After a few months of lurking I guess it is time to introduce myself.  My name is Jane Van Nort.  My children, David (27), Jonathan( 24) and Alice (21) were all breastfed and grew up attending LLL meetings.  David and his wife, Lesley, made me a grandmother almost 3 years ago so I have a beautiful breastfed granddaughter named Katherine.  My husband still hands out my business card to any pregnant women he meets and is a great supporter of breastfeeding.  I am IBCLC since 1985 and was an active LLLL for 10 years and am now Leader Reserve.  Here in Houston, TX, my adopted hometown, I have a retail store/office for private practice and classes and I am a contract LC for two WIC projects.  Hi to all my friends in ILCA and LLL.  I look forward to seeing you all at conferences.

In my practice I see only problems or perceived problems.  Babies are weighed routinely pre and post feed.  I feel this weighing is an important part of my assessment.  Like Jan Barger mentioned,  some babies look and sound like they are swallowing but the scale says there is nothing going into the baby!  Mothers like knowing how much the baby is getting from the breast.  I find that it is a great teaching tool to show Mom how much milk the sleepy baby is taking in and the importance of waking him up and keeping him feeding effectively.  Most of the babies I work with are still drugged from Mom's epidural and are not good feeders.  We always discuss the range of normal in the amount of milk taken in and the frequency of feedings.  Moms may weigh their babies anytime at our office.  

This past week I saw a mom with severe nipple thrush and baby had untreated oral thrush.  Mom was also having shooting breast pain.  Nipples were cracked at base of nipple and the infection extended to the edge of the areola.  OB Dr was faxed info on fluconazole and Dr. Newman's multi purpose nipple cream but it was the weekend and he wasn't in his office.  It took 3 days to get the cream prescribed and the nipple thrush was getting worse even with use of Nystatin topically and fluconazole.  The compounding pharmacist labeled  it "Dr.Newman's cream" and it worked very well, mom was back nursing after 48 hours treatment (she had been pumping only for 3 days due to the pain).  I suspect there may have been a  secondary bacterial infection of the nipples.  By the way, it cost $55.00 for the 2 oz. of cream and the pharmacist said the mom would have to submit it to the insurance company and be reimbursed (hopefully).

Jane Van Nort
Houston, Texas
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