Hi folks, I really owe you a full report of the physician's seminar, which
audience (of about 250?) was by the way about half physicians and the other
half mostly LCs and/or LLLLeaders, I think.  It was extremely stimulating. It
would be impossible to do the conference justice, but just to give you  a
flavor,-- it began Thursday afternoon with two simulataneous seminars--One
was Ruth Lawrence and Maryann Neifert presenting BF 101; the other was the
session I told you I went to with Liz Feldman and Linda Black on Mother baby
separation, a session peppered with the comments of the audience  who
included Larry Gartner, Chele Marmet, Kathleen Auerbach, Lois Arnold and I
can't name everyone else. (There were no further simultaneous presentations,
so I had none of the difficult choices that faced me when I signed up for the
regular LLLI conference which begins tomorrow.) Yesterday morning began with
Ruth Lawrence giving the anatomy and physiology, Michael Kramer (McGill,
Montreal) describing a multicenter prospective study he's setting up in
Belarus (White Russia) that will compare outcomes for hospitals that are
trained to be Baby Friendly with control hospitals (matched for rural vs
urban, region etc). Belarus was chosen because it is a "developed country" in
terms of sanitation etc., but has hospitals at the state US hopsitals were 20
or 30 yrs ago with respect to birth practices, so that there won't be any
confounding by control hospitals getting more baby friendly. Interesting
stuff. Then Armond Goldman gave a fascinating talk about some very complex
stuff involving immunology and host defenses; then Ruth Lawrence and Mary
Dobbins addressed "insufficient milk"-- poor breast, poor milk or poor care?"
(and added "poor culture")  Later yesterday afternooon John Lantos, a
bioethicist, gave a general approach to address ethical issues; he wasn't
attuned to what the ethical issues are, but recognized it, and the session
was saved by the numerous issues brought up by the audience. By the way
throughout, the questions and the comments from the audience were as
stimulating as the talks themselves. Yesterday afternoon ended with David
Rassin (Nutrition, U texas Galveston) on Growth Development and the
Uniqueness of Human Milk.  This morning we began with Gene Cranston Anderson
on Kangaroo Care,  Lennart Righard with a lot of impressive videos of
squatting births, home births, self attachment, latch-on (Chloe Fisher in
great video which superimposed artist crosssectional drawing over video in
stop action of correct and incorrect latchon),  cobathing to facilitate
latchon, etc.; Edward Newton (OBGyn U Texas, Houston, also son of Niles
Newton) on the influences of ob practices on initiation and Maintenance of
lactation (which began with physician and nurse surveys of knowledge,
attitudes etc, and an interesting question of where they got their
breastfeeding information (half from textbooks; 20% from wife/I can't
remember the rest of the breakdown) and then a review of the number of pages
in each of these basic medical and nursing texts on the number of pages
devoted to BF! Pretty sad)
The meeting ended with Andrea Ruff giving some pretty depressing data on HIV
transmission thru human milk, and the recommendations which have to vary by
country because of different risk benefit ratios-- basically where the risk
of mortality from resp and gastro infx is high (developing countries), then
the benefit of BF outweighs the current known risk of HIV, but where the risk
of mortality from resp/gastro illnesses is low ("developed"), the risks
outweigh the benefits.

Then the LLLI Medical Associates met for lunch, and Alicia and I sat with
Beth Williams and Anne Eglash of lactnet, they're also founding pres and VP
of Academy of Breastfeeding Medicine.  (Also at our table were Ruth Lawrence
and her husband.) It was a pretty exciting group of people in that room, and
a lot of new things are just getting off the ground in the field-- in terms
of public advocacy, LLLI literature search heading toward electronic access,.
 And then this evening we attended the signing of the charter papers or
whatever for ABM (caps), accompanied by pictures etc so we can all "remember
when"-- Signatories were Beth and Anne, Larry Gartner, Miriam Labbock, Ruth
Lawrence, Marianne Neifert, Jack Newman, Edward Newton, Victoria
Nichols-Johnson, and Chris Wade. Audrey Naylor and Richard Schanler couldn't
make it; (neither could honorary member C. Everett Koop); also absent were
the reception's refreshments, but there was no damper on the occasion--

I have to say for this relative newcomer to the field, it has been incredible
to attend such a small conference so dense with so many of the people whose
names we quote all the time. It is too late at night for me to articulate how
stimulating the presentations and the questions and interactions all were.

Another sidelight to all this, is that during this time we have been the
minority conference in this large hotel, which was simulatenously hosting a
huge conference of the National Federation for the Blind-- there were white
canes everywhere (many dashing quite fast); at certain crowded times there
were people posted  along the hallways calling out "this way to the general
session" "mens bathroom right here"; there were little braille tape markers
pasted on walls, people with guide dogs, children with canes, older people
with canes, people from all walks of life--- a real educational
experience....

This afternoon, the white canes and guide dogs began to be replaced by babies
in slings, children and luggage sitting in hallways,  the squeals and hugs of
old friends reuniting, as one conference was replaced by another-- I can only
imagine what an interesting job it must be to work in this hotel--

Well, g'night folks-- I'm staying for the big conference, so these posts will
continue, unless someone protests--

And thank you again for all the nurture 3 feedback, I've passed it onto the
LC went home today feeling confident in the information she had from you all.


Tina Smillie