From: Westra, Mary
Sent: Wednesday, December 03, 2014 10:57 AM
To: [log in to unmask]
Subject: Great posts, Great Peeps!

Dear Lactnet friends,

I always enjoy reading posts and gain a lot of insight from them.  These latest posts blew me away and I must express my gratitude.  First is Pat.  Wow what a tremendous labor of love.  If I ever write a thesis you'll be the first to get it. Keep posting all your great finds.

Next are the posts on antibiotic use and other treatments.  Thank you Jane and Alla for your perspectives.  I am thinking, as with almost everything in life, it is always balance and careful respect and use of the tools we have including our clinical assessments.  Just as an addition to this topic,  I attended a lecture from one of our neonatologists this month on early onset neonatal sepsis.  At our institution we tend to treat a lot of full term babies for rule out sepsis if mothers GBS (group beta strep) culture is unknown or positive and she did not complete antibiotic therapy during labor.  The emphasis of his research was that the most valid indicators of sepsis were clinical symptoms and not laboratory results (CRP,CBC and WBC differential).  He stated that there are well documented studies that antibiotic use in early life is associated with increase in asthma and other auto immune disease.   Makes sense knowing what we are beginning to know about the microbiome.  It also makes sense to aggressively treat (i.e. antibiotics) a baby who is showing systemic illness because we know that microbes make babies very sick, very quickly.

And thanks so much to all of you out there who dedicate your work to help humans at one of the most vulnerable points of their lives.

M. Westra R.N., IBCLC

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