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From: LACTNET automatic digest system <[log in to unmask]>
To: [log in to unmask]
Sent: Thu, February 11, 2010 5:22:41 PM
Subject: LACTNET Digest - 11 Feb 2010 - Special issue (#2010-156)
There are 7 messages totaling 368 lines in this issue.
Topics in this special issue:
1. Chemistry exam 2009
2. Transmission of Yellow Fever Vaccine Through Breastfeeding
3. exclusive breastfeeding for 6 months
4. Manicurist Breastfeeding Mom
5. Scales and nipple blebs
6. breastmilk supplementation
7. yellow fever vaccine
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Date: Thu, 11 Feb 2010 16:43:57 -0500
From: Julieanne Hensby <[log in to unmask]>
Subject: Re: Chemistry exam 2009
Keep writing Marianne! The fact that they took 6 months to reply says to me that perhaps the path 'they' to 'check out' your info led to an unexpected destination.
Cheers, Julieanne
IBCLC, Australia
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Date: Thu, 11 Feb 2010 21:55:54 +0000
From: "Frank J. Nice" <[log in to unmask]>
Subject: Transmission of Yellow Fever Vaccine Through Breastfeeding
I am bewildered by the report.
It states that "no breast milk or maternal serum was collected for yellow fever virus testing." Why not?
Could not the 17DD yellow fever vaccine virus also be transmitted directly by a mosquito bite, or is it only specific to the vaccine?
Can someone elucidate on this?
Frank J. Nice, RPh, DPA, CPHP
Check out my new website and book, "Nonprescription Drugs for the Breastfeeding Mother" at:
www.nicebreastfeeding.com
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Date: Thu, 11 Feb 2010 16:58:29 -0500
From: Nikki Lee <[log in to unmask]>
Subject: exclusive breastfeeding for 6 months
Dear Friends:
A comment was made in the last digest about expecting infants to terminate
exclusive breastfeeding at 6 months.
The AAP policy says "about 6 months"......some babies are ready for solids
sooner, and some later.
warmly,
--
Nikki Lee RN, BSN, Mother of 2, MS, IBCLC, CCE, CIMI
craniosacral therapy practitioner
www.breastfeedingalwaysbest.com
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Date: Fri, 12 Feb 2010 09:01:44 +1100
From: Nina Berry <[log in to unmask]>
Subject: Re: Manicurist Breastfeeding Mom
Not done the research BUT ... if the other option is to feed the baby formula, then I would bet London to a brick that the formula is more of a health hazard to her baby than the breastmilk that possibly contains infinitesimally small amounts of acetone/toluene.
Cheers
Nina Berry
Australia
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Date: Thu, 11 Feb 2010 16:17:38 -0600
From: Kershaw Jane <[log in to unmask]>
Subject: Re: Scales and nipple blebs
Actually, one our LC's had this problem. Went to a breast surgeon who did this very thing. No more problems!
-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Kathleen Huggins
Sent: Wednesday, February 10, 2010 9:27 PM
Subject: Scales and nipple blebs
Hello! I was always my understanding the Medela scales are purchased
from Tanita and are simply privately labeled for them. The Tanita
scales are much less expensive. They have several models to chose from. Their info is:
Phone: (847) 640-9241
Fax: (847) 640-7978
eMail: [log in to unmask]
Web: www.tanita.com
For many, many years, I have wanted to discuss my experiences with nipple blebs. I have literally seen hundreds of them over the past 30 years. I vividly remember the first mom who came to me. She was totally backed up with nearly a quarter of her breast very full. I pumped her. I heated her breast. We tried both nursing and hand expression. After nearly an hour, I called her OB in frustration! I was instructed by the mom's OB (over the phone) to take an insulin syringe and poke at the white bleb. I gently scraped it away and suddenly her milk squirted out several inches spraying me right in my face!
So they continued to come, these blebs! Time after time, the moms had tried numerous things at home but many of them came in to the clinic. We instructed the mom in our presence to gently use the tiny needle on a TB or insulin syringe in good light moving the needle side ways from the outside of the bleb toward the middle. Usually, the mothers denied having any pain using this procedure although often they did bleed for a minute or two. It has always seemed to me that we were removing a top layer of skin allowing the milk to begin to flow. Yes, sometimes we would get a string of white material, sometimes a tiny grain, sometimes nothing but foremilk.
Rarely we got no where despite removing the bleb.
What I am writing now is a secret that I have kept for many years.
