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Subject:
From:
"Catherine Watson Genna, IBCLC" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 26 Jul 2006 08:49:09 -0400
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I agree that high risk mothers need the option of hospital care, but we 
should still do what we can to make hospital care more responsive to the 
needs of the newborn for contact with his or her mother, and promote as 
much autonomy as possible for birthing moms. As well as educating staff 
to help with breastfeeding. I have the utmost respect for those of you 
that are working so hard to see that these things happen at your 
institution.

Remember though that neonatal encephalopathy (babes without any gag, 
blink or suck reflexes, with altered level of consciousness, etc) is not 
necessarily a result of birth asphyxia. We used to think it was, but the 
terminology has been changed to reflect the new understanding that the 
brain injury could have happened any time.

I have one little one in my practice who clearly had a prenatal event 
(mom noticed she stopped moving as much, her doc took her seriously and 
checked it out, the baby's reactivity was poor, they delivered by rapid 
Cesarean and the baby has bilateral brain injury. She's progressing, but 
definitely has motor issues, and perhaps cognitive ones as well). 
Another babe that I'm seeing with a colleague had a beautiful home 
birth, no distress, but a few hours after birth the midwife did not like 
how he looked and transported him to the hospital with his mom. He 
started seizing and had the whole scary gamut of encephalopathy 
symptoms. He is recovering well, and has just begun breastfeeding at 
about 5-6 mos. Yet another child had a prenatal stroke and has mild CP 
and had seizures until he had half his hippocampus removed on the 
injured side.

Catherine Watson Genna, IBCLC  NYC

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