouth
>among breastfed babies seems to be common enough to warrent further study.
>
>My personal hypothesis is that Emma's somewhat shallow latch may have played
>a part in her dental woes. It's plausible that her imperfect latch
>contributed to milk pooling in her mouth for extended periods of time while
>she slept, and I've wondered if a slightly shallow latch is a common
>denominator among breastfed kids with classic bottle mouth type decay.
>
>I'd be very interested in any observations anyone else has made and whether
>or not you feel that an imperfect latch can have an impact on dental health.
>....This could be yet *another* reason to make sure that the nursing dyads we
>work with are getting the latch right!
>
>BTW, my DA <hi Judy!> told me that changing the baby's position after s/he's
>fallen asleep can trigger a swallow, minimizing insult to the tooth enamel.
>
>Diane DiCarlo
>LLLL
>Brooklyn, NY
>
>------------------------------
>Date:    Tue, 2 Sep 1997 06:58:43 -0500
>From:    "Patricia Gima, IBCLC" <[log in to unmask]>
>Subject: Re: hydrogel dressing
>MIME-Version: 1.0
>Content-Type: text/plain; charset="us-ascii"
>
>I had a client last Friday with severly damaged nipples.  The baby's suck
>was improved with Cranio-sacral treatment.  I tried to find the hydrogel
>dressing without success and mom's nipples went on to scab over, then came
>mastitis.
>
>I remember some wise person on Lactnet saying last summer that one source of
>mastitis is such damaged nipples through which bacteria enter the breast.
>This is as opposed to the different type of infection that follows a plugged
>duct. The former always needs antibiotic treatment, whereas the latter can
>sometimes be treated without.
>
>I believe that with this hydrogel dressing and the accompanying healing from
>deep within the nipples first and progressing outward, the enclosing of
>bacteria inside might be prevented.
>
>The presenter gave detailed diagrams of the method of healing that takes
>place beneath this dressing.  The substance is like a very thick water--sort
>of like the gelatinous inside of an aloe plant.
>
>Thank you, those who responded to my post.
>
>Patricia Gima, IBCLC
>Milwaukee
>mailto:[log in to unmask]
>
>------------------------------
>Date:    Tue, 2 Sep 1997 07:43:39 -0500
>From:    "Patricia Gima, IBCLC" <[log in to unmask]>
>Subject: Re: "Bottle Mouth"
>MIME-Version: 1.0
>Content-Type: text/plain; charset="us-ascii"
>
>There was an extensive thread on Lactnet on this topic within the last year.
>Check the Archives under dental caries.
>
>Having one child with serious decay from age one, I have concluded that it
>was due to the incomplete enamel areas of her primary teeth. Her teeth
>continued to decay long after she was no longer feeding at the breast and
>continued despite brushing after anything that entered her mouth.  She did
>continue eating, though she had NO sweets from age 2 'till her primary teeth
>were gone, but she still had 4-5 new cavities every 4 months when we visited
>the dentist.
>
>I attribute her inadequate enamelling to my prenatal diet that was deficient
>in calcium. I have since learned that the small amount of calcium in
>prenatal vitamins combined with my high protein and other phosphorus intake
>were the probable cause of my insufficient calcium assimilation.  I had
>symptoms of ca. deficiency during my pregnancy that I didn't know at that
>time was due to that cause.
>
>I also discovered after my second child that I am allergic to( or have a
>"sensitivity to", if you prefer) dairy products.  I believe that
>assimilation of nutrients is interefered with when there is an allergy to a
>given food.
>
>With my second baby I took responsibility for my own nutrition and focused
>on calcium and magnesium, and didn't overeat proteins, and avoided such high
>phosphorus substances as colas and root beer.  I didn't rely on dairy
>products for my calcium intake.
>
>Baby #2 nursed much more at night than baby #1 and continued for 4 years.
>She had no cavities because she had solid enamel on her teeth.
>
>If a child has inadequate enamelling of teeth there will probably be some
>decay caused by her feeding "all night."  There will be some decay caused by
>her feeding at all. But if cavity-free is what we are aiming for, then the
>only solution is to suspend ALL eating and drinking until these teeth are
>replaced by the permantent teeth. Actually, even that wouldn't stop the
>decay, just slow it.
>
>The many benefits of breastfeeding, including at nighttime, far outweigh the
>negative effects of cavities in the primary teeth.  Our years in the dental
>chair were hard, but Lia learned a healthy respect for dental health and we
>went through it all together.  And I know that if I had weaned her, her
>overall health, including emotional, would have been compromised...and her
>teeth would have continued to decay. Remember, the benefits of breastfeeding
>are life-long.
>
>Patricia Gima, IBCLC
>Milwaukee
>
>mailto:[log in to unmask]
>
>--------------------------------
I have obtained hydrogel dressing from my daughter's dermatologist.