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Subject:
From:
Cynthia Dillon Payne <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 26 Sep 1997 11:06:31 -0400
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My husband graduated from Harvard Medical School in 1982.  I checked his
OB/GYN textbook "Obstetrics: Essentials of Clinical Practice" by Kenneth R.
Niswander, MD. 1976.
Under the prenatal exam: "Breasts: Palpation for masses is as essential in
the pregnant as in the nonpregnant patient.  The adequacy of the nipples for
nursing should be noted."  That's it.  Two sentences and no explanantion of
"adequacy" or how to check the nipples.
In the puerperium chapter: "The baby should be put to the breast about 12
hours after delivery and at 4 hour intervals thereafter.  The 2:00 AM may be
omitted if desired.  Before nursing the nipples should be cleansed, and the
nursing time should be limited to no more than 3 minutes on each breast.
 This time can gradually be lengthened to a maximum of 10 minutes on each
breast.  A vigourous newborn can easily empty the breast in this length of
time, and longer intervals lead to sore and cracked nipples.  After nursing,
it is again wise to clean the nipples thoroughly and apply commercial nipple
cream to keep them soft."  No description of positioning, proper latch,
swallowing, etc.
In regard to breast infections "Discontinuation of nursing is usually
necessary because it is painful.  In a mother extremely eager to resume
nursing, twice-daily emptying of the breast will maintain the milk supply
until nursing can be resumed."  Remember that he is a fairly recent graduate.
 This advice seems absurd to us, but if a physician doesn't attend any bf
conferences since his/her graduation than this is the only information they
have!  By the way my husband went into gastroenterology not OB.
Cynthia D. Payne
LLL of Berkshire County, Mass.

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