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Subject:
From:
Annelies Bon <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Mon, 7 Jan 2002 09:26:23 +0100
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Thank you alle for sending me all the references and lists. I will make a short
list, for our bf counsellors. It is intended only to catch all dangerous
situations. Once in a while pour counsellors suspect speaking with a mother with a
baby in danger, but I wonder if we might miss some.

It will be difficult to compile such a short list that will not miss any. Remeber,
we do not see them, but only talk to the mothers by phone.

Our experiences is dat the two most important questions: stools and urine output,
aren't allways be answered clear by the mothers. So I'll have to add a few more
questions.

In all the literature I read so far I do not see mentioned the nipple shield as
risky attribute. I guess this is because all the literature is from the US.
However, in my country, nipple shields are heavily used and misused, and are
definitly identified as risk attributes of inadequate milk intake. Nipple shields
can be bought everywhere. The cases of underfeeding that are described in the
Dutch medical literature all mention nipple shields were used.

Nipple shields are often introduced by the maternity nurses who come of the housed
for 7 days after delivery. The common scenario is as follows: baby is reluctant to
nurse, cannot 'get' the breast. At the 3/4th day the mother is heavily engorged
and the breast is even more difficult to grasp. Here the nurse introduces the
nipple shield. The attachment problem is now 'solved', everyone is happy.

This is a potential dangerous situation. Sometimes everything goes well despite
the nipple shield (as happened to me, 11 years ago), sometimes the baby becomes a
very slow weigth gainer or even looses weigth.

For this reason i'll add the nippel shield to the red flag list.


regards, Annelies Bon
Lay counsellor of the Dutch bf organization "Borstvoeding Natuurlijk"

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