Hello,
I am looking for a CST and possibly a doc to release tongue tie. I have client leaving in a couple of days to spend summer near Westerly, RI.
Thank you,
Leigh Anne O'Connor, IBCLC
New York, NY
Sent from my Verizon Wireless BlackBerry
-----Original Message-----
From: LACTNET automatic digest system <[log in to unmask]>
Date: Sat, 6 Jun 2009 11:43:04
To: <[log in to unmask]>
Subject: LACTNET Digest - 6 Jun 2009 - Special issue (#2009-591)
There are 5 messages totalling 354 lines in this issue.
Topics in this special issue:
1. regaining birthweight
2. lactation survey
3. need evidence based info regarding appropriate weight gain
4. baby throwing up breast milk but not formula
5. infant weights
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Date: Sat, 6 Jun 2009 10:58:08 -0400
From: Rachel Myr <[log in to unmask]>
Subject: regaining birthweight
Joy Noel-Weiss asks what we mean by birthweight. If the mother and baby =
are
looked after in accordance with Baby-Friendly guidelines, the baby will n=
ot
be removed from skin contact with mother for about an hour, or until it h=
as
attached and suckled at her breast. Often this suckling will lead to
passing significant amounts of meconium. The baby's recorded birthweight=
will be lower than it would if the baby were weighed immediately after
birth, before coming to mother's chest, and the baby will have a bit more=
slack because the first meconium will not be part of the magical 7 or 10 =
per
cent 'allowable' weight loss. Babies born after CS will have more fluid =
on
board because they have not experienced having fluid squeezed out of thei=
r
lungs and abdomens while passing through the birth canal, and they are of=
ten
weighed before suckling or even having skin contact with mother, so they =
run
a higher risk of eliciting concern for larger losses in the first three d=
ays
of life.
Has there been any research to support the idea that a baby's fluid and
electrolyte balance is affected by maternal IV administration in labor?=20=
I'm much less concerned about the percentage loss than about how the baby=
is
reacting to it. A baby who is actively feeding well every time it shows
signs of interest in doing so does not worry me on day three or five, eve=
n
if weight loss is more than ten percent. The parents only need to know w=
hat
to expect for the next day or two when they should be able to see someone=
who can take a look, hear how things are going, and weigh the baby again.=
A
baby who is looking jaundiced, having scant urine with brick dust stains,=
and feeding only when prompted and cajoled or coerced, worries me even if=
the weight loss may not be more than five percent. But as long as I am
confident that I know *why* the baby is taking longer than average to reg=
ain
its birthweight, and that appropriate supportive measures are in place, I=
'm
comfortable with deviation from the expected.
It floors me when I get a call from a community practitioner (normally a
PHN, who are responsible for all routine well-child care here from 1 week=
until 18 years of age) who has a baby in her office that hasn't gained
anything from day three to day ten, and when I ask about urine and stool
output, she says 'just a moment' and I hear her asking the mother the sam=
e
question. I should be happy that they are phoning us, but I am mostly
concerned that they don't even know to ask these questions first!
Rachel Myr
Kristiansand, Norway
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------------------------------
Date: Sat, 6 Jun 2009 11:04:18 -0400
From: Cindy Curtis <[log in to unmask]>
Subject: Re: lactation survey
I would of done it for free, I could care less about the money, there are a
lot of pros and cons with filling it out....... Hopefully one day we will be
able te view the results and see who sponsored it...
Cindy Curtis RNC IBCLC CCE CD
http://www.breastfeedingonline.com
mailto:[log in to unmask]
-----Original Message-----
From: Lactation Information and Discussion
[mailto:[log in to unmask]] On Behalf Of Valerie Vanderlip
Sent: Saturday, May 30, 2009 10:22 PM
To: [log in to unmask]
Subject: lactation survey
I received the letter from E- rewards too but when I tried to do the survey
this morning I was informed that there was no longer a need. They had
reached their quota for the study.
Too bad, the stipend was $37. (US)
Valerie Vanderlip
Marietta, Georgia USA
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------------------------------
Date: Sat, 6 Jun 2009 10:06:33 -0500
From: Linda Anderegg <[log in to unmask]>
Subject: Re: need evidence based info regarding appropriate weight gain
Rachel and all,
This cracked me up. Definitely one to save in my Lactnet Quotes folder!
