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Subject:
From:
"Hurst, Nancy" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 1 Nov 1995 12:35:58 +0000
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Hi Barbara - and Ditto to your comments!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
 ----------
From: Lactation Information and Discussion
To: Recipients of LACTNET digests
Subject: LACTNET Digest - 27 Oct 1995 to 28 Oct 1
Date: Saturday, October 28, 1995 8:54AM

Date:    Sat, 28 Oct 1995 00:38:56 -0400
From:    "Patricia Drazin, IBCLC" <[log in to unmask]>
Subject: Re: circumcism

marie:

    i think that there are a number of factors involved with the differences
between a bris and a hopital circ.

             1) bris is on the 8th day of life. clotting factor is in effect
                 circ is pre discharge

             2) the equipment/procedure is TOTALLY different

             3) the aura/atmosphere is different...
                            bris is normally at home surrounded by family
friends.,.... infant is with mom until just prior
                             circ is in hospit rm with rn/md and sterile
situation
                   - when i was in the south i was told often the baby had
to
wait till md arrived...as he got fussy,. paci inserted to quiet...could wait
some time. also \helpod in nursery post circ....
                     at home feddings are not inturruped., time out of arms
is limited if at all...
different groups do this differently.
   traditionally mom is not in the room during....but separation is still
minimal
    re wine.... not always used....if  done it is put on a 2x2 for the
infant
to suck .
              bris is very fast.


                                        patricia
 ------------------------------
Date:    Sat, 28 Oct 1995 00:38:57 -0400
From:    "Patricia Drazin, IBCLC" <[log in to unmask]>
Subject: Re: nipple preference

R:

   intersting article by m. neifert, r lawrence and j seacat ...nipple
confusion: toward a formal definition....J PEDIATR 199:126:S125-9)

                           patricia

 ------------------------------
Date:    Fri, 27 Oct 1995 22:35:03 -0700
From:    Gretchen Dimico <[log in to unmask]>
Subject: YEAST

Has anyone hear of yeast infection caused by the common form of baker's
yeast?  A women said it was discussed by Dr. Art Uline on TV recently and
that it was resistant to common treatment modalities.  I have been reading
all the comments on yeast infections last week, but this was new to me.
Gretchen Dimico, PhD, RNC, IBCLC
Associate Professor
Lewis-Clark State College

 ------------------------------
Date:    Sat, 28 Oct 1995 01:19:00 -0400
From:    Elisa Hirsch <[log in to unmask]>
Subject: UCLA superbills

Jeanette,
Yes, the superbills are alive and well.  The address you posted is correct.
 Request them from Carol Follingstad.  I use them all the time and fine they
are very useful.
Elisa
[log in to unmask]

 ------------------------------
Date:    Sat, 28 Oct 1995 02:57:02 -0400
From:    "Laurie Wheeler, RNC, MN, IBCLC." <[log in to unmask]>
Subject: Dr. Dean Edell

I did not hear of his latest report, but I've heard him on the radio and he
is VERY pro-breastfeeding.  He should join ABM (the physician org).  He
reaches alot of
"everyday" people and he when I heard his show a few months ago he
unequivocably endorsed breastfeeding.

Laurie Wheeler, Rnc, Mn, Ibclc
Louisiana

 ------------------------------

Date:    Sat, 28 Oct 1995 02:57:07 -0400
From:    "Laurie Wheeler, RNC, MN, IBCLC." <[log in to unmask]>
Subject: vitamins and toddlers

I'm pretty comfortable with no vits for the bf baby, but what about a
toddler, mostly on mother's milk and being offered solids but partaking of
VERY little?  Do these children need a vitamin supplement?  I've looked in
my
reference books but don't find anything on vits and toddlers.

Laurie Wheeler, Rnc, Mn, Ibclc
Louisiana

 ------------------------------

Date:    Sat, 28 Oct 1995 07:39:06 -0400
From:    Lesley Robinson <[log in to unmask]>
Subject: Re: ABM

With reference to the question,

"Shouldn't ABM stand for artificial breastmilk not artificial baby milk?"

I think this is another example of a "Britishism".  I have noticed on trips
to the UK that this term is used.  Also "BM" does not have the same fecal
connotations it has in the US.  Although I have always considered myself a
native speaker of British English,  all my children were born in the US and
 I realised (realized) when answering some of my cousin's pregnant wife's
questions about breastfeeding, that in England I just don't speak
breastfeeding.  I had to rush out and procure a copy of THE WOMANLY ART from
a London League Group and do some swatting (British for studying).  I
remember being extremely shocked when my mother-in -law first offered to
"nurse" my baby... after all she hadn't nursed her own!

