From Interlibrary loan, I have received Dr. Gary Chan's 1997 book Lactation:
The Breast-Feeding Manual for Health Professionals.  It is published by
Precept Press, Chicago.  Chan is the editor and wrote some of the chapters.
He is a professor of pediatrics at the College of Medicine, University of
Utah in Salt Lake City.  Other contributors, all from Salt Lake City as
well, are Pamela Binns, Licensed Occupational Therapist, Alison Bunnell,
Registered Dietician, Delma Johnson, Registered Nurse and "Certified
Lactation Educator," Lauri Moyer-Mileur, Registered Dietician and Asst.
Professor of Food and Nutrition, and Laura Wham, Registered Nurse and
"Certified Lactation Specialist."  Thus, no IBCLCs.  It appears to have been
written as a "quick and dirty" version of Lawrence.  In the acknowledgements
he thanks the staff of Wellstart International in San Diego, California, and
later in the book he has some forms from Chele Marmet (forms for breast
assessment and infant's physical assessment) that say "Used with permission."

It is a strange little book.  Some chapters are written in prose, with
paragraphs and complete sentences.  Other parts are like the outline from a
talk.  Some parts sound up-to-date, others not.  Some chapters cite sources
at the end such as Ruth Lawrence, Riordan and Auerbach, etc., but the
chapter on drugs in breast milk does not cite Tom Hale.

Chapters include:
Section 1.  Prinicples of Lactation
1.  Anatomy and physiology of lactation (Chan)
2.  Benefits of lactation and human milk composition (Chan)
3.  History and examination of the breast-feeding mother and infant (Wham)
4.  Dietary recommendations for lactating women and nursing infants (Chan)
5.  Medical contraindications to breast-feeding (Chan)
6.  The effects of drugs and herbs on lactation Chan and Bunnell)
7.  Human milk expression and storage (Johnson)

Section 2.  Sustaining healthful lactation
8.  Engorgement (Chan)
9.  Sore nipples (Chan)
10.  Insufficient milk supply (Chan)
11.  Mastitis (Chan)
12.  Feeding Twins and Triplets (Chan)
13.  Relactation (Chan)
14.  Weaning and suppression of lactation (Chan)

Section 3.  Special lactation issues
15.  Parent education on breast-feeding issues concerning the infant (Chan)
16.  Jaundice and breast-feeding (Chan)
17.  Failure to thrive (Chan)
18.  Human milk and the preterm infant (Moyer-Mileur)
19.  Feeding the preterm infant (Binns)
20.  Feedint the infant with cleft lip, cleft palate, or neurologic
impairment (Bunnell)

Section 4.  Lactation Support Groups  [this is a wonderful, alphabetical
list of many different organizations -- great for photocopying and keeping
handy]

Index


I have not read this book from cover to cover, but here are a few gems:

Chapter 1 begins: "Lactation is the physiologic completion of the
reproductive cycle.  The breast develops and readies itself to nourish the
infant by 16 weeks into the pregnancy.  The breast is inactive by hormones
(sic) that suppress the lactation response. . . ."

Chapter two includes growth charts for breastfed babies adapted from Dewey
et al. 1992 --   Chan says: "By 12 months, breast-fed infants have
comparable length and head circumference gains as formula-fed infants but
their weight is about the 10th percentile when plotted on standard growth
curves.  Because of the difference in growth, growth curves for exclusively
breast-fed infants HAVE BEEN ESTABLISHED." (my emphasis)

Y'all know this is one of my pet peeves.  The DARLING research is by no
means comprehensive enough, or done on a big enough sample to derive growth
charts from.  But -- there they are, plain as day, with no disclaimers.

Chapter Five, Medical Contrindications to Breast-Feeding
Includes the following:
Maternal breast cancer -- "There are concerns about the passage of cancer
cells in the milk to the infnat with subsequent development of breast cancer
in the infant.  However, studies do not support this concern.  Development
of breast cancer is associated with family and pregnancy history, and not
the breast-feeding history."  That's the sum total on this topic.

Maternal AIDS

Mother with Hepatitis C Virus  - he says you shouldn't nurse if you have
Hepatitis C, which is not *my* understanding of the current literature.  He
cites the Committee on Infectious Disease Report, American Academy of
Pediatrics Redbook, edition 23, 1994.

Mothers with active cytamegalovirus infection who have delivered a preterm
infant

Mothers with primary herpes simplex mucocutaneous lesions or herpetic
lesions on the breasts (he says they can breastfeed after all their lesions
have healed)

Maternal medications -- see chapter six

"Infant with Metabolic Disorders such as galactosemia and phenylketonuria
should be on specialized formulas that eliminate the carbohydrate or protein
the infant cannot metabolize."

The drugs chapter says the information is derived from P.O. Anderson's
article, Drug use during breast-feeding, Clinical Pharmacology, 1991, and an
AAP report from 1989, and the information on herbs comes mostly from a 1983
publication.  Where is Tom Hale's book??

Skipping to chapter 14 on weaning, which I think is truly interesting:

"Weaning is the process by which substantial nutrition other than breast
milk is introduced with the final goal of breast-feeding cessation.  Weaning
occurs gradually over weeks or months.  The decision to wean is based on
cultural and psychosocial issues.  In many cultures, a subsequent pregnancy
signals the time for weaning.  In other cultures, the continuation of
breast-feeding is determined by mutual consent of the mother and child.
There is no set timetable indicating when to wean.  It may start anytime
during the first two to four years of life."  [YES, he really says that!!!!
Whee!!!!]  "As health care providers, we should provide appropriate
information so that the mother can make her own decision."  He cites
Lawrence and Riordan and Auerbach as sources.


But, darn, in the next chapter he writes: "Almost half of all infants do not
sleep through the night until three to four months of age."


Anyway . . . . a mixed bag.  I'd be interested in an evaluation of the
clinical information from the IBCLCs on the list.
Katherine A. Dettwyler, Ph.D.
Associate Professor of Anthropology and Nutrition
Texas A&M University