When our efforts to unblock a bleb failed, we turned to our favorite surgeon, Dr. H. His office used to be close to the clinic and he often would come over while the mom was still in the clinic. And, this is what he did.......
He took a tear duct probe, one that was several inches long. If you have never seen one, they are nearly as thin as a strand of hair. He introduced the probe into the duct and went up into the breast. Then he would feel a "POP". He would remove the probe and Voila!: MILK FLOW! He was always able to clear every single one. I asked him once if we could video tape one but he said no, unfortunately.
So, my opinion is that a bleb occurs when there is a blockage anywhere in a duct, not just at the nipple. I think that when the duct is blocked, skin grows over it. These moms also have horrible shooting pain probably because milk cannot drain and the duct spasms.
Have I freaked you out?
Kathleen
--
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Date: Thu, 11 Feb 2010 16:19:52 -0600
From: Kershaw Jane <[log in to unmask]>
Subject: Re: breastmilk supplementation
If you believe the research on let-down which shows that if there is not adequate vacuum on the nipple, when the milk lets down, it 'backs up" into less full areas and is less available on the next let-down, this would make perfect sense. If the baby doesn't have enough vacuum, then he won't get as much milk as possible from the first let-down and the less milk obtained (percentage-wise) of total volume, the less total will be obtained of available milk. Did I lose you there? So the advice to express BEFORE nursing might actually work better than expressing after.
-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of laurie wheeler
Sent: Wednesday, February 10, 2010 10:12 PM
Subject: breastmilk supplementation
In my experience, the babies that truly need supplementation (meet medical
criteria) are also not sucking well. So I think it makes sense to have mom express prior to the feeding. If baby was latching well, the supplement could be given via lactation aid while baby was doing his breastfeeding.
In my experience also, the mother often does not extract enough colostrum for the amount prescribed by the doctor to feed infant. So formula is given.
In my experience, many mothers don't express when asked to or not often enough. Not sure why but can think of several reasons, one of which might be lack of continuous access to supportive staff, including the fact that lactation staff are doing inpatients, outpatients, and are not there 24/7.
In my opinion, if baby was kept skin to skin (a practice not used nearly enough in our hospital) the amounts extracted would likely be increased, and the need for colostrum would likely be decreased, a win-win situation.
Laurie Wheeler RN MN IBCLC
Mississippi USA
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------------------------------
Date: Thu, 11 Feb 2010 16:22:32 -0600
From: Kershaw Jane <[log in to unmask]>
Subject: Re: yellow fever vaccine
Shouldn't this apply to ANY live attenuated vaccine?
-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Nikki Lee
Sent: Thursday, February 11, 2010 11:30 AM
Subject: yellow fever vaccine
Dear Friends:
This is interesting.
Nursing mothers should not receive smallpox vaccine (CDC recommendation) and now, not yellow fever vaccine.
<http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5905a2.htm?s_cid=mm5905a2_>
"On March 23, the mother, aged 22 years, delivered a healthy female infant at 39 weeks' gestational age by elective cesarean delivery. During that same month, a yellow fever epidemic had spread to a nonendemic area in Rio Grande do Sul state where the mother resided (*1*). On April 7, when the mother was
15 days postpartum, she visited her health-care provider to have the sutures removed from her caesarean incision. While in the provider's office, she received 17DD yellow fever vaccine. She had not been vaccinated for yellow fever previously. On April 12, 5 days after receiving the vaccine, she reported a headache, malaise, and low fever, which persisted for 2 days. The mother did not seek medical care for her symptoms."
(snip)
"The infant, who was exclusively breast-fed, was hospitalized at age 23 days with seizures requiring continuous infusion of intravenous anticonvulsants.
The infant received antimicrobial and antiviral treatment for meningoencephalitis. The presence of 17DD yellow fever virus was detected by reverse transcription--polymerase chain reaction (RT-PCR) in the infant's cerebrospinal fluid (CSF); yellow fever--specific immunoglobulin M (IgM) antibodies also were present in serum and CSF. The infant recovered completely, was discharged after 24 days of hospitalization, and has had normal neurodevelopment and growth through age 6 months. The findings in this report provide documentation that yellow fever vaccine virus can be transmitted via breast-feeding. Administration of yellow fever vaccine to breast-feeding women should be avoided except in situations where exposure to yellow fever viruses cannot be avoided or postponed."
warmly,
Nikki Lee RN, BSN, Mother of 2, MS, IBCLC, CCE, CIMI craniosacral therapy practitioner www.breastfeedingalwaysbest.com
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End of LACTNET Digest - 11 Feb 2010 - Special issue (#2010-156)
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