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Date: Sat, 1 Oct 2005 11:37:43 -0400
Subject: LACTNET Digest - 30 Sep 2005 to 1 Oct 2005 - Special issue (#2005-257)
There are 7 messages totalling 361 lines in this issue.<br><br>Topics in this special issue:<br><br> 1. unusual case<br> 2. Re IBCLC process<br> 3. Jennie - making enough milk<br> 4. Sore nipples<br> 5. American Heart Association New Guidelines<br> 6. National Children's Study<br> 7. Nat'l Children's Study<br><br>Lactnet Archives are at:<br>LACTNET Archives http://peach.ease.lsoft.com/archives/lactnet.html<br>To Manage your Subscription, ie go nomail, index, etc, go to:<br>http://peach.ease.lsoft.com/archives/lactnet.html<br><br>Thanks- Kathleen Bruce, Kathy Koch, Rachel Myr,<br>Melissa Vickers, Karen Zeretzke, Karleen Gribble, LACTNET Facilitators<br><br>Questions to [log in to unmask]<br><br> ***********************************************<br><br>To temporarily stop your subscription: set lactnet nomail<br>To start it again: set lactnet mail (or digest)<br>To unsubscribe: unsubscribe lactnet<br>All commands go to
[log in to unmask]<br><br>The LACTNET mailing list is powered by L-Soft's renowned<br>LISTSERV(R) list management software together with L-Soft's LSMTP(R)<br>mailer for lightning fast mail delivery. For more information, go to:<br>http://www.lsoft.com/LISTSERV-powered.html<br><br>----------------------------------------------------------------------<br><br>Date: Sat, 1 Oct 2005 07:14:22 EDT<br>From: Nikki Lee <[log in to unmask]><br>Subject: unusual case<br><br>Dear Friends:<br> Here is a case where the baby seems to be angry with the mother.<br> First baby; failed induction ---->cesarean section. (This is becoming a <br>common birth scenario in the USA.) I came as mother-baby nurse to see them 5 <br>days after the birth. She wanted to breastfeed; the baby would have none of <br>it. <br> At first I suspected that the hospital style method of "helping" <br>breastfeeding had derailed attachment. Baby would go to breast and scream, arch <br>back,
and refuse. The mother does have grade I inverted nipples, which will <br>protrude after stimulation. This baby quickly became overwhelmed when placed s2s <br>on mother's chest. No way would he even approach the breast. She told me that <br>he didn't even want to be held by her at times. <br> She worked for a week with a hospital grade electric pump and a nipple <br>shield. She established a full supply. She comes from Bermuda, where <br>breastfeeding is the norm. <br> I went to see them again after 1 week. The baby will, thanks to mother <br>and father co-bedding, will now snuggle with mom. He has latched on exactly <br>twice (for good feeds) but usually freaks out and refuses the breast. She can <br>bottle feed him, and does it in breastfeeding style, holding him and the <br>bottle next to her naked breast. She has tried giving him 1/4 to 1/2 oz via bottle <br>before offering the breast, so he will have something in his tummy and be <br>calmer. He still
won't latch. He will root vigorously on his dad, but not on <br>her.<br> We did get him to latch briefly on a nipple shield when he was held in <br>an entirely new position: sitting upright, facing the breast.<br> Meanwhile, he is a pound over birthweight on a diet of exclusive <br>mother's milk, and cute and alert. <br> I wish I knew what was going on. I have encouraged continued pumping, <br>safe co-bedding, s2s, patience and persistence, no battles at breast. CST while <br>in her arms did not matter to this fellow. We didn't try remedial co-bathing <br>because they don't have a bathtub; we did s2s again, and he did tolerate <br>that much better than when I first met him.<br> Any other ideas? <br> warmly,<br>Nikki Lee RN, MS, Mother of 2, IBCLC, CCE<br>Maternal-Child Adjunct Faculty Union Institute and University<br>Film Reviews Editor, Journal of Human Lactation<br>www.breastfeedingalwaysbest.com<br><br>