<<The baby, according to the pediatrician, 'looks great, is healthy, happy,
sleeping well and is appropriately alert' but this same pediatrician fears
that the mother is sacrificing the baby's health 'on the altar of
breastfeeding'. Say what?! What would it take to convince the doctor that
the baby is thriving? (And last time I visited my local house of
breastfeeding worship, infant sacrifice was definitely *not* part of the
liturgy. What faith does the doctor think the parents adhere to, anyway?)
Of course I guess the concern is understandable, since slimness is a major
public health menace in the world today. (!!)>>
Sounds like Katherine has the problem figured out and this lucky baby will
not be sacrificed!
Linda Anderegg, BSN, RNC, IBCLC in Chicago
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------------------------------
Date: Sat, 6 Jun 2009 11:19:50 -0400
From: Linda Palmer <[log in to unmask]>
Subject: Re: baby throwing up breast milk but not formula
How is this baby doing? About the only allergens in milk formulas are the=
milk=20
proteins and often corn. It's very possible that baby is sensitive to som=
ething=20
else in mom's diet. The chicken pot pie likely has pepper and onion, both=
=20
potential irritants/allergens, and of course wheat, a biggy. When a perso=
n=20
immediately throws up an allergen exposure then there are generally not=20=
any/many other symptoms because the allergen has not entered the system.=20=
The baby can have ample mast cells in the esophagus or stomach to cause=20=
immediate rejection as opposed as to allowing the stuff to stew in the=20=
intestines allowing all kinds of bodily reactions.
linda palmer, dc
www.BabyReference.com
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------------------------------
Date: Sat, 6 Jun 2009 11:42:32 -0400
From: [log in to unmask]
Subject: infant weights
Over and over again, =C2=A0I emphasize to all that weights have to be take=
n in context! =C2=A0Birth weight and weight loss
and weight gain, hydration status, infant health, maternal health, milk tr=
ansfer, day of life or age of infant, height growth,=C2=A0
infant demeanor, infant output, accuracy of the weight/scale, length of ti=
me from the last feeding, the gain from birth and the gain from the last=
weight. =C2=A0All of these factors and maybe even a few
more must be taken into account when making feeding recommendations. =C2=
=A0
Birth weights can be incorrect or inflated! =C2=A0Numbers can be transpose=
d or misread. =C2=A0The numbers must also add
up. =C2=A0Numbers of feedings day and night, number of bottles, number of=
expressed ounces, number of oz offered vs those taken.
I can't tell you how many times I ask mothers who express concern over the=
ir young infant's "weight loss" whether or not=C2=A0
their pediatrician weighed the infant naked and the answer is "NO!". =C2=
=A0Sometimes even with ALL the clothes on!
I think that there is a wide variation in not so much what is normal but,=
what can be overcome. =C2=A0Long term Underfeeding and dehydration is not=
going to work.=C2=A0
Long term underfeeding will lead to loss of height and failure to thrive.=
=C2=A0Overfeeding short term leads to stomach upset and long term obesity=
.
But a little of either can be overcome. =C2=A0
The big question in my mind is when to supplement with formula (when expre=
ss
ed breastmilk is not available) ! =C2=A0When do the risks outweigh the ben=
efits. =C2=A0If an infant can't feed=C2=A0
or is getting dehydrated then we must supplement! =C2=A0IF an infant does=
not demonstrate increasing weight gain with good breastfeeding management=
,=C2=A0
use of galactogogues over a period of a few weeks then, we are going to =
=C2=A0have to supplement. =C2=A0Weight loss can't be allowed to continue=
but, what about weight=C2=A0maintenance?
A few days, a week--very gray area! And the mom may have a very=C2=A0defin=
ite=C2=A0opinion about all of this and her infant's physician may also be=
a part of the equation.=C2=A0For example, you might let a 10 lb newborn=
go a little longer than a 4 lb preemie. =C2=A0
But, I think that this is the crux of the question--Not, "what is normal?"=
but, What can be overcome without the use of formula and without endanger=
ing the infant and while supporting
the mother and her milk production. =C2=A0What is acceptable for this uniq=
ue dyad? =C2=A0
Christine M. Betzold NP CLC MSN
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------------------------------
End of LACTNET Digest - 6 Jun 2009 - Special issue (#2009-591)
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