Dear Lisa,
You are quite right about premies...and about full term babies too. Having
hands out and allowing them to go to the midline and mouth is physiologic.
I personally only recommend swaddling in 3 situations:
1) where a baby is persistently crying - here the arms out leads to flailing
and increasing distress and disorganization
2) sleep - babies sleeping on hteir backs with their arms out often startle
and awaken excessively. Swaddling can often help babies stay in a sleep
state about 1 hour longer. That's not enough to interfere with nursing (the
babies just feed more frequently during the day) and the extra rest can help
increase a woman's milk supply.
3) feeding - when a baby is arching and struggling, the wrapping may help in
focusing the baby on thier task at the breast.
Harvey Karp, MD
Date: Wed, 16 Oct 2002 15:06:35 -0400
From: Lisa JOnes RN CLE IBCLC <[log in to unmask]>
Subject: WRAPPING BABIES
In defense of the nursing staff, especially within the NICU careful
swaddling of infants lower body provides organization for some stressed
infants. I rarely see arms covered or wrapped unless this is a very
disorganized child that really needs the support. Most of our staff know
that developmentally, infants use their hands as a comfort and a baby tries
to self calm by bringing hands to midline ( AKA centering) which is why
NICU infant are suppose to be positioned often on their sides with a body
roll to snuggle their body into and wrap their arms around. Occ. a new
nurse or older mom will burrito a baby, along with covering babes hands
with socks or mittens. When I explain that they are depriving the infant of
the ability to self calm and self organize, causing the babe more stress,
they start to get it. I remind all moms, remember your ultrasound pictures?
In almost all of them, the babys hands are either clasped to their chest or
along the sides of their face. That tactile comfort is what they used in
utero- why deprive them of it now, once their born and facing so much more
stress to adapt to the outside world.
It really helps to bring in a guest speaker who is familiar with infant
developmental support- then its not always just the "LC" who is trying to
educate the staff- the more people who say it, the sooner others tend to
buy into it.
Lisa JOnes RN CLE IBCLC
enjoying an unusual 70 degrees in Tacoma, WA
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Date: Wed, 16 Oct 2002 15:26:20 -0400
From: Karen Foard <[log in to unmask]>
Subject: Nonhodkins lymphoma and bf
Does anyone have any experience with a mom who had non Hodgkin's
lymphoma in her past? I have a mother who had chemo plus full frontal
radiation to her upper torso (belly button to chin) 12 years ago, who
has a 3 week old and has not experienced lactogenesis.
In a hypothetical situation, would subsequent pregnancies lay down any
behaving appropriately cells? Or would you think that all cells have
been permanently zapped?
Moral of the story: Take a REALLLLLLLLLY good history.
Karen Foard, (IBCLC)
State College, PA
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Date: Wed, 16 Oct 2002 15:26:43 -0500
From: "Stearns, Crystal" <[log in to unmask]>
Subject: JCAHO
Hi all,
We just had our JCAHO visit for my OB unit today and all went wonderfully.
The questions asked of me were many and most directed toward working with
different cultures. He also wanted to know if we saw every BF baby (and we
do) and he loved our education-charting form.
Just an FYI
Crystal Stearns RNC, MS, IBCLC
Mercy Memorial Health Center
Ardmore, OK 73401
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Date: Wed, 16 Oct 2002 17:30:10 -0400
From: Kathleen Bruce <[log in to unmask]>
Subject: Re: Nonhodkins lymphoma and bf
Karen, I have experience with a mother who had bilateral Wilm's tumor in
her childhood...and who had a LOT of radiation to her front chest. She had
problems with her supply also. This type of radiation is what my friend,
John, the Radiation oncologist calls "Niagara Falls", whereas xray to scan
a bone for a break is a faucet drip. Could definitely impact supply.
Kathleen
At 03:26 PM 10/16/2002 -0400, you wrote:
>Does anyone have any experience with a mom who had non Hodgkin's
>lymphoma in her past? I have a mother who had chemo plus full frontal
>radiation to her upper torso (belly button to chin) 12 years ago, who
>has a 3 week old and has not experienced lactogenesis.
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Date: Wed, 16 Oct 2002 14:38:34 -0700
From: Susan Johnson <[log in to unmask]>
Subject: Re: use of HMF after discharge
I do run into mothers continuing to use HMF
post-discharge. In some cases the physician's
instructions are unclear in mother's eyes.
HMF is sold over the counter in pharmacies in my area.
One local pharmacist tells me there is "a demand." I
do not know what parents think when they see the
product (right next to the "colostrum" products) on
display as they wait for prescriptions to be filled.
Susan Johnson MFA, IBCLC
Salt Lake City, USA
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Date: Wed, 16 Oct 2002 17:59:44 EDT
From: Judi Hall <[log in to unmask]>
Subject: Re: babies NPO for surgery
I know there are a variety of approaches to how long a baby must be NPO
before surgery. I need something official to help convince anesthesia that
an 8 month old going for ear tubes at 8 AM does not need to be NPO for 8
hours before.
thanks,
Judi Hall
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------------------------------
End of LACTNET Digest - 16 Oct 2002 - Special issue (#2002-1332)
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