Cheerio.
Lesley Robinson, IBCLC, LLL Leader
Corning, NY (formerly of North-west London)

 ------------------------------

Date:    Sat, 28 Oct 1995 06:50:39 -0500
From:    Anne Eglash <[log in to unmask]>
Subject: Re: Vaccinations and tandem nursing?

I see no problem tandem nursing..as the  2 month old gets bigger she will
grab the older kids cups, items, in other words alot more that breast gets
shared between 2 siblings, so I see no reason to pick out a breast as a
vector as opposed to a teething ring.Anne Eglash

 ------------------------------
Date:    Sat, 28 Oct 1995 08:15:17 EDT
From:    "Jeanette F. Panchula" <[log in to unmask]>
Subject: IBLCE TEST

Queary:
Is there a list of those who passed the test available? We would like to
begin
an ILCA group here and would like to invite those who are IBCLC's - how do
we
find them???

Jeanette Panchula, BSW, RN, IBCLC - Puerto Rico
[log in to unmask]

 ------------------------------
Date:    Sat, 28 Oct 1995 09:53:46 -0400
From:    "Barbara Wilson-Clay, Ibclc" <[log in to unmask]>
Subject: bottle teats - hey, lets talk about them

Hi all.  I hope I don't get scalped for this, but I don't know if I think it
is such a great idea to be dogmatic about anything, including this issue of
nipple confusion.  I am tremendously against baby's having first feeds on
bottle teats -- esp. for no good reason, however, I see plenty of babies for
whom bottle use does not appear to be a major big deal.  I also see a lot of
babies -- like the one I saw yest. on day 3 with over 12% loss of body
weight
and inverting nipples in mom which no one commented on in hospt.  Mom was
sent over immed. from her pedi visit with hideous engorgement and a baby who
was lethargic, jaundiced, and totally discombubulated.  This little guy
couldn't make anything work for him, and the parents were freaked.  We tried
several feeding methods unsuccessfully (he blew bubbles a lot.)  Ultimately
we stuck a bottle in his mouth and got an oz in him.  Bottles work well and
they work fast, and some of the babies I see are in such sad shape that we
feed them first and get some energy in them, then we resolve the
breastfeeding problems.  Now maybe this means I'm not very skillful with
teaching alternate feeding methods, but I think many of the crises I'm
handed
would result in weanings if I was too rigid with parents.  Most of them say
they will cup, SNS or finger feed, but they get home and don't have 17 yrs
of
practice feeding this way and because its 'hard' they panic.  If they have
the option of a bottle with expressed HM (human milk) they see baby get fed,
feel less frightened, and can begin the follow through on salvaging things
as
baby's energy returns to normal.  I use thin silicone nipple shields to coax
these babies back to breast with a familiar sensation if they get bonded to
the teats.  Then we fix the primary prob.ie getting the nipples sucked out
with a pump, re-do the positioning, monitoring weights closely all the
while.
 Now I certainly don't handle all my babies this way, and there are some
where I strongly warn against bottle exposure, but I have reasons for all my
protocols, and I also try to evaluate on a case by case basis what will or
won't work.  I monitor my results to see if I get ok outcomes.  This
argument
is similar to the pacifier discussion.  I like to use long, round pacifiers
with some babies:  to exercise a weak, low tone soft palate in some preemies
or hypotonic infants, or to train down the tongue in babies for whom this is
a problem.  I would be very annoyed to have these items banned because
sometimes they are useful tools.

I stand by my belief that what used to 'happen' to some of the poorly
sucking
infants we sometimes see was that they died.  For whatever reason, they
aren't 'normal' at least not in the early neonatal period.  Some of this is
doubtless iatrogenic from delivery issues. maybe some relates to what
Phillip
Zeskind discussed at the Atlanta ILCA conf.  when he talked of ponderal
indices and the need for another, more subtle 'Apgar' which measures issues
such as the kind of interuterine exposures to stress, drugs, environmental
contaminants etc. to which babies arrive having been exposed to. LCs see
many
babies who will recover completely, and some who will ultimately show up as
having problems.  I'm committed to saving breastfeeding for these babies --
all of them, and I'll use whatever works to strengthen them quickly and get
them going at breast. Even bottles, even nipple shields, even pacifiers.
 But
there has to be knowledge and intent behind the choice of a tool. Instead of
trying to pass laws or make rules prohibiting things, perhaps we should be
sharing how we make these clinical decisions appropriately and what kind of
outcomes occur.
Barbara Wilson-Clay, BSE, IBCLC
priv. pract. Austin, Tx

 ------------------------------

End of LACTNET Digest - 27 Oct 1995 to 28 Oct 1995 - Special issue
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