Hi All,

I have two questions. I have a mother who takes Elavil 20mg daily
for interstitial cystitis. Since she has breastfeeding she has
not taken it. Now she feels she needs to restart. To the pharmicist,MD's out
there: since this is a small dose compared to what other women take
for depression is this a concern and couldn't she just time the medication
to the last feeding in the evening? Her baby sleeps 4-5 hours at noc.

My next concern is about the book Baby ---- one of my local pediatricians is
now advocating this book to all his patients. In the past week I have had two
moms call me upset with me and him because they don't know who to believe
regarding
breastfeeding and parenting issues. I called him and "chewed" his ear for 1/2
hour. He feels that babies come out of the uterus with the expectation of
being held every hour for 24 hours and being fed every hour if they want. (His
idea).
If the baby is not taught that interaction, feeding and sleeping do not occur
on a given schedule then later on they will have behavior difficulties. He had
suggested to these two mothers that they should put their infants on a 3-4
hour feeding schedule. One was a mother of a 35 week gestation infant who was
feeding every hour but falling asleep at the breast the other was a mother of
a 51/2 week old with sore nipples, baby with diaper rash and thrush. The
limiting of feeding frequency would "heal" her nipples.

I shared my concern of making a recommendation of structured feeding
especially with a 35 week gestation infant when no one had observed this
infant at the breast and how important it was to correct the behavior at the
breast. The sore breasts etc. needed medical tx. not limiting feedings. He did
agree with me on this. I told him that I hoped our dialogue could continue
because I was concerned that this wouldn't be the last I would hear from other
mothers.

Aside, he is expecting twins in a few weeks and not delivering at my
institution(whew!)

Anyone have suggestions?

Thanks,
Cheryl Stuhldreher, RN IBCLC