***********************************************<br><br>To temporarily stop your subscription: set lactnet nomail<br>To start it again: set lactnet mail (or digest)<br>To unsubscribe: unsubscribe lactnet<br>All commands go to [log in to unmask]<br><br>The LACTNET mailing list is powered by L-Soft's renowned<br>LISTSERV(R) list management software together with L-Soft's LSMTP(R)<br>mailer for lightning fast mail delivery. For more information, go to:<br>http://www.lsoft.com/LISTSERV-powered.html<br><br>------------------------------<br><br>Date: Sat, 1 Oct 2005 13:01:46 +0000<br>From: laurie wheeler <[log in to unmask]><br>Subject: Re IBCLC process<br><br>Very good points being made about the IBCLC process, the testing, supervised <br>hours etc. Below I will describe a model that seemed to work very well and <br>could be used by many students:<br><br>I have a good friend who took the BSC course via distance learning. <br>(Breastfeeding Support Consultants, I
believe). She took the course many <br>years ago and I am not sure if the program still exists. She is an RN, <br>however, she had worked a few years, then had her family and had not <br>practiced nursing for over 20 yrs. After the program, she re-entered nursing <br>via work as an RN/IBCLC once her children were older. Anyway, as I recall, <br>the course involved extensive reading, documented clinical hours (she worked <br>at a bf-friendly peds office), recorded transcripts sent to and critiqued by <br>the instructor, observing classes and critiquing them, and many many <br>conversations with the instructor by phone. I am sure I am not doing the <br>program justice because it was a very comprehensive course that took a long <br>time to complete. The counseling part was very strong. The final test, as I <br>recall, was taken by my friend at a university library where it was <br>proctored. This lady is an excellent IBCLC and her counseling skills are <br>excellent. The course
was not inexpensive, but not prohibitive, and a <br>student can pace themselves doing the work. For example, a student could <br>take 1 yr or 3 yrs to complete, if I am not mistaken. I think some of these <br>former instructors may be on lactnet and could comment.<br><br>One important thing I would like to mention is that this LC often comments <br>that she feels at a disadvantage because she does not have a really strong <br>clinical background in neonatal. She has often stated that having been an RN <br>in a nicu is a real advantage (myself and another one of her colleagues). I <br>think this would be especially true for hospital-based LCs. So that those <br>types of clinical experiences, and others, would be very valuable.<br><br>Laurie Wheeler, IBCLC, MN, RN<br>Tupelo MS, s.e. USA<br><br> ***********************************************<br><br>To temporarily stop your subscription: set lactnet nomail<br>To start it again: set lactnet mail (or digest)<br>To
unsubscribe: unsubscribe lactnet<br>All commands go to [log in to unmask]<br><br>The LACTNET mailing list is powered by L-Soft's renowned<br>LISTSERV(R) list management software together with L-Soft's LSMTP(R)<br>mailer for lightning fast mail delivery. For more information, go to:<br>http://www.lsoft.com/LISTSERV-powered.html<br><br>------------------------------<br><br>Date: Sat, 1 Oct 2005 13:28:17 +0000<br>From: laurie wheeler <[log in to unmask]><br>Subject: Jennie - making enough milk<br><br>Jennie<br>Welcome and good luck with your studies.<br><br>The questions you raise are excellent and the answers can be very <br>complicated. ["Why can I only produce 1-2 oz. of milk from both breasts when <br>I pump? She wants so much to breastfeed her daughter, but through nursing <br>and pumping, the baby is not getting satisfied. How can I encourage her to <br>keep trying...? Is this normal as a first time mother to produce so little?]<br>I will try to give
you some ideas about what is going on.<br><br>First, it is *possible* that she is thinking she is not making enough milk, <br>but she really is. The baby's behavior of wanting to nurse alot may be <br>misinterpreted as abnormal when it is normal. She may be scheduling her <br>baby's feeds somewhat or using a pacifier instead of nursing. She may be <br>judging her milk production based on pumping which can be misleading. In my <br>experience, MANY store-bought pumps are of very poor quality and do not <br>extract much milk. Mothers make varying amounts of milk and have varying <br>storage capacities and therefore need to feed their babies differently. This <br>is an area just bursting with new research and the answers are not all in <br>yet. I have seen some healthcare staff tell very new mothers in hospital to <br>pump to see how much they are getting or to pump to stimulate the milk and <br>when the mother gets just a little, this kills her confidence. The mother <br>may get
