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LACTNET  July 1995, Week 2

LACTNET July 1995, Week 2

Subject:

LLLI-last day

From:

Tina Smillie MD <[log in to unmask]>

Reply-To:

Lactation Information and Discussion <[log in to unmask]>

Date:

Wed, 12 Jul 1995 02:09:12 -0400

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (96 lines)

Greetings (yawn) from Chicago; Roving reporter is getting tired--

Only two sessions today-- first I went to Judith Roepke's presentation on
Growth of breastfed babies, reviewing the recent research including the
DARLING studies-- basically saying what you'd thought it would say, but data
is on too unrepresentative (white middle class, very well nourished in
pregnancy) a group to draw new growth curves yet.  (Of course, so are the
curves we're currently using).  Anyway, new research is also soon to be
published, in August, I think, so stay tuned. The slides for this lecture
were too small a print to read in great detail from where i was sitting, too
dense with data, in too dark a room, reviewed many different studies, for me
bottom line message is I've got to read those studies myself. Briefly, bf
infnts gain MORE than artificially fed infants in the first 3 mos, then drop
off and are below the weights of artificially fed "norms" by six months, come
together by age 24 mos. Showed data using bf as "norm" and how artificially
fed infants would then be underwt 1st few mos and then overweight.  Also data
on caloric intake per kg, and at various ages, showing much more efficient
utilization of energy, with good growth on fewer calories.  I need to get to
this literature. Q & A revealed anecdotal stories re exclusively bf infants
way past a year, some individual stories and some international cultural
stories. However no data, just reports of good health. Also re the hassles
many moms get re their marginally small healthy bf infants, it bears
repeating that the growth curve is only a screening tool that needs to be
correlated with other clinical data, like is the kid healthy, following own
curves, developmentally appropriate and thriving. It is a screening tool and
not a diagnosis.
Second session I went to was Chele Marmet and insufficient milk, this
session, while mentioning the media controversy, was more oriented toward
management of real cases, which is of course feed the baby, then worry about
diagnosis and addressing causes. She's big on the periodontal syringe instead
of SNS etc, because in this case (altho I think she extends her thinking
beyond sick babies on this) baby needs positive feedback for appropriate
suck, and with SNS learns to suck wrong because he's trying to get that stuff
out of the tube instead of working his little tongue to strip those
lactiferous sinuses. So, with periodontal syringe, well trained LC can give
positive feedback by controlling milk outflow from syringe when baby is
sucking correctly-- builds better mild supply, etc. Anyway, that's her
thinking. I know there are others who feel differently, I'm just the reporter
here.  Anyway, it was a useful session, practical.

Lunch was one of those talks about getting your life organized, throwing out
that junk, etc. After that Cynthia Payne and I went for a walk to Grant Park,
Buckingham fountain, the aquarium, etc.

All in all I think the sessions at the big conference were good, and quite
practical, altho I think the earlier conference was probably just a little
better, maybe simply because of its size, and because the speakers from this
second conference were many of them in the audience of the first. The second
conference benefited by having the interesting anecdotal expertise of LCs and
leaders from other cultures.

And in truth, a detraction to the second conference was the large and
overcrowded rooms, and the moms in the back of the room who were very slow to
respond to their usually older toddlers' noisy needy cues. Architectually
they were nice for league, most rooms where CERP sessions were held had a
series of columns about 3/4 of the way back, only a few chairs were in this
space, so it belonged to the toddlers.  This was fine first thing in the
morning, but all of these sessions were either 1 1/2 or 2 hours long, which
gets a bit much for the little ones. None of the sessions I went to took a
break in the two hours. The front of the room typically was packed with
"serious" CERP seekers, taking notes, etc. I'm very good at screening out a
sort of basal level of happy gurgly, chattery kidsounds from the back.  But
toward the end of each session the types of sounds would gradually change,
and I have to say I was amazed at the number of moms supposedly into
attachment parenting who could just let those unhappy sounds go and go and
go.  It was never in any of these sessions just one child, it was always a
chorus of them, as the long session grew on. I felt sorry for the kids more
than for us as participants, because there were always several children,
keeping the noise less personal than when you hear that single lone cry of
distress-- and I usually sat up in the front half of the room where I usually
could, if I chose, tune my ears into the speaker and hear her/him over the
changing din, but if I tuned into the children I was distracted by their
distress.  I was surprised.  The physician conference, with its smaller
numbers and relatively fewer children, and larger and more separate facility
next door, worked this issue better. I don't know what you can do with 3000
people, if half of them are kids. I do think they should make somewhat
stricter rules re CERP sessions, a la quiet babes in arms and easy going
toddlers. High need kids, tired kids and this isn't a good time anymore kids
don't belong there. But then, they probably don't really need to be dragged
to the other sessions either. Also LLLI scheduled us all to the hilt-- every
moment from 7 am to 9 pm was scheduled, with 1 1/2 and 2 hr sessions with
only half hour breaks between them.  Everyone complained that there was no
time to go to the exhibits, make a phone call, run an errand-- and these were
all people who didn't have childrenwith them. I don't know how you could do
anything for your kids with that schedule. End critique.

There is some kind of coliseum or something near here-- the Grateful Dead a
few nights ago times two nights, and now tonight Pearl Jam.  the streets
outside the hotel get very noisy, then very quiet for a few hours, and then
in the wee hours, noisy again... never bothers me, tho, since I'm always up
communing with youall.

NO report tomorrow. Next post will be Thursday from Scottsdale.

Tina

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