Coach Smith back again. 

 

Just because lots of people have written about a practice or lots of books
advise something does not mean the practice is based on any research, or
even any sound understanding of physiology. BF texts (and indeed most texts)
are initially written from the experience of the authors, often before much
research existed. The early books were state-of-the-art at the time of their
writing. As ideas are researched, the books are revised! (When I revised my
Exam Review book, at least 15% of the original questions were no longer
"sound" and needed substantial revision or complete rewriting - in just 5
years.) 

 

In breastfeeding care, we often started out with "many mothers have found."
That's a form of informal "research" based on experience, and the stuff that
support-groups are made of. Most of those practices turn out to be sound
when the research is eventually done, but occasionally a "tried and true"
practice turns out to be harmful.  

 

Here are some examples of formerly "tried and true" practices - advised in
books - that turned out to be harmful:

*        Application of heat to episiotomy incisions/perineal tears

*        Pubic shave and routine enema; routine episiotomy

*        Ethanol (alcohol drips) to stop preterm labor

*        Continuing to exercise past the point of pain ("no pain, no gain")

*        Straight-leg sit-ups 

*        Rubbing butter into a burn

*        Merthiolate antiseptics (contained mercury)

 

This list could go on and on. Bottom line: please THINK about what we're
doing. If there's no real research on a subject, start thinking about the
physiology and investigate it. 

 

The entire text of "A Guide to Effective Care in Pregnancy and Birth"
(Cochrane reviews of maternity care practices) is freely downloadable from
Childbirth Connection's helpful web site.

http://www.childbirthconnection.com/article.asp?ClickedLink=329
<http://www.childbirthconnection.com/article.asp?ClickedLink=329&ck=10218&ar
ea=27> &ck=10218&area=27 

If you don't care to download the entire book, at least download and read
the Executive Summary / Synopsis
http://www.childbirthconnection.com/article.asp?ck=10064 

 

Linda J. Smith, BSE, FACCE, IBCLC

Bright Future Lactation Resource Centre Ltd.

6540 Cedarview Ct, Dayton OH 45459 USA

(937) 438-9458 / fax (937) 438-3229

www.BFLRC.com

 

-----Original Message-----
From: [log in to unmask] [mailto:[log in to unmask]] 
Sent: Wednesday, January 09, 2008 9:20 PM
Subject: Use of heat

 

In regard to the thread about the use of heat (I have copied and pasted some
comments below)....how can we as professionals practice effectively when the
resources we are utilizing recommend practices that are not researched??This
includes resources that the IBLCE considers recommended reading for exam
candidates. 

 

Use of both heat and cold are commonly referenced in numerous lactation
texts and resources, including resources listed as suggested reading to sit
the IBLCE exam. I have what I would consider a relatively large, and current
library of lactation texts and resources, the references to the use of heat
and cold are common, varying somewhat but certainly easily located
and?abundant within some resources.?

 

I know better then to simply blindly accept every statement as?fact, and I
can perform my own review of the literature, but this theme is so prevalent,
and repeated often (not just in?one or two resources, but numerous, current
texts).?

And I don't think it is reasonable for practitioners to personally
research?each conclusion and recommendation made in resources that are
generally considered reliable, although I have certainly engaged in this
when faced with circumstances when recommendations appear conflicting or
practices seemingly evolve, I will attempt to collectively review my
professional resources and examine the topic closely.

 

I haven't concluded how I feel about the use of heat and cold now, I haven't
ruled out changing my existing recommendations but it is disappointing to
have to look at practices that are so abundantly addressed in current,
recently published literature with skepticism. 

 

 

Michelle

 

"Coach Smith here.

 

There is NO RESEARCH - repeat, NO RESEARCH supporting the use of heat on

engorged breasts, inflamed breasts, sore breasts, or any other condition of

the lactating breast!? NO RESEARCH. Yes, many books and articles and people

suggest using heat, without ANY research to back up that advice!"

 

 

"To add to Linda's post, there is no evidence showing that cold is good for?


swollen breasts either. 

?

Here is a topic "Heat or cold for treatment of mastitis" that desperately? 

needs some research, if anyone needs a thesis topic!

?

warmly,

?

Nikki Lee RN,? MS, IBCLC, CCE, CIMI

craniosacral therapy practitioner

_www.myspace.com/adonicalee? "

 

 

 

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