into a rut of pumping rather than responding and bf the baby.<br><br>However, NEVER doubt a mother who says her baby is not happy nor satisfied <br>and do evaluate the situation right away.<br><br>Second, she may indeed be making too little milk. To explore this can be <br>very involved. Here are some things to consider: observe position and latch <br>- often it is impossible for baby to extract much milk due to extremely poor <br>pos/latch; maternal history of endocrine or other medical problems; breast <br>size, shape, growth; medications; breastfeeding patterns - when did she <br>initiate, how often etc? Lactogenesis II or did the milk come in? In my <br>experience, moms get very full breasts on day 3 or 4 and can express several <br>oz of milk at that time, like 3 oz or more each side. Then there are baby <br>factors like prematurity, near-term gestation, tongue-tie, poor latching <br>etc. Did the baby lose alot of weight, become jaundiced, how is the voiding <br>and
stooling etc. Inadequate or infrequent emptying of the breasts can <br>quickly lead to a downward spiral of chronic low milk production.<br><br>Based on a thorough evaluation, recommendations can be made such as: respond <br>to the baby and nurse much more; fix the positioning and latch; intensive <br>pumping with a top quality pump; supplementing at the breast or by other <br>method. Close followup is usually indicated.<br><br>Laurie Wheeler, IBCLC, MN, RN<br>Tupelo MS, s.e. USA<br><br> ***********************************************<br><br>To temporarily stop your subscription: set lactnet nomail<br>To start it again: set lactnet mail (or digest)<br>To unsubscribe: unsubscribe lactnet<br>All commands go to [log in to unmask]<br><br>The LACTNET mailing list is powered by L-Soft's renowned<br>LISTSERV(R) list management software together with L-Soft's LSMTP(R)<br>mailer for lightning fast mail delivery. For more information, go
to:<br>http://www.lsoft.com/LISTSERV-powered.html<br><br>------------------------------<br><br>Date: Sat, 1 Oct 2005 10:17:44 EDT<br>From: [log in to unmask]<br>Subject: Sore nipples<br><br>I spoke with mom who is nursing 3rd baby and has had nipple pain with all 3. <br> Pumped x 1yr mostly due to pain. Reports "slice around base of nipple <br>where it meets areola. Pumping is painful, but nipple is healed with pumping. <br>Can nurse about 2 x day. Baby is 4weeks old. I saw them in the hospital at <br>day2. Saw no problem with latch or with baby's oral anatomy. Mom has well <br>everted nipples.<br>She has never had problems with mastitis or thrush. I will see her for <br>consult tomorrow,but was hoping someone might have some ideas? Thanks, Pat <br>Garrison, IBCLC in Alabama<br><br> ***********************************************<br><br>To temporarily stop your subscription: set lactnet nomail<br>To start it again: set lactnet mail (or
digest)<br>To unsubscribe: unsubscribe lactnet<br>All commands go to [log in to unmask]<br><br>The LACTNET mailing list is powered by L-Soft's renowned<br>LISTSERV(R) list management software together with L-Soft's LSMTP(R)<br>mailer for lightning fast mail delivery. For more information, go to:<br>http://www.lsoft.com/LISTSERV-powered.html<br><br>------------------------------<br><br>Date: Sat, 1 Oct 2005 10:24:06 -0400<br>From: Mirine Dye <[log in to unmask]><br>Subject: American Heart Association New Guidelines<br><br>AHA statement, "Dietary Recommendations for Children and Adolescents: A =<br>Guide for Practitioners," is available today on the association's Web =<br>site and published online in Circulation: Journal of the American Heart =<br>Association. It is endorsed by the American Academy of Pediatrics,=20<br><br>http://www.americanheart.org/presenter.jhtml?identifier=3D3034000<br><br>At-a-Glance: American Heart Association's Dietary
Recommendations for =<br>Children and Adolescents<br>"Here is a summary of key American Heart Association dietary =<br>recommendations for preventing the development of cardiovascular disease =<br>from infancy and childhood.<br><br>Start in infancy.<br><br>If possible, feed breast milk exclusively for the first four to six =<br>months and continue breastfeeding until one year of age."<br><br><br><br><br>~~~~~~~~~~~~~~~~~~~~~~~<br>Mirine R. Dye, CCE,CD,CLE<br>Florida Keys =20<br><br> ***********************************************<br><br>To temporarily stop your subscription: set lactnet nomail<br>To start it again: set lactnet mail (or digest)<br>To unsubscribe: unsubscribe lactnet<br>All commands go to [log in to unmask]<br><br>The LACTNET mailing list is powered by L-Soft's renowned<br>LISTSERV(R) list management software together with L-Soft's LSMTP(R)<br>mailer for lightning fast mail delivery. For more information, go
