Dear Friends:
    Enkin and Keirse's "A Guide to Effective Care in Pregnancy and
Childbirth" 3rd edition talks about routine or prophylactic care during the 3rd stage of
labor: as postpartum hemorrhage is a great potential hazard, practitioners
have a choice between expectant management (or watchful waiting) or active
management (oxytocic drugs, early clamping of the cord, and controlled cord
traction).
    While there doesn't seem to be any impact of using either pitocin or
ergotamine on breastfeeding, this resource talks about nipple stimulation
(immediate suckling after delivery) as something that "merits further evaluation,
particularly in developing country settings." I found that surprising.
    warmly,
Nikki Lee RN, MS, Mother of 2, IBCLC, CCE, CIMI
Maternal-Child Adjunct Faculty Union Institute and University
Film Reviews Editor, Journal of Human Lactation
Support the WHO Code and the Mother-Friendly Childbirth Initiative

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