to:<br>http://www.lsoft.com/LISTSERV-powered.html<br><br>------------------------------<br><br>Date: Sat, 1 Oct 2005 10:41:35 -0500<br>From: "Julia R. Barrett" <[log in to unmask]><br>Subject: National Children's Study<br><br>>Renee Drake posted:<br>><br>>How does one see if they can participate in the study? I have breastfed<br>>children that I would love to have participate.<br><br>See the website at <http://www.nationalchildrensstudy.gov>. I believe that <br>they are recruiting expectant parents or those anticipating pregnancy in <br>the near future because the researchers are looking to measure exposures <br>starting in utero. I don't think they're recruiting older kids because this <br>is a prospective study.<br><br>Children *having been* breastfed would constitute retrospective data. Do <br>check the site though, especially if you'll be adding to your family. (Hey, <br>maybe I can convince my husband about a third child ... we could <br>participate in scientific
progress and the enlightenment of humankind. ;-) )<br><br>regards,<br>Julia<br><br>Julia R. Barrett<br>Freelance Science Writer & Editor<br>Mom to Sean (5) and Kira (2)<br>Madison, Wisconsin<br><br> ***********************************************<br><br>To temporarily stop your subscription: set lactnet nomail<br>To start it again: set lactnet mail (or digest)<br>To unsubscribe: unsubscribe lactnet<br>All commands go to [log in to unmask]<br><br>The LACTNET mailing list is powered by L-Soft's renowned<br>LISTSERV(R) list management software together with L-Soft's LSMTP(R)<br>mailer for lightning fast mail delivery. For more information, go to:<br>http://www.lsoft.com/LISTSERV-powered.html<br><br>------------------------------<br><br>Date: Sat, 1 Oct 2005 10:43:04 -0500<br>From: "Julia R. Barrett" <[log in to unmask]><br>Subject: Nat'l Children's Study<br><br>Melissa Vance posted:<br><br>> From what I just read they will be looking at breastfeeding
in relation to<br>>obesity. The question in my mind is whether it will be done right. I<br>>remember in the women's health study with nurses, the question was merely if<br>>they had breastfed--not how long, how much supplements (food or formula),<br>>whether scheduled, etc. If they just ask did you breastfeed and don't look<br>>into the variables, it will be worthless. Also, it seems that they should be<br>>looking into BF for more than obesity.<br><br>The design of the National Children's Study will allow any number of <br>studies to be done, so any researcher who wants to look further into the <br>effects of breastfeeding should be able to do this.<br><br>What the National Children's Study will do is gather a huge amount of <br>detailed health data on 100,000 children. Researchers can then use this <br>database to answer specific questions, many of which have not yet been <br>asked. So, for example, if someone in the future wanted to study the <br>effects of infant feeding
on onset of puberty, they could draw on the <br>children's study for the necessary data.<br><br>I don't know how detailed they're going to be with the breastfeeding data <br>though. I know they know about the distinction between "breastfeeding" and <br>"exclusive breastfeeding," but I don't know if the distinction made it <br>through the design process. (I know they know because I had conversation <br>with people involved with designing the study and they certainly knew the <br>difference.)<br><br>At any rate, you've inspired me to find out more. :-) I'll post any <br>relevant information I find.<br><br>regards,<br>Julia<br><br>Julia R. Barrett<br>Freelance Science Writer & Editor<br>Mom to Sean (5) and Kira (2)<br>Madison, Wisconsin<br><br> ***********************************************<br><br>To temporarily stop your subscription: set lactnet nomail<br>To start it again: set lactnet mail (or digest)<br>To unsubscribe: unsubscribe lactnet<br>All commands go to
[log in to unmask]<br><br>The LACTNET mailing list is powered by L-Soft's renowned<br>LISTSERV(R) list management software together with L-Soft's LSMTP(R)<br>mailer for lightning fast mail delivery. For more information, go to:<br>http://www.lsoft.com/LISTSERV-powered.html<br><br>------------------------------<br><br>End of LACTNET Digest - 30 Sep 2005 to 1 Oct 2005 - Special issue (#2005-257)<br>*****************************************************************************